Effects of Evidence-based Interventions Based on WHO PEN for People Living With HIV and Cardio-metabolic Conditions in Lusaka, Zambia: A Hybrid Effectiveness-Implementation Stepped Wedge Trial
Led by University of North Carolina, Chapel Hill · Updated on 2025-08-24
5620
Participants Needed
12
Research Sites
N/A
Total Duration
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U
University of North Carolina, Chapel Hill
Lead Sponsor
N
National Heart, Lung, and Blood Institute (NHLBI)
Collaborating Sponsor
AI-Summary
What this Trial Is About
Researchers are evaluating the effects of a multi-level intervention called TASKPEN, adapted from the World Health Organization's Package of Essential Noncommunicable Disease Interventions (WHO-PEN), on clinical and implementation outcomes in people living with HIV (PLHIV) who also have cardio-metabolic conditions in Lusaka, Zambia. This hybrid effectiveness-implementation stepped wedge trial aims to assess control of both HIV and cardio-metabolic diseases, intervention reach, and quality of life improvements among the participants.
The TASKPEN intervention includes five evidence-based components: integrated HIV and non-communicable disease care in a single service point, adapted WHO PEN protocols and training materials, access to cardio-metabolic screening and laboratory monitoring, an electronic medical record module focused on non-communicable diseases, and a strengthened supply chain for related medications. The trial involves 12 health facilities transitioning sequentially from standard care to the TASKPEN intervention in randomized clusters over several months.
Participants will complete bio-behavioral surveys at baseline and at multiple follow-up points, totaling about 5,100 participants across all sites. A nested cohort of approximately 320 participants with cardio-metabolic conditions will be followed longitudinally for detailed clinical outcomes. Researchers will monitor HIV viral suppression, blood pressure, glucose levels, cardiovascular risk scores, medication adherence, and quality of life over up to 24 months, alongside implementation outcomes and factors influencing the intervention's success.
CONDITIONS
Brief Title
Effects of a Package of Evidence-based Interventions and Implementation Strategies Based on WHO PEN for People Living With HIV and Cardio-metabolic Conditions in Lusaka, Zambia
Who Can Participate
Age: 18Years +
All Genders
Eligibility Criteria
You may qualify if you...
Adults aged 18 years or older
HIV-infected individuals seeking HIV services at study sites
Participants must provide written informed consent
For nested cohort: presence of one or more cardio-metabolic conditions or risk factors such as tobacco use, hypertension, diabetes, prediabetes, or dyslipidemia
In-depth interview participants must be HIV-positive adults aged 18 or older who have received HIV and/or NCD services at TASKPEN sites
Focus group participants must be 18 or older and healthcare workers involved with TASKPEN or HIV/NCD services
Key informant interview participants must be 18 or older facility or policy leaders familiar with HIV/NCD issues
Implementation questionnaire participants must be HIV-positive adults exposed to TASKPEN or healthcare providers/managers familiar with TASKPEN
Costing study participants must be HIV-positive adults who received services at TASKPEN sites or healthcare providers/managers familiar with HIV/NCD issues
You will not qualify if you...
Previous participation in a study survey
Individuals seeking one-time services or planning to transfer HIV care to another site
Unwilling or unable to provide written informed consent
Adults without documented HIV infection or without cardio-metabolic conditions or risk factors
In-depth interview participants without evidence of HIV/NCD services received during the study period
Implementation questionnaire participants not exposed or familiar with TASKPEN
Potential IDI, FGD, or KII participants unwilling or unable to provide written informed consent
People planning to transfer HIV care to another site
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Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Baseline Survey
Duration - Short period before intervention introduction
Participants complete a baseline bio-behavioral survey to collect initial health data before introduction of the TASKPEN intervention.
1 visit (in-person)
Intervention Implementation
Duration - Varies by site; at least 6 months after crossover
Participants receive the TASKPEN package, an integrated HIV and cardio-metabolic non-communicable disease care approach adapted for Zambia.
Visits depend on routine care schedules and intervention delivery
Sequential Cross-over Surveys
Duration - Repeated every 6 months up to 24 months
Participants complete follow-up surveys at 6-month intervals to assess health outcomes and intervention effects. Different clusters cross over to the intervention sequentially after each survey.
1 survey visit every 6 months, total up to 5 surveys
Nested Cohort Longitudinal Follow-up
Duration - Up to 24 months
A subgroup of participants with cardio-metabolic conditions are followed longitudinally to monitor detailed clinical outcomes over time.
Regular follow-up visits according to cohort protocol
Evaluating a multifaceted implementation strategy and package of evidence-based interventions based on WHO PEN for people living with HIV and cardiometabolic conditions in Lusaka, Zambia: protocol for the TASKPEN hybrid effectiveness-implementation stepped wedge cluster randomized trial.
Michael E Herce, Samuel Bosomprah, Felix Masiye...