Introduction
cardiovascular disease, hypertension, Hypertension
CARDIOVASCULAR DISEASE, KIDNEY DISEASE, CVD, HYPERTENSION, HYPERTENSION
Hypertension is the leading attributable risk factor for mortality globally. Evidence suggests that lifestyle modification and pharmacological treatment can lower BP and reduce the risk of adverse cardiovascular disease outcomes (CVD) and kidney disease. However, BP control rates remain suboptimal globally [Recently, we reported findings from COBRA-BPS, a cluster randomized controlled trial in 30 rural communities in three South Asian countries (Bangladesh, Pakistan and Sri Lanka) over 2 years and demonstrated that a community health worker (CHW) led multicomponent intervention was more effective in lowering systolic BP by 5 mm Hg versus usual care in adults with hypertension [The pre-implementation interviews of stakeholders identified a number of barriers in accessing hypertension care in the 3 countries, which have also been reported from many other LMICs. Some of the key barriers include lack of awareness about hypertension, poor patient and healthcare provider communication between patient and healthcare provider, poor access to quality care and anti-hypertensive medications, long travel time to clinics, long queues at the clinics, and inadequate training of healthcare providers and insufficient resources for management of hypertension [Although the COBRA-BPS multicomponent intervention was designed to address barriers to hypertension management and was effective and cost-effective in lowering BP, it remains unclear if the multicomponent intervention was also acceptable to the stakeholders after their experience in delivering and receiving the intervention.We aimed to explore the post-intervention acceptability of COBRA-multicomponent intervention from key stakeholders’ perspectives, including healthcare providers (community health workers and physicians) and patients from three countries.We used the Theoretical Framework of Acceptability (TFA) which focuses on affective attitude, burden, ethicality, intervention coherence, opportunity cost, perceived effectiveness, and self-efficacy [