{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T21:34:08Z","timestamp":1764884048833,"version":"3.46.0"},"reference-count":35,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"unspecified","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Institutes of Health, National Institute of Child Health and Human Development","award":["R01HD103512"],"award-info":[{"award-number":["R01HD103512"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,22]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There is a pressing need for effective interventions that can support healthcare workers and caregivers in the challenging yet crucial task of disclosing the HIV status to infected children and adolescents. Previously, we developed and tested a successful disclosure intervention called Sankofa in Ghana. In an ongoing 5-year follow-up study, Sankofa 2, we aim to build on the successful Sankofa trial by testing the intervention on a larger scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This study is a pragmatic, stepped-wedge cluster randomised trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>It is being conducted in 12 HIV paediatric clinics in Ghana to examine the effectiveness, health benefits, cost and implementation of the Sankofa intervention. Caregiver\u2013child dyads (n=700) will be enrolled. Evaluation of effectiveness, health benefits, cost and implementation of the Paediatric HIV disclosure intervention, Sankofa 2, is posed to offer valuable insights for scale-up and sustainability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical clearance has been obtained from the Ghana Health Service Ethics Review Committee, the University of Ghana Ethical and Protocol Review Committee, the Committee on Human Research Publication and Ethics of the Kwame Nkrumah University of Science and Technology, the Johns Hopkins Medicine Institutional Review Board and the Yale School of Medicine Human Investigation Committee. The clinical trial was registered on ClinicalTrials.gov on 5 March 2021. All caregiver participants are required to provide written informed consent and the children assent before enrolment. If either the child or caregiver says no to the study, the dyad is not eligible for the study. No study-related procedures are performed until consent is obtained. The results of the trial will be added on ClinicalTrials.gov, published in peer-reviewed journals and presented at international conferences.<\/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=\"NCT04791865\">NCT04791865<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-099681","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T06:25:18Z","timestamp":1763101518000},"page":"e099681","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Scale-up of a paediatric HIV disclosure intervention in Ghana using a stepped wedge cluster randomised trial design: Sankofa 2 protocol and implementation"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct04791865","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5023-1953","authenticated-orcid":false,"given":"Nancy R","family":"Reynolds","sequence":"first","affiliation":[{"name":"Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronika","family":"Shabanova","sequence":"additional","affiliation":[{"name":"Yale University, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorna","family":"Renner","sequence":"additional","affiliation":[{"name":"University of Ghana, Accra, Greater Accra Region, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sampson","family":"Antwi","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti Region, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Ayisi Addo","sequence":"additional","affiliation":[{"name":"Ghana Health Service, Accra, Greater Accra Region, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony K","family":"Enimil","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti Region, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Lartey","sequence":"additional","affiliation":[{"name":"University of Ghana, Accra, Greater Accra Region, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geliang","family":"Gan","sequence":"additional","affiliation":[{"name":"Yale University, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Parziale","sequence":"additional","affiliation":[{"name":"Yale University, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kofi","family":"Aikins Amissah","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti Region, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas T","family":"Kusah","sequence":"additional","affiliation":[{"name":"University of Ghana, Accra, Greater Accra Region, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela L","family":"Ofori-Atta","sequence":"additional","affiliation":[{"name":"University of Ghana, Accra, Greater Accra Region, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Slade","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Agyarko-Poku","sequence":"additional","affiliation":[{"name":"Ghana Health Service, Accra, Greater Accra Region, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elijah","family":"Paintsil","sequence":"additional","affiliation":[{"name":"Yale University, New Haven, Connecticut, USA"},{"name":"University of Ghana, Accra, Greater Accra Region, Ghana"},{"name":"Boston Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"2025120413272193000_15.11.e099681.1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.103.1.164"},{"key":"2025120413272193000_15.11.e099681.2","unstructured":"Guideline on hiv disclosure counseling for children up to 12 years of age. 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