Adapting an Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Co-Design of the MIMIC Intervention
Background: Uptake of evidence-based care for acute myocardial infarction (AMI) is suboptimal in Tanzania, but there are currently no published interventions to improve AMI care in sub-Saharan Africa. Objectives: Co-design a quality improvement intervention for AMI care tailored to local contextual...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ubiquity Press
2024-03-01
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| Series: | Annals of Global Health |
| Subjects: | |
| Online Access: | https://account.annalsofglobalhealth.org/index.php/up-j-agh/article/view/4361 |
| _version_ | 1797202879703941120 |
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| author | Julian T. Hertz Kristen Stark Francis M. Sakita Jerome J. Mlangi Godfrey L. Kweka Sainikitha Prattipati Frida Shayo Vivian Kaboigora Julius Mtui Manji N. Isack Esther M. Kindishe Dotto J. Ngelengi Alexander T. Limkakeng, Jr Nathan M. Thielman Gerald S. Bloomfield Janet P. Bettger Tumsifu G. Tarimo |
| author_facet | Julian T. Hertz Kristen Stark Francis M. Sakita Jerome J. Mlangi Godfrey L. Kweka Sainikitha Prattipati Frida Shayo Vivian Kaboigora Julius Mtui Manji N. Isack Esther M. Kindishe Dotto J. Ngelengi Alexander T. Limkakeng, Jr Nathan M. Thielman Gerald S. Bloomfield Janet P. Bettger Tumsifu G. Tarimo |
| author_sort | Julian T. Hertz |
| collection | DOAJ |
| description | Background: Uptake of evidence-based care for acute myocardial infarction (AMI) is suboptimal in Tanzania, but there are currently no published interventions to improve AMI care in sub-Saharan Africa. Objectives: Co-design a quality improvement intervention for AMI care tailored to local contextual factors. Methods: An interdisciplinary design team consisting of 20 physicians, nurses, implementation scientists, and administrators met from June 2022 through August 2023. Half of the design team consisted of representatives from the target audience, emergency department physicians and nurses at a referral hospital in northern Tanzania. The design team reviewed multiple published quality improvement interventions focusing on ED-based AMI care. After selecting a multicomponent intervention to improve AMI care in Brazil (BRIDGE-ACS), the design team used the ADAPT-ITT framework to adapt the intervention to the local context. Findings: The design team audited current AMI care processes at the study hospital and reviewed qualitative data regarding barriers to care. Multiple adaptations were made to the original BRIDGE-ACS intervention to suit the local context, including re-designing the physician reminder system and adding patient educational materials. Additional feedback was sought from topical experts, including patients with AMI. Draft intervention materials were iteratively refined in response to feedback from experts and the design team. The finalized intervention, Multicomponent Intervention to Improve Myocardial Infarction Care in Tanzania (MIMIC), consisted of five core components: physician reminders, pocket cards, champions, provider training, and patient education. Conclusion: MIMIC is the first locally tailored intervention to improve AMI care in sub-Saharan Africa. Future studies will evaluate implementation outcomes and efficacy. |
| first_indexed | 2024-04-24T08:10:27Z |
| format | Article |
| id | doaj.art-43874e35bf3644b89db72920524e1f13 |
| institution | Directory Open Access Journal |
| issn | 2214-9996 |
| language | English |
| last_indexed | 2024-04-24T08:10:27Z |
| publishDate | 2024-03-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | Annals of Global Health |
| spelling | doaj.art-43874e35bf3644b89db72920524e1f132024-04-17T06:33:33ZengUbiquity PressAnnals of Global Health2214-99962024-03-01901212110.5334/aogh.43614361Adapting an Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Co-Design of the MIMIC InterventionJulian T. Hertz0https://orcid.org/0000-0002-7396-4789Kristen Stark1Francis M. Sakita2Jerome J. Mlangi3Godfrey L. Kweka4Sainikitha Prattipati5Frida Shayo6Vivian Kaboigora7Julius Mtui8Manji N. Isack9Esther M. Kindishe10Dotto J. Ngelengi11Alexander T. Limkakeng, Jr12https://orcid.org/0000-0002-9822-5595Nathan M. Thielman13https://orcid.org/0000-0001-8152-2879Gerald S. Bloomfield14https://orcid.org/0000-0002-7176-1611Janet P. Bettger15https://orcid.org/0000-0001-9708-8413Tumsifu G. Tarimo16Duke Global Health Institute, Duke University, Durham, North Carolina; Department of Emergency Medicine, Duke University School of Medicine, Durham, North CarolinaDuke Global Health Institute, Duke University, Durham, North CarolinaKilimanjaro Christian Medical Center, Moshi; Kilimanjaro Christian Medical University, MoshiKilimanjaro Christian Medical Center, MoshiKilimanjaro Christian Medical Center, MoshiDuke Global Health Institute, Duke University, Durham, North CarolinaKilimanjaro Christian Medical Center, MoshiKilimanjaro Christian Medical Center, MoshiKilimanjaro Christian Medical Center, MoshiKilimanjaro Christian Medical Center, MoshiKilimanjaro Christian Medical Center, MoshiKilimanjaro Christian Medical Center, MoshiDepartment of Emergency Medicine, Duke University School of Medicine, Durham, North CarolinaDuke Global Health Institute, Duke University, Durham, North Carolina; Department of Internal Medicine, Duke University, Durham, North CarolinaDuke Global Health Institute, Duke University, Durham, North Carolina; Department of Internal Medicine, Duke University, Durham, North Carolina; Duke Clinical Research Institute, Durham, North CarolinaDuke Global Health Institute, Duke University, Durham, North CarolinaKilimanjaro Christian Medical Center, MoshiBackground: Uptake of evidence-based care for acute myocardial infarction (AMI) is suboptimal in Tanzania, but there are currently no published interventions to improve AMI care in sub-Saharan Africa. Objectives: Co-design a quality improvement intervention for AMI care tailored to local contextual factors. Methods: An interdisciplinary design team consisting of 20 physicians, nurses, implementation scientists, and administrators met from June 2022 through August 2023. Half of the design team consisted of representatives from the target audience, emergency department physicians and nurses at a referral hospital in northern Tanzania. The design team reviewed multiple published quality improvement interventions focusing on ED-based AMI care. After selecting a multicomponent intervention to improve AMI care in Brazil (BRIDGE-ACS), the design team used the ADAPT-ITT framework to adapt the intervention to the local context. Findings: The design team audited current AMI care processes at the study hospital and reviewed qualitative data regarding barriers to care. Multiple adaptations were made to the original BRIDGE-ACS intervention to suit the local context, including re-designing the physician reminder system and adding patient educational materials. Additional feedback was sought from topical experts, including patients with AMI. Draft intervention materials were iteratively refined in response to feedback from experts and the design team. The finalized intervention, Multicomponent Intervention to Improve Myocardial Infarction Care in Tanzania (MIMIC), consisted of five core components: physician reminders, pocket cards, champions, provider training, and patient education. Conclusion: MIMIC is the first locally tailored intervention to improve AMI care in sub-Saharan Africa. Future studies will evaluate implementation outcomes and efficacy.https://account.annalsofglobalhealth.org/index.php/up-j-agh/article/view/4361acute myocardial infarctionco-designsub-saharan africaimplementation sciencequality improvement |
| spellingShingle | Julian T. Hertz Kristen Stark Francis M. Sakita Jerome J. Mlangi Godfrey L. Kweka Sainikitha Prattipati Frida Shayo Vivian Kaboigora Julius Mtui Manji N. Isack Esther M. Kindishe Dotto J. Ngelengi Alexander T. Limkakeng, Jr Nathan M. Thielman Gerald S. Bloomfield Janet P. Bettger Tumsifu G. Tarimo Adapting an Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Co-Design of the MIMIC Intervention Annals of Global Health acute myocardial infarction co-design sub-saharan africa implementation science quality improvement |
| title | Adapting an Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Co-Design of the MIMIC Intervention |
| title_full | Adapting an Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Co-Design of the MIMIC Intervention |
| title_fullStr | Adapting an Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Co-Design of the MIMIC Intervention |
| title_full_unstemmed | Adapting an Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Co-Design of the MIMIC Intervention |
| title_short | Adapting an Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Co-Design of the MIMIC Intervention |
| title_sort | adapting an intervention to improve acute myocardial infarction care in tanzania co design of the mimic intervention |
| topic | acute myocardial infarction co-design sub-saharan africa implementation science quality improvement |
| url | https://account.annalsofglobalhealth.org/index.php/up-j-agh/article/view/4361 |
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