{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:59:25Z","timestamp":1791237565949,"version":"4.1.0"},"reference-count":27,"publisher":"Ubiquity Press, Ltd.","issue":"1","license":[{"start":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T00:00:00Z","timestamp":1701043200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"crossref","award":["R01HL144708"],"award-info":[{"award-number":["R01HL144708"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["gh"],"abstract":"<jats:p>Background: The Extension for Community Health Outcomes (ECHO) model has been used extensively to link care providers in rural communities with experts with the aim of improving local patient care. Objective: The aim of this qualitative research study was to assess the feasibility, acceptability, perceived needs, and contextual factors to guide implementation of a hypertension focused ECHO program for Community Health Extension Workers (CHEWs) in the Federal Capital Territory, Nigeria. Methods: From September 2020 to December 2020, key informant interviews were performed with seven global organizations (hubs) providing ECHO training focused on cardiovascular disease or nephrology to identify contextual factors and implementation strategies used by each hub. In February 2022, seven focus group discussions were performed with 42 frontline healthcare workers in the Federal Capital Territory to inform local adaptation of a hypertension ECHO program. Directed content analysis identified major themes which were mapped to the Consolidated Framework for Implementation Research. Qualitative analyses were performed using Dedoose, and results were synthesized using the Implementation Research Logic Model. Results: We found both barriers and facilitators across the Consolidated Framework for Implementation Research domains that mapped to a number of constructs in each one. The results of these analyses confirmed that the core components of the ECHO model are a feasible and appropriate intervention for hypertension education of healthcare workers. However, implementing the ECHO program within the Federal Capital Territory may require strategies such as utilizing communications resources effectively, developing incentives to motivate initial participation, and providing rewards or recognition for ongoing engagement. Conclusions: These results provide valuable formative insights to guide implementation of our proposed hypertension ECHO program for CHEWs in the Federal Capital Territory, Nigeria. This information was used for key decisions around: 1) scope and content of training, 2) format and frequency, 3) selection of implementation strategies, and 4) building a community of practice.<\/jats:p>","DOI":"10.5334\/gh.1277","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T06:34:51Z","timestamp":1701066891000},"page":"64","source":"Crossref","is-referenced-by-count":8,"title":["Formative Evaluation and Adaptation of a Hypertension Extension for Community Health Outcomes Program for Healthcare Workers within the Federal Capital Territory, Nigeria"],"prefix":"10.5334","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1573-0554","authenticated-orcid":false,"given":"Abigail S.","family":"Baldridge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Goldstar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2364-3669","authenticated-orcid":false,"given":"Grace C.","family":"Bellinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail T.","family":"DeNoma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5028-5428","authenticated-orcid":false,"given":"Ikechukwu A.","family":"Orji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2295-908X","authenticated-orcid":false,"given":"Gabriel L.","family":"Shedul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9531-8227","authenticated-orcid":false,"given":"Rosemary C. B.","family":"Okoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7737-900X","authenticated-orcid":false,"given":"Nanna R.","family":"Ripiye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adaora","family":"Odukwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olabisi","family":"Dabiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Nneka","family":"Mobisson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2084-1988","authenticated-orcid":false,"given":"Dike B.","family":"Ojji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7412-2519","authenticated-orcid":false,"given":"Mark D.","family":"Huffman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2570-3426","authenticated-orcid":false,"given":"Namratha R.","family":"Kandula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4355-7437","authenticated-orcid":false,"given":"Lisa R.","family":"Hirschhorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3285","published-online":{"date-parts":[[2023,11,27]]},"reference":[{"issue":"9\u20130","key":"key20231127063426_B1","first-page":"344","article-title":"Prevalence and risk factors for hypertension and association with ethnicity in Nigeria: Results from a national survey","volume":"24","year":"2013","journal-title":"Cardiovasc J Afr"},{"issue":"2","key":"key20231127063426_B2","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1097\/HJH.0000000000000413","article-title":"An estimate of the prevalence of hypertension in Nigeria: a systematic review and meta-analysis","volume":"33","year":"2015","journal-title":"J Hypertens"},{"issue":"7","key":"key20231127063426_B3","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1001\/jama.2013.108769","article-title":"Improved blood pressure control associated with a large-scale hypertension program","volume":"310","year":"2013","journal-title":"JAMA"},{"issue":"4","key":"key20231127063426_B4","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1111\/jch.12803","article-title":"The Kaiser permanente northern California Story: Improving hypertension control from 44% to 90% in 13 Years (2000 to 2013)","volume":"18","year":"2016","journal-title":"J Clin Hypertens (Greenwich)"},{"issue":"1","key":"key20231127063426_B5","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1186\/s43058-022-00328-9","article-title":"Hypertension Treatment in Nigeria (HTN) Program: Rationale and design for a type 2 hybrid, effectiveness, and implementation interrupted time series trial","volume":"3","year":"2022","journal-title":"Implement Sci Commun"},{"key":"key20231127063426_B6","unstructured":"Center for Disease Control and Prevention. Hypertension Management Training Curriculum. 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