Evidence map›Paper›PMID 39516847›Full record

ArticleTrials2024

Addressing Hypertension and Diabetes through Community-Engaged Systems (ANDES) in Puno, Peru: rationale and study protocol for a hybrid type 2 effectiveness and implementation randomized controlled trial.

Lindsay J Underhill, Kendra N Williams, Lucy Cordova-Ascona, Karina Campos, Lisa de Las Fuentes, Mark D Huffman, Joel Gittelsohn, Kenneth B Schechtman, Zoila Vela-Clavo, Carla Tarazona-Meza and 14 more

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05524987 (Addressing HyperteNsion and Diabetes Through Community-Engaged Systems in Puno, Peru), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

NCT05524987 naactive not recruitingnot on this map

Addressing HyperteNsion and Diabetes Through Community-Engaged Systems in Puno, Peru (ANDES Study)

TypeinterventionalSponsorUniversidad Peruana Cayetano HerediaRan2023 to 2026Enrolled1,068ConditionsHypertension, DiabetesArmsANDES INTERVENTION
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Co-developing a community health worker-led hypertension control intervention in Peru through a human-centered design approach.Revista panamericana de salud publica = Pan American journal of public health · 2026
    Article
  2. ANDES trial and integration of the HEARTS model in Puno, Peru.Revista panamericana de salud publica = Pan American journal of public health · 2025
    Article
  3. Article
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

24 authors.

Lindsay J UnderhillGlobal Health Center, Institute for Public Health and Cardiovascular Division, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
Kendra N WilliamsCenter for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Lucy Cordova-AsconaFacultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru.
Karina CamposFacultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru.
Lisa de Las FuentesGlobal Health Center, Institute for Public Health and Cardiovascular Division, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
Mark D HuffmanGlobal Health Center, Institute for Public Health and Cardiovascular Division, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
Joel GittelsohnDepartment of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Kenneth B SchechtmanCenter for Biostatistics and Data Science, Institute for Informatics, Data Science, and Biostatistics (I2BD), School of Medicine, Washington University, St Louis, MO, USA.
Zoila Vela-ClavoFacultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru.
Carla Tarazona-MezaCenter for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Laura K BeresDepartment of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Parker K AcevedoCenter for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Abigail BarkerCenter for Advancing Health Services, Policy, & Economics Research, Washington University in St. Louis, St. Louis, MO, USA.
Nishadi RajapakseNational Institute of Diabetes and Digestive and Kidney Diseases, Division of Diabetes, Endocrinology and Metabolic Diseases, National Institutes of Health, Bethesda, MD, USA.
Makeda WilliamsCenter for Translation Research and Implementation Science, National Heart, Lung and Blood Institute (NHLBI), NIH, Bethesda, MD, USA.
Veronica TonweCenter for Translation Research and Implementation Science, National Heart, Lung and Blood Institute (NHLBI), NIH, Bethesda, MD, USA.
Aaloke ModyInfectious Diseases Division, Department of Medicine and Dissemination and Implementation Center, Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA.
Raquel HurtadoDirección General de Intervenciones Estratégicas en Salud Pública, Ministerio de Salud del Peru, Lima, Peru.
Juan Carlos MendozaPrograma Presupuestal de Enfermedades No TransmisiblesDirección Regional de Salud, Puno, Peru.
Gonzalo CuentasHospital Base III, EsSalud, Puno, Peru.
Elvin H GengInfectious Diseases Division, Department of Medicine and Dissemination and Implementation Center, Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA.
William Checkley *Pulmonary and Critical Care Medicine Division, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Victor G Dávila-Román *Global Health Center, Institute for Public Health and Cardiovascular Division, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
Stella M Hartinger-Peña *Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru. stella.hartinger.p@upch.pe.ORCID http://orcid.org/0000-0003-3523-1725

Funding

Addressing HyperteNsion and Diabetes through Community-Engaged Systems in Puno Peru (ANDES study)UH3HL152371 · NHLBI · UNIVERSIDAD PERUANA CAYETANO HEREDIA · PI William Checkley, Victor G. Davila-Roman · 2023 to 2026
$4.9M
Multi-component INTERLUNG intervention to protect lung health in NepalR01ES037151 · NIEHS · JOHNS HOPKINS UNIVERSITY · PI William Checkley · 2025 to 2026
$1.8M
NHLBI NIH HHS UH3 HL152371NIEHS NIH HHS R01 ES037151
6 · The paper itself

Abstract

backgroundHypertension is the most common cardiovascular disease in Peru despite the availability of cost-effective, evidence-based treatment. Here we describe the rationale and study design for a hybrid type 2 randomized controlled trial to test the implementation and effectiveness of a community health worker (CHW)-led hypertension control program within the national primary care system in Puno, Peru.

methodsWe will recruit 1068 adult participants with hypertension aged ≥ 18 years in Puno, Peru, via facility-based enrollment and community health fairs. Participants will be individually randomized (1:1) to either continue with usual care or participate in a 12-month CHW-led home-based hypertension control program consisting of blood pressure monitoring, medication adherence support, and healthy lifestyle counseling. Outcome development and reporting are guided by the Consolidated Framework for Implementation Research (CFIR), the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, and the Proctor et al. framework. Clinical effectiveness outcomes include mean change in systolic blood pressure (primary outcome), diastolic blood pressure, and HbA1C. Implementation outcomes include fidelity (i.e., CHW protocol adherence and dose), reach, adoption, sustainability, acceptability, and cost-effectiveness. DISCUSSION: The ANDES trial is testing the first CHW-led multicomponent strategy for hypertension and type 2 diabetes management in Peru. This type 2 hybrid trial will provide critical insights into the individual, community, and system-level factors necessary for successful implementation and effectiveness. These data can inform the future adaptation and scaling of the ANDES strategy in Peru and other LMICs, as well as influence policies at the system level to support this transition. Furthermore, by addressing both hypertension and diabetes, the ANDES strategy supports integrated care approaches advocated by the WHO HEARTS technical package, ultimately enhancing health outcomes and reducing morbidity and mortality in the region.

trial registrationClinicalTrials.gov, ID: NCT05524987 , Addressing Hypertension and Diabetes through Community-Engaged Systems in Puno, Peru (ANDES study), prospectively registered on September 1, 2021.

Indexed as

Community Health WorkersDiabetes Mellitus, Type 2HypertensionRandomized Controlled Trials as TopicAdultAntihypertensive AgentsBlood PressureCommunity Health ServicesCounselingGlycated HemoglobinHealthy LifestyleHumansMedication AdherencePeruPrimary Health CareTreatment OutcomeAntihypertensive AgentsGlycated HemoglobinCommunity health workersHypertensionImplementationLMICsPeruTask-shiftingType 2 diabetesWHO HEARTS

Identifiers

PMID39516847
PMCPMC11549830

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Registered trials

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.