{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:32:48Z","timestamp":1789421568873,"version":"build-2803163510"},"reference-count":61,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T00:00:00Z","timestamp":1729209600000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Edwards Life Sciences"},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"crossref","award":["GNT1194707"],"award-info":[{"award-number":["GNT1194707"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Australian Medical Research Futures Fund Cardiovascular Health Mission","award":["GNT2015869"],"award-info":[{"award-number":["GNT2015869"]}]},{"name":"Rotary Club of Kiama"},{"name":"Medtronic Australasia"},{"name":"Rhodes Trust"},{"name":"Wellcome Senior Fellowship","award":["207522"],"award-info":[{"award-number":["207522"]}]},{"name":"Humpty Dumpty Foundation"},{"name":"NHMRC PhD Scholarship","award":["GNT2005316"],"award-info":[{"award-number":["GNT2005316"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,9,16]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Rheumatic heart disease (RHD) is underdiagnosed globally resulting in missed treatment opportunities and adverse clinical outcomes. We describe the protocol for a study which aims to co-design, implement and conduct an evaluation of a task-sharing approach to echocardiographic active case finding for early detection and management of RHD in high-risk settings in Australia and Timor-Leste.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>Echocardiograms will be obtained by trained local staff using hand-held echocardiographic devices employing the \u2018Single Parasternal Long Axis view with a Sweep of the Heart\u2019 (SPLASH) technique and interpreted by experts remote from the site of acquisition. Approximately 1500 children and pregnant women will be screened across high-risk communities in Australia and Timor-Leste over an 18-month period. The study will use a type II effectiveness-implementation hybrid design. A tailored package of implementation strategies will be co-designed with communities and health services and mapped onto a Theory of Change framework. The clinical effectiveness will be assessed as the change in the proportion of the target population that are prescribed secondary prophylaxis for RHD by the end of the study compared with baseline. The implementation will be assessed as the adoption, penetration, sustainability, fidelity and cost of the programme with a mixed-methods theory-based and economic evaluation. Data will include numbers of normal, abnormal and uninterpretable SPLASH echocardiograms obtained, numbers of participants progressing through the cascade of care, interviews with staff and programme costs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>Ethical approval has been obtained from the Human Research Ethics Committee of the NT Department of Health and Menzies School of Health Research, Darwin (HREC-2022-4479), the Western Australian Aboriginal Health Ethics Committee (HREC-1237) and the Instituto Nasional Saude Publika Timor-Leste Ethics and Technical Committee (03-UEPD\/INSP-TL\/V\/2023). Informed consent is required to be enrolled. Study findings will be disseminated in the communities involved and submitted for publication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06002243\">NCT06002243<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-083467","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T14:00:55Z","timestamp":1729260055000},"page":"e083467","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["NEARER SCAN (LENO BESIK) evaluation of a task-sharing echocardiographic active case finding programme for rheumatic heart disease in Australia and Timor-Leste: protocol for a hybrid type II effectiveness-implementation study"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct06002243","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8035-3150","authenticated-orcid":false,"given":"Benjamin","family":"Jones","sequence":"first","affiliation":[{"name":"Health Systems Collaborative, Nuffield Department of Medicine, University of Oxford, Oxford, UK"},{"name":"Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Marangou","sequence":"additional","affiliation":[{"name":"Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Yan","sequence":"additional","affiliation":[{"name":"Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, 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