COM-B domain | Barriers | Facilitators |
---|---|---|
Psychological capability | Patient lack of knowledge of HTN risk, complications, HTN-HIV drug interactions, and self-management | Healthcare providers have adequate knowledge of HTN screening |
Healthcare providers lack knowledge of treating HTN and HTN-HIV drug interactions | Healthcare providers and patients can leverage ART adherence support which is already being provided to PLHIV to provide adherence support for both HTN and HIV treatment | |
Lack of monitoring indicators for HTN | ||
Physical capability | There were no barriers in this domain | HTN/HIV peer educators and healthcare providers have adequate skills to screen for HTN among PLHIV |
Measuring BP is easy for most of the healthcare providers including HIV peer educators | ||
Physical opportunity | Lack of simple evidence-based treatment protocol for HTN care | Availability of BP machines and staff to measure and record blood pressure |
Lack of on-site HTN medications despite demand from patients and providers | ||
Cost of buying anti-hypertensive medicines is high; patients cannot afford | ||
Inadequate maintenance of automated BP machines at the HIV clinic | ||
Lack of data collection tools and databases for HTN care | ||
Social opportunity | HTN prescriptions are mainly done by doctors; limited task shifting to clinical officers and nurses | Patients are interested in being supported by PLHIV peer educators to improve adherence to HTN and HIV treatment |
Reflective motivation | Patients prioritize adherence to ART over HTN medications | Patients and healthcare providers have great interest in HTN/HIV integrated care |
Automatic motivation | Lack of performance targets and review of HTN care quality | There were no facilitators in this domain |