The Bangladesh D-Magic Trial. Diabetes Mellitus: Action Through Groups or Information for Better Control?

Lead Research Organisation: University College London
Department Name: Institute for Global Health

Abstract

As survival improves in low-income countries the problem of non-communicable diseases, including diabetes, increases. Diabetes currently affects between 20-30% of the population of Bangladesh either as pre-diabetes or fully expressed diabetes mellitus. The problem of diabetes and its complications is a growing concern among communities, health service providers and policymakers, yet raw data on the magnitude and underlying causes of the problem are scarce, especially in rural areas. Underlying the increasing prevalence in Bangladesh are patterns of dietary change, changing lifestyles and increases in other risk factors like lack of exercise and smoking. Our study will generate prevalence data on pre-diabetes, diabetes, and associated risk factors in rural villages in Bangladesh and explore the impacts of two interventions to improve the detection, management and prevention of diabetes in these deprived populations. The first intervention will use mobile phone technology to send health promotion information and targeted diabetes prevention and management messages to the population whilst also implementing simple messages and quiz 'apps' to facilitate health provider training and decision support in relation to diabetes care. The second intervention will focus on participatory community groups, engaging communities in a series of meetings in which the population themselves identify and address factors that may increase their risks of diabetes or prevent the effective management of the disease. It is hypothesised that collective community messaging and engagement in this way will enhance awareness and trigger behaviour change leading to lower burdens of risk factors and disease indicators, measured through large community surveys. The simultaneous evaluation of the two interventions in different areas will allow a comparison of the benefits of each compared to a 'control' area that only receives standard diabetes prevention and care services. A strong focus on implementation and process evaluation will identify the likely scalability and sustainability of these interventions.

Technical Summary

Aim: To evaluate and understand the impact and cost-effectiveness of mHealth and a community mobilisation interventions to raise awareness, change behaviour and reduce the prevalence of diabetes and pre-diabetes and NCD risk-factors in rural Bangladesh.

Design: Three-arm cluster randomised control trial with 60 clusters. 20 clusters will receive the mHealth intervention, 20 will receive the participatory community mobilisation intervention and 20 will be designated control clusters, receiving only standard services. All study clusters will benefit from health systems strengthening initiatives.

Participants: Adults aged 20 years and above residing in the 60 study clusters (impact evaluation); health service providers, policy-makers and community groups (process and economic evaluation).

Methods: Sample surveys of 6000 participants will take place before and after intervention implementation. Diabetes prevalence will be estimated from random capillary blood glucose levels. Anthropometric and blood pressure measures and survey data on participant demographic and socio-economic characteristics, lifestyle and behavioural risk factors, diabetes awareness indicators and health seeking behaviour will be gathered. Process and cost data will be gathered using mixed methods.

Primary outcome: Prevalence of diabetes and pre-diabetes in individuals aged 20 years or more between intervention and control arms after the intervention

Selected secondary outcomes: self-awareness of diabetic status; smoking prevalence; physical inactivity; mean population diastolic and systolic blood pressure; mean population body mass index; mean population waist and hip circumference ratio; awareness of diabetes symptoms; utilisation of diabetic services.

Process evaluation will address the aim of understanding the operational factors affecting intervention delivery and impact. An economic evaluation will address the aim of understanding the interventions' cost-effectiveness.

Planned Impact

This research has the potential to impact three main non-academic beneficiaries:

a) Individuals and communities in the study areas
Our study builds on increasing recognition of the potential role of mHealth and participatory interventions in facilitating enhanced awareness of health and its determinants among individuals and communities. Through active community engagement throughout the project, we anticipate that the study will increase individual and collective awareness of diabetes and its determinants, which will result in interrelated effects of improved understandings of the prevention and treatment of the disease, behaviour change, service use and effective management of community resources for healthier lives and improved diabetes management. In addition, should the interventions being evaluated prove effective, our project will have brought about direct quantifiable improvements in health of the study population. Should the interventions prove effective, they will be rolled out to the study control areas as a matter of priority.

b) Service providers & policy makers
One of the greatest challenges to improving health services in resource-poor settings is the absence of reliable data needed to understand populations, disease burdens and changing patterns of lifestyle and behavioural factors associated with increased risk of disease. Our project will generate locally relevant data needed to inform responsive health systems and service provision. At the health facility level, for example, better quality data regarding their catchment population and improved awareness will better inform the management of facility resources for diabetes prevention and management, leading to better quality services. Traditional data flows to higher levels of health service management will also strengthen opportunities for well-informed changes to practice to be implemented from within the hierarchy of the service supply side. At the district level, this may include evidence-based resource allocation and, assuming evidence of cost-effective intervention impact, inclusion of the intervention strategies in local or national implementation plans. At the same time, a better informed population, with increased individual and population awareness of diabetes, its determinants and consequences, will have enhanced capacity to hold service providers to account - an essential part strengthening health services.

c) Advocacy and implementation groups
The strong implementation research focus of our project and our commitment to share protocols, data and results throughout the study will inform diabetes and non-communicable disease advocacy and implementation groups throughout Bangladesh and globally. Lessons learned from our project and broad engagement with a range of stakeholders will enable others to build on the work we do share key lessons throughout their own networks.

Publications

10 25 50

 
Description Health Systems Strengthening
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Influenced training of practitioners or researchers
Impact The Bangladesh DMagic team provided training on the prevention and control of diabetes to 96 informal health care providers (village doctors and pharmacy shop owners) across the four sub-district project areas in Faridpur District, Bangladesh. Training employed a participatory method and impact was assessed through a pre- and post-training test of practitioners knowledge, which indicated a notable increase in knowledge on methods to prevent, test for and control diabetes following the training. In addition, the training activity created an opportunity for informal health providers within project areas to meet with each other and with qualified health professionals, strengthening linkages between these parts of the health system in Bangladesh. Informal health care providers who participated in the training have requested further training/refresher training in the future.
 
Description SAARC Declaration on Diabetes Prevention and Control
Geographic Reach Asia 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description Assessing the potential of innovative qualitative methodologies in Randomised Controlled Trials (RCTs)
Amount £46,811 (GBP)
Funding ID HOP001\1027 
Organisation Academy of Medical Sciences (AMS) 
Sector Charity/Non Profit
Country United Kingdom
Start 04/2017 
End 04/2019
 
Description Contextual Awareness, Response and Evaluation: Diabetes in Ghana
Amount £2,041,746 (GBP)
Funding ID MR/T029919/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 06/2020 
End 07/2023
 
Description Developing and evaluating an adapted behavioural activation intervention for people with depression and diabetes in South Asia
Amount £3,005,541 (GBP)
Funding ID NIHR200806 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 08/2020 
End 08/2024
 
Description Focus on the Positive
Amount £1,000 (GBP)
Organisation University College London 
Sector Academic/University
Country United Kingdom
Start 06/2017 
End 07/2018
 
Description GetAMoveOn: Adaptation and feasibility testing of mHealth to promote physical activity among older adults in urban Bangladesh
Amount £40,000 (GBP)
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 06/2018 
End 02/2019
 
Description Global Engagement Grant
Amount £1,610 (GBP)
Organisation University College London 
Department UCL Global Engagement Office
Sector Academic/University
Country United Kingdom
Start 04/2017 
End 07/2017
 
Description NEWTON FUND INSTITUTIONAL LINKS GRANT: Multi-morbidity and infectious diseases: an opportunity to strengthening links between the UK and Peru.
Amount £95,103 (GBP)
Funding ID 413495350 
Organisation British Council 
Sector Charity/Non Profit
Country United Kingdom
Start 02/2019 
End 02/2020
 
Description Public Engagement Awards
Amount £75,000 (GBP)
Funding ID 209722/Z/17/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 04/2018 
End 04/2019
 
Description UCL Beacon Bursary: Sharing knowledge about diabetes
Amount £2,000 (GBP)
Organisation University College London 
Sector Academic/University
Country United Kingdom
Start 12/2018 
End 07/2019
 
Description UCL Global Engagement Fund: DMagic dissemination and establishing links with South Africa.
Amount £2,000 (GBP)
Organisation University College London 
Sector Academic/University
Country United Kingdom
Start 08/2018 
End 07/2019
 
Description UCL Grand Challenges
Amount £3,981 (GBP)
Organisation University College London 
Sector Academic/University
Country United Kingdom
Start 12/2015 
End 06/2017
 
Description GACD Working Groups 
Organisation Global Alliance for Chronic Diseases
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution The D-Magic team have participated in new collaborations and working groups established by the Global Alliance for Chronic Diseases (GACD). These include working groups on data standardisation, context and mHealth intervention development. Collaborations has involved participation in meetings, completion of surveys, and contributions to draft manuscripts.
Collaborator Contribution The working groups have been facilitated by the GACD secretariat and led by GACD-funded researchers across the network.
Impact Draft manuscripts have been developed and work is ongoing. The collaboration is multi-disciplinary, representing social science, health systems research and epidemiology.
Start Year 2016
 
Description Karolinska Institutet 
Organisation Karolinska Institute
Country Sweden 
Sector Academic/University 
PI Contribution DClare project co-investigator Dr Carina King and PHIND Injuries co-investigator Prof. Marie Hasselberg are based at the Department of Global Public Health at Karolinska Institute.
Collaborator Contribution Dr King leads DClare activities in survey design and data processing. Dr Hasselberg contributes to protocol design in the injury intervention development project.
Impact Trial registration; co-authored publications.
Start Year 2019
 
Description Quality of Life 
Organisation Karolinska Institute
Country Sweden 
Sector Academic/University 
PI Contribution Project health economist Dr Hassan Haghparast-Bidgoli applied for and was awarded a UCL Global Engagement grant to initiate a collaboration and host a workshop with experts in health-related quality of life measurement and analysis based in Sweden. A two day workshop was held in London with a specific focus on the quality of life measurements being applied in the DMagic project. The workshop was attended by Dr Fottrell (UCL), Dr Abdul Kuddus (Diabetic Association of Bangladesh), Mr Sanjit Shaha (Diabetic Association of Bangladesh), Prof. Kishwar Azad (Diabetic Association of Bangladesh), and Dr Jahangir Khan (Karolinska Institute, Sweden) and Dr Aliasghar Ahmad Kiadaliri (Lund University, Sweden).
Collaborator Contribution Drs Khan and Kiadaliri contributed their time and technical expertise to the workshop. Specifically they reviewed the aims and methods of the quality of life and health economic components of the DMagic project.
Impact Two day workshop in London on 15th & 16th May 2017 and funding application to the EuroQol Group which is still under consideration. This collaboration was multi-disciplinary and the disciplines include were: health economics, epidemiology and medicine.
Start Year 2017
 
Description Quality of Life 
Organisation Lund University
Country Sweden 
Sector Academic/University 
PI Contribution Project health economist Dr Hassan Haghparast-Bidgoli applied for and was awarded a UCL Global Engagement grant to initiate a collaboration and host a workshop with experts in health-related quality of life measurement and analysis based in Sweden. A two day workshop was held in London with a specific focus on the quality of life measurements being applied in the DMagic project. The workshop was attended by Dr Fottrell (UCL), Dr Abdul Kuddus (Diabetic Association of Bangladesh), Mr Sanjit Shaha (Diabetic Association of Bangladesh), Prof. Kishwar Azad (Diabetic Association of Bangladesh), and Dr Jahangir Khan (Karolinska Institute, Sweden) and Dr Aliasghar Ahmad Kiadaliri (Lund University, Sweden).
Collaborator Contribution Drs Khan and Kiadaliri contributed their time and technical expertise to the workshop. Specifically they reviewed the aims and methods of the quality of life and health economic components of the DMagic project.
Impact Two day workshop in London on 15th & 16th May 2017 and funding application to the EuroQol Group which is still under consideration. This collaboration was multi-disciplinary and the disciplines include were: health economics, epidemiology and medicine.
Start Year 2017
 
Description UK Working Group on NCDs 
Organisation Parliament of UK
Country United Kingdom 
Sector Public 
PI Contribution DMagic PI was an invited partipant at a round table discussion in the UK Houses of Parliament with the All Party Parliamentary Group for Global Health and the NCD Alliance to discuss the Global Burden of NCDs and the UK's role in leadership.
Collaborator Contribution Contributions to round-table discussion and debate.
Impact Contribution to debate and discussion in preparation to the UK's participation in the UN High Level meeting on NCDs. Participation has helped to establish ongoing networks with a range of parties active in NCD prevention and research.
Start Year 2018
 
Description University of York 
Organisation University of York
Country United Kingdom 
Sector Academic/University 
PI Contribution In 2019 Dr Ed Fottrell joined the 'Improving Outcomes in Mental and Physical Multimorbidity and Developing Research Capacity (IMPACT) in South Asia' consortium led by the University of York. As part of this work DMagic partners joined the network and subsequently we have secured NIHR funding for work on diabetes and depression in Bangladesh and Pakistan.
Collaborator Contribution The Diabetic Association of Bangladesh joined this network and attended a workshop in York to develop a funding bid (as co-investigators) to develop and test an intervention for diabetes and depression in Bangladesh and Pakistan.
Impact This is a multidisciplinary collaboration that has so far resulted in secured funding for research activity that will begin in 2020.
Start Year 2019
 
Title Participatory Learning & Action and mHealth interventions for diabetes 
Description Two interventions were developed and evaluated through a cluster randomised controlled trial. The first is Participatory Learning and Action community mobilisation, which entails a series of monthly, facilitated group meetings to identify, discuss and address contextual drivers of diabetes. The second is an mHealth, voice message health promotion intervention to raise awareness of and prevent diabetes. These interventions and their evaluation were part of the MRC-funded DMagic trial. 
Type Preventative Intervention - Behavioural risk modification
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2016
Development Status Closed
Clinical Trial? Yes
Impact Both the PLA intervention and the mHealth intervention significantly increased population-level awareness and understanding of diabetes. The PLA intervention also significantly reduced the prevalence of diabetes and intermediate hyperglycaemia and the two-year incidence of diabetes among individuals with intermediate hyperglycaemia pre-intervention. The PLA intervention was deemed highly cost effective and subsequent analysis shows that its reach and impacts are equitably distributed across sex, wealth and age groups. 
 
Description 2nd Behaviour Change Conference: Digital Health and Wellbeing (London) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact D-Magic project team member Dr Hannah Jennings presented at the 2nd Behaviour Change Conference: Digital Health and Wellbeing in London on the 24th February 2016. Dr Jennings presented findings from the project's formative work and specifically on the development of our mHealth intervention development. Her presentation was followed by questions from the audience and networking.
Year(s) Of Engagement Activity 2016
URL http://www.ucl.ac.uk/behaviour-change/CBC_Conference_2016
 
Description Adapting PLA 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Dr Joanna Morrison, UCL Institute for Global Health co-investigator on DMagic and DClare moderated a webinar discussion about adaptations to the participatory learning and action intervention approach. Professor Kishwar Azad, Co-I of DMagic and DClare presented experiences of successfully adapting PLA to prevent Type-2 diabetes in rural Bangladesh. Annemijn Sondaal, collaborator on the PHIND injuries project Women and Children First, provided a case study on adapting PLA to improve family planning uptake among rural communities in Ethiopia. Engagement and dissemination objectives were achieved and the webinar was part of a wider initiative to develop a community of practice for community mobilisation interventions.
Year(s) Of Engagement Activity 2021
 
Description Attend GACD meeting and discuss our research 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Hannah Jennings and Joanna Morrison attended the Global Alliance for Chronic Diseases Annual Scientific meeting. We presented our research in two working groups - an Mhealth and a community engagement group - and at a plenary. We also networked with funders and other researchers during this meeting allowing us to inform others about our work, and explore future collaborations. Hannah joined the concepts and contexts working group, which aims to document how context is described and considered in formative research and in describing why interventions were effective or not.
Year(s) Of Engagement Activity 2016
URL http://www.gacd.org/research/research-network/asm-meetings/2016_asm
 
Description BIRDEM Hospital (Dhaka) Grand Round Presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact In April 2017 D-Magic project PI Dr Ed Fottrell presented the D-Magic project and findings from the baseline survey to an audience of physicians and practitioners at the BIRDEM hospital (Dhaka) Grand Round meeting. The meeting presentation was attended by more than 100 people and was followed by questions, discussion and recommendations from audience members with regards to future analysis, investigation and interpretation of data. Dr Fottrell was requested to present again to the same audience once the final project results are known in 2018.
Year(s) Of Engagement Activity 2017
 
Description Bangladesh Endocrine Society Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Dr Naveed Ahmed, researcher on the Dmagic project presented findings from the DMagic project to members of the Bangladesh Endocrine Society in Dhaka, Bangladesh in October 2019. This was followed by discussion and questions.
Year(s) Of Engagement Activity 2019
 
Description Camden Primary Care 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Our participatory community mobilisation intervention is a new intervention developed as part of this research project and ours is the first population-level evidence of effectiveness and with potential for "reverse translation" to high-income country contexts. To date, we have engaged with patient groups in the UK to explore opportunities for implementation in this context and, following a series of meetings and workshops, have developed an ongoing collaboration with Camden Clinical Commissioning Group to initiate the process of intervention adaptation and roll-out across the London Borough of Camden, covering a population of around 250,000.
Year(s) Of Engagement Activity 2019,2020
 
Description Community Orientation and Consent 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact The D-Magic project team held a community orientation meeting in Faridpur, Bangladesh in September 2015 to introduce the project and gain community consent to the study in the area. The event was attended by local community leaders (including upazila (sub-district) chairmen), local government officials (including the Faridpur District Commissioner), and health professionals (including the Civil Surgeon). A presentation of the project sparked questions from the workshop participants, providing an opportunity for clarifications of the interventions to be tested and the study design. The result of this was general approval by the community leaders to conduct the study. Following this consent, we conducted and filmed a public randomisation of study villages to intervention or control arms, which ensured transparency of the process.
Year(s) Of Engagement Activity 2015
 
Description Conference presentation - Qualitative Health Research Network - 'Trusted Messages' March 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Dr Joanna Morrison presented process evaluation research about the mHealth messaging intervention tested in the DMagic trial at a qualitative health research conference focused around the theme of trust.
Year(s) Of Engagement Activity 2021
 
Description DMagic Community Mobilisation Documentary 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact The DMagic project team produced a short film describing the community mobilisation intervention and its effects on community behaviours. The film was shown at events in Dhaka, Faridpur and London and have been viewed more than 100 times on YouTube in the first 6 weeks. This film has raised awareness and understanding of the project.
Year(s) Of Engagement Activity 2019
URL https://www.youtube.com/watch?v=4OcXRuYtTRM&fbclid=IwAR1eggV64GFaZhWYIqYm4HEQNdmsJCW3YMHjXaSvIujCL4j...
 
Description DMagic Faridpur Dissemination Event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact The Bangladesh DMagic study team ran a one day dissemination event to share and discuss study findings to practitioners, community representatives, local politicians and the general public in Faridpur district - the setting of our research. The event was chaired by the Faridpur Civil Surgeon and was followed by active discussion and positive feedback from participants, who all expressed a desire for ongoing collaboration. The event was covered by the local press (in Bangla).
Year(s) Of Engagement Activity 2019
 
Description DMagic Project Dissemination, Dhaka 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact More than 100 participants from the Government of Bangladesh, academia, NGOs, civil society, industry and the media attended a dissemination workshop event in Dhaka where the DMagic project interventions and trial findings were presented. Presentation of the research was followed by active questioning and discussion from the audience. The event was attended by government officials, including Md. Asadul Islam, Secretary, Health Services Division, Ministry of Health & Family Welfare, Government of Bangladesh, Dr Nur Mohammad, Line Director, Non-communicable Diseases, Directorate General of Health Services, Government of Bangladesh and Prof. Dr. Abdul Kalam Azad, Director General, Directorate General of Health Services, Government of Bangladesh. The Government Line Director of NCDs publicly responded to our findings and later engaged in more private conversations to express a desire to scale-up and support project activities throughout the country and these conversations are ongoing.

The event was covered by the media, with a report in the Dhaka Tribune (link below).
Year(s) Of Engagement Activity 2019
URL https://www.dhakatribune.com/health/2019/01/18/diabetic-who-me
 
Description Diabetes & Endocrine Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact DMagic project researcher Dr Naveed Ahmed presented baseline survey findings in the Invited Lecture Session of the 23rd Diabetes and Endocrine Conference (DEC) held from January 25-27, 2018 at the Bangladesh University of Health Sciences (BUHS). The participants at this session included senior and junior professors of Endocrinology and Metabolism from the leading public and private hospitals of the country as well as epidemiologists from various NGOs operating in Bangladesh. Other members of the audience included physicians from different branches of Medicine and Surgery, nutritionists and students at BUHS. The presentation was followed by a lively question answer session.
Year(s) Of Engagement Activity 2018
URL http://buhs.ac.bd/index.php/2018/02/06/23rd-diabetic-endocrine-conference/
 
Description Digital Health Seminar 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Dr Fottrell was invited to present a lunchtime seminar as part of the Frontiers in Digital Health seminar series. His hour-long seminar focussed on digital intervention development, implementation and evaluation, using the DMagic project as a case study. The seminar sparked numerous questions and follow-up requests for further discussion and potential new collaborations.
Year(s) Of Engagement Activity 2018
 
Description GACD ASM 2019 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited presentation and panel discussion on the topic of scale-up to GACD ASM audience.
Year(s) Of Engagement Activity 2019
URL https://www.gacd.org/research/research-network/gacd-annual-scientific-meeting-2019
 
Description GACD Annual Scientific Meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact DMagic PI Dr Fottrell participated in the Global Alliance for Chronic Diseases Annual Scientific Meeting in Sao Paulo, Brazil, where he presented DMagic study findings to other grant holders from across the globe and subsequently engaged in round table discussions. Based on this, future discussions are planned with colleagues from South Africa, where the DMagic interventions may be applied.
Year(s) Of Engagement Activity 2018
 
Description GACD Digital Health 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof. Kishwar Azad and Dr Abdul Kuddus attended the Implementation science and digital healthcare interventions workshop organized by GACD on July 07, 2021 and Dr Abdul Kuddus presented paper "Learning from a diabetes mHealth intervention in rural Bangladesh: what worked, what did not and what next?"
Year(s) Of Engagement Activity 2021
 
Description GACD Implementation Science Workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The purpose of this workshop was to discuss aspects of the field of dissemination and implementation science. Through plenary sessions, group work and discussion, practitioners, policymakers and researchers focussed on methods of implementation science and how to influence policy and practice.
Year(s) Of Engagement Activity 2017
 
Description GetAMoveOn Film 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact DMagic investigators Fottrell and Jennings were interviewed and helped to produce a short film about a follow-on project which has adapted and tested the feasibility of DMagic mHealth messages to improve physical activity among older adults in urban Faridpur, Bangladesh. The film has only been online for 1 week (as of 7/3/2019) but is expected to raise the profile of our work.
Year(s) Of Engagement Activity 2019
URL https://www.youtube.com/watch?v=3Gv_CoIxNsk&feature=youtu.be
 
Description Global Alliance for Chronic Diseases Context & Concepts Working Group 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Dr Hannah Jennings represents the D-Magic project on the GACD Contexts and Concepts Working Group.

The aims of the working group are:

•To describe the different steps or methods used to identify theories/models/frameworks in the different phases of the identified studies
•To describe the different steps or methods used to identify components of context that were incorporated in the identified studies
•To describe how context was incorporated into the identified studies and at which levels
•To identify common methodological and analytical themes across the selected projects and two case studies (if needed) for a manuscript on the topic.
Year(s) Of Engagement Activity 2015,2016,2017
 
Description International Health Economics conference at Basel Switzerland, 13th-17th July 2019 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Project co-investigator Hassan Haghparast-Bidgoli and his MSc student Rohit Syed-Hasan gave oral presentations at this international conference on:

"The acceptance and willingness to pay (WTP) for a mHealth mobile voice messages for preventing diabetes and non-communicable disease risk factors in rural Bangladesh: a contingent valuation study" (presenter: Hassan Haghparast-Bidgoli).
"Assessing the inequality in health care seeking costs for Type 2 diabetes mellitus in rural Bangladesh" (Presenter: RohitSyed-Hasan)

Presentations were followed by questions and discussion.
Year(s) Of Engagement Activity 2019
 
Description Karolinska Institute Lifestyle4Health Network 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Dr Carina King presnted work on DMagic and DClare to an academic audience as part of a network at Karolinska Institute, Sweden, to promote mutual learning around behaviour change and non-communicable diseases. Approximately 20 people attended, with the aim to share learning and promote collaboration.
Year(s) Of Engagement Activity 2021
 
Description MRC Epidemiology Group - Cambridge 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact In November 2020, Dr Fottrell was invited to deliver a seminar on the DMagic project to staff and students at the MRC Epidemiology Unit, Cambridge University. The event was followed by a series of one-to-one and small group meetings to explore common areas of academic interest and potential collaboration. As a result of this, a new collaboration has been formed and future activities are being planned.
Year(s) Of Engagement Activity 2019
 
Description Mt Hood Diabetes Challenge in Asia: Economics, simulation modelling & diabetes at Seoul,South Korea, 30th Nov-1st Dec 2019 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Based on analysis of DMagic data under the supervision of Co-investigatro Dr Hassan Haghpparast-Bidgoli, Mr Damon Mohebbi presented the following paper at the above conference.

"Economic evaluation of diabetes prevention interventions in Bangladesh using Markov modelling".

The presentation was followed by question and discussion.
Year(s) Of Engagement Activity 2019
 
Description Participation in Global Alliance for Chronic Diseases Annual Scientific Meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Funding agency representatives, national policy makers in Argentina and approximately 100 awardees of GACD grants from across all funding agencies attended the Annual Scientific Meeting in Argentina. The purpose was to share experiences in implementing and evaluating GACD projects and to collaborate in GACD-led working groups related to data, methods and implementation. The meeting helped to strengthen collaborations and progress activities related to GACD working groups.
Year(s) Of Engagement Activity 2017
 
Description Press release 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact We released a press release related to the DMagic trial publication. The press release was developed in collaboration wit the Global Alliance for Chronic Diseases and led to a news story on various websites, including the MRC news web page (link below). Publication of the trial findings along with the press release led to substantial social media activity related to the project (e.g. through Twitter), with the development of a specific project hashtag #DMagicTrial.
Year(s) Of Engagement Activity 2019
URL https://mrc.ukri.org/news/browse/new-study-sheds-light-on-community-based-approach-to-diabetes-preve...
 
Description Realising community engagement webinar 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof. Ed Fottrell and Prof. Kishwar Azad participated in a webinar hosted by Women & Children First UK on the theme of 'Realising Community Engagement in Global Health'. Prof. Azad discussed lessons learned from adapting PLA for diabetes in Bangladesh, and Prof. Fottrell discussed key future research priorities for PLA and related community mobilisation approaches. The purpose of sharing experiences and disseminating activities and findings to a wide international community of participants who may be engaged in health promotion and community mobilisation activities was achieved. This activity contributed to the establishment of a community of practice for participatory community mobilisation activties.
Year(s) Of Engagement Activity 2021
 
Description Reasons to Be Chereful Podcast with Ed Miliband & Geoff Lloyd 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Project co-investigator Prof Anthony Costello participated in a well-established podcast to talk about a body of research on community mobilisation to improve health,with specific reference to the Bangladesh DMagic trial. The podcast increased awareness of the project and stimulated ongoing discussions about the transferability of the intervention from Bangladesh to the UK context.
Year(s) Of Engagement Activity 2018
URL https://www.anthonycostello.net/podcast/reasons-to-be-cheerful-my-podcast-with-ed-miliband-and-geoff...
 
Description Regional Public Health Conference 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Dr Abdul Kuddus attended the 9th Regional Public Health Conference held on 25 & 26 February, 2002 organized by Faculty of Public Health, Bangladesh University of Health Sciences, Dhaka and shared poster presentation on "Learning from a diabetes mHealth intervention in rural Bangladesh: what worked, what did not and what next?" During the poster presentation various queries were responded regarding D-Magic trial and DClare scale up of the PLA intervention in Alfadanga Upazila.
Year(s) Of Engagement Activity 2021
 
Description SciDev.net 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact I was interviewed about my MRC-funded 'D-Magic' diabetes project by the online science and development news site SciDev.net. This gave me the opportunity to describe the problem of diabetes in Bangladesh and the specific details of my project. The interview was published online as a podcast and to date (within one month of publication) it has been listened to approximately 100 times and shared through social media approximately 50 times.
Year(s) Of Engagement Activity 2016
URL http://www.scidev.net/global/disease/multimedia/doctors-bangladesh-diabetes-mobile.html
 
Description Seminar & round table discussion, Peru 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact In January 2020, PI Dr Ed Fottrell visited CRONICS Centre of Excellence for Chronic Diseases in Lima Peru where he delivered a seminar on the DMagic project and discussed the potential of community mobilisation interventions for multimorbidity in resource-poor settings. This was followed by a round-table discussion of the challenges of preventing and controlling multiple chronic conditions in low-income communities.
Year(s) Of Engagement Activity 2020
 
Description South Asian Association for Regional Cooperation (SAARC) meeting on non-communicable disease prevention and control in South Asia. 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact In September 2019, Fottrell was an invited international expert and speaker at a meeting of the South Asian Association for Regional Cooperation (SAARC) on non-communicable disease prevention and control in the South Asia region. SAARC is the regional intergovernmental organisation and geopolitical union of eight South Asian states comprising 21% of the world's population. Fottrell delivered two presentations, participated in round-table discussions and formulation of the "2030 SAARC Declaration" for the prevention and control of diabetes in the region.
Year(s) Of Engagement Activity 2019
 
Description UCL Centre for Global Non-communicable diseases: "In conversation" seminar series. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact DMagic investigators Fottrell, Jennings and Morrison presented a seminar on the DMagic project to an audience of academics, practitioners, students and representatives of UK non-communicable disease charities. The seminar was followed by an in-depth discussion and question and answer session and has led to follow-on requests for further information/future collaboration.
Year(s) Of Engagement Activity 2018
URL https://www.eventbrite.co.uk/e/ucl-centre-for-global-ncds-seminar-series-in-conversation-tickets-518...
 
Description UCL Grand Challenge Voices 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Project co-investigator Prof Anthony Costello was interviewed for a UCL podcast which included discussion of the DMagic project and the observed study impacts in Bangladesh. This podcast has served to raise the profile of the DMagic community mobilisation intervention and has led to ongoing discussions with potential collaborators interested in implementing the intervention in the UK context.
Year(s) Of Engagement Activity 2019
URL https://soundcloud.com/uclsound/voices-from-grand-challenges-the-power-of-sympathy-groups-with-prof-...
 
Description UCL Lancet Lecture 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact In 2019, Dr Fottrell provided the offical response to the annual UCL Lancet Lecture, which was delivered by Prof. Rachel Neugent on disucssed NCDs as a global health emergency. The UCL Lancet Lecture is a high profile event in central London, is streamed live and is preserved as a film that can be watched online. Dr Fottrel explicitly referred to the DMagic project in his response.
Year(s) Of Engagement Activity 2019
URL https://www.ucl.ac.uk/grand-challenges/ucl-lancet-lecture-2019
 
Description UCL South Asia Regional Network Meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Prof. Fottrell presented an overview of research activities undertaken in Bangladesh, with a particular focus on the DMagic, DClare and PHIND Injuries projects. The audiience represented academics and researchers from a range of disciplines across UCL with an interest in South Asia.
Year(s) Of Engagement Activity 2021
 
Description University of Witwatersrand seminar and field visit 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Dr Fottrell presented the DMagic project to an audience of academics and students at the University of Witwatersrand School of Public Health in South Africa. The presentation was followed by questions and discussion. Subsequent meetings with academics at WITS led to the development of a funding bid to conduct research on multimorbidity in South Africa, which was successfully funded in March 2020.
Year(s) Of Engagement Activity 2019
 
Description Uppsala Diabetes Centre lecture 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof. Fottrell gave an invited key-note lecture at the opening symposium for the Uppsala Diabetes Centre in Sweden, November 30th 2021.
Year(s) Of Engagement Activity 2021
URL https://www.kalendarium.uu.se/event?eventId=65808
 
Description Visual Participatory Analysis 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Study participants or study members
Results and Impact DMagic study findings were presented to study participants in Faridpur in an innovative, artistic way to 1) disseminate study findings and 2) enable participants to contribute to the interpretation of study findings. The study team worked with a local artist to represent study findings in an appropriate, visual way suited to the study population (with high levels of illiteracy and innumeracy). Notes from these sessions were used to inform study interpretation and have contributed to subsequent research reports.
Year(s) Of Engagement Activity 2017,2018
 
Description community advisory committee meetings 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact We held a meeting with four advisory committees in each upazilla of Faridpur District where we are running the group intervention. There were around 5 or 6 people at each meeting. They were conducted in the local area. They were attended by local leaders, non governmental organisation workers, and the general public. We discussed our project activities with them and provided them with the flipchart which facilitators use in women's and men's group meetings. We encouraged them to attend the community meetings that groups were running, and those who had attended meetings gave us feedback about the intervention and the community response. They were keen for the intervention to be scaled up and they though that the community learned from the intervention.
Year(s) Of Engagement Activity 2017
 
Description community advisory committees 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact We convened community advisory committees in each upazilla of Faridpur District where we will conduct the study. The committees had between 5 to 8 people and they were asked to provide advice on the best way to implement interventions, ensure a good understanding of interventions and measurement, provide feedback on project plans and intervention activities, provide a forum to discuss community concerns. We discussed the intervention with each group and asked for their advice on specific intervention components (hiring of facilitators, timing of meetings etc), and this was reported on and used to inform the development of interventions.
Year(s) Of Engagement Activity 2015