Lown Scholar Projects

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PI: Abhinav Vaidya

Institution: Kathmandu Medical College
Title: Formative research to inform a community-based CVD prevention intervention among urban poor in Kathmandu, Nepal
Budget: $22,821
Start date: 3/1/2020
End date: 5/1/2021
Co-investigators: Natalie Oli
HSPH mentor: Lindsay Jaacks

Cardiovascular diseases  and their behavioral risk factors such as tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol are emerging public health problems in Nepal. Most of the focus, however, has been on hospital-centric curative services for CVDs, rather than on primary prevention. Our recent CVD-focused community-based interventions in Nepal have yielded success in terms of improving the knowledge and perceptions of mothers, and improving cascade of care of diabetes management through involvement of community health volunteers. This study aims to conduct formative research to inform the design and implementation of a community-based CVD prevention intervention in the Sinamangal-Minbhawan squatter area.

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PI: Bruce Twinamasiko

Institution: Church of Uganda Kisiizi Hospital
Title: Effect of a community health worker led intervention to control high blood pressure in south western Uganda: a pilot pragmatic cluster randomized trial
Budget: $15,000
Start date: 3/1/2020
End date: 5/1/2021
Co-investigators: Samson Okello, Edson Mutahi, Eleanor Kengoma
HSPH mentor: Samson Okello

In Uganda, the prevalence of hypertension is 26%and only 26.7% of patients have controlled high blood pressure. Poor blood pressure control is increasing despite the availability of effective medications. Blood pressure control is much more complicated by scarcity of health professionals in most parts of the country and up to one third of doctors leave the country in search of better jobs. This study aims to test whether a comprehensive intervention program including community health workers, physician training, and text messaging, will improve high blood pressure control among hypertensive patients attending hypertension clinics in southwestern Uganda.

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PI: Frederick Wekesah

Institution: African Population and Health Research Center
Title: Investigating the role of sugar-sweetened beverages in and perceptions towards childhood obesity in the slums of Nairobi
Budget: $38,841
Start date: 3/1/2020
End date: 5/1/2021
Co-investigators: Steven Goetmaker, Shukri Mohamed, Martin Kavao, Gershim Asiki
HSPH mentor: Steven Goetmaker

Childhood obesity is an emerging public health issue in Kenya. Research childhood obesity related to diet and physical activity has been conducted in some populations in Kenya, but no data exists on the double burden of childhood malnutrition, and on the consumption of sugar-sweetened beverages, and its association with childhood obesity and/or childhood undernutrition. This mixed-methods study will investigate the factors associated with childhood malnutrition, and childhood obesity in the slums of Nairobi, and aims to highlight the link between sugar-sweetened beverages on excessive weight gain and childhood obesity. This study also seeks to identify and isolate potential barriers or facilitators in addressing childhood malnutrition in this community.

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PI: Juan Pablo Gonzalez-Rivas

Institution: Foundation for the Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN)
Title: Hybridized Three Steps (HITS) Intervention to Prevent Diabetes in Venezuela. HITS Diabetes with Prevention, An EVESCAM lifestyle intervention study
Budget: $39,038
Start date: 3/1/2020
End date: 5/1/2021
Co-investigators: Ramfis Nieto-Martinez
HSPH mentor: Ramfis Nieto-Martinez

In Venezuela, cardiovascular disease (CVD) is responsible for 30.5% of all deaths, increasing by 8.3% since 2007 to 2017. The prevalence of cardiometabolic risk factors in the country is also increasing. Through the VENMOLS and EVASCAM surveys, it has been estimated that 1.7 million of adults could advance to type 2 diabetes (T2D) in the next 3 to 5 years. In previous studies, lifestyle interventions only showed a pooled mean weight loss 1.57 kg higher than standard care, demonstrating the large difficulties in weight loss of participants at community levels. This study aims to improve the effectiveness of T2D prevention programs through a transculturalization process incorporating multiple validated components by extension, positively impact T2D incidence, prevalence, quality of life, and health care costs.

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PI: Natasha Sobers

Institution: The George Alleyne Chronic Disease Research Center, Carribean Institute for Health Research
Title: Assessing effectiveness of a chronic disease self-management program in faith-based organizations in Barbados: A cluster randomized clinical trial
Budget: $15,000
Start date: 3/1/2020
End date: 5/1/2021
Co-investigators: Trevor Ferguson, Ian Hambleton, Saria Hassan, Simon Anderson
HSPH mentor: Trevor Ferguson

In Barbados, levels of hypertension (40.7%) are high and account for the highest proportion of deaths due to cardiovascular and NCDs. The financial implications of the high and increasing prevalence are grave especially in Barbados, which in 2018, was among the top five most indebted nations in the world. Tackling NCDs requires a multi-level approach involving the health system, providers and the individual. This study seeks to evaluate the effectiveness and cultural appropriateness of a hypertension self-management program including lifestyle workshops, self-monitoring training, and tools to enhance medication adherence, in a small island developing state with a high burden of NCDs.

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PI: Paula Margozzini

Institution:  Pontificia Universidad Católica de Chile, Medical School
Title: Reductive validity of chronic disease multimorbidity-based risk stratification in Chile: Cohort analysis using a national health survey, ENS 2010
Budget: $14,882
Start date: 3/1/2020
End date: 5/1/2021
Co-investigators: Alvaro Passi, Samanta Anriquez
HSPH mentor: Goodarz Danaei

In Chile, 70% of the over-14-year-old population has chronic disease multi-morbidity (MM). People who live with 5 or more chronic diseases has increased from 11.9% to 17.5 % between 2010 and 2017 national health surveys. The Ministry of Health (MINSAL) has recently proposed a national shift to a new MM based chronic care mode, which included a new definition of MM strata, However, it’s capacity to predict important and costly events like hospitalizations and deaths that are amenable with primary care is not known. This study seeks to contribute to a gap of knowledge using newly available and nationally representative data through cohort analysis of linked death certificates and hospital discharge data associated to the 2010 National Health Survey (Encuesta Nacional de Salud, ENS 2010). The general aim is to estimate the predictive validity of the simpler stratification definition that MINSAL wants to implement.

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PI: Pilly Chillo

Institution: Muhimbili University Of Health And Allied Science
Title: Assessing feasibility and Acceptability of a School-based Rheumatic Heart Disease (RHD) Control Program in Manyara Region, Tanzania
Budget: $15,000
Start date: 3/1/2020
End date: 5/1/2021
Co-investigators: Marina Njelekela
HSPH mentor: Vanessa Kerry

Rheumatic heart disease (RHD) accounts for approximately 275,000 deaths annually, and although almost eradicated in developed countries, RHD continues to affect many children and young adults in Sub Saharan African countries, including Tanzania. RHD can largely be prevented when appropriate control programs are implemented focusing on community awareness, appropriate diagnosis and treatment of its cause, namely Group A beta haemolytic Streptococcus (GAS) sore throat infection as well as proper management of Acute Rheumatic Fever. Since the most vulnerable populations for GAS throat infections are children, there is strong potential for RHD control programs to be successful when targeting primary schools, improving the reach of primary and secondary prevention as well as case detection of RHD. This study aims to assess the feasibility and acceptability of a school-based RHD control program in Manyara Region using the World Heart Federations’s RHD control toolkit.

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PI: Sairu Philip

Institution: T. D. Medical College Alappuzha
Title: Evaluation of a community engaged intervention for stroke prevention in Alappuzha, Kerala, India
Budget: $24,944
Start date: 3/1/2020
End date: 5/1/2021
Co-investigators: Rekha Rachel Philip
HSPH mentor: Kathyrn Rexrode

In Kerala, in terms of years of life lost, stroke isthe second leading cause among females and third leading cause among males. Of the stroke cases, about 15% of the patients become bedridden in the community. The Government of Kerala has realized the magnitude of the problem and has been initiating district-level stroke centers since 2017 where treatment for acute stroke is given free. Engaging the community in educating its population regarding warning signals of stroke and stroke risk factors could result in improved stroke awareness, facilitating early detection, effective thrombolytic treatment and better stroke outcomes, as well as prevention through management of stroke risk factors. This study aims to evaluate the impact of a community intervention for stroke awareness and prevention on pre-hospital time and management of risk factors.

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PI: Sudha Ramalingam

Institution: PSG Institute of Medical Sciences and Research
Title: Design, Implementation and Evaluation of a Comprehensive School Based Intervention for Prevention of Cardiometabolic Risk factors among Adolescents in Rural Schools at Coimbatore, India (PRANA: Prevention through Nutrition and Activity) – a Pilot study
Budget: $24,944
Start date: 3/1/2020
End date: 5/1/2021
Co-investigators:
HSPH mentor: Joseph Brain, Nancy Long Seiber

Among the Indian states, Tamilnadu ranks first in Ischemic Heart Disease and second in Diabetes Mellitus, requiring urgent action. With about 25% of the population being adolescents, there is also a rise in the cardiometabolic risk factors in this age group. The existing national programs, such as the School health program, National Program for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke, and the Rashtriya Kishor Sawstya Karyakram, focus on undernutrition, menstrual hygiene and substance abuse and not on NCDs, resulting in large void to of prevention. This study seeks to prevent the adult onset of cardiometabolic diseases by designing, implementing and evaluating the effectiveness of a comprehensive school-based intervention program among adolescents aged 10-18 years in the rural area of Coimbatore, India.

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PI: Rosana Poggio 

Institution:  Institute for Clinical Effectiveness (IECS) 
Title: An innovative approach to improve quality of care for cardiovascular disease risk factors management in Poor Urban Settings: A feasibility study in Argentina
Budget: $46,008
Start date: 3/1/2019
End date: 2/28/2020
Co-investigators: Laura Gutierrez, Vilma Irazola
HSPH mentor: Vilma Irazola

Argentina is the highest contributor to cardiovascular disease burden in South Latin America. 36% of the population is uninsured and is constituted mainly of the poorest. This population shows a higher prevalence of the main determinants of CVDs: hypertension, obesity, diabetes, and high cholesterol, compared to the more affluent population. The Ministry of Health created the “REDES” program to improve the coverage of CVD prevention in the uninsured population. The objective of this study is to evaluate the feasibility of a multi-component intervention targeting the health care system, providers and individual barriers to improve detection and risk factors management in the uninsured poor population with moderate or high CVD risk in Argentina.

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PI: Aswathy Sreedevi

Institution: Amrita Institute of Medical Sciences
Title: Effectiveness of a ‘tobacco smoke free home’ intervention in partnership with women’s self help groups in the slums of Kochi corporation, Kerala: a cluster randomized trial
Budget: $49,590
Start date: 3/1/2019
End date: 9/30/2020
Co-investigators: Sobha George, Arathi Sekhar, Vijaya Kumar, Jaideep Menon
HSPH mentor: Jon Rohde

Exposure to second hand smoke is a well-established cause of heart disease and lung cancer. Smoking regulations in public places have not resulted in substantial reductions in SHS exposure among women and children, as the biggest source of involuntary exposure to tobacco smoke, particularly for children, is smoking by parents and other members of the household. In Kochi corporation, cardiovascular health issues are the third most common cause of morbidity. About 21% of its population now live in slum areas with high occupancy rates where smoking within the home can result in high second-hand exposure. An initial experience with an initiative of ‘Quit Tobacco international activities’ suggests that “tobacco smoke free homes initiatives” are feasible. This study aims to determine the effectiveness of “smoke free home” intervention in partnership with women’s self-help groups in the slums of Kochi corporation, Kerala.

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PI: Alfa Muhihi

Institution: Management and Development for Health (MDH)
Title: Assessing effects of community health workers interventions for reduction of blood pressure among adults in Morogoro, Tanzania: a demonstration study
Budget: $38,740
Start date: 3/1/2019
End date: 9/30/2020
Co-investigators: David Urassa, Emmy Metta, Deodatus Kakoko
HSPH mentor: Marina Njelekela

In Tanzania, risk factors for cardiovascular diseases have increased at an alarming rate over the past two decades, contributing significantly to mortality. Despite this, public knowledge of CVD risk factors is low, especially in rural areas where a shortage of human resources for health is markedly high. The burden of CVD-related mortality has declined in high-income countries largely because of effective community-based interventions, but in most LMICs there is inadequate responsive interventions for primary prevention for known risk factors. This study aims to determine baseline prevalence and determinants of hypertension among adults in Morogoro, Tanzania, determine effects of interventions involving community health workers on reduction of blood pressure among hypertensive adults in Morogoro, and explore perceived quality and acceptability of interventions involving CHWs for reduction of blood pressure among adults in Morogoro.

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PI: Jaime Miranda

Title: A faith-based intervention to change preferences on sugar-sweetened beverages: a cluster-randomized controlled trial
Budget: $36,800
Start date: 6/1/2019
End date: 2/28/2020
Co-investigators: Antonio Bernabe-Ortiz, Jessica Zafra-Tanaka
HSPH mentor: Goodarz Danaei, Department of Global Health and Population

Andean Latin America has one of the highest levels of intake of sugary beverages in the world. With an annual 655,000 deaths, globally, attributed to their consumption, due to diabetes, cardiovascular diseases, and different types of cancer, innovative and effective strategies to reduce consumption is necessary. As one of the key institutional actors in Latin American societies, Catholic churches have the potential to serve as a vehicle to introduce and engage prevention-related strategies. This study aims to assess and explore the impact on revealed preferences of interventions of varying degrees of intensity consisting of short messages regarding the protection of one’s health given by catholic priests during mass over a 12-week period.

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PI: Eleonora d’Orsi

Title: Workshops of digital inclusion as a tool to promote healthy lifestyle among digitally illiterate patients with diabetes or hypertension living in Florianopolis, south Brazil
Budget: $14,999
Start date: 3/1/2019
End date: 2/28/2020
Co-investigators: Marcia Scazufca, André Junqueira Xavier, Anna Quialheiro da Silva, Thamara Huevler Figueiro
HSPH mentor: Marcia Scazufca

Cardiovascular disease in the leading cause of death in Brazil, accounting for 29.1% of total deaths in the country in 2016. There is emerging evidence that internet-based interventions may reduce cardiovascular risk, making the digital inclusion of socioeconomic groups with lower access to internet a possible low-cost strategy to reduce cardiovascular risk factors. The specific aims of this study are to adapt an existing digital inclusion program for digitally illiterate hypertension and/or diabetes primary care users, estimate the feasibility of the digital inclusion program in one primary health care center, and estimate the effect of the program in cardiovascular health, mental health, and quality of life of the participants.

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PI: Ricardo Peña Silva

Title: Impact of a patient-targeted MOOC on cardiovascular health outcomes and health literacy of patients with hypertension, in Colombia
Budget: $39,779, with $15,000 funded by the Lown Scholars Program
Start date: 1/1/2019
End date: 6/30/2020
Co-investigators: Rima Rudd, Carlos Mendivil, Luis Jorge Hernandez, Jovana Ocampo, Conecta-TE, Margaret Raba
HSPH mentor: Rima Rudd, Department of Social and Behavioral Sciences

It is expected that in 2025 almost three quarters of patients with hypertension and/or cardiovascular disease will live in developing countries. Addressing disparities is a critical component of management strategies for chronic diseases, as there is evidence shows that level of education and health literacy are associated with poorer control of hypertension. Based on recommendation by the National Academy of Sciences, the significance of this project is to improve health outcomes on a broad scale by improving health literacy and incorporating adequate teaching materials and strategies that target particular patient needs. This study aims to develop a patient-targeted MOOC in cardiovascular health, guided by health literacy data from patients with cardiovascular disease. A small group of patients that will pilot the MOOC in a subnet of hospitals in Bogotá and the study will explore their experience.

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PI: Ghada El-Hajj Fuleihan

Title: Lifestyle and Environmental Determinants of Maternal and Offspring Obesity
Budget: $15,000 funded by the Lown Scholars Program
Start date: 3/1/2019
End date: 9/30/2020
Co-investigators: Najat Saliba, Carla Makhlouf Obermyer, Anwar Nassar, Marlene Chakhtoura, Ziyad Mahfoud
HSPH mentor: Wafaie Fawzi, Department of Global Health and Population, Department of Nutrition, Department of Epidemiology

WHO reports that cardiovascular disease and cancer are the leading causes of mortality in Lebanon, with rates of 47% and 22%. In Lebanon, 65% of adults are overweight, 27% are obese and these rates are increasing alarmingly among children and adolescents. There is evidence from Western studies that prenatal exposure to maternal smoking is a major precursor of adverse health outcomes in the offspring, though data for risk factors to cardiovascular diseases in the Middle East is lacking. This study aims to validate environmental pollutant measurements and lifestyle assessment instruments (dietary and activity questionnaires) to be used post-partum, and explore the impact of environmental pollutants on the obesity phenotype in mother-offspring pairs.

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PI: Marcia Scazufca

Title: Cluster randomized controlled trial to lower blood pressure among old adults with hypertension and depression within the Family Health Strategy in São Paulo, Brazil
Awarded Institution: Institute of Psychiatry, University of São Paulo
Budget: $9,250
Start date: 3/1/2018
End date: 3/1/2019
Co-investigators: Roopen Araya
HSPH mentor: Goodarz Danaei, Department of Global Health and Population

This study aims to test whether behavioral activation will improve control of raised blood pressure among older adults with depression registered with the Family Health Program (primary care) in São Paulo, Brazil compared with enhanced usual care. The project will also evaluate the cost-effectiveness of the intervention during the 12 months of the intervention.

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PI: Dalia Stern

Title: Acceptability, feasibility and effectiveness of a worksite intervention to reduce cardiometabolic risk in Mexico
Awarded Institution: National Institute of Public Health, Mexico
Budget: $56,050.81 with $12,962.86 awarded by the Lown Program
Start date: 3/1/2018
End date: 3/1/2019
Co-investigators: Ruy-López Ridaura
HSPH mentors: Donna Spiegelman, Department of Epidemiology, Department of Biostatistics, Department of Nutrition; Josiemer Mattei, Department of Nutrition

This study will assess the adoption, fidelity, acceptability, feasibility, and effectiveness of a worksite environmental intervention to reduce cardiometabolic risk in Mexico. An optimal site for conducting a workplace intervention will be selected using a comprehensive survey and a specific intervention will be developed based on the characteristics of the chosen workplace. The study will then implement and evaluate the fidelity and effectiveness of a multi-component workplace intervention to reduce cardiometabolic risk.

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PI: Davood Khalili

Title: Cost-effectiveness of risk-based prevention in primary health care setting in rural and urban areas in Iran: from prediction to action (PredAction project)
Awarded Institution: Research Institute for Endocrine Sciences in Shahid Beheshti University of Medical Sciences, Tehran)
Budget: $10,118
Start date: 3/1/2018
End date: 3/1/2019
Co-investigator: Noushin Fahimfar
HSPH mentor: Goodarz Danaei, Department of Global Health and Population

This study aims to determine the clinical usefulness of the risk-based interventions for CVD prevention in urban and rural areas of Iran. Specifically, the study will assess the acceptability and preferences for treatment threshold among service users and healthcare providers in urban and rural populations by using knowledge, attitude and practice (KAP) study and Treatment Trade-off Method (TTM) used in shared decision making and will determine the clinical usefulness of the Globorisk prediction model in different preferred risk thresholds for treatment by calculating the ‘Net Benefit’.

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PI: Alberto Morales

Title: Access to medications in Cuban moderate-high cardiovascular risk hypertensive patients. A pilot Study.
Awarded Institution: Cardiocentro “Ernesto Che Guevara”
Budget: $2,500
Start Date: 3/1/2018
End Date: 3/1/2019
Co-investigators: Richard Kones and Veronika J. Wirtz
HSPH mentors: Goodarz Danaei, Department of Global Health and Population; Ankur Pandya, Department of Health Policy and Management

This study will determine the affordability, availability, accessibility and patient adherence to medications in ambulatory hypertensive patients with moderate to high cardiovascular risk treated at a Cuban tertiary cardiovascular hospital. The study also aims to identify the main causes of non-adherence to medication especially focusing on socioeconomic factors.

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PI: Ramfis Nieto-Martinez

Title: Effect of Socioeconomic Status on Cardiometabolic Risk During the Venezuelan Humanitarian Crisis: EVESCAM Cohort Study
Awarded Institution: Foundation for Public Health and Epidemiology Research in Venezuela (FISPEVen). Venezuelan Society of Internal Medicine (SVMI)
Budget: $23, 501
Start Date: 3/1/2018
End Date: 3/1/2019
Co-Investigators: Juan P. González-Rivas, Eunice Ugel, Maritza Durán, Maria Ines Marulanda, Hermes Florez, Jeffrey I. Mechanick

HSPH mentors: Goodarz Danaei, Department of Global Health and Population

This study aims to examine recent changes in CVD risk in each socioeconomic status during the current economic and political crisis in Venezuela. The team will use data from a sample of 2,042 participants from the cross-sectional version of the EVESCAM to assess the change between 2015/2017 and 2018/2019 in 10-year fatal CVD risk, across different socioeconomic strata and will also examine changes in specific CVD risk factors in the same population

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PI: Rakesh Suseela
Title: Effectiveness of a community based education and peer support led by women self-help group members in improving the control of hypertension: an implementation research in urban slums of Kochi city, Kerala, India
Awarded Institution: Amrita Institute of Medical Sciences
Budget: $58,275 with $37, 315 awarded by the Lown Program
Start Date: 3/1/2018
End Date: 3/1/2019
Co-investigators: Menon J, Aswathy S, Teena MJ, Sobha George
HSPH mentors: Goodarz Danaei, Department of Global Health and Population; Rajani Ved, Donna Spiegelman, Department of Epidemiology, Department of Biostatistics, Department of Nutrition

This study assesses the effectiveness of a community based education and peer support led by women self-help group members in reducing systolic blood pressure among people with hypertension in urban slums of Kochi, Kerala, India. The study will also examine the acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost and coverage of the program.

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PI: Seyed Hesameddin Abbasi

Title: Association between socioeconomic factors and major adverse cardiac events (MACE) in patients with premature coronary artery disease in Iran
Awarded Institute: Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Budget: $100,000 with $10,000 awarded by the Lown Program
Start Date: 11/1/2017
End Date: 11/1/2018
Co-Investigators: Seyed Ebrahim Kassaian, Saeed Sadeghian, Masoumeh Lotfi, Arash Jalali, Tahereh Davarpasand
HSPH mentor: Murray Mittleman, Department of Epidemiology

This study aims to explore the association between socioeconomic factors (including level of education, employment/unemployment status, household income, and gender) and major adverse cardiac events in patients with premature coronary artery disease (those occurring in the fourth and fifth decade of life) in Iran.

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PI: Trevor Ferguson

Title: Cardiovascular Health in Urban Poor and Middle Income Communities in Jamaica: Impact of Psychosocial Stress, Social Networks and Social Support
Awarded Institute: Caribbean Institute for Health Research (formerly Tropical Medicine Research Institute), The University of the West Indies, Mona, Kingston, Jamaica
Budget: $49,988
Start date: November 2017
End date: May 2019
Co-investigators: Novie Younger-Coleman, Ishtar Govia, Rainford Wilks, David Williams, Marshall Tulloch-Reid
HSPH mentor: David Williams, Department of Social and Behavioral Sciences

This study evaluates the association between cardiovascular health and neighborhood poverty, psychosocial stress, and social support and seek to identify factors which may serve as a basis for social, behavioral or policy interventions to improve cardiovascular health in Jamaica. Specifically, the project will use a recently conducted national survey to estimate the prevalence of Ideal Cardiovascular Health (ICH) and its components among Jamaicans living in low-income, middle-income and high-income urban communities and evaluate whether there are significant differences by community income categories. It will also estimate levels of psychosocial stress among persons in low-, middle-, and high- income communities, evaluate differences between community income groups, and determine whether the level of psychosocial stress is associated with cardiovascular health. The study will also evaluate the impact of community characteristics, social networks and social support on cardiovascular health and identify modifiable factors which may serve as targets for intervention. Finally additional characteristics or attitudes which may contribute to cardiovascular health will be identified by conducting in-depth qualitative interviews among persons with ICH in each community income category.

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PI: Vilma Irazola

Title: Assessing the Interaction between Built Environment and Cardiometabolic Risk Factors: Its Role on Health Disparities
Awarded Institute: South American Center of Excellence for Cardiovascular Health at the Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
Budget: $40,000
Start Date: January 2017
End Date: December 2017
Co-investigators: Adolfo Rubinstein, Natalia Elorriaga, Luz Gibbons, María Calderón
HSPH mentor: Marcia Castro, Department of Global Health and Population

This study evaluated the influence of Built Environments on health-related behaviors and cardiometabolic outcomes in the Southern Cone of Latin America, focusing on urban poor and health disparities. Food and physical activity environment and its relationship with socioeconomic status factors in four communities in Argentina, Chile and Uruguay were examined and the association between characteristics of the build environment and physical activity and diet and cardiometabolic conditions (hypertension, diabetes and obesity) were quantified in adults 35-74 years old in the four communities. The study also explored the agreement between perceived and objectively measured built environment, and their association with physical activity, diet, obesity and diabetes in adults 35-74 years old in the four communities.

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PI: Devaki Nambiar

Title: Assessing Coverage, Inequalities, and Frontline Provider Workflows for Hypertension and Diabetes Screening, Treatment and Follow-up in Two Indian States
Awarded Institution: The George Institute for Global Health, Delhi , India
Budget: $64,008 with $49,099 awarded by the Lown Program
Start date: 11/1/2017
End date: 11/1/2018
Co-investigators: Rajani Ved
HSPH mentor:
Richard Cash, Department of Global Health and Population

This study aims to assess the coverage of screening, treatment and follow-up for hypertension and diabetes by frontline health workers in two Indian states (Delhi and Himachal Pradesh) and to determine inequalities in screening, treatment, and follow-up coverage by gender, poverty and caste status at facility level across these two states and to characterize the workflow of frontline health workers undertaking screening, treatment and follow-up monitoring for hypertension and diabetes in these two states.

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PI: Okechukwu Ogah

Title: A study to explore the cardiovascular disease risk factors profile and burden of cardiovascular diseases in urban slums of Aba, Abia State, Nigeria
Awarded Institute: Division of Cardiology, Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
Budget: $13,000
Start date: 11/1/2017
End date: 11/1/2018
Co-investigators: Innocent Chukwuonye, Ijeoma Nduka
HSPH mentors: Goodarz Danaei, Department of Global Health and Population

This study aims to determine the prevalence of CVD risk factors such as hypertension, diabetes mellitus, dyslipidemia, obesity and overweight, cigarette smoking, alcohol abuse and physical activity in slums in Aba, Nigeria. It will also examine the knowledge, attitude and health seeking behavior of inhabitants of these slums on CVD risk factors and compare this population with high-income segment of the population based on a recent study in the same state by Ogah et al.

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PI: Prajjwal Pyakurel

Title: Worksite Intervention Study to Prevent Diabetes in Nepal
Awarded Institute: BP Koirala Institute of Health Science, Nepal
Budget: $39,312
Start date: 11/1/2017
End date: 6/1/2019
Co-investigators: Archana Shrestha,  Biraj Man Karmacharya, Hyam Sundar Budhathoki
HSPH mentors: Donna Spiegelman, Department of Epidemiology, Department of Biostatistics, Department of Nutrition

This study attempts to measure the effectiveness of a six-month intervention to provide healthier food options in a worksite cafeteria on diabetes risk and to measure the effectiveness of an individual-level lifestyle education on the risk of diabetes.