LeveRaging Community Engagement to SusTAIN NCD InTegrated Care Models (RETAIN-IT)

PROJECT SUMMARY The increased life expectancy of people living with HIV/AIDS (PLWH) and the associated burden of non- communicable diseases (NCDs) in PLWH has prompted an urgent need for effective community engaged strategies that engage care PLWH with comorbid NCDs in clinical treatment. Current integrated models of care

lack a focus on community engagement as a strategy to refer impacted individuals to clinical treatment – an integral aspect of translating evidence-based practices (EBPs) in LMICs. More specifically, despite the use of community clinical linkages as an effective strategy to link impacted individuals to clinical treatment for complex

health conditions (such as opioid use disorder and emerging infections like the COVID-19 pandemic), its use for NCD prevention among PLWH and comorbid hypertension in low- and middle-income countries (LMICs) is suboptimal. In order to sustain the public health gains made in the treatment of HIV, community clinical linkages

must be prioritized as a key component of HIV/NCD integrated care models in LMICs. Guided by the Community- Based System Dynamics (CBSD) and Human-Centered Design (participatory approaches that involve participants in developing solutions to complex system challenges), this K01, “LeveRaging Community

Engagement to SusTAIN NCD InTegrated Care Models (RETAIN-IT)”, leverages the infrastructure of a community-based organization (Network of People Living with HIV in Nigeria (NEPWHAN)) to co-develop a community-clinical linkage (CCL) model that will facilitate the referral of PLWH to primary healthcare centers for

hypertension treatment. The research aims of this proposal are to: 1) identify and map the multi-level barriers and facilitators of developing a community-clinical linkage model for care of PLWH and comorbid hypertension in Akwa Ibom, Nigeria; 2) co-develop with NEPWHAN, a culturally tailored, community led strategy for linking

PLWH with comorbid hypertension to primary health centers for management of hypertension; and 3) assess the acceptability, appropriateness, and feasibility of the community-led strategy using a pre-post pilot study design. To accomplish these research aims and prepare for a larger study, the applicant will receive training in:

1) systems science theory and methods, including community-based system dynamics; 2) partnership building with community partners; and 3) in using community clinical linkage models as an implementation strategy for advancing evidence-based practices for integrated models of care in PLWH and comorbid NCDs under the

direction of Drs. Gbenga Ogedegbe, Antoinette Schoenthaler, Nadia Islam, Brita Roy, and Dike Ojji. Findings from the proposed research will advance research on the role of community clinical linkages in sustaining integrated NCD models of care in LMICs and directly aligns with NHLBI’s strategic goal to advance translational

research by facilitating innovation and accelerating research translation.