Integrating places of worship (PoWs) into the primary care pathway to prevent and control non-communicable diseases (NCDs) in the Caribbean

Lead Research Organisation: King's College London
Department Name: Diabetes & Nutritional Sciences

Abstract

The Caribbean has the highest proportion of people suffering from chronic diseases such as diabetes, cancers, stroke and heart disease in the Americas. As in other parts of the world, this is a consequence of ageing populations, urbanisation, lifestyle changes resulting from globalisation such as unhealthy diets, lack of exercise, use of alcohol and cigarettes, and other social influences. The effects of these factors on health are worse in poor communities. Health systems in poorer countries in the Caribbean face challenges in preventing chronic diseases and meeting the needs of those affected. Our approach considers how to enhance health services taking into account the wider social and cultural context in which people live. It will use the strengths and assets of communities to promote health and reach the poorest in a cost effective and sustainable way.
Religion plays an important role in the Caribbean with almost everyone attending a place of worship such as a church, mandir or mosque, at least once a month. Many studies have shown that places of worship can be used successfully to promote healthy lifestyles. However these programmes are often discontinued after the research is completed. In collaboration with national and international agencies including Ministries of Health, Inter-Religious Organizations, the Healthy Caribbean Coalition, the Caribbean Public Health Agency, and the Pan American Health Organization, we will plan and implement an intervention which uses health advocates recruited from places of worship to promote health and lifestyle changes and support the management of chronic diseases. The health advocates will be linked into local primary health care centres and supervised by nurses to ensure that when needed, early referrals are made and patients are followed up in the community. By evaluating the intervention as it is implemented in real time, we will examine whether and how this approach will improve the prevention and early detection of chronic diseases as well as support the care and treatment of those already affected.
The study will take place in three of the less wealthy Caribbean Commonwealth countries which face challenges in providing quality health care: Guyana, Jamaica and Dominica. Each of these have different social and cultural features so we will be able to compare the results and develop solutions that have relevance to the entire region. We will focus on poor rural and urban areas where the need is greatest. We will work with the Ministries of Health, nurses and doctors in regional and local health care centres and hospitals, religious leaders and congregations. The Ministry of Health will train members of the congregations to be health advocates. They will be taught to conduct simple tests such as measuring blood pressure and weight, encourage people to take medications as prescribed and attend clinic appointments, inform people about welfare benefits and help with applications, and support a healthier, more active lifestyle, such as providing exercise or healthy cooking sessions. Health advocates will be supervised and monitored by nurses at local health centres who will be trained in this new role. We will conduct continual evaluation to look at if and how the intervention is working to address the needs of the community, especially the most vulnerable.
If the research is successful, we will develop a tool kit for the Caribbean providing guidelines on how health systems and communities can work together to combat chronic diseases through the engagement of places of worship and other community-based organisations. Changing the health system in this way will reach more people than through traditional health care by providing easily accessible and regular health advice and support in the heart of local communities. It will result in significant social and economic benefits by reducing health care costs for chronic diseases and preventing disability and premature death.

Technical Summary

We will evaluate the integration of health advocates in places of worship into the primary care pathway and the potential impact on health literacy, adoption of healthy lifestyles, early detection and referral, and NCD management. The Caribbean has the highest NCD mortality in the Americas placing huge pressure on fragile health systems. Task shifting and collaborative community-based interventions are advocated to reduce inequalities in health and address the burden of NCD, but have seldom been evaluated in LMIC. The intervention will be conducted in 3 of the least affluent CARICOM countries with differing sociocultural contexts to enhance adaptability. We will recruit health advocates from places of worship in poor urban and rural communities to conduct health promotion activities, support treatment adherence, and ensure prompt referral. Our intervention has the features of a complex intervention, i.e. multiple components and outcomes, interactions and feedback loops between intervention and context. Based on the principles of realist evaluation and MRC guidelines for the evaluation of complex interventions, we will evaluate the intervention in real time to observe the interaction between the context of the intervention, the mechanism (how it works), and the outcomes. We will use a mixed methods approach including: 1) concept mapping with stakeholders to gather information on factors influencing implementation, prioritise areas for health system improvement, and foster collaboration; 2) observation and interviews with congregants and health advocates to track the implementation in context over time; 3) quantitative survey of congregants at baseline and endline to examine the influence of the intervention on lifestyle change, health literacy, satisfaction with services, and well-being. If the intervention is successful we will develop a toolkit for up-scaling across the Caribbean through established partnerships with health ministries and regional stakeholders.

Planned Impact

We plan to evaluate the integration of places of worship into the care pathway to prevent and control non-communicable diseases (NCDs). Universal health coverage is crucial to reach vulnerable populations. Given the wide reach of places of worship, this innovative model of service delivery will increase health literacy and accelerate access to care among vulnerable communities thus reducing social inequalities in NCD. It will also have societal benefit by improving the health and well being of the entire population. It will reduce care costs and prevent morbidity, mortality and reduced productivity. Arguably it could be seen as poverty reduction strategy given the greater vulnerability of the poor to NCD.
This approach will have significant impact on the organisational culture and effectiveness of primary health care. It helps to bring health care and information as close as possible to where people live, and is embedded in the cultural and social context. The intervention will strengthen collaboration between health services and communities, increase awareness of community needs among health workers, and strengthen the health workforce through the use of health advocates (HAs). Early intervention and prevention in primary care should reduce the need for treatment of NCDs and complications in secondary and tertiary services. Training of primary care workers and HAs will continue after the close of the project, supported by Ministries of Health (MoHs) and the Caribbean Public Health Agency (CARPHA). A network of practitioners and HAs will act as mentors and trainers for other community-based interventions and findings will be relevant to other health domains e.g. mother and child health.
The research will benefit national MoHs and regional health networks, including the Pan American Health Organization (PAHO) and CARPHA, by providing evidence to support NCD Action Plans and commitments to whole system approaches and intersectoral partnerships. If successful the study will provide a model for scale up and on-going evaluation. With support from PAHO/CARPHA/MoHs we will produce a toolkit to guide policy makers on best practice for up-scaling the intervention. The longstanding relationship between the University of the West Indies (UWI), CARPHA and CARICOM provides an effective conduit for research evidence to influence government policy and for Caribbean-wide uptake of the approach with the support of WHO/PAHO. The approach also has international transferable value to resource poor communities with high levels of religious involvement.
We will disseminate findings to stakeholders via professional development events and workshops with professional, patient and civil society organisations (e.g. the Healthy Caribbean Coalition, national Diabetes and Nurses Associations). We will hold seminars at UWI, University of Guyana, Ross University School of Medicine and other higher education institutions to present the findings to students and researchers in the fields of nursing, medicine, and public health. Results will be presented at regional and international conferences, including a symposium hosted by CARPHA at their annual scientific meeting, and in articles in high impact scientific journals. With the support of a communications expert (Co-I PM) we will disseminate findings to communities through local and regional media and through film, drama, and music at places of worship, festivals, and other community events.
This project will strengthen the scientific partnership between UK and UWI research groups and establish a new regional coalition with researchers in Guyana and Dominica. PhD & MPH students, including those in the new Guyana programme directed by Co-I RG, as well as junior researchers will be mentored in topics including social determinants of health and evaluating community-based interventions. We will support local students to complete postgraduate projects based on the research at masters and doctoral level.

Publications

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Delgado-Angulo EK (2018) Ethnicity, migration status and dental caries experience among adults in East London. in Community dentistry and oral epidemiology

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Etyang AO (2016) The Malaria-High Blood Pressure Hypothesis. in Circulation research

 
Title CONTACT Posters and Fliers 
Description Posters and fliers developed by the CONTACT Study team to disseminate information about the study, NCDs and risk factors, and NCD prevention and control strategies. Materials utilized simple language and images that would be readily understood by persons with low literacy levels. 
Type Of Art Image 
Year Produced 2018 
Impact Not yet assessed. 
 
Title Health Advocate Training Materials 
Description CONTACT Study pamphlets; health advocate topic guides; role play scenarios and case studies for health advocate training 
Type Of Art Creative Writing 
Year Produced 2018 
Impact Successful training of health advocates to disseminate information about NCDs and risk factors and facility lifestyle change. 
 
Title Places of Worship Health Talk 
Description Health Talk (combination of static images, voice-over narration/explanation, and existing footage) covering a range of common health topics, such as food safety and hygiene, stress management and lifestyle change, using simple language and images/footage to provide information to congregation members while waiting for interviews and health advocate clinics. 
Type Of Art Film/Video/Animation 
Year Produced 2018 
Impact Audience remained engaged throughout viewing, requested additional information, and enacted physical activity segment. 
 
Description Social and religious capital is context specific but can strengthen primary health care systems in the Caribbean region
Exploitation Route Policy workshops with a range of policy actors, implementers and civic organisations are planned to take place in each country
Sectors Communities and Social Services/Policy,Education,Environment,Healthcare,Government, Democracy and Justice

 
Description Capacity building has been a key impact with international scholarships awarded to local researchers and training materials incorporated into local university programmes
First Year Of Impact 2019
Sector Education,Healthcare,Government, Democracy and Justice
Impact Types Societal

 
Description Chair, Risk of the Resilience, Ethnicity and AdolesCent Mental Health study Steering Group
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Participation in a advisory committee
 
Description Master of Public Health Thesis - PHCC Readiness Evaluation
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Influenced training of practitioners or researchers
 
Description Member of National Medical Council Continuing Medical Education Sub-Committee
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
 
Description Member of Scientific Committee for Born in Bradford cohort study
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Participation in a advisory committee
 
Description Member, Scientific Advisory Group, HEKIMA-Kenya Study
Geographic Reach Africa 
Policy Influence Type Membership of a guideline committee
 
Description Training of nurses, community health workers and lay health advocates in NCD prevention
Geographic Reach South America 
Policy Influence Type Influenced training of practitioners or researchers
Impact 15 health advocates, 4 community health workers and 4 primary care nurses trained in NCD prevention
 
Description Training of researchers in Guyana in qualitative research methods
Geographic Reach South America 
Policy Influence Type Influenced training of practitioners or researchers
Impact 13 researchers at the University of Guyana and 1 at the Ministry of Public Health in Guyana trained in qualitative methods
 
Description ARC Discovery Projects
Amount £247,000 (GBP)
Organisation Australian Research Council 
Sector Public
Country Australia
Start 01/2011 
End 11/2013
 
Description Big lottery Fund
Amount £395,973 (GBP)
Organisation Big Lottery Fund 
Sector Public
Country United Kingdom
Start 03/2011 
End 03/2015
 
Description CLRN
Amount £105,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 09/2012 
End 03/2014
 
Description Commonwealth Shared Scholarship
Amount £35,000 (GBP)
Organisation Foreign and Commonwealth Office (FCO) 
Sector Public
Country United Kingdom
Start 10/2019 
End 09/2020
 
Description Department of Health -Public Health Consortium
Amount £4,200,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 02/2011 
End 05/2016
 
Description GCRF - Global Impact Acceleration
Amount £1,500 (GBP)
Organisation King's College London 
Sector Academic/University
Country United Kingdom
Start 10/2018 
End 03/2019
 
Description KCL Together
Amount £50,000 (GBP)
Organisation King's College London 
Sector Academic/University
Country United Kingdom
Start 04/2017 
End 03/2018
 
Description Newton Fund
Amount £136,604 (GBP)
Funding ID MR/R022739/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 04/2018 
End 10/2019
 
Description Overcoming ethnic differences: A 3-D approach to somatic growth when predicting lung function in children
Amount £1,160,000 (GBP)
Funding ID 094129/B/10/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2010 
End 12/2015
 
Description Overcoming ethnic differences: A 3-D approach to somatic growth when predicting lung function in children
Amount £50,000 (GBP)
Organisation Asthma UK 
Sector Charity/Non Profit
Country United Kingdom
Start 04/2010 
End 12/2011
 
Description PAHO/WHO Guyana Studentship
Amount $15,000 (USD)
Organisation Pan American Health Organization 
Sector Charity/Non Profit
Country United States
Start 10/2019 
End 09/2020
 
Description Rapid Response Research Grants
Amount £144,000 (GBP)
Funding ID MR/R022739/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 03/2018 
End 02/2019
 
Description Sheffield Overseas Scholarship
Amount £15,000 (GBP)
Organisation University of Sheffield 
Sector Academic/University
Country United Kingdom
Start 10/2019 
End 09/2020
 
Title Concept Mapping with Stakeholders 
Description Qualitative data collection on intervention enablers and challenges is conducted by means of focus prompts to be completed by stakeholders, generating statements that can be sorted by common themes and rated for importance and feasibility of change. Quantitative analysis of sorted and ranked data allows generation of visual 'go-zone maps' that identify priority areas for action/intervention. 
Type Of Material Improvements to research infrastructure 
Year Produced 2017 
Provided To Others? Yes  
Impact Concept mapping allowed participatory approaches to development and implementation of a complex health systems intervention, via engagement of, and input from, key stakeholders at all levels. 
 
Title Congregational Questionnaire 
Description Baseline questionnaire 
Type Of Material Improvements to research infrastructure 
Provided To Others? No  
Impact not yet assessed 
 
Title Monitoring Intervention 
Description Development of logbooks to track health advocate activities in places of worship 
Type Of Material Improvements to research infrastructure 
Year Produced 2019 
Provided To Others? No  
Impact Health Advocates were able to maintain records of congregants' health visits and results. Researchers were able to assess health advocate implementation of intervention. 
 
Title NCD readiness 
Description Assessment of readiness of primary care centres and places of worship for NCD interventions - questionnaire based 
Type Of Material Improvements to research infrastructure 
Provided To Others? No  
Impact not yest assessed 
 
Title Sampling frame 
Description Sampling frame of places of worship in regions taking part in the study. Undertaken by medical students as part of their practicum 
Type Of Material Improvements to research infrastructure 
Provided To Others? No  
Impact not yet assessed 
 
Title Training of health advocates 
Description Training course for health advocates - covers prevention behaviours, access to primary care, adherence and motivational interviewing skills; role play a major part of the course 
Type Of Material Improvements to research infrastructure 
Provided To Others? No  
Impact Not yet assessed 
 
Title Training of researchers 
Description 4 day course on qualitative methods covering theory, methods, process evaluation and role play 
Type Of Material Improvements to research infrastructure 
Provided To Others? No  
Impact not yet assessed 
 
Title Use of Social Media Platform for Health Advocate Training and Retention 
Description All health advocates were added to a WhatsApp group that they could access on their mobile devices. The Study team maintains daily contact with the group, providing technical information about NCD prevention and control, advice, and encouragement, and receiving updates on health advocate performance, enablers, challenges and innovations. 
Type Of Material Improvements to research infrastructure 
Year Produced 2018 
Provided To Others? No  
Impact 12 (80%) of 15 initially trained health advocates have been retained (3 replacement health advocates have since been added to the group); health advocate health literacy and ability to convey NCD-related information has improved noticeably; health advocates' personal health behaviour has improved. 
 
Title CONTACT Study - Qualitative Interviews, Baseline and End-line 
Description Transcripts of over 100 interviews conducted with various stakeholders in Guyana. Additional transcripts for Jamaica and Dominica. 
Type Of Material Database/Collection of data 
Year Produced 2019 
Provided To Others? No  
Impact Currently being analyzed to determine stakeholder perspectives on the intervention, including congregant experiences and outcomes. 
 
Title CONTACT Study Dominica - Concept Mapping Database 
Description Qualitative data on enablers and challenges to CONTACT intervention collected from stakeholders in health sector and civic society in Dominica. 
Type Of Material Database/Collection of data 
Year Produced 2018 
Provided To Others? No  
Impact Data used to inform subsequent planning and implementation of intervention. 
 
Title CONTACT Study End-line Evaluation Database 
Description Quantitative data on demographics, socioeconomic characteristics, risk factors, medical history, wellbeing, health behavior, health spending and feedback on intervention from congregants in intervention places of worship. 
Type Of Material Database/Collection of data 
Year Produced 2019 
Provided To Others? No  
Impact Analyses are ongoing to determine whether the data indicate any change in behaviors as a consequence of the intervention. 
 
Title CONTACT Study Guyana - Baseline Congregation Health Survey Database 
Description Data on demographic characteristics, past and current medical history, current lifestyle (diet, exercise), health-seeking behavior and quality of life from about 450 congregants from 9 places of worship (intervention sites) in Guyana. 
Type Of Material Database/Collection of data 
Year Produced 2018 
Provided To Others? No  
Impact 3 papers using data from this database have been submitted for presentation at the 64th Annual CARPHA Health Conference. 
 
Title CONTACT Study Guyana - Concept Mapping Database 
Description Qualitative data about enablers and challenges to the CONTACT intervention, collected from about 15 stakeholders in the health sector and civic society. 
Type Of Material Database/Collection of data 
Year Produced 2017 
Provided To Others? No  
Impact Findings presented at 63rd Annual CARPHA Health Conference. Abstract published in West Indian Medical Journal Supplement (2018). Data used to inform subsequent planning and implementation of intervention. 
 
Title CONTACT Study Guyana - LIHP Concept Mapping Database 
Description Qualitative data from 20 stakeholders in health, financial and governance sectors, regarding suggestions for, challenges to and enablers of sustainability of internationally funded projects after funding has ceased. 
Type Of Material Database/Collection of data 
Year Produced 2019 
Provided To Others? No  
Impact Data were used to develop a generic sustainability framework for incorporation of internationally funded projects into Guyana's national budget after funding ceases. This framework was created by a CONTACT Study Guyana team member, and is being applied to development of a sustainability plan for the CONTACT intervention. 
 
Title CONTACT Study Guyana - PHCC Readiness Evaluation Database 
Description Data (over 400 variables) from 6 primary healthcare centres (3 intervention and 3 control) on physical and human resources, services offered, patient volumes and waiting times, NCD clinic information, and staff perspectives on CONTACT intervention. 
Type Of Material Database/Collection of data 
Year Produced 2018 
Provided To Others? No  
Impact Data on PHCC readiness used for paper submitted to 64th Annual CARPHA Health Conference. Findings informed subsequent planning and implementation of intervention. 
 
Title CONTACT Study Guyana - POW Readiness Evaluation Database 
Description Data (over 400 variables) from 14 places of worship (POW; 9 intervention and 5 control) on physical resources, services and groups, congregation size, NCD awareness, and perspectives on CONTACT intervention. 
Type Of Material Database/Collection of data 
Year Produced 2018 
Provided To Others? No  
Impact Data on POW readiness used for paper submitted to 64th Annual CARPHA Health Conference. Findings informed subsequent planning and implementation of intervention. 
 
Title CONTACT Study Jamaica - Concept Mapping Database 
Description Qualitative data about enablers and challenges to the CONTACT intervention, collected from stakeholders in the health sector and civic society. 
Type Of Material Database/Collection of data 
Year Produced 2018 
Provided To Others? No  
Impact Data used to inform subsequent planning and implementation of intervention. 
 
Description CONTACT Study - 4 Governmental Partnerships 
Organisation Government of Dominica
Department Ministry of Health, Wellness and New Health Investment
Country Dominica 
Sector Public 
PI Contribution Supported health sector strengthening by: training young local scientists in research theory and methods and grant administration; training lay congregation members to serve as health advocates in places of worship, thus shifting some NCD prevention and control burden away from primary health care centres.
Collaborator Contribution Health Ministries: Provided access to primary care clinics and permission for staff to take part in research; press coverage; cabinet support. In Guyana: indirect financial support in the form of health advocate stipends, health advocate training resources, health education materials for distribution to congregations. Ministry of Communities: Use of boardroom/conference room & printing facilities, clerical services - for health advocate meetings and training sessions.
Impact Completion of 12 primary health care clinic baseline evaluation surveys (6 facilities in Guyana, 4 in Jamaica, 2 in Dominica); NCD prevention and control training of 15 health advocates from 9 places of worship and 3 community health workers in Guyana; training and heath education materials; Caribbean-wide press-release raising awareness of CONTACT Study; various local media publications.
Start Year 2016
 
Description CONTACT Study - 4 Governmental Partnerships 
Organisation Government of Guyana
Department Ministry of Communities
Country Guyana 
Sector Public 
PI Contribution Supported health sector strengthening by: training young local scientists in research theory and methods and grant administration; training lay congregation members to serve as health advocates in places of worship, thus shifting some NCD prevention and control burden away from primary health care centres.
Collaborator Contribution Health Ministries: Provided access to primary care clinics and permission for staff to take part in research; press coverage; cabinet support. In Guyana: indirect financial support in the form of health advocate stipends, health advocate training resources, health education materials for distribution to congregations. Ministry of Communities: Use of boardroom/conference room & printing facilities, clerical services - for health advocate meetings and training sessions.
Impact Completion of 12 primary health care clinic baseline evaluation surveys (6 facilities in Guyana, 4 in Jamaica, 2 in Dominica); NCD prevention and control training of 15 health advocates from 9 places of worship and 3 community health workers in Guyana; training and heath education materials; Caribbean-wide press-release raising awareness of CONTACT Study; various local media publications.
Start Year 2016
 
Description CONTACT Study - 4 Governmental Partnerships 
Organisation Government of Guyana
Department Ministry of Public Health
Country Guyana 
Sector Public 
PI Contribution Supported health sector strengthening by: training young local scientists in research theory and methods and grant administration; training lay congregation members to serve as health advocates in places of worship, thus shifting some NCD prevention and control burden away from primary health care centres.
Collaborator Contribution Health Ministries: Provided access to primary care clinics and permission for staff to take part in research; press coverage; cabinet support. In Guyana: indirect financial support in the form of health advocate stipends, health advocate training resources, health education materials for distribution to congregations. Ministry of Communities: Use of boardroom/conference room & printing facilities, clerical services - for health advocate meetings and training sessions.
Impact Completion of 12 primary health care clinic baseline evaluation surveys (6 facilities in Guyana, 4 in Jamaica, 2 in Dominica); NCD prevention and control training of 15 health advocates from 9 places of worship and 3 community health workers in Guyana; training and heath education materials; Caribbean-wide press-release raising awareness of CONTACT Study; various local media publications.
Start Year 2016
 
Description CONTACT Study - 4 Governmental Partnerships 
Organisation Jamaica Ministry of Health
Country Jamaica 
Sector Public 
PI Contribution Supported health sector strengthening by: training young local scientists in research theory and methods and grant administration; training lay congregation members to serve as health advocates in places of worship, thus shifting some NCD prevention and control burden away from primary health care centres.
Collaborator Contribution Health Ministries: Provided access to primary care clinics and permission for staff to take part in research; press coverage; cabinet support. In Guyana: indirect financial support in the form of health advocate stipends, health advocate training resources, health education materials for distribution to congregations. Ministry of Communities: Use of boardroom/conference room & printing facilities, clerical services - for health advocate meetings and training sessions.
Impact Completion of 12 primary health care clinic baseline evaluation surveys (6 facilities in Guyana, 4 in Jamaica, 2 in Dominica); NCD prevention and control training of 15 health advocates from 9 places of worship and 3 community health workers in Guyana; training and heath education materials; Caribbean-wide press-release raising awareness of CONTACT Study; various local media publications.
Start Year 2016
 
Description CONTACT Study - Non-Governmental/Donor Agency Partnerships 
Organisation Pan American Health Organization
Country United States 
Sector Charity/Non Profit 
PI Contribution Support for PAHO's mission "to lead strategic collaborative efforts among Member States and other partners to promote equity in health, to combat disease, and to improve the quality of, and lengthen, the lives of the peoples of the Americas".
Collaborator Contribution Technical support and advice regarding NCD prevention and control (Guyana, Jamaica); diplomatic support in engaging Ministry of Public Health (Guyana); funding for health advocate training (Jamaica) and graduation ceremonies (Guyana, Jamaica).
Impact 15 health advocates completed training in Jamaica. Award ceremonies for health advocates (Guyana, Jamaica); provision of stipends for health advocates by Ministry of Public Health (Guyana) enabling retention after training.
Start Year 2016
 
Description CONTACT Study - Partnerships with 6 Central Religious Organisations 
Organisation Central Jamaica Conference of SDA
Country Jamaica 
Sector Charity/Non Profit 
PI Contribution Opportunity for central religious bodies to contribute to NCD prevention and promotion within their subsidiary/member places of worship.
Collaborator Contribution Registries of or contact information for individual places of worship; facilitation of networking between research teams and places of worship. Guidance on cultural and religious matters that could impact intervention.
Impact Engagement of 9 intervention places of worship in Guyana; identification of 15 health advocates in Guyana.
Start Year 2016
 
Description CONTACT Study - Partnerships with 6 Central Religious Organisations 
Organisation Government of Guyana
Department Department of Public Information
Country Guyana 
Sector Public 
PI Contribution Opportunity for central religious bodies to contribute to NCD prevention and promotion within their subsidiary/member places of worship.
Collaborator Contribution Registries of or contact information for individual places of worship; facilitation of networking between research teams and places of worship. Guidance on cultural and religious matters that could impact intervention.
Impact Engagement of 9 intervention places of worship in Guyana; identification of 15 health advocates in Guyana.
Start Year 2016
 
Description CONTACT Study - Partnerships with 6 Central Religious Organisations 
Organisation Guyana Hindu Dharmic Sabha
Country Guyana 
Sector Public 
PI Contribution Opportunity for central religious bodies to contribute to NCD prevention and promotion within their subsidiary/member places of worship.
Collaborator Contribution Registries of or contact information for individual places of worship; facilitation of networking between research teams and places of worship. Guidance on cultural and religious matters that could impact intervention.
Impact Engagement of 9 intervention places of worship in Guyana; identification of 15 health advocates in Guyana.
Start Year 2016
 
Description CONTACT Study - Partnerships with 6 Central Religious Organisations 
Organisation Jamaica Council of Churches
Sector Public 
PI Contribution Opportunity for central religious bodies to contribute to NCD prevention and promotion within their subsidiary/member places of worship.
Collaborator Contribution Registries of or contact information for individual places of worship; facilitation of networking between research teams and places of worship. Guidance on cultural and religious matters that could impact intervention.
Impact Engagement of 9 intervention places of worship in Guyana; identification of 15 health advocates in Guyana.
Start Year 2016
 
Description CONTACT Study - Transdisciplinary Academic Collaboration 
Organisation King's College London
Country United Kingdom 
Sector Academic/University 
PI Contribution Supported widening of collaborative networks. Identified and trained medical/MPH/social science students to take part in the project e.g., as survey interviewers.
Collaborator Contribution Significantly enhanced the health research landscape in Guyana by enabling cross-disciplinary and multinational collaboration. Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance.
Impact Multi-disciplinary collaboration involves public health research and health promotion, clinical medicine, health economics, epidemiology, biostatistics & data management, management/administration, social science, nutrition, anthropology, among others. Outputs include: research protocols; training materials in research methods; quantitative and qualitative research datasets from >500 community and health sector participants; 9 conference submissions and journal publications; contribution to establishment of a complex intervention for health system strengthening and prevention & control of NCDs.
Start Year 2016
 
Description CONTACT Study - Transdisciplinary Academic Collaboration 
Organisation New York University
Department School of Medicine
Country United States 
Sector Academic/University 
PI Contribution Supported widening of collaborative networks. Identified and trained medical/MPH/social science students to take part in the project e.g., as survey interviewers.
Collaborator Contribution Significantly enhanced the health research landscape in Guyana by enabling cross-disciplinary and multinational collaboration. Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance.
Impact Multi-disciplinary collaboration involves public health research and health promotion, clinical medicine, health economics, epidemiology, biostatistics & data management, management/administration, social science, nutrition, anthropology, among others. Outputs include: research protocols; training materials in research methods; quantitative and qualitative research datasets from >500 community and health sector participants; 9 conference submissions and journal publications; contribution to establishment of a complex intervention for health system strengthening and prevention & control of NCDs.
Start Year 2016
 
Description CONTACT Study - Transdisciplinary Academic Collaboration 
Organisation Ross University School of Medicine
Country Dominica 
Sector Academic/University 
PI Contribution Supported widening of collaborative networks. Identified and trained medical/MPH/social science students to take part in the project e.g., as survey interviewers.
Collaborator Contribution Significantly enhanced the health research landscape in Guyana by enabling cross-disciplinary and multinational collaboration. Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance.
Impact Multi-disciplinary collaboration involves public health research and health promotion, clinical medicine, health economics, epidemiology, biostatistics & data management, management/administration, social science, nutrition, anthropology, among others. Outputs include: research protocols; training materials in research methods; quantitative and qualitative research datasets from >500 community and health sector participants; 9 conference submissions and journal publications; contribution to establishment of a complex intervention for health system strengthening and prevention & control of NCDs.
Start Year 2016
 
Description CONTACT Study - Transdisciplinary Academic Collaboration 
Organisation University of the West Indies
Country Barbados 
Sector Academic/University 
PI Contribution Supported widening of collaborative networks. Identified and trained medical/MPH/social science students to take part in the project e.g., as survey interviewers.
Collaborator Contribution Significantly enhanced the health research landscape in Guyana by enabling cross-disciplinary and multinational collaboration. Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance.
Impact Multi-disciplinary collaboration involves public health research and health promotion, clinical medicine, health economics, epidemiology, biostatistics & data management, management/administration, social science, nutrition, anthropology, among others. Outputs include: research protocols; training materials in research methods; quantitative and qualitative research datasets from >500 community and health sector participants; 9 conference submissions and journal publications; contribution to establishment of a complex intervention for health system strengthening and prevention & control of NCDs.
Start Year 2016
 
Description Collaboration with University of New South Wales (Australia) 
Organisation University of New South Wales
Country Australia 
Sector Academic/University 
PI Contribution CI on grant application that will combine community participatory techniques with epidemiological and political-ecological assessments to examine the effects of climate change and water related environmental degradation, and exclusion from management and governance of local environment on mental health in indigenous people, particularly young people, in regions vulnerable to climate extremes, and to provide pilot data and protocol development for a larger multi-country study.
Collaborator Contribution Australia - expertise and experience of research with indigeneity
Impact Research yet to begin
Start Year 2020
 
Description Transdisciplinary collaboration 
Organisation Jamaica Ministry of Health
Country Jamaica 
Sector Public 
PI Contribution - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois)
Collaborator Contribution Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project
Impact Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide
Start Year 2016
 
Description Transdisciplinary collaboration 
Organisation Ministry of Health
Country Rwanda 
Sector Public 
PI Contribution - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois)
Collaborator Contribution Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project
Impact Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide
Start Year 2016
 
Description Transdisciplinary collaboration 
Organisation Ministry of Public Health
Country Lebanon 
Sector Public 
PI Contribution - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois)
Collaborator Contribution Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project
Impact Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide
Start Year 2016
 
Description Transdisciplinary collaboration 
Organisation New York University
Department School of Medicine
Country United States 
Sector Academic/University 
PI Contribution - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois)
Collaborator Contribution Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project
Impact Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide
Start Year 2016
 
Description Transdisciplinary collaboration 
Organisation Pan American Health Organization
Country United States 
Sector Charity/Non Profit 
PI Contribution - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois)
Collaborator Contribution Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project
Impact Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide
Start Year 2016
 
Description Transdisciplinary collaboration 
Organisation Ross University
Country United States 
Sector Academic/University 
PI Contribution - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois)
Collaborator Contribution Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project
Impact Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide
Start Year 2016
 
Description Transdisciplinary collaboration 
Organisation University of Ghana
Country Ghana 
Sector Academic/University 
PI Contribution - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois)
Collaborator Contribution Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project
Impact Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide
Start Year 2016
 
Description Transdisciplinary collaboration 
Organisation University of West Indies
Country Jamaica 
Sector Academic/University 
PI Contribution - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois)
Collaborator Contribution Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project
Impact Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide
Start Year 2016
 
Title Health Centre Readiness Evaluation Questionnaire 
Description Development of a new health centre assessment tool based on The Who Building Blocks for Health System Strengthening. 
IP Reference  
Protection Protection not required
Year Protection Granted
Licensed No
Impact Has allowed evaluation of the readiness of primary care centres for a complex intervention to prevent and control NCDs within the context of the wider health system.
 
Title Health Advocate Promotion of NCD Prevention and Control in Places of Worship 
Description Health promotion by health advocates in places of worship who are trained to: provide health talks on NCDs, risk factors and strategies for behavior modification; facilitate lifestyle change especially in relation to diet and physical activity (e.g., organizing cooking classes, exercise sessions, walking groups, gardening groups, etc); conduct simple screening for overweight/obesity, high blood pressure and diabetic foot; and refer congregants to the linked primary health care centre for follow-up as required. The intervention is currently being implemented in 6 places of worship in Guyana; another 2 will come on stream within a month. Places of worship in Dominica and Jamaica should begin the intervention within two months. Data collection for evaluation of the intervention is underway. 
Type Preventative Intervention - Behavioural risk modification
Current Stage Of Development Initial development
Year Development Stage Completed 2019
Development Status Under active development/distribution
Impact Most health advocates and many congregants have begun to adopt healthier lifestyles (less sugar, salt and fats in diet; more physical activity). Observations and interviews will be conducted in coming months to assess sustainability and impact of these changes. 
 
Description Advisory Group meeting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Discuss progress with fous on new intervnetion component of gardening for sustainable environments in he Kalinago Territory
Year(s) Of Engagement Activity 2019
 
Description CONTACT Study Guyana Facebook Page 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Facebook Page (Community) set up for Guyana component of project to share information about the Study and NCD prevention & control with general audiences. 64 persons are currently actively following the Study.
Year(s) Of Engagement Activity 2017,2018,2019
 
Description Contact Study Website 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Project website established to disseminate information about the study objectives, methods, staff, outcomes and partners. Links were also provided to information about non-communicable diseases.
Year(s) Of Engagement Activity 2019,2020
 
Description KCL Population Health and Nutrition Research Group Symposium: "Preventing and Controlling Non-Communicable Diseases and Mental Health Disorders: Novel Strategies for Low/Middle Income Settings" 
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 A one-day symposium hosted by the KCL Population Health and Nutrition Department to disseminate information about CONTACT and other KCL collaborations in LMIC. Symposium formed part of a week of activities aimed at engaging LMIC researchers with KCL researchers and postgraduate students, for paper writing, project planning and capacity building.
Year(s) Of Engagement Activity 2019
 
Description Launch 
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 Media (as a channel to the public)
Results and Impact Discussed at cabinet meeting in February 2017 - central government support approved
Research Features request
Year(s) Of Engagement Activity 2017
URL http://www.motp.gov.gy/index.php/2015-07-20-18-49-38/2015-07-20-18-50-14/1745-new-group-looking-to-t...
 
Description Meeting with MoPH National Planning Committee 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Guyana Co-PI and Project Coordinator presented overview of CONTACT Study to Minister for Public Health and Heads of Departments within the Ministry at their routine Planning Meeting, and received positive feedback on the proposed activities. The Minister promised technical and financial support, and the Director of Regional Health Services agreed to permit access to health centres.
Year(s) Of Engagement Activity 2017
 
Description NCD Prevention 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Third sector organisations
Results and Impact Sensitization to planned intervnetion programme
Year(s) Of Engagement Activity 2017
 
Description PHC Sensitization 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Research staff visited intervention health centres to engage health workers in planning for the intervention; feedback from staff was incorporated into intervention development and health workers accepted their role in the intervention.
Year(s) Of Engagement Activity 2018,2019
 
Description Sensitization about Study - 23 Meetings with Stakeholders in Jamaica 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Study participants or study members
Results and Impact Overview of study was presented at scheduled religious services at 5 places of worship, with aim of sensitizing congregation about the study and inviting nominations for health advocate posts. Fliers describing the health advocate role were distributed. Religious leaders committed to supporting project, and several persons volunteered to serve as health advocates. Meetings were also held with Ministry of Health officials and other policy makers, and central religious bodies, with the aim of soliciting overarching support for the study.
Year(s) Of Engagement Activity 2017,2018
 
Description Sensitization about Study - 9 Places of Worship in Guyana 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Overview of study was presented at scheduled religious services at 3 Christian, 3 Hindu and 3 Muslim places of worship, with aim of sensitizing congregation about the study and inviting nominations for health advocate posts. Fliers describing the health advocate role were distributed. Religious leaders committed to supporting project, and several persons volunteered to serve as health advocates.
Year(s) Of Engagement Activity 2017,2018
 
Description community workshops with indigenous people 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact 18 Kalinago residents in Dominica attended 4 workshops to discuss priorities for prevention of NCDs
Year(s) Of Engagement Activity 2017