Evidence map›Paper›PMID 36348310›Full record

ArticleBMC primary care2022

Design and feasibility of an implementation strategy to address Chagas guidelines engagement focused on attending women of childbearing age and children at the primary healthcare level in Argentina: a pilot study.

Karen Klein, Javier Roberti, Mariel Rouvier, Maria Belizan, Maria Luisa Cafferata, Amanda Mabel Berrueta, Juan Pedro Alonso

Open access · goldAbstract read
In one paragraph

Article in BMC primary care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 31% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
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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

7 authors at 2 institutions in 1 country.

Karen KleinInstitute of Clinical Effectiveness and Health Policy (IECS), City of Buenos Aires, Argentina. kklein@iecs.org.ar.ORCID 0000-0003-4619-5432
Javier RobertiInstitute of Clinical Effectiveness and Health Policy (IECS), City of Buenos Aires, Argentina.
Mariel RouvierMinistry of Public Health of Chaco, Resistencia, Chaco, Argentina.
Maria BelizanInstitute of Clinical Effectiveness and Health Policy (IECS), City of Buenos Aires, Argentina.
Maria Luisa CafferataInstitute of Clinical Effectiveness and Health Policy (IECS), City of Buenos Aires, Argentina.
Amanda Mabel BerruetaInstitute of Clinical Effectiveness and Health Policy (IECS), City of Buenos Aires, Argentina.
Juan Pedro AlonsoInstitute of Clinical Effectiveness and Health Policy (IECS), City of Buenos Aires, Argentina.
Instituto de Efectividad Clínica y Sanitaria · ARCentro Científico Tecnológico - San Juan · AR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChagas is a public health problem, especially in Latin America, exacerbated by migratory movements and increasing urbanization. Argentina is among the countries with the highest estimated prevalence in the region, with 1,500,000 people infected, with mother to child as the main mode of transmission. Vertical transmission has been significantly reduced by treating women of childbearing age; several guidelines in the region recommend treatment as a primary prevention strategy for the child and a secondary prevention strategy for women and their families. Despite recommendations, women of childbearing age are not always treated, and children do not receive timely diagnosis and treatment. The objective of this research was to design an implementation strategy to improve using Chagas guidelines focused on attending women of childbearing age and children at the primary healthcare level and pilot it in three primary health care centers in Argentina.

methodsWe conducted a pilot feasibility study using the Consolidated Framework for Implementation Research. A qualitative process evaluation was conducted using semi-structured interviews with health care providers and observations in primary health care centers.

resultsWe developed a multifaceted implementation strategy including training, flowcharts and reminders, a register of suspected and confirmed cases, and the selection of a management facilitator. The pilot study took place between September 2019 and May 2020. The implementation level was heterogeneous and varied depending on the components, being the facilitating factors, the simplicity of the intervention, professionals' willingness to expand the indication of serologic tests, and staff commitment to the adoption of intervention components. The main barriers found were the change of authorities at the local level, some professionals´ reluctance to administer etiological treatment, staff shortages, lack of diagnostic supplies, and the health emergency caused by the COVID-19 pandemic.

conclusionsBehavioral change strategies should be applied to improve implementation to address some of the main barriers, including support actions offered by opinion leaders, medical experts, and local health authorities. Rapid diagnostic tests should be readily available to maintain behavior changes. We suggest further refinement of the strategy and its implementation in more centers to assess outcomes prospectively with a hybrid implementation research design.

Indexed as

COVID-19PandemicsArgentinaChildFeasibility StudiesFemaleHumansInfectious Disease Transmission, VerticalPilot ProjectsPrimary Health CareChagasEffective interventionFeasibilityGuidelineImplementation strategyPrimary health care

Identifiers

PMID36348310
PMCPMC9643922
OpenAlexW4308571880

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.