Abstract
BACKGROUND: Chagas disease (ChD) affects over six million people in Latin America, with Chagas cardiomyopathy (CCM) being a severe chronic complication in approximately 30% of those with ChD. OBJECTIVES: To develop, adapt, and evaluate the feasibility, acceptability, and potential impact of a multicomponent tele-education intervention to promote early identification and comprehensive management of CCM among public primary care physicians in an endemic community. METHODS: This mixed-methods study was conducted in San Juan Province, Argentina. The qualitative phase consisted of a needs assessment through local focus groups with health authorities, leaders of local health programs, and healthcare providers from the primary, secondary, and tertiary levels. The quantitative phase, designed as an uncontrolled before-and-after study, involved 23 primary care physicians who participated in a tele-education intervention designed to improve early identification, risk stratification, and appropriate follow-up of CCM, including guidance on the use of the local Tele-Chagas platform. Knowledge, attitudes, and practices (KAP) were assessed through before-and-after intervention surveys. Feasibility and acceptability were evaluated using a 5-point Likert scale. RESULTS: Focus groups identified limited CCM-specific training as a major barrier to timely referral and treatment. Following the intervention, the median knowledge scores increased from 1 to 2.5 (median difference = 1.5; 95% CI: 0.5-2.5; p = 0.013), and the proportion achieving ≥75% correct answers changed from 0% at baseline to 50% post-intervention. The majority of participants assigned the highest scores (four or five on the Likert scale) to the main characteristics of the educational materials, including weekly delivery, use of WhatsApp as the communication tool, content usefulness, and audiovisual features. CONCLUSIONS: A tele-education intervention demonstrated positive implementation outcomes and significantly improved ChD-related knowledge among participating primary care physicians in San Juan Province, Argentina. Tailored tele-education tools may have the potential to improve CCM management in primary care settings within endemic areas.