Developing T4 Translational Research Capacity for Control of Hypertension in Rwanda

项目摘要 为了响应RFA-HL-17-003，我们建议创建一个由学者、临床医生、 社区卫生保健提供者和公共卫生专家建立国内能力， (T4)卢旺达高血压（HTN）控制的翻译研究（TR）。HTN是一个主要的风险因素， 心血管疾病（CVD），是低收入和中等收入国家的主要死亡原因 （LMIC），死亡人数超过艾滋病毒，疟疾和结核病的总和。HTN约占1050万 占全球残疾调整生命年总数的12.8%。试点数据显示，36%的卢旺达人 成年人有HTN，33%的人不知道他们的HTN。卢旺达启动了艾滋病毒治疗模式， 在高等教育、省和地区关注某些非传染性疾病的管理 医疗保健金字塔的各个层次，以及关于HTN/CVD护理的数据将用于指导U24规划， 实践与传播。尽管有新的证据表明有效的行为改变干预措施（从 高收入国家）在HTN控制方面，基础设施和能力方面的信息不足， 参与T4 TR以控制卢旺达境内的HTN。拟议计划将解决这些差距： 以及传播信息和开展艾滋病毒/艾滋病宣传运动的干预措施有限， 开展可持续的传播和实施研究。根据提议，区域联盟 卢旺达大学医学和健康科学学院（UR- CMHS）与位于美国密苏里州圣刘易斯的华盛顿大学合作，整合资源， T4 TR方面的专门知识，组建培训小组，并将通过国内讲习班实施技能培训， 远程学习/培训和指导，以发展D& IR的能力。我们将实施T4 TR 为初级学者提供能力保留和后期指导课程，并培训UR-CMHS教师 通过继续医学教育（CME）认证计划。我们将开发并验证 定性和定量工具，进行案头审查，并开展长期高技术需求评估 T4 TR的护理、能力、设施、资源和能力，以支持实施基于证据的 减少HTN/CVD发病率的干预措施。我们将促进当地和美国的伙伴关系，包括信仰- 基础组织、非政府组织和基层社区一级的伙伴， 资源与现有的培训计划可持续和独立的T4 TR能力。我们将优先考虑 干预领域，制定研究计划，并通过社区网络传播研究结果， 网站、保健论坛和资源共享数据库，以指导政策和实践。我们将 与指导委员会成员合作，根据具体情况评估项目进展情况 目标、里程碑和成果计量。该计划将建立所需的网络和能力， 建议并实施对HTN控制具有高度影响的T4 TR，并对卢旺达的公共卫生产生重大影响。

Project Summary In response to RFA-HL-17-003, we propose to create a collaborative team of academics, clinicians, community healthcare providers and public health experts to build in-country capacity to conduct late-stage (T4) translation research (TR) for hypertension (HTN) control in Rwanda. HTN is a major risk factor for cardiovascular disease (CVD), and is the leading cause of death in low-income and middle countries (LMICs), killing more people than HIV, malaria, and tuberculosis combined. HTN accounts for ~10.5 million deaths and 12.8% of total global disability adjusted life years. Pilot data suggest that 36% of Rwandan adults have HTN, and 33% are unaware of their HTN. Rwanda has initiated an HIV model of treatment and care for the management of certain non-communicable diseases (NCDs) at tertiary, provincial and district levels of the healthcare pyramid, and data on HTN/CVD care will be exploited to guide U24 planning, practice and dissemination. Despite emerging evidence for effective behavioral change interventions (from high income countries) on HTN control, there is inadequate information on infrastructure and capacity to engage in T4TR for HTN control in Rwanda. The proposed plan will address these gaps: underutilization and limited interventions to disseminate information and implement HTN awareness campaigns and develop sustainable dissemination and implementation (D&I) research. As proposed, the Regional Alliance for Sustainable Development and the University of Rwanda College of Medicine and Health Sciences (UR- CMHS) have partnered with Washington University in St Louis, MO, USA, amalgamated resources and expertise in T4TR, formed training teams, and will implement skills training through in-country workshops, distance learning/training, and mentorships to develop competencies for D&IR. We will implement T4TR curriculum on competencies retention and post-mentorship for junior Scholars and train UR-CMHS faculty through the Continuous Medical Education (CME) Accreditation program. We will develop and validate qualitative and quantitative tools, conduct desk reviews and carry out needs assessments for HTN chronic care, capacity, facilities, resources and capabilities for T4TR to support implementation of evidence-based interventions to reduce HTN/CVD morbidities. We will foster local and US partnerships, including Faith- based and non-governmental organizations and grassroots community-level partners, and leverage resources with existing training programs for sustainable and independent T4TR capacity. We will prioritize intervention areas, develop a research plan, and disseminate findings through community networks, websites, healthcare forums and resource-sharing databases to guide policy and practice. We will collaborate with Steering Committee members to evaluate program progress based on concrete specific aims, milestones and outcome measures. This plan will establish the required network and capacity to propose and conduct high impact T4TR on HTN control and substantially impact public health in Rwanda.