Study protocol for the SMART2D adaptive implementation trial: a cluster randomised trial comparing facility-only care with integrated facility and community care to improve type 2 diabetes outcomes in Uganda, South Africa and Sweden

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dc.contributor.authorGuwatudde, David
dc.contributor.authorAbsetz, Pilvikki
dc.contributor.authorDelobelle, Peter
dc.contributor.authorÖstenson, Claes-Göran
dc.contributor.authorOlmen Van, Josefien
dc.contributor.authorMolsted Alvesson, Helle
dc.contributor.authorMayega, Roy William
dc.contributor.authorEkirapa Kiracho, Elizabeth
dc.contributor.authorKiguli, Juliet
dc.contributor.authorSundberg, Carl Johan
dc.contributor.authorSanders, David
dc.contributor.authorTomson, Göran
dc.contributor.authorPuoane, Thandi
dc.contributor.authorPeterson, Stefan
dc.contributor.authorDaivadanam, Meena
dc.date.accessioned2022-04-30T08:57:45Z
dc.date.available2022-04-30T08:57:45Z
dc.date.issued2018
dc.description.abstractType 2 diabetes (T2D) is increasingly contributing to the global burden of disease. Health systems in most parts of the world are struggling to diagnose and manage T2D, especially in low-income and middle-income countries, and among disadvantaged populations in high-income countries. The aim of this study is to determine the added benefit of community interventions onto health facility interventions, towards glycaemic control among persons with diabetes, and towards reduction in plasma glucose among persons with prediabetes. Methods and analysis An adaptive implementation cluster randomised trial is being implemented in two rural districts in Uganda with three clusters per study arm, in an urban township in South Africa with one cluster per study arm, and in socially disadvantaged suburbs in Stockholm, Sweden with one cluster per study arm. Clusters are communities within the catchment areas of participating primary healthcare facilities. There are two study arms comprising a facility plus community interventions arm and a facility-only interventions arm. Uganda has a third arm comprising usual care. Intervention strategies focus on organisation of care, linkage between health facility and the community, and strengthening patient role in selfmanagement, community mobilisation and a supportive environment. Among T2D participants, the primary outcome is controlled plasma glucose; whereas among prediabetes participants the primary outcome is reduction in plasma glucose.en_US
dc.identifier.citationGuwatudde D, Absetz P, Delobelle P, et al. Study protocol for the SMART2D adaptive implementation trial: a cluster randomised trial comparing facility-only care with integrated facility and community care to improve type 2 diabetes outcomes in Uganda, South Africa and Sweden. BMJ Open 2018;8:e019981. doi:10.1136/ bmjopen-2017-019981en_US
dc.identifier.other10.1136/ bmjopen-2017-019981
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/3035
dc.language.isoenen_US
dc.publisherBMJ Openen_US
dc.subjectSMART2Den_US
dc.subjectCommunity careen_US
dc.subjectDiabetes outcomesen_US
dc.subjectUgandaen_US
dc.subjectSouth Africaen_US
dc.subjectSwedenen_US
dc.titleStudy protocol for the SMART2D adaptive implementation trial: a cluster randomised trial comparing facility-only care with integrated facility and community care to improve type 2 diabetes outcomes in Uganda, South Africa and Swedenen_US
dc.typeArticleen_US
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