Scaling Out and Scaling Up the Systems Analysis and Improvement Approach to Optimize the Hypertension Diagnosis and Care Cascade for HIV-infected Individuals (SCALE SAIA-HTN)

The overall objective of our UG3/UH3 (SCALE SAIA-HTN) is to establish a robust evidence base on the effectiveness of a multi-component implementation strategy (SAIA) on the HTN/HIV cascade using a ‘scaling-out’ framework, whereby strength can be ‘borrowed’ from prior effectiveness trials. SCALE SAIA-HTN will be ‘scaled out’ through a novel modality delivered by district health supervisors (rather than study nurses). We will also ‘scale up’ SAIA-HTN by expanding to all districts in two additional provinces (15 districts), serving as a foundation for national scale-up. We propose three aims for the UG3 (Planning) and two for UH3 (Implementation) phases.