Testing a Registry-Based Strategy (ACT+) to Reduce Loss to Follow-Up in Rheumatic Heart Disease Screening in Uganda

N/ANot Yet RecruitingNCT07606131

Children's Hospital Medical Center, Cincinnati16 enrolled

Overview

This study aims to improve follow-up care after positive rheumatic heart disease (RHD) screening in Northern Uganda. It will identify barriers and co-develop an enhanced ACT+ strategy, then evaluate its effectiveness in increasing linkage to confirmatory echocardiography, along with its adoption, acceptability, and feasibility. Secondary outcomes include time to diagnosis, initiation of treatment, and factors influencing implementation.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SCREENING

Masking

NONE

Enrollment

Conditions

Rheumatic Heart Disease

Interventions

The ACT+ StrategyOTHER

The Active Community Case Management Tool (ACT) is a cloud-based, dynamic RHD case management tool developed by CCHMC in partnership with global stakeholders, including UHI and the RRCU. ACT provides real-time data on patient status, clinical outcomes, and care processes, supporting both individual patient management (electronic medical record functions) and system-level quality improvement (registry and dashboard functions).

Eligibility

Sex: ALLHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: Community Members * 18 years of age or older * Received a positive ADUNU echocardiographic screening result within the past 24 months OR parent/legal guardian of a minor who received a positive ADUNU echocardiographic screening result within the past 24 months Inclusion Criteria: Providers * Employed at an ADUNU-participating facility or confirmatory echo facilities at the time of study * Holds a designated ADUNU role (nurse screener, confirmatory provider, or referral support staff) or is involved in RHD screening, diagnosis or care * Ability to provide informed consent in Acholi, Luo, or English Inclusion Criteria: Regional RHT ACT Nurse Coordinator * Employed as a Regional ACT Nurse at the time of study * Has familiarity with ADUNU program * Ability to provide informed consent in Acholi, Luo, or English Inclusion Criteria: District Health Office Team Members and District RHD Focal Persons * Employed at District Health Office within an ADUNU-participating district * Has familiarity with ADUNU program * Ability to provide informed consent in Acholi, Luo, or English Exclusion Criteria: * No formal exclusion criteria beyond inability to provide informed consent. Individuals with significant cognitive or communication impairment precluding interview participation will not be enrolled.

Locations (1)

Uganda Heart Institute

Kampala, Uganda

Outcomes

Primary Outcomes

Facility-level linkage to confirmation rate

The proportion of individuals with a positive ADUNU screening result who complete confirmatory echocardiography within the 9-month intervention period.

Time frame: 9 months

Secondary Outcomes

Time (days) from positive screen to confirmatory echocardiography

% providers entering \>90% of screening records OR completing all monthly outreach activities

Time frame: 9 months

Central Contacts

Isabella Brigham

CONTACT

513-517-1307 isabella.aspromonte@cchmc.org

Data from ClinicalTrials.gov

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