Integrating community-based HIV and non-communicable disease care with microfinance groups: a feasibility study in Western Kenya
Abstract Background The Harambee study is a cluster randomized trial in Western Kenya that tests the effect, mechanisms, and cost-effectiveness of integrating community-based HIV and non-communicable disease care within microfinance groups on chronic disease treatment outcomes. This paper documents...
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | Pilot and Feasibility Studies |
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| Online Access: | https://doi.org/10.1186/s40814-022-01218-6 |
| _version_ | 1797973717342486528 |
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| author | Catherine Kafu Juddy Wachira Victor Omodi Jamil Said Sonak D. Pastakia Dan N. Tran Jael Adongo Onyango Dan Aburi Marta Wilson-Barthes Omar Galárraga Becky Lynn Genberg |
| author_facet | Catherine Kafu Juddy Wachira Victor Omodi Jamil Said Sonak D. Pastakia Dan N. Tran Jael Adongo Onyango Dan Aburi Marta Wilson-Barthes Omar Galárraga Becky Lynn Genberg |
| author_sort | Catherine Kafu |
| collection | DOAJ |
| description | Abstract Background The Harambee study is a cluster randomized trial in Western Kenya that tests the effect, mechanisms, and cost-effectiveness of integrating community-based HIV and non-communicable disease care within microfinance groups on chronic disease treatment outcomes. This paper documents the stages of our feasibility study conducted in preparation for the Harambee trial, which include (1) characterizing the target population and gauging recruitment capacity, (2) determining community acceptability of the integrated intervention and study procedures, and (3) identifying key implementation considerations prior to study start. Methods Feasibility research took place between November 2019 and February 2020 in Western Kenya. Mixed methods data collection included surveys administered to 115 leaders of 105 community-based microfinance groups, 7 in-person meetings and two workshops with stakeholders from multiple sectors of the health system, and ascertainment of field notes and geographic coordinates for group meeting locations and HIV healthcare facilities. Quantitative survey data were analyzed using STATA IC/13. Longitude and latitude coordinates were mapped to county boundaries using Esri ArcMap. Qualitative data obtained from stakeholder meetings and field notes were analyzed thematically. Results Of the 105 surveyed microfinance groups, 77 met eligibility criteria. Eligible groups had been in existence from 6 months to 18 years and had an average of 22 members. The majority (64%) of groups had at least one member who owned a smartphone. The definition of “active” membership and model of saving and lending differed across groups. Stakeholders perceived the community-based intervention and trial procedures to be acceptable given the minimal risks to participants and the potential to improve HIV treatment outcomes while facilitating care integration. Potential challenges identified by stakeholders included possible conflicts between the trial and existing community-based interventions, fear of group disintegration prior to trial end, clinicians’ inability to draw blood for viral load testing in the community, and deviations from standard care protocols. Conclusions This study revealed that it was feasible to recruit the number of microfinance groups necessary to ensure that our clinical trial was sufficient powered. Elicitation of stakeholder feedback confirmed that the planned intervention was largely acceptable and was critical to identifying challenges prior to implementation. Trial registration The original trial was prospectively registered with ClinicalTrials.gov (NCT04417127) on 4 June 2020. |
| first_indexed | 2024-04-11T04:08:47Z |
| format | Article |
| id | doaj.art-9e98ac20aad24c2d89bed6139e90195f |
| institution | Directory Open Access Journal |
| issn | 2055-5784 |
| language | English |
| last_indexed | 2024-04-11T04:08:47Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Pilot and Feasibility Studies |
| spelling | doaj.art-9e98ac20aad24c2d89bed6139e90195f2023-01-01T12:13:17ZengBMCPilot and Feasibility Studies2055-57842022-12-018111510.1186/s40814-022-01218-6Integrating community-based HIV and non-communicable disease care with microfinance groups: a feasibility study in Western KenyaCatherine Kafu0Juddy Wachira1Victor Omodi2Jamil Said3Sonak D. Pastakia4Dan N. Tran5Jael Adongo Onyango6Dan Aburi7Marta Wilson-Barthes8Omar Galárraga9Becky Lynn Genberg10Academic Model Providing Access to HealthcareAcademic Model Providing Access to HealthcareAcademic Model Providing Access to HealthcareAcademic Model Providing Access to HealthcareAcademic Model Providing Access to HealthcareAcademic Model Providing Access to HealthcareAcademic Model Providing Access to HealthcareAcademic Model Providing Access to HealthcareDepartment of Epidemiology, Brown University School of Public HealthDepartment of Health Services, Policy and Practice, Brown University School of Public HealthDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthAbstract Background The Harambee study is a cluster randomized trial in Western Kenya that tests the effect, mechanisms, and cost-effectiveness of integrating community-based HIV and non-communicable disease care within microfinance groups on chronic disease treatment outcomes. This paper documents the stages of our feasibility study conducted in preparation for the Harambee trial, which include (1) characterizing the target population and gauging recruitment capacity, (2) determining community acceptability of the integrated intervention and study procedures, and (3) identifying key implementation considerations prior to study start. Methods Feasibility research took place between November 2019 and February 2020 in Western Kenya. Mixed methods data collection included surveys administered to 115 leaders of 105 community-based microfinance groups, 7 in-person meetings and two workshops with stakeholders from multiple sectors of the health system, and ascertainment of field notes and geographic coordinates for group meeting locations and HIV healthcare facilities. Quantitative survey data were analyzed using STATA IC/13. Longitude and latitude coordinates were mapped to county boundaries using Esri ArcMap. Qualitative data obtained from stakeholder meetings and field notes were analyzed thematically. Results Of the 105 surveyed microfinance groups, 77 met eligibility criteria. Eligible groups had been in existence from 6 months to 18 years and had an average of 22 members. The majority (64%) of groups had at least one member who owned a smartphone. The definition of “active” membership and model of saving and lending differed across groups. Stakeholders perceived the community-based intervention and trial procedures to be acceptable given the minimal risks to participants and the potential to improve HIV treatment outcomes while facilitating care integration. Potential challenges identified by stakeholders included possible conflicts between the trial and existing community-based interventions, fear of group disintegration prior to trial end, clinicians’ inability to draw blood for viral load testing in the community, and deviations from standard care protocols. Conclusions This study revealed that it was feasible to recruit the number of microfinance groups necessary to ensure that our clinical trial was sufficient powered. Elicitation of stakeholder feedback confirmed that the planned intervention was largely acceptable and was critical to identifying challenges prior to implementation. Trial registration The original trial was prospectively registered with ClinicalTrials.gov (NCT04417127) on 4 June 2020.https://doi.org/10.1186/s40814-022-01218-6Differentiated careHuman immunodeficiency viruses (HIV)Non-communicable diseasesCommunity-based careMicrofinanceFeasibility study |
| spellingShingle | Catherine Kafu Juddy Wachira Victor Omodi Jamil Said Sonak D. Pastakia Dan N. Tran Jael Adongo Onyango Dan Aburi Marta Wilson-Barthes Omar Galárraga Becky Lynn Genberg Integrating community-based HIV and non-communicable disease care with microfinance groups: a feasibility study in Western Kenya Pilot and Feasibility Studies Differentiated care Human immunodeficiency viruses (HIV) Non-communicable diseases Community-based care Microfinance Feasibility study |
| title | Integrating community-based HIV and non-communicable disease care with microfinance groups: a feasibility study in Western Kenya |
| title_full | Integrating community-based HIV and non-communicable disease care with microfinance groups: a feasibility study in Western Kenya |
| title_fullStr | Integrating community-based HIV and non-communicable disease care with microfinance groups: a feasibility study in Western Kenya |
| title_full_unstemmed | Integrating community-based HIV and non-communicable disease care with microfinance groups: a feasibility study in Western Kenya |
| title_short | Integrating community-based HIV and non-communicable disease care with microfinance groups: a feasibility study in Western Kenya |
| title_sort | integrating community based hiv and non communicable disease care with microfinance groups a feasibility study in western kenya |
| topic | Differentiated care Human immunodeficiency viruses (HIV) Non-communicable diseases Community-based care Microfinance Feasibility study |
| url | https://doi.org/10.1186/s40814-022-01218-6 |
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