Scaling up the Community Health Assessment Program in the Philippines (CHAP-P)

Background

High blood pressure and diabetes are leading risk factors for morbidity and mortality worldwide, with particularly strong prevalence in low- and middle-income countries (LMICs), where awareness, diagnosis, and treatment are also poorer. Showing consistent results of improving cardiovascular outcomes in Canada, the Cardiovascular Health Awareness Program (CHAP) was adapted to the Philippines, an LMIC, as the Community Health Assessment Program in the Philippines (CHAP-P). CHAP-P is a community-based, volunteer-led cardiovascular/diabetes risk assessment and blood pressure monitoring program with health education sessions.

Aims

The current study aims to assess the scalability of CHAP-P across an entire Administrative Region of the Philippines, Region IX, Zamboanga Peninsula (population: 3.6 million, 67 municipalities and 4 cities). The study will identify factors and processes affecting acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, cost-effectiveness, penetration, and sustainability of CHAP-P; and develop tools to further scale-up CHAP-P nationally and in similar LMICs. The proposed implementation science approach will integrate several components: the Knowledge-to-Action Framework, to be used as a process model to guide planning and implementation; combined use of the Consolidated Framework for Implementation Research (CFIR) and Theoretical Domains Framework (TDF) as implementation theories to help understand and explain influences on implementation outcomes at the community (CFIR) and individual (TDF) levels; and development of a program logic model to outline our program theory.

Project plan

There will be 3 main stages of research implementation: 1) Scale-up strategic planning, involving stakeholders across all levels to plan the best way to scale-up CHAP-P region-wide; 2) Implementation and quality improvement, where the program will be implemented and best practices learned from early adopters will be integrated into the program; and 3) Research evaluation and knowledge translation. Stage 3 will also include readiness assessments in selected partner countries (to potentially include Thailand, Tunisia, and Peru). This proposal meets all objectives of the current opportunity. It enhances scale-up of the evidence-based CHAP intervention aimed at prevention/detection and management of hypertension and diabetes in the Philippines, an LMIC. It develops strategies to overcome barriers and enhance facilitators by including a multidisciplinary/cross-sectoral team of lay health workers, health professionals, government officials from various levels, citizens, and researchers.

Finally, it creates new knowledge on how to appropriately adapt CHAP-P, taking into consideration the different geographic, economic, and cultural factors in the Zamboanga Peninsula include rurality and geographic isolation, poverty, and a diverse set of languages and religions, learning which can then be applied nationally and to other LMICs.

Publications and output

You may visit the project website for more information.

Funding organisations

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