ANDES trial and integration of the HEARTS model in Puno, Peru
Background: HEARTS is the regional strategy led by the Pan American Health Organization to strengthen hypertension and diabetes control in primary health care. This report summarizes formative and process evidence from the ANDES trial in Puno, Peru, and its alignment with HEARTS implementation. Meth...
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2025
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| author | Gonzalo Cuentas Lucy Cordova-Ascona Lisa de las Fuentes Anderson N. Soriano-Moreno Lindsay J. Underhill Kendra N. Williams Zoila Vela-Clavo Carlos Diaz‐Arocutipa Juan Carlos Mendoza Elvin Geng William Checkley Stella M. Hartinger Víctor G. Dávila‐Román |
| author_browse | Anderson N. Soriano-Moreno Carlos Diaz‐Arocutipa Elvin Geng Gonzalo Cuentas Juan Carlos Mendoza Kendra N. Williams Lindsay J. Underhill Lisa de las Fuentes Lucy Cordova-Ascona Stella M. Hartinger Víctor G. Dávila‐Román William Checkley Zoila Vela-Clavo |
| author_facet | Gonzalo Cuentas Lucy Cordova-Ascona Lisa de las Fuentes Anderson N. Soriano-Moreno Lindsay J. Underhill Kendra N. Williams Zoila Vela-Clavo Carlos Diaz‐Arocutipa Juan Carlos Mendoza Elvin Geng William Checkley Stella M. Hartinger Víctor G. Dávila‐Román |
| author_sort | Gonzalo Cuentas |
| collection | Producción científica |
| description | Background: HEARTS is the regional strategy led by the Pan American Health Organization to strengthen hypertension and diabetes control in primary health care. This report summarizes formative and process evidence from the ANDES trial in Puno, Peru, and its alignment with HEARTS implementation. Methods: We assessed 414 health facilities using an adapted World Health Organization Service Availability and Readiness Assessment (SARA-NCD), conducted 55 semi-structured interviews with health professionals, and applied the Hill-Bone adherence scale to 204 hypertensive patients. Results: Facility readiness was 28% for hypertension and 29% for diabetes. Lower-level facilities - posts and basic health centers - showed markedly lower readiness (OR = 0.20 for hypertension; OR = 0.03 for diabetes). Provider interviews identified limited prioritization of hypertension, weak supply chains, and insufficient training. Mean adherence score was 48.3 ± 4.0 (medication 31.6 ± 3.5; appointment-keeping 5.98 ± 1.27; salt reduction 10.67 ± 1.18). Conclusions: Findings reveal major readiness gaps and systemic barriers to hypertension and diabetes management in high-altitude Andean regions. Community health worker-supported interventions such as ANDES can facilitate adoption of HEARTS strategies in resource-limited primary care settings. |
| format | Article |
| id | oai:cris.upeu.edu.pe:20.500.15037/568 |
| institution | UPeU |
| language | English |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| record_format | dspace |
| spelling | oai:cris.upeu.edu.pe:20.500.15037/5682026-10-30T16:14:41ZANDES trial and integration of the HEARTS model in Puno, PeruGonzalo CuentasLucy Cordova-AsconaLisa de las FuentesAnderson N. Soriano-MorenoLindsay J. UnderhillKendra N. WilliamsZoila Vela-ClavoCarlos Diaz‐ArocutipaJuan Carlos MendozaElvin GengWilliam CheckleyStella M. HartingerVíctor G. Dávila‐RománPsychological interventionMedicineGeographyDiabetes mellitusPrimary careHealth careHealthcare systemWork (physics)Primary health careDiseaseEnvironmental healthEconomic growthBusinessCommunity healthGovernment (linguistics)Psychological interventionDiabetes mellitusPrimary careHealth careHealthcare systemWork (physics)Life Sciences Biochemistry, Genetics and Molecular Biology Genetics High Altitude and HypoxiaHealth Sciences Medicine Cardiology and Cardiovascular Medicine Blood Pressure and Hypertension StudiesHealth Sciences Medicine Cardiology and Cardiovascular Medicine Cardiovascular Health and Risk FactorsBackground: HEARTS is the regional strategy led by the Pan American Health Organization to strengthen hypertension and diabetes control in primary health care. This report summarizes formative and process evidence from the ANDES trial in Puno, Peru, and its alignment with HEARTS implementation. Methods: We assessed 414 health facilities using an adapted World Health Organization Service Availability and Readiness Assessment (SARA-NCD), conducted 55 semi-structured interviews with health professionals, and applied the Hill-Bone adherence scale to 204 hypertensive patients. Results: Facility readiness was 28% for hypertension and 29% for diabetes. Lower-level facilities - posts and basic health centers - showed markedly lower readiness (OR = 0.20 for hypertension; OR = 0.03 for diabetes). Provider interviews identified limited prioritization of hypertension, weak supply chains, and insufficient training. Mean adherence score was 48.3 ± 4.0 (medication 31.6 ± 3.5; appointment-keeping 5.98 ± 1.27; salt reduction 10.67 ± 1.18). Conclusions: Findings reveal major readiness gaps and systemic barriers to hypertension and diabetes management in high-altitude Andean regions. Community health worker-supported interventions such as ANDES can facilitate adoption of HEARTS strategies in resource-limited primary care settings.Articlehttps://pubmed.ncbi.nlm.nih.gov/41409883https://doi.org/10.26633/rpsp.2025.12010.26633/rpsp.2025.120https://hdl.handle.net/20.500.15037/568W4417398103enRevista Panamericana de Salud Pública1020-49891680-53482025-12-162026-06-13T08:17:35Z2026-06-13T08:17:35Z |
| spellingShingle | Psychological intervention Medicine Geography Diabetes mellitus Primary care Health care Healthcare system Work (physics) Primary health care Disease Environmental health Economic growth Business Community health Government (linguistics) Psychological intervention Diabetes mellitus Primary care Health care Healthcare system Work (physics) Life Sciences Biochemistry, Genetics and Molecular Biology Genetics High Altitude and Hypoxia Health Sciences Medicine Cardiology and Cardiovascular Medicine Blood Pressure and Hypertension Studies Health Sciences Medicine Cardiology and Cardiovascular Medicine Cardiovascular Health and Risk Factors Gonzalo Cuentas Lucy Cordova-Ascona Lisa de las Fuentes Anderson N. Soriano-Moreno Lindsay J. Underhill Kendra N. Williams Zoila Vela-Clavo Carlos Diaz‐Arocutipa Juan Carlos Mendoza Elvin Geng William Checkley Stella M. Hartinger Víctor G. Dávila‐Román ANDES trial and integration of the HEARTS model in Puno, Peru |
| title | ANDES trial and integration of the HEARTS model in Puno, Peru |
| title_full | ANDES trial and integration of the HEARTS model in Puno, Peru |
| title_fullStr | ANDES trial and integration of the HEARTS model in Puno, Peru |
| title_full_unstemmed | ANDES trial and integration of the HEARTS model in Puno, Peru |
| title_short | ANDES trial and integration of the HEARTS model in Puno, Peru |
| title_sort | andes trial and integration of the hearts model in puno peru |
| topic | Psychological intervention Medicine Geography Diabetes mellitus Primary care Health care Healthcare system Work (physics) Primary health care Disease Environmental health Economic growth Business Community health Government (linguistics) Psychological intervention Diabetes mellitus Primary care Health care Healthcare system Work (physics) Life Sciences Biochemistry, Genetics and Molecular Biology Genetics High Altitude and Hypoxia Health Sciences Medicine Cardiology and Cardiovascular Medicine Blood Pressure and Hypertension Studies Health Sciences Medicine Cardiology and Cardiovascular Medicine Cardiovascular Health and Risk Factors |
| topic_facet | Psychological intervention Medicine Geography Diabetes mellitus Primary care Health care Healthcare system Work (physics) Primary health care Disease Environmental health Economic growth Business Community health Government (linguistics) Psychological intervention Diabetes mellitus Primary care Health care Healthcare system Work (physics) Life Sciences Biochemistry, Genetics and Molecular Biology Genetics High Altitude and Hypoxia Health Sciences Medicine Cardiology and Cardiovascular Medicine Blood Pressure and Hypertension Studies Health Sciences Medicine Cardiology and Cardiovascular Medicine Cardiovascular Health and Risk Factors |
| url | https://pubmed.ncbi.nlm.nih.gov/41409883 https://doi.org/10.26633/rpsp.2025.120 https://hdl.handle.net/20.500.15037/568 |
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