Scenarios
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Outreach
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In the baseline scenario, no one is enrolled in the intervention. Simulants not enrolled in this intervention may be prescribed medications to lower their blood pressure or lipid levels, but will not receive the adherence boost that occurs with the intervention.

In this scenario, adherence to SBP-lowering and LDL-c lowering therapies would increase through patient outreach. Methods for outreach would include options such as regular phone calls between provider and patient, a mobile app with reminders and guidance about the importance of taking medications, or a patient support clinic.

**Scenarios:**

	- Outreach 1.0: Following a prescription of new lipid- and/or blood pressure-lowering medication(s), all eligible patients are enrolled. The initial medication fill rate increases 2x and the medication adherence each month is increased 2x for each prescription. The coverage of the intervention should scale linearly over the first year such that there is 0% coverage at baseline and 100% at the end of Year 1.  
	
	- Outreach 0.5: Following a prescription of new lipid- and/or blood pressure-lowering medication(s), 50% of eligible patients are enrolled. The enrollment decision is made randomly by simulant. The initial medication fill rate increases 2x and the medication adherence each month is increased 2x for each prescription. The coverage of the intervention should scale linearly over the first year such that there is 0% coverage at baseline and 50% at the end of Year 1.


specify when these levels of coverage should be attained, and if there should be an immediate scale up or a gradual scale up from baseline (and if gradual, describe how, e.g. linear scale up from baseline levels on 2022-01-01 to 100% coverage on 2023-01-01)

Polypill
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This scenario involves fixed dose combination medication for reducing systolic blood pressure. 

**Scenarios:**
	- Polypill 1.0: All individuals with IHD, past ischemic stroke, or prevalent PAD (who are not already on medications) receive atorvastatin (10 mg), amlodipine (2.5 mg), losartan (25 mg), and hydrochlorothiazide (12.5 mg) regardless of SBP or LDL-c levels. Medications lead to expected reduction in SBP and LDL-c. Adherence is increased 13% following receipt of those medications.  
	- Polypill 0.5: Above scenario with, but a reduction to 50% of individuals meeting criteria receiving prescription for atorvastatin (10 mg), amlodipine (2.5 mg), losartan (25 mg), and hydrochlorothiazide (12.5 mg) regardless of SBP or LDL-c levels). Medications lead to expected reduction in SBP and LDL-c. Adherence among individuals receiving therapy is increased 13% following receipt of those medications. 


Lifestyle modification education
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Under this intervention, lifestyle modification education regarding physical activity, healthy eating, weight loss, and tobacco cessation is utilized.  

**Scenarios:**
	- Lifestyle 1.0: Enrollment will occur following a routine health facility or primary care visit. Individuals with BMI >= 25 or FPG 100-125 mg/dl at the time of the visit will receive weekly sessions for 6 months followed by monthly sessions for 6 months. Each session attended will result in 0.3% loss of body weight (initially represented as BMI, but eventually to use weight when available). Adherence will decline in a linear fashion, with 50% of individuals continuing sessions at 6 months and all completing sessions by 1 year.  
	
	- Lifestyle 0.5: Scenario described above but with 50% of adherence at initiation; adherence will decline in a linear fashion from that point. 


Combined scenarios
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	- Combination 1.0: Combination of outreach 1.0, polypill 1.0, and lifestyle 1.0  
	- Combination 0.5: Combination of outreach 0.5, polypill 0.5, and lifestyle 0.5