{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:00:59Z","timestamp":1790359259282,"version":"4.1.0"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["#K23-HL155500"],"award-info":[{"award-number":["#K23-HL155500"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute myocardial infarction (AMI) is an increasing cause of morbidity and mortality in Sub-Saharan Africa (SSA) but is often underdiagnosed and undertreated. To address this gap, the Multicomponent Intervention to Improve Myocardial Infarction Care (MIMIC) was developed and implemented to improve evidence-based AMI care. The aim of this study was to explore stakeholder perceptions of the acceptability of MIMIC following its implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative study involved in-depth interviews with 20 key stakeholders (physicians, nurses, administrators, and patients diagnosed with AMI) who participated in MIMIC during the first year of implementation in the emergency department (ED) of a regional referral center in northern Tanzania. Purposive sampling was used to recruit diverse participants. Interviews were guided by a semi-structured interview guide informed by the Theoretical Framework of Acceptability (TFA). Interview transcripts were thematically analyzed by a team of coders using an inductive, grounded theory approach guided by the seven TFA domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nineteen major themes emerged across all TFA domains. Overall, participants described MIMIC as acceptable, minimally burdensome, and well-aligned with professional and ethical values. Perceived effectiveness was most emphasized, with staff citing improvements in AMI recognition, electrocardiogram (ECG) and troponin testing, and use of evidence-based therapies. Most components were described as effective and easily integrated into existing workflows. Patients valued the educational pamphlet for improving knowledge and self-efficacy, though staff expressed concerns about distributing it during acute care, contributing to inconsistent delivery. Champions were viewed as key in promoting adherence and sustaining implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MIMIC was found to be acceptable in all seven TFA domains among ED providers and patients, with perceived effectiveness driving positive attitudes across stakeholder groups. MIMIC\u2019s co-design approach likely contributed to high intervention acceptability. Patient education strategies may require adaptation to improve fidelity. These findings support continued implementation and targeted adaptation of MIMIC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0357564","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:30:31Z","timestamp":1790357431000},"page":"e0357564","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stakeholder perceptions of the acceptability of an intervention to improve uptake of evidence-based emergency myocardial infarction care in Tanzania: A qualitative study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2088-3862","authenticated-orcid":true,"given":"Spencer F.","family":"Sumner","sequence":"first","affiliation":[{"name":"Duke University School of Medicine","place":["Durham, North Carolina, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis M.","family":"Sakita","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre","place":["Moshi, Tanzania"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin F.","family":"Haukila","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre","place":["Moshi, Tanzania"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Wanda","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre","place":["Moshi, Tanzania"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godfrey L.","family":"Kweka","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre","place":["Moshi, Tanzania"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome J.","family":"Mlangi","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre","place":["Moshi, Tanzania"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankrasi","family":"Shayo","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre","place":["Moshi, Tanzania"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tumsifu G.","family":"Tarimo","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre","place":["Moshi, Tanzania"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4917-0995","authenticated-orcid":true,"given":"Simran","family":"Khanna","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine","place":["Durham, North Carolina, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6543-9768","authenticated-orcid":true,"given":"Claire","family":"Wang","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine","place":["Durham, North Carolina, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Pyne","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine","place":["Durham, North Carolina, United States of 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