ArticleJournal of clinical hypertension (Greenwich, Conn.)2021
Mapping stages, barriers and facilitators to the implementation of HEARTS in the Americas initiative in 12 countries: A qualitative study.
Article in Journal of clinical hypertension (Greenwich, Conn.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
What it found
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Who cites it
35 citing papers in PubMed.
- Implementation outcomes from the Hypertension Treatment in Nigeria program: results from a type 2 hybrid interrupted time series trial.Implementation science : IS · 2025Trial
- Scaling integrated cardiovascular-kidney-metabolic care through primary health care in the Americas: a health policy analysis of HEARTS 2.0 implementation levers and architecture.Lancet regional health. Americas · 2026Review
- Implementation of stroke prevention: a review of challenges and opportunities in the Americas.Lancet regional health. Americas · 2026Review
- Readiness to deliver integrated cardiovascular, kidney and metabolic care in primary healthcare: phase II of HEARTS 2.0 in 26 countries in the Americas.BMJ global health · 2026Article
- Healthcare providers' perceptions of the HEARTS Clinical Pathway in Belize: barriers and facilitators.Revista panamericana de salud publica = Pan American journal of public health · 2026Article
- [The HEARTS initiative: Experience with community cardiovascular health champions in a municipality in ChileIniciativa HEARTS: experiência com promotores comunitários de saúde cardiovascular em um município chileno].Revista panamericana de salud publica = Pan American journal of public health · 2026Article
- Using implementation science for WHO noncommunicable disease technical packages in low-and middle-income countries: a scoping review.Frontiers in health services · 2026Review
- Trends and disparities in obesity and atherosclerotic cardiovascular disease mortality in a 25-year retrospective analysis.Scientific reports · 2025Article
- Candidate Interventions for Integrating Hypertension and Cardiovascular-Kidney-Metabolic Care in Primary Health Settings: HEARTS 2.0 Phase 1.Global heart · 2025Article
- HEARTS in the Americas: Targeting Health System Change to Improve Population Hypertension Control.Current hypertension reports · 2024Review
- [HEARTS in the Americas: targeting health system change to improve population hypertension controlHEARTS nas Américas: impulsionar mudanças no sistema de saúde para melhorar o controle da hipertensão arterial na população].Revista panamericana de salud publica = Pan American journal of public health · 2024Article
- Barriers to access to antihypertensive medicines: insights from the HEARTS initiative in latin American and Caribbean region.Journal of pharmaceutical policy and practice · 2024Article
- Using the RE-AIM framework to evaluate the implementation and effectiveness of a WHO HEARTS-based intervention to integrate the management of hypertension into HIV care in Uganda: a process evaluation.Implementation science communications · 2023Review
- Malaysian burden of disease: years of life lost due to premature deaths.BMC public health · 2023Article
- International Consensus on Standardized Clinic Blood Pressure Measurement - A Call to Action.The American journal of medicine · 2023Article
- The HEARTS partner forum-supporting implementation of HEARTS to treat and control hypertension.Frontiers in public health · 2023Article
- [Exploring facilitators and barriers to implementing expanded nursing roles in MexicoEstudo de facilitadores e barreiras para a implementação de funções ampliadas de enfermagem no México].Revista panamericana de salud publica = Pan American journal of public health · 2023Article
- [Monitoring and evaluation platform for HEARTS in the Americas: improving population-based hypertension control programs in primary health carePlataforma de monitoramento e avaliação do programa HEARTS nas Américas: melhoria dos programas de controle da hipertensão de base populacional na atenção primária à saúde].Revista panamericana de salud publica = Pan American journal of public health · 2023Article
- Noncommunicable diseases in the Americas: a review of the Pan American Health Organization's 25-year program of work.Revista panamericana de salud publica = Pan American journal of public health · 2023Article
- Hypertension Treatment in Nigeria (HTN) Program: rationale and design for a type 2 hybrid, effectiveness, and implementation interrupted time series trial.Implementation science communications · 2022Article
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The World Health Organization (WHO) Global Hearts Initiative offers technical packages to reduce the burden of cardiovascular diseases through population-wide and targeted health services interventions. The Pan American Health Organization (PAHO) has led implementation of the HEARTS in the Americas Initiative since 2016. The authors mapped the developmental stages, barriers, and facilitators to implementation among the 371 primary health care centers in the participating 12 countries. The authors used the qualitative method of document review to examine cumulative country reports, technical meeting notes, and reports to regional stakeholders. Common implementation barriers include segmentation of health systems, overcoming health care professionals' scope of practice legal restrictions, and lack of health information systems limiting operational evaluation and quality improvement mechanisms. Main implementation facilitators include political support from ministries of health and leading scientific societies, PAHO's role as a regional catalyst to implementation, stakeholder endorsement demonstrated by incorporating HEARTS into official documents, and having a health system oriented to primary health care. Key lessons include the need for political commitment and cultivating on-the-ground leadership to initiate a shift in hypertension care delivery, accompanied by specific progress in the development of standardized treatment protocols and a set of high-quality medicines. By systematizing an implementation strategy to ease integration of interventions into delivery processes, the program strengthened technical leadership and ensured sustainability. These study findings will aid the regional approach by providing a staged planning model that incorporates lessons learned. A systematic approach to implementation will enhance equity, efficiency, scale-up, and sustainability, and ultimately improve population hypertension control.
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