Development and Testing of a Sub-district Specific Model of 'Whole-of-government', and 'Whole-of-society' Approaches for the Prevention and Control of Non-communicable Diseases in a Sub-district of Bangladesh

NCT06453382 | Active Not Recruiting

• 1 other identifier: IRB-10 November'22-045
• Study Type: interventional
• Target: 450
• Locations: 1 country
• Sites: 1

Brief Summary

Globally, non-communicable diseases (NCDs) are the leading cause of both mortality and morbidity. This intervention study aims to prevent and manage NCDs by adopting the World Health Organization's (WHO) comprehensive 'whole-of-government' and 'whole-of-society' approach. Although the Bangladesh government has devised a Multisectoral Action Plan (MAP) for NCD prevention and control, there's a need to operationalize these approaches at the sub-district level. This requires establishing a framework, implementing it, and assessing its effectiveness. To accomplish the study's objectives, the investigators will initially identify key stakeholders involved in NCD-related work or potentially able to contribute. Subsequently, investigators will qualitatively explore their potential involvement in NCD prevention and control, including their current roles and responsibilities, and how they could further contribute. Workshops will be conducted with these stakeholders to develop a tailored intervention model for NCD prevention and control at the sub-district level, utilizing the 'whole-of-government' and 'whole-of-society' approach. Following this, the sub-district specific model will be implemented, and the process will be documented. Finally, an evaluation will be conducted to assess the effectiveness of the sub-district specific model in achieving NCD-specific outcomes.

Conditions

Hypertension; Diabetes; Asthma; Chronic Obstructive Pulmonary Disease (COPD)

Keywords

Non-communicable disease; Hypertension; Diabetes; Chronic respiratory disease; Whole of government; Whole of society

Outcome Measures

Primary Outcomes (7)

• Number of trained healthcare providers in government healthcare facility in sub-district changes

  We will perform a baseline service availability and readiness assessment of the healthcare facility using a tool adapted from WHO's harmonized health facility assessment tool. After that, at the end line, we again perform service availability and readiness assessments of those particular healthcare facilities.

  2 years

• Number of equipment/logistics in government healthcare facility in sub-district changes

  We will perform a baseline service availability and readiness assessment of the healthcare facility using a tool adapted from WHO's harmonized health facility assessment tool. After that, at the end line, we again perform service availability and readiness assessments of those particular healthcare facilities.

  2 years

• Change in the proportion of physical activity, tobacco consumption, fruits and vegetable consumption among adolescents and adults

  We will conduct baseline and end line community survey of adolescent and adult participants. From there, we will measure the change of the proportions of the NCD risk factors.

  2 years

• Prevalence of NCDs reduced among the adults (>/= 18 years)

  We will conduct baseline and end line community survey of adolescent and adult participants. From there, we will measure the change of the proportions of the NCD risk factors.

  2 years

• Proportion of adherence to medication and lifestyle modification measures change among the people with NCDs

  We will conduct baseline and end line community survey of adolescent and adult participants. From there, we will measure the change of the proportions of the NCD risk factors.

  2 years

• The proportion of people with control of hypertension, lung function, and blood sugar increased

  We will conduct baseline and end line community survey of adolescent and adult participants. From there, we will measure the change of the proportions of the NCD risk factors.

  2 years

• The proportion of adults screened for cancer, diabetes, mental health disorders, hypertension and chronic respiratory diseases increased

  We will conduct baseline and end line community survey of adolescent and adult participants. From there, we will measure the change of the proportions of the NCD risk factors.

  2 years

Study Arms (1)

'Whole of government' and 'whole of society' approach

EXPERIMENTAL

Sub-district level potential human resources engagement to control and prevent NCDs

Behavioral: Behavioural change modification, Screening, NCD related knowledge practice and attitude

Interventions

Behavioural change modification, Screening, NCD related knowledge practice and attitude BEHAVIORAL

The investigators will provide periodic training regarding the control and prevention of NCDs to the stakeholders. The investigators will provide WHO-Package of Essential Non-Communicable Diseases (PEN) protocol training to the stakeholders involved in healthcare service delivery. The investigators will equip the government healthcare facilities with the equipment needed for the screening of NCDs. For the stakeholders who are not directly involved with healthcare service delivery, the investigators will train them about the 5 NCDs (diabetes, hypertension, chronic respiratory disease, cancer, and mental illness) and the 5 NCD risk factors (unhealthy diet, inadequate physical activity, tobacco cessation, alcohol cessation, and air pollution). The investigators will also share information, education, and communication (IEC) materials with the stakeholders, and then they will share the information with the community.

'Whole of government' and 'whole of society' approach

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Work within the area of study site

You may not qualify if:

• Do not work within the area of study site

Sponsors & Collaborators

• BRAC University: lead

Study Sites (1)

BRAC James P Grant School of Public Health

Dhaka, 1213, Bangladesh

Location

MeSH Terms

Conditions

Hypertension; Diabetes Mellitus; Asthma; Pulmonary Disease, Chronic Obstructive; Noncommunicable Diseases

Interventions

Mass Screening

Condition Hierarchy (Ancestors)

Vascular Diseases; Cardiovascular Diseases; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Bronchial Diseases; Respiratory Tract Diseases; Lung Diseases, Obstructive; Lung Diseases; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Immune System Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Diagnostic Techniques and Procedures; Diagnosis; Health Surveys; Surveys and Questionnaires; Data Collection; Epidemiologic Methods; Investigative Techniques; Diagnostic Services; Preventive Health Services; Health Services; Health Care Facilities Workforce and Services; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health; Public Health Practice

Study Officials

• Malay K Mridha, PhD

  BRAC James P Grant School of Public Health, BRAC University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 14, 2024
• First Posted: June 11, 2024
• Study Start: September 1, 2022
• Primary Completion: May 31, 2024
• Study Completion: August 31, 2024
• Last Updated: June 11, 2024

Record last verified: 2024-06

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE

Locations

BA (1)