{
  "abstract": "Background: 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. Methods: 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. Results: 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. Conclusion: 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’s 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.",
  "abstract_shown": true,
  "affiliations": [
    "Duke University School of Medicine, Durham, North Carolina, United States of America",
    "Department of Emergency Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania",
    "Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, United States of America",
    "Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America",
    "Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America",
    "Department of Physical Medicine & Rehabilitation, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America",
    "Department of Emergency Medicine, Duke University, Durham, North Carolina, United States of America"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Spencer F. Sumner"
    },
    {
      "affs": [
        1
      ],
      "name": "Francis M. Sakita"
    },
    {
      "affs": [
        2
      ],
      "name": "Kelvin F. Haukila"
    },
    {
      "affs": [
        3
      ],
      "name": "Lisa Wanda"
    },
    {
      "affs": [
        4
      ],
      "name": "Godfrey L. Kweka"
    },
    {
      "affs": [
        5
      ],
      "name": "Jerome J. Mlangi"
    },
    {
      "affs": [
        6
      ],
      "name": "Pankrasi Shayo"
    },
    {
      "name": "Tumsifu G. Tarimo"
    },
    {
      "name": "Simran Khanna"
    },
    {
      "name": "Claire Wang"
    },
    {
      "name": "Abigail Pyne"
    },
    {
      "name": "Preeti Manavalan"
    },
    {
      "name": "Nathan M. Thielman"
    },
    {
      "name": "Janet P. Bettger"
    },
    {
      "name": "Julian T. Hertz"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e1cqbb1nqmas3.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0357564",
  "fulltext_url": null,
  "id": "e1cqbb1nqmas3",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0357564",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3600|Health Policy Implementation Science"
    ],
    [
      "plos",
      "/Computer and information sciences/Computer networks/Internet"
    ],
    [
      "plos",
      "/Medicine and health sciences/Cardiology/Myocardial infarction"
    ],
    [
      "plos",
      "/Medicine and health sciences/Critical care and emergency medicine"
    ],
    [
      "plos",
      "/Medicine and health sciences/Critical care and emergency medicine/Triage"
    ],
    [
      "plos",
      "/Medicine and health sciences/Health care/Health care providers/Nurses"
    ],
    [
      "plos",
      "/Medicine and health sciences/Health care/Health care providers/Physicians"
    ],
    [
      "plos",
      "/Medicine and health sciences/Health care/Patients"
    ],
    [
      "plos",
      "/People and places/Population groupings/Professions/Medical personnel/Nurses"
    ],
    [
      "plos",
      "/People and places/Population groupings/Professions/Medical personnel/Physicians"
    ],
    [
      "plos",
      "/Research and analysis methods/Bioassays and physiological analysis/Electrophysiological techniques/Cardiac electrophysiology/Electrocardiography"
    ]
  ],
  "openalex": "W7214385619",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0357564&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-25",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/e1cqbb1nqmas3.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:43Z",
      "native_id": "10.1371/journal.pone.0357564",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0357564"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:cardiology",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Stakeholder perceptions of the acceptability of an intervention to improve uptake of evidence-based emergency myocardial infarction care in Tanzania: A qualitative study",
  "title_text": "Stakeholder perceptions of the acceptability of an intervention to improve uptake of evidence-based emergency myocardial infarction care in Tanzania: A qualitative study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:43Z",
  "url": "https://research.draconitic.com/paper/e1cqbb1nqmas3",
  "venue": "PLOS One",
  "versions": []
}