Affordable, inclusive and evidence-led
About ACROSS
ACROSS is an international research programme working with communities, health professionals and research partners to develop affordable, culturally appropriate and sustainable home-based cardiac rehabilitation in Bangladesh and Pakistan.
Affordable Cardiac Rehabilitation: An Outreach Inter-Disciplinary Strategic Study
ACROSS is funded by the National Institute for Health and Care Research through the Research and Innovation for Global Health Transformation programme. It is led by the University of Glasgow and delivered through partnerships involving universities, health organisations, researchers, clinicians and communities across the UK, Bangladesh and Pakistan.
The programme brings together expertise in cardiac rehabilitation, mental health, behaviour change, clinical trials, implementation science, health economics, capacity strengthening and community engagement.
Programme overview
ACROSS at a Glance
The challenge
Why ACROSS is needed
Cardiovascular disease is a major cause of death, disability and pressure on health systems. People living with heart disease may also experience anxiety or depression, which can affect recovery, quality of life and their ability to manage long-term health needs.
Cardiac rehabilitation can support recovery through physical activity, education, psychological support and help with healthy living. However, access remains limited in many lower-resource settings, particularly where facility-based services are difficult to reach or sustain.
Our response
What ACROSS aims to achieve
ACROSS is developing and evaluating a home-based rehabilitation programme that responds to physical and mental health needs while reflecting local languages, cultures, health systems and community priorities.
The long-term ambition is to generate practical evidence for an approach that is acceptable, clinically effective, affordable, scalable and sustainable within Bangladesh and Pakistan.
From development to impact
What the Programme Is Doing
Four connected areas of work take ACROSS from collaborative design through feasibility testing, evaluation and long-term capacity strengthening.
Co-design and adaptation
Working with patients, caregivers, health professionals and communities to adapt rehabilitation to local priorities and contexts.
Feasibility and pilot testing
Examining whether the intervention and trial processes are acceptable, practical and ready for wider evaluation.
Effectiveness and implementation
Evaluating health outcomes, cost-effectiveness and the factors that influence sustainable implementation in health systems.
Capacity strengthening and impact
Supporting research skills, rehabilitation delivery, knowledge exchange and pathways for evidence to inform policy and practice.
International partnership
Where We Work
ACROSS connects complementary academic, clinical, community and health-system expertise across three partner countries.
United Kingdom
Programme leadership, research methodology, trial design, health economics, academic supervision and coordination support.
Bangladesh
Clinical, community and research partnerships supporting contextual adaptation, feasibility, evaluation, capacity strengthening and health economics.
Pakistan
Clinical, community and research partnerships supporting co-design, intervention adaptation, evaluation, engagement and implementation within local systems.
Principles Guiding ACROSS
Co-designed
Shaped with patients, caregivers, communities and health professionals.
Integrated
Responding to physical health, mental health and wider support needs.
Contextually appropriate
Adapted to languages, cultures, communities and health systems.
Affordable and sustainable
Designed with future delivery, scale-up and long-term impact in mind.
Programme publication
Read the ACROSS Research Programme Protocol
The published protocol provides detailed information about the programme rationale, study design, intervention development, evaluation and planned pathways to impact.
Explore ACROSS
Funding acknowledgement: ACROSS is funded by the National Institute for Health and Care Research (NIHR) under Award ID NIHR205540. The views expressed are those of the authors and do not necessarily reflect those of the NIHR or the Department of Health and Social Care.