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Report

Teaser, summary, work performed and final results

Periodic Reporting for period 1 - SPICES (Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research (SPICES Project))

Teaser

Summary

By the year 2030, non-communicable diseases will account for more than three-quarters of deaths worldwide. In Europe, cardiovascular diseases (CVDs) will be the leading causes of death. The burden of CVD is highest among individuals in the lower socio-economic quintiles. In low- and middle-income countries (LMIC) where CVDs will be responsible for more deaths than infectious diseases, maternal and perinatal conditions, and nutritional disorders combined. Several interventions with scale-up potential can strengthen health systems to provide care for CVD. However, implementation to scale remains limited. Therefor the overall objective of the SPICES project is to implement and evaluate a comprehensive CVD prevention and care program at the community level in five countries (Belgium, France, Uganda, UK, South Africa), to identify and compare barriers and facilitators for implementation across study contexts and to develop a learning community. The project focusses on four (4) groups of interventions: Health promotion; cardiovascular risk profiling; Management and Self-management & follow-up.

Work performed

During the past 18 months, the project mainly focused on: 1) performing a situational analysis in the different settings in order to understand healthcare and lifestyle practices, barriers, and facilitators in relation to CVD prevention in each setting; 2) make a detailed overview of existing interventions to inform the development of the comprehensive CVD interventions in the different sites; 3) develop an overall implementation and evaluation plan to serve as a basis for the development of contextual study plans for each site.
A a three day kick off meeting was organised to harmonize differences and discuss the work packages in detail. Four (4) more face to face meetings were held at different locations. Every meeting included one or two workshop(s) linked to the learning needs of the teams. We also planned a field visit per setting in order to allow teams to explore and learn from other contexts and to interact with local stakeholders. To support the communication of the project, a logo, a project website and two newsletters were developed. The website is periodically updated and is aimed at the general public. A dissemination and communication plan was worked out (D8.1). During the reporting period, 7 posters and 1 presentation were given at national and international conferences. To enhance project management, a management software EMDESK was procured and developed and teams were trained to use this system. Finally, project management support structures were installed: The general assembly, the Executive Board and the external independent Ethics Board comprising of two members. All the deliverables and milestones planned in the first 18-month reporting period have been produced/attained.
In the next paragraphs, a summary of the results is provided.
(1) Situational analysis
We conducted a situational analysis of the burden of CVDs, contextual factors, current practices and policies in the different sites based on literature, CVD stakeholder mapping and (group) interviews, and use of existing data across 5 countries. Findings on the following topics were reported: CVD and risk factors, Policies and stakeholders, Organization of care for CVDs, Challenges and Opportunities. (D2.1). The University of Manchester developed a questionnaire to evaluate the readiness of the different settings for e-and mhealth applications. For Uganda and South Africa text messaging interventions and / or intervention for healthcare workers seem best There is the potential to target a smartphone-based intervention for healthcare workers as more of them have smartphones than in the general population. For Belgium, United Kingdom and France a wide range of mHealth interventions, including smartphone or text messaging is feasible for participants and/or healthcare workers.

(2) Detailed overview of existing interventions and strategies in literature to inform interventions/strategies for the SPICES project
NTU lead the preparation of the intervention plan on health promotion and identified community engagement as a model of choice to be applied in the SPICES project. The metaphor of a traffic light system for working with people at risk to CVD was identified as a useful tool for signposting people to appropriate services. People in the orange zone will receive interventions. A training workshop in community engagement approaches was held in Nottingham in October 2017.
The University of Manchester worked on identifying a cardiovascular (CVD) risk profiling tool which is effective and can be feasibly implemented across the partner sites. Non-laboratory based CVD risk scoring tools were considered to be more suitable for use in the SPICES project given the potential issues with accessing laboratory testing facilities in some sites. The interHEART tool appeared to be the most suitable candidate for the SPICES project. (D4.1)
The Universities of Antwerp and Brest worked together on the literature review on existing interventions and strategies for