Exploring barriers and facilitators to integrated hypertension-HIV management in Ugandan HIV clinics using the Consolidated Framework for Implementation Research (CFIR)

Muddu, Martin; Tusubira, Andrew K.; Nakirya, Brenda; Nalwoga, Rita; Semitala, Fred C.; Akiteng, Ann R.; Schwartz, Jeremy I.; Ssinabulya, Isaac

doi:10.1186/s43058-020-00033-5

Implementation Science Communications

Table 4 Significant CFIR constructs and their related barriers or facilitators for integrated HTN/HIV care

From: Exploring barriers and facilitators to integrated hypertension-HIV management in Ugandan HIV clinics using the Consolidated Framework for Implementation Research (CFIR)

CFIR Domain	CFIR Construct	Barrier or facilitator	Explanation of facilitators and barriers
Intervention characteristics	Relative advantage	Facilitator	Integrated HTN/HIV care saves time and costs on patient transport and improves patient retention. Patients receive both HTN and HIV care in the same clinic on the same appointment date.
	Adaptability	Facilitator	HTN/HIV integration fits within routine care in HIV clinics. HTN services can be tailored and refined to meet health needs of PLHIV.
	Complexity	Facilitator	Healthcare providers perceived provision of HTN care services in HIV clinics as straight forward and not complex.
Inner setting	Implementation climate
	Compatibility	Facilitator	HTN/HIV integration was compatible and would fit within the existing workflows at the HIV clinics.
	Organizational incentives and rewards	Barrier	Lack of functional BP machines and medicines for HTN treatment in HIV clinics hinder HTN/HIV integration.
	Readiness for implementation
	Available Resources	Barrier	Lack of functional BP machines, inadequate medicines to treat HTN, and extra work load to limited healthcare providers arising from offering HTN services hinder HTN service provision in HIV clinics.
	Access to knowledge and information	Barrier	Many PLHIV are not aware of HTN services at HIV clinics, hence low demand. Lack of training and continuing medical education for healthcare providers on HTN care hinders HTN/HIV integration.
Characteristics of individuals	Knowledge and beliefs about the intervention	Barrier	Some healthcare providers lacked knowledge and skills to screen and treat HTN in the HIV clinics.
Characteristics of individuals	Self-efficacy	Barrier	Some healthcare providers lacked confidence in their own ability to screen and prescribe medicines for HTN in HIV clinics.
Process of implementation	Planning	Barrier	Inadequacies in preparation and planning for integrated HTN/HIV care: healthcare provider and patient orientation to integrated HTN/HIV care were generally suboptimal.

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ISSN: 2662-2211

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