Barriers targeted | COM-B Domain | Intervention function | Behavior change technique (BCT) | Mode of delivery |
---|---|---|---|---|
Component 1: Health education, medication adherence, and lifestyle counseling | ||||
 Patient lack of knowledge of HTN risk, complications and self-management | Psychological capability | Education | Information about health consequences of HTN | Health education by HTN/HIV peer educators |
 Healthcare providers and patients lack knowledge of HTN-HIV drug interactions | Psychological capability | Education | Information about health consequences of HTN | Health education by nurse and dispenser |
 Patients prioritize adherence to ART over HTN medications | Reflective motivation | Persuasion | Information about health consequences of HTN | Adherence counseling for both anti-hypertensives and ART by nurse |
Component 2: Routine HTN screening during each clinic visit | ||||
 Inadequate supply of automated BP machines | Physical opportunity | Environmental restructuring | Adding objects to the environment | Provide 2 automated BP machines to HIV clinic |
Component 3: Task shifting of HTN screening and treatment | ||||
 HTN/HIV peer educators’ skills to measure BP | Physical capability | Training | Demonstration of the behavior | Nurses to mentor HTN/HIV peer educators to measure BP |
 HTN prescriptions are mainly done by doctors; limited task shifting to clinical officers and nurses | Social opportunity | Modeling | Demonstration of the behavior | Train nurses on HTN treatment through CME and mentoring |
Component 4: Evidence based HTN treatment protocol | ||||
 Lack of simple evidence-based treatment protocol for HTN | Physical opportunity | Enablement | Social support | Provide stepwise evidence-based treatment protocol to all clinical rooms |
Component 5: Consistent supply of HTN medicines free to patients | ||||
 Lack of on-site HTN medications  despite demand from  patients and providers | Physical opportunity | Enablement | Social support | Pharmacy assistant to make timely orders of protocol anti-hypertensive medicines |
 Cost of buying anti-hypertensive medicines is high; patients can’t afford | Physical opportunity | Enablement | Social support | Provide anti-hypertensive medicines to patients at no cost |
Component 6: Inclusion of HTN-specific monitoring and evaluation tools | ||||
 Lack of monitoring indicators for HTN | Psychological capability | Enablement | Goal setting | Apply WHO HTN monitoring indicators and mentor providers on them |
 Lack of performance targets and review of HTN care quality | Automatic motivation | Persuasion | Feedback on behavior | Develop and share quarterly targets with providers. Monthly performance review meetings |
 Lack of data collection tools and data bases for HTN care | Physical opportunity | Enablement | Social support | Integrate HTN data elements into HIV data collection tools and EMR. Print and avail HTN register and patient treatment cards |