Evidence map›Paper›PMID 32503887›Full record

ArticleBMJ global health2020

Community-based interventions for detection and management of diabetes and hypertension in underserved communities: a mixed-methods evaluation in Brazil, India, South Africa and the USA.

Luisa S Flor, Shelley Wilson, Paurvi Bhatt, Miranda Bryant, Aaron Burnett, Joseph N Camarda, Vasudha Chakravarthy, Chandrashekhar Chandrashekhar, Nayanjeet Chaudhury, Christiane Cimini and 42 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 5 pooled it
10.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 5 syntheses or guidelines pooled it, 76 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

52 authors at 17 institutions in 4 countries.

Luisa S FlorDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Shelley WilsonDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Paurvi BhattMedtronic Foundation, Minneapolis, Minnesota, USA.
Miranda BryantDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Aaron BurnettDepartment of Emergency Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Joseph N CamardaDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Vasudha ChakravarthyDevelopment Solutions, New Delhi, Delhi, India.
Chandrashekhar ChandrashekharMAMTA Health Institute for Mother and Child, New Delhi, Delhi, India.
Nayanjeet ChaudhuryMedtronic Foundation, Minneapolis, Minnesota, USA.
Christiane CiminiSchool of Medicine, Federal University of Jequitinhonha and Mucuri Valleys, Teofilo Otoni, MG, Brazil.
Danny V ColombaraPublic Health Seattle and King County, Seattle, Washington, USA.
Haricharan Conjeevaram NarayananABT Associates Inc, Cambridge, Massachusetts, USA.
Matheus Lopes CortesAnisio Teixeira Campus, Federal University of Bahia Multidisciplinary Institute in Health, Vitoria da Conquista, Bahia, Brazil.
Krycia CowlingDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Jessica DalyMedtronic Foundation, Minneapolis, Minnesota, USA.
Herbert DuberDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Vinayakan Ellath KavinkareMAMTA Health Institute for Mother and Child, New Delhi, Delhi, India.
Patrick EndlichSchool of Medicine, Federal University of Jequitinhonha and Mucuri Valleys, Teofilo Otoni, MG, Brazil.
Nancy FullmanDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Rose GabertSchool of Medicine, University of Washington, Seattle, Washington, USA.
Thomas GlucksmanDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Katie Panhorst HarrisDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Maria Angela Loguercio BouskelaResearch and Teaching Institute, Hospital Sirio-Libanes, Sao Paulo, São Paulo, Brazil.
Junia MaiaTelehealth Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Charlie MandileHealthFinders Collaborative, Northfield, Minnesota, USA.
Milena S MarcolinoTelehealth Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Susan MarshallRegions Hospital, Saint Paul, Minnesota, USA.
Claire R McNellanNational CASA/GAL Association for Children, Seattle, Washington, USA.
Danielle Souto de MedeirosAnisio Teixeira Campus, Federal University of Bahia Multidisciplinary Institute in Health, Vitoria da Conquista, Bahia, Brazil.
Sóstenes MistroAnisio Teixeira Campus, Federal University of Bahia Multidisciplinary Institute in Health, Vitoria da Conquista, Bahia, Brazil.
Vasudha MulakaluriDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Jennifer MurphreeRegions Hospital, Saint Paul, Minnesota, USA.
Marie NgIBM Watson Health, San Jose, California, USA.
J A Q OliveiraTelehealth Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Márcio Galvão OliveiraAnisio Teixeira Campus, Federal University of Bahia Multidisciplinary Institute in Health, Vitoria da Conquista, Bahia, Brazil.
Bryan PhillipsHealth Policy and Management, University of California Los Angeles, Los Angeles, California, USA.
Vânia PintoSchool of Medicine, Federal University of Jequitinhonha and Mucuri Valleys, Teofilo Otoni, MG, Brazil.
Tara Polzer NgwatoSocial Surveys Africa, Johannesburg, Gauteng, South Africa.
Tia RadantRegions Hospital, Saint Paul, Minnesota, USA.
Marissa B ReitsmaDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Antonio Luiz RibeiroTelehealth Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Gregory RothDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
Davi RumelResearch and Teaching Institute, Hospital Sirio-Libanes, Sao Paulo, São Paulo, Brazil.
Gaurav SethiMAMTA Health Institute for Mother and Child, New Delhi, Delhi, India.
Daniela Arruda SoaresAnisio Teixeira Campus, Federal University of Bahia Multidisciplinary Institute in Health, Vitoria da Conquista, Bahia, Brazil.
Tsega TamenePillsbury United Communities, Minneapolis, Minnesota, USA.
Blake ThomsonNuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK.
Harsha TomarMAMTA Health Institute for Mother and Child, New Delhi, Delhi, India.
Mark Thomaz Ugliara BaroneMedtronic Foundation, Minneapolis, Minnesota, USA.
Sameer ValsangkarResearch and Monitoring Systems, The Catholic Health Association of India, Hyderabad, Telangana, India.
Alexandra WollumIbis Reproductive Health, Cambridge, Massachusetts, USA.
Emmanuela GakidouDepartment of Health Metrics Sciences, University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA gakidou@uw.edu.
Institute for Health Metrics and Evaluation · USUniversidade Federal da Bahia · BRUniversity of Washington · USMamta Health Institute for Mother and Child · INMedtronic (United States) · USRegions Hospital · USUniversidade Federal de Minas Gerais · BRUniversidade Federal dos Vales do Jequitinhonha e Mucuri · BRAbt Global (United States) · USCatholic Health Association of India · INHospital Sírio-Libanês · BRIbis Reproductive Health · USIBM (United States) · USPublic Health – Seattle & King County · USUniversidade Municipal de São Caetano do Sul · BRUniversity of California, Los Angeles · USUniversity of Oxford · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAs non-communicable disease (NCD) burden rises worldwide, community-based programmes are a promising strategy to bridge gaps in NCD care. The HealthRise programme sought to improve hypertension and diabetes management for underserved communities in nine sites across Brazil, India, South Africa and the USA between 2016 and 2018. This study presents findings from the programme's endline evaluation.

methodsThe evaluation utilises a mixed-methods quasi-experimental design. Process indicators assess programme implementation; quantitative data examine patients' biometric measures and qualitative data characterise programme successes and challenges. Programme impact was assessed using the percentage of patients meeting blood pressure and A1c treatment targets and tracking changes in these measures over time.

resultsAlmost 60 000 screenings, most of them in India, resulted in 1464 new hypertension and 295 new diabetes cases across sites. In Brazil, patients exhibited statistically significant reductions in blood pressure and A1c. In Shimla, India, and in South Africa, country with the shortest implementation period, there were no differences between patients served by facilities in HealthRise areas relative to comparison areas. Among participating patients with diabetes in Hennepin and Ramsey counties and hypertension patients in Hennepin County, the percentage of HealthRise patients meeting treatment targets at endline was significantly higher relative to comparison group patients. Qualitative analysis identified linking different providers, services, communities and information systems as positive HealthRise attributes. Gaps in health system capacities and sociodemographic factors, including poverty, low levels of health education and limited access to nutritious food, are remaining challenges.

conclusionsFindings from Brazil and the USA indicate that the HealthRise model has the potential to improve patient outcomes. Short implementation periods and strong emphasis on screening may have contributed to the lack of detectable differences in other sites. Community-based care cannot deliver its full potential if sociodemographic and health system barriers are not addressed in tandem.

Indexed as

Diabetes MellitusHypertensionBrazilHumansIndiaSouth Africadiabeteshypertensionpublic health

Identifiers

PMID32503887
PMCPMC7279660
OpenAlexW3033818220

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.