Prajapati, DipankerSapkota, SujataSuwal, Punya ShoriAryal, AnuMaharjan, RashmiMagar, Sudip AleMagar, Kamala RanaPoudel, KabitaPyakurel, PrajjwalVaidya, AbhinavShrestha, Archana2025-07-282025-07-282025https://hdl.handle.net/20.500.14572/842Dipanker Prajapati Shahid Gangalal National Heart Centre, Bansbari, Bagmati, Nepal. National Academy of Medical Sciences, Kathmandu, Bagmati, Nepal. Sujata Sapkota Manmohan Memorial Institute of Health Sciences, Soaltee Mode, Kathmandu, Nepal.Dhulikhel Hospital - Kathmandu University Hospital, Dhulikhel, Kavre, Nepal Punya Shori Suwal Central Institute of Science and Technology, Baneswor, Kathmandu, Nepal Anu Aryal Department of Health Policy and Management, University of California, Los Angeles, USA Rashmi Maharjan Department of Nursing and Midwifery, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal Sudip Ale Magar Department of Health Services, Ministry of Health and Population, Teku, Kathmandu, Nepal Kamala Rana Magar Pokhara Academy of Health Sciences, Ramghat-10, Pokhara, Nepal Kabita Poudel School of Nursing, Pokhara Academy of Health Sciences, Pokhara-11, Kaski, Gandaki, Nepal Prajjwal Pyakurel SAARC TB and HIV/AIDS Centre, Thimi, Bhaktapur, Nepal Abhinav Vaidya Kathmandu Medical College Public Limited, Sinamangal, Kathmandu, Nepal Archana Shrestha Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, NepalAbstract Introduction: Nepal endorsed and implemented the WHO Package of Essential Non-communicable Disease Intervention. However, its implementation is far from satisfactory. We designed and implemented an intervention to reinforce peer coaching and clinical audit mechanisms in primary- level health facilities, and tested its feasibility and preliminary effectiveness. This paper details the methodology used in designing, implementing and assessing the intervention. Methods: The study adoptes a hybrid type II implementation trial design. The intervention assignment followed a non-blinded, two-arm, parallel randomized controlled trial design with a 1:1 allocation ratio. Seventeen primary-level public health facilities with at least one trained staff were randomized. The clinical staff at the intervention health facilities received peer-coaching and clinical audit reinforcement, while the control group followed their usual practice. The study was conducted over a 12-month duration. A mixed-method approach, applying pre-post assessment and thematic analysis, to inform the intervention development and assess implementation outcomes and its effectiveness was. The study was guided by the Proctor framework. Ethical clearance was obtained from the Nepal Health Research Council (Registraion number: 30212021). Discussion: The tools and methods that guide intervention implementation and assessment have the potential to be replicated in various settings to design strategies to improve Package of Essential Non-communicable Disease Intervention adoption and sustainment.en-USOther