{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:56:44Z","timestamp":1790571404654,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["71804004"],"award-info":[{"award-number":["71804004"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Care Science"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Gaps in primary care (PC) restrict its potential as a core foundation of the health system in its response to the growing burden of cardiovascular disease (CVD). China has been promoting County\u2010wide Tight Medical Alliances to strengthen PC by integrating services from hospitals and PC providers. However, a practical model of care for effective CVD risk management is still lacking. We developed a multifaceted intervention, namely the Cardiovascular\u2010Risk\u2010Stratified Integrated Management model, to strengthen PC for CVD risk management by leveraging both PC providers and hospital\u2010based specialists in the County\u2010wide Tight Medical Alliances. The purpose of this study is to evaluate the effectiveness of the Cardiovascular\u2010Risk\u2010Stratified Integrated Management model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study is a multicenter, cluster\u2010randomized controlled trial conducted with a total of 2560 patients with diagnosed hypertension and\/or diabetes, aged 41\u201370 years, served by 64 family doctor teams in three county\u2010wide tight medical alliances. The primary outcome is the change in 10\u2010year CVD risk score from baseline to 12 months after intervention, using the World Health Organization CVD risk laboratory\u2010based chart for East Asians. Secondary outcomes include 12\u2010month and 6\u2010month changes in CVD risk factors, and incidence rate of major adverse cardiovascular events, and so forth. All participants will receive outcome measurements at baseline, 6, and 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study pioneers a PC\u2010based integration of individualized CVD risk management with economic incentives, evaluating its effects on resource allocation and preventive outcomes to inform scalable models in low\u2010 and middle\u2010income countries. The study findings will be disseminated through multiple channels, including a final report, publications in peer\u2010reviewed journals, and evidence\u2010based recommendations tailored to healthcare providers, health service commissioners, and policymakers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      Clinical Trials ID: NCT06302127. Date of registration: March 8, 2025. Prospectively registered. URL of Trial Registry Record:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT06302127\">https:\/\/clinicaltrials.gov\/study\/NCT06302127<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hcs2.70105","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:36:56Z","timestamp":1790570216000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of a Primary\u2010Care\u2010Centered Integrated Care Intervention for Stratified Cardiovascular Risk Control in China: Study Protocol for a Pragmatic Cluster Randomized Controlled Trial"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5214-8828","authenticated-orcid":false,"given":"Weijia","family":"Lu","sequence":"first","affiliation":[{"name":"School of Public Health Peking University Beijing China"},{"name":"China Center of Health Development Studies Peking University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxin","family":"Xia","sequence":"additional","affiliation":[{"name":"China Center of Health Development Studies Peking University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziming","family":"Wang","sequence":"additional","affiliation":[{"name":"China Center of Health Development Studies Peking University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaoyun","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health Peking University Beijing China"},{"name":"China Center of Health Development Studies Peking University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiting","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Public Health Peking University Beijing China"},{"name":"China Center of Health Development Studies Peking University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuxiang","family":"Xie","sequence":"additional","affiliation":[{"name":"Peking University Clinical Research Institute Peking University First Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6364-0887","authenticated-orcid":false,"given":"Jin","family":"Xu","sequence":"additional","affiliation":[{"name":"China Center of Health Development Studies Peking University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.11.007"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/cm9.0000000000002927"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048004020949326"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l2358"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czad058"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-017-0593-z"},{"key":"e_1_2_11_8_1","unstructured":"The State Council of the People's Republic of China \u201cOpinions of the State Council on Implementing the Health China Action\u201d [in Chinese] The State Council of the People's Republic of China published June 24 2019 https:\/\/www.gov.cn\/zhengce\/content\/2019-07\/15\/content_5409492.htm."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00428-4"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn112138-20220509-00350"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-071952"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000133427.35111.67"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006887.pub4"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2012.1350"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fmre.2021.08.008"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd007899.pub2"},{"key":"e_1_2_11_17_1","unstructured":"World Bank Data Team \u201cNew Country Classifications by Income Level: 2017\u20102018 \u201dWorld Bank Blogs published July 1 2017 https:\/\/blogs.worldbank.org\/en\/opendata\/new-country-classifications-income-level-2017-2018."},{"key":"e_1_2_11_18_1","unstructured":"\u201cHealthy China: Deepening Health Reform in China: Building High\u2010Quality and Value\u2010Based Service Delivery (English) \u201dWorld Bank Group published March 28 2019 https:\/\/documents.worldbank.org\/en\/publication\/documents-reports\/documentdetail\/690791553844042874."},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32136-1"},{"key":"e_1_2_11_20_1","unstructured":"\u201cNotice of Issuance of the Guiding Opinions on Promoting Contracted Services Provided by Family Doctors\u201d [in Chinese] National Health Commission of the People's Republic of China published June 6 2016 https:\/\/www.nhc.gov.cn\/tigs\/c100053\/201606\/a2f65c166d5b438f8abb684d3a8c13d0.shtml."},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.3587"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15112378"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmx137"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-032444"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114284"},{"key":"e_1_2_11_27_1","unstructured":"World Health Organization \u201cHEARTS: Technical Package for Cardiovascular Disease Management in Primary Health Care: Risk\u2010Based CVD Management \u201dWorld Health Organization published July 13 2020 https:\/\/www.who.int\/publications\/i\/item\/9789240001367."},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2021.100096"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31949-X"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2016.08.594"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/16094069251337938"}],"container-title":["Health Care Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hcs2.70105","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hcs2.70105","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hcs2.70105","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:37:09Z","timestamp":1790570229000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hcs2.70105"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,27]]},"references-count":30,"alternative-id":["10.1002\/hcs2.70105"],"URL":"https:\/\/doi.org\/10.1002\/hcs2.70105","archive":["Portico"],"relation":{},"ISSN":["2771-1749","2771-1757"],"issn-type":[{"value":"2771-1749","type":"print"},{"value":"2771-1757","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,27]]},"assertion":[{"value":"2025-08-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hcs2.70105"}}