Welcome to the GACD case study library
This part of the eHub presents real-world examples of implementation research and practice from across the GACD community. The case studies show how evidence is translated into action in diverse health systems and contexts. While broadly relevant, many focus on chronic non-communicable diseases (NCDs) in lower-resourced settings.
Each case study is structured for quick learning and practical use—covering the setting and problem, intervention design and adaptation, stakeholder engagement, outcomes, and considerations for scale-up and sustainability. Use the theme filters to refine by topic, or search by key words to find specific content.
A co-designed, culturally tailored implementation intervention strengthened smoking-cessation care in Aboriginal Medical Services by training health providers, supporting patients with tailored resources, and improving access to oral NRT.
The ICAN QUIT in Pregnancy initiative addressed the high prevalence of smoking among Aboriginal and Torres Strait Islander pregnant women in Australia through a multi-component implementation intervention. Recognising that standard smoking cessation care (SCC) was often culturally unresponsive or inconsistently delivered, this programme targeted health providers (HPs) at Aboriginal Medical Services (AMS). The intervention utilised the Behaviour Change Wheel (BCW) to design a system that included webinar-based training for providers, culturally specific educational resources for patients, and the provision of free oral Nicotine Replacement Therapy (NRT).
The step-wedge cluster randomised pilot trial across six AMSs demonstrated that the intervention was feasible and acceptable. It succeeded in improving health providers' knowledge and attitudes towards NRT and resulted in a validated smoking cessation rate of 13.6% among participants at 12 weeks. The project highlights the necessity of co-design and culturally tailored implementation strategies to close the health gap in Indigenous communities.
A structured group-education programme improved diabetes self-management in South African primary care, demonstrating strong acceptability, fidelity and clinically meaningful health improvements.
GREAT for diabetes is a structured, four-session, group-based education and empowerment program designed for people with poorly controlled or newly diagnosed type 2 diabetes in public sector primary care. Grounded in a guiding communication style derived from motivational interviewing, it standardises high-quality self-management support while fitting routine workflows. With World Diabetes Foundation support and National Department of Health endorsement, GREAT was implemented (2019–2022) across districts in five South African provinces, with scale-up restarted post-COVID.
Mixed-methods evaluations reported high acceptability among policy-makers, managers, clinicians and patients; good fidelity to core content (66%–94% across sessions); incremental start-up costs of ~US$494 per facility; and early reach of 588 patients at the time of the initial evaluation, with later routine implementation in the Western Cape reporting 41 groups and 252 patients (NTSS) and an estimated ~300 patients per facility per year in KESS. Facilities documented clinically meaningful improvements in HbA1c, blood pressure, weight and patient experience. A health-system logic model (theory of change) identified governance, resourcing, team-based organisation of care and routine monitoring as the decisive determinants of sustainability.
A trial comparing community mobilisation and mHealth in rural Bangladesh showed large impacts for participatory group action, while voice-messaging alone improved knowledge but not outcomes.
The DMagic initiative in rural Bangladesh tested two distinct population-level strategies to prevent and control type 2 diabetes (T2DM) and intermediate hyperglycaemia. This three-arm, cluster-randomised trial compared a participatory community mobilisation approach (Participatory Learning and Action, or PLA) and an mHealth voice-messaging intervention against usual care. The PLA intervention involved facilitated monthly community group meetings to identify and address local health barriers. The mHealth intervention delivered twice-weekly voice messages promoting behaviour change.
The trial demonstrated that the PLA intervention led to a large, significant reduction in the prevalence of T2DM and intermediate hyperglycaemia (aOR 0.36) and a reduced 2-year incidence of T2DM in high-risk cohorts (aOR 0.39). In contrast, the mHealth intervention, while improving knowledge, had no effect on disease outcomes. The DMagic trial highlights that active community participation is a highly effective and equitable strategy for NCD prevention in LMICs, superior to passive information-based approaches.
A peer-supported and technology-enabled model improved access and adherence for hypertension management in Western Kenya.
The PT4A initiative in Western Kenya implemented a peer-supported, technology-enabled model to improve access and adherence for hypertension management. This model integrated community-based delivery, digital tracking systems, and peer-led engagement to strengthen treatment continuity, especially among patients with limited access to health facilities. By addressing both structural and behavioural barriers to hypertension care, PT4A demonstrated improved medication adherence, clinical follow-up, and patient engagement in long-term chronic disease management.
An integrated referral network with digital tools and peer support strengthened hypertension care across the health system.
The STRENGTHS project built on prior regional initiatives to develop a multi-level referral network for hypertension management in Western Kenya. Integrating digital health tools and peer support, it streamlined communication between community health volunteers, clinics, and referral hospitals. The model improved efficiency, reduced patient drop-off, and enhanced coordination across care levels, demonstrating the value of embedded digital infrastructure and team-based care in strengthening health systems for chronic disease management.
A reciprocal learning approach adapted self-management strategies across three diverse health-system contexts.
The SMART2D initiative promoted a people-centred approach to Type 2 diabetes prevention and management across Uganda, South Africa, and Sweden. It employed reciprocal learning and context-specific adaptation to tailor self-management strategies to local needs. By emphasising shared decision-making, community engagement, and health-system integration, SMART2D demonstrated the effectiveness of cross-context adaptation in strengthening chronic-disease prevention and care models globally.
This case study summarises the Kerala Diabetes Prevention Program and its adaptation and early scale in India.
The Kerala Diabetes Prevention Program (K-DPP) adapted elements from global lifestyle intervention programs for diabetes prevention to the Indian context. Using peer leaders and group-based lifestyle modification sessions, it promoted sustained health behaviour change within communities. The project showed positive effects on weight, physical activity, and diabetes risk factors while demonstrating how culturally tailored peer-led models can be scaled within primary health systems.
A contextual analysis informed the design of a diabetes prevention programme tailored to Kerala’s health system and population.
This situational analysis examined the prevalence, risk factors, and policy context surrounding Type 2 diabetes in Kerala. Findings highlighted key health-system challenges, including fragmented service delivery and gaps in preventive care. The insights informed the design of a state-wide diabetes prevention programme, aligning intervention priorities with local health needs and existing public-health infrastructure.
A national community-based physical-activity programme scaled through multisector partnerships and navigated policy and funding shifts.
Brazil’s Academia da Cidade programme scaled up local physical-activity initiatives to a national level through strong multisectoral collaboration, public-health policy alignment, and sustained political commitment. The initiative overcame funding and governance challenges to establish sustainable infrastructure supporting physical-activity promotion across diverse communities.
This knowledge-synthesis initiative consolidated global and national evidence to guide plain-packaging policy development for tobacco products in India, emphasising local context in adopting evidence-based policy actions.
This case study outlines the process of synthesising knowledge on tobacco plain-packaging policies for implementation in India, emphasising the importance of local context in adopting evidence-based policies and interventions. By combining systematic reviews with stakeholder consultations, the initiative bridged research evidence with political realities, supporting feasible, context-specific policy development for tobacco control.
A promising clean-cooking technology proved unacceptable in daily life, underscoring the need to assess acceptability before trials.
This study explored the acceptability of introducing solar-oven technology (“HotPot”) as a cleaner-cooking alternative to reduce household air pollution in rural Senegal. Despite technical feasibility, limited cultural acceptance and lifestyle compatibility constrained adoption. Findings emphasise the importance of formative research on acceptability and usability before implementing technological interventions in community-health contexts.
An integrated clinic model and affordable footwear supported healing while revealing barriers that limit population-level reach.
This case study from Vellore examined both the effectiveness and reach of a diabetic-foot intervention integrating low-cost rocker footwear with clinic-based care. While clinical outcomes were favourable, limited patient access and affordability constrained broader reach. The findings highlight the value of assessing population-level coverage and contextual barriers in parallel with clinical-impact evaluations.
A combined provider app and patient voice-messaging system improved secondary-stroke-prevention outcomes in rural China.
The SINEMA initiative deployed a multifaceted mHealth intervention in rural China integrating an Android-based app for village doctors and automated voice messages for patients. This model improved medication adherence, physical activity, and secondary-prevention outcomes, demonstrating how locally tailored mHealth solutions can strengthen primary-care delivery for chronic-disease management in resource-limited settings.
A collaborative-care model integrated depression treatment into diabetes care and improved mental and cardiometabolic outcomes.
The INDEPENDENT study in India developed a collaborative-care model that integrated evidence-based depression management into diabetes treatment. Using decision-support tools and care-coordination strategies, the model achieved significant improvements in both mental-health and cardiometabolic outcomes. It illustrates the potential of integrated chronic-care frameworks for addressing multi-morbidity in resource-limited settings.
A pilot in factory canteens informed a national salt-reduction strategy tailored to Mongolia’s food environments.
This pilot programme tested workplace-based salt-reduction strategies in Mongolia’s factory canteens to inform a national hypertension intervention. By engaging workers, canteen staff, and policy leaders, the study demonstrated feasible approaches to reducing dietary salt intake and supported the development of a context-specific national strategy for non-communicable-disease prevention.
A phone-based counselling and SMS programme improved weight outcomes and showed scalable potential in low-resource cities.
The GISMAL initiative developed a multinational mHealth intervention for cardiometabolic risk reduction across Latin America. Through behavioural counselling and SMS follow-ups, it promoted sustained weight loss and blood-pressure control. Findings demonstrate the feasibility of scaling digital-health solutions across diverse urban populations to reduce chronic-disease burden.