The National Heart, Lung, and Blood Institute (NHLBI) has awarded a $648,073 Project Grant (CFDA 93.837 - Cardiovascular Diseases Research) to The Johns Hopkins University to conduct the ADHINCRA study, which aims to address hypertension care in Ghana and Nigeria. The project will implement a multilevel intervention that integrates home-based blood pressure monitoring, team-based care with nurse training, and simplified hypertension treatment protocols to improve blood pressure control in...
This Project Grant awarded by the National Institute of Child Health and Human Development (NICHD) under the Child Health and Human Development Extramural Research program (CFDA 93.865) aims to improve the quality of care for people with sickle cell disease (SCD) by assessing the safety of different hormonal contraceptive methods and evaluating patient and provider factors affecting contraceptive use. The $469,500 award to Emory University will leverage health system data from Kaiser...
This Project Grant award of $743,488.00 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), under CFDA Program 93.865 Child Health and Human Development Extramural Research, aims to examine the mechanisms and optimization of malaria chemoprevention strategies to improve birth outcomes in Africa. The research objectives are to: 1) characterize the mechanisms mediating the effects of sulfadoxine-pyrimethamine (SP) and dihydroartemisinin-piperaquine...
This Project Grant award from the National Heart Lung and Blood Institute (CFDA 93.837 - Cardiovascular Diseases Research) to Emory University provides $202,366.00 in funding to investigate the role of heme-induced complement activation in sickle cell disease (SCD) pregnancy. The project aims to 1) characterize the effects of SCD and heme-induced complement activation on pregnancy outcomes in a pre-clinical mouse model, and 2) determine if heme and/or complement modulation can improve...
This Project Grant award from the National Heart, Lung, and Blood Institute (NHLBI), under the Cardiovascular Diseases Research program (CFDA 93.837), will fund the implementation and pilot-testing of an integrated sickle-cell screening and violence prevention program in antenatal care settings in India. The $167,560 award to the Trustees of Boston University, Massachusetts will be used to: 1) conduct formative research to inform the adaptation of the Jamii Bora intervention, 2) adapt the...
This Project Grant awarded by the National Heart, Lung, and Blood Institute (NHLBI) under the Cardiovascular Diseases Research program (CFDA 93.837) provides $156,340 in funding to Connecticut Children's Medical Center to develop and test a communication-enhancement intervention for healthcare providers (HCPs) to improve health outcomes in pediatric sickle cell disease (SCD) patients. The 5-year award period runs from June 15, 2025 to May 31, 2030. The key activities include refining an...
This federal Project Grant award, provided by the National Heart, Lung, and Blood Institute (NHLBI) under the Cardiovascular Diseases Research program (CFDA 93.837), aims to adapt and preliminarily test an individualized care plan (ICP) prototype for inpatient sickle cell disease (SCD) vaso-occlusive episode (VOE) care. The total award amount is $191,792.00 over the project period of September 17, 2024 to August 31, 2029. The key objectives are to: 1) develop an ICP prototype adapted from the...
This Project Grant award from the National Heart Lung and Blood Institute (CFDA 93.837 - Cardiovascular Diseases Research) will fund a $496,503 research study at the University of Pennsylvania Clinical Practices examining sex and gender influences on inflammation and pain in sickle cell disease (SCD). The objectives are to (1) ascertain sex- and gender-related mechanisms of perimenstrual vaso-occlusive pain episodes (VOEs) in SCD, and (2) determine the therapeutic effectiveness of the...
This Project Grant award from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) under CFDA 93.865 - Child Health and Human Development Extramural Research, will provide $2,114,125.00 from September 15, 2024 to June 30, 2029 to determine the impact of telehealth on severe maternal morbidity (SMM) and SMM disparities, and develop guidelines for implementing telehealth to address equity issues and reduce SMM disparities. The key products and services to...
This federal Project Grant award from the National Institute of General Medical Sciences (NIGMS) under the Biomedical Research and Research Training (CFDA 93.859) program provides $272,856 to Emory University to implement the "ELEVATING MENTORING POSSIBILITIES FOR OVERCOMING WITHSTANDING EDUCATIONAL ROADBLOCKS IN SICKLE CELL DISEASE (EMPOWER SCD): STEMM MENTORING FOR YOUTH WITH SICKLE CELL DISEASE" project over a 5-year period starting September 1, 2024. The project aims to use...
MULTIDISCIPLINARY SICKLE CELL DISEASE OBSTETRICS CARE PROGRAM IN GHANA: NON-ACADEMIC VS.ACADEMIC HOSPITAL (PILOT STUDY) - WITH INCREASING LIFE EXPECTANCY IN AFRICA, PREGNANCY HAS BECOME AN EMERGING LIFE-THREATENING COMPLICATION IN SCD WOMEN. IN LOW AND MIDDLE-INCOME COUNTRIES, THE ODDS RATIO OF MATERNAL DEATH ASSOCIATED WITH SCD IS 22.81, 95% CI 14.67-35.46.1 FROM 2012-2014, THE OBSTETRICS DEPARTMENT, KORLE-BU TEACHING HOSPITAL (KBTH), ACCRA, GHANA, ESTABLISHED AN OBSTETRICIAN-LED SCD OBSTETRICS (OB) CLINIC. THE INSTITUTIONAL MATERNAL MORTALITY FOR SCD OVER THESE THREE YEARS (2012-2014) WAS APPROXIMATELY 12%. IN JANUARY 2015, A MULTIDISCIPLINARY SCD OB TEAM WAS ESTABLISHED. THE TEAM CONDUCTED A COMBINED RETROSPECTIVE/ PROSPECTIVE CASE SERIES OF ALL MATERNAL DEATHS IN WOMEN WITH SCD AT KBTH OVER SEVEN YEARS (2010-2016).2 THIS RETROSPECTIVE DATA COLLECTION HIGHLIGHTED FAILURES AND CHALLENGES TO DELIVERING IMPROVED CARE. ACUTE CHEST SYNDROME, PRECEDED BY ACUTE PAIN EPISODES, WAS THE LEADING CAUSE OF DEATH IN NEARLY 87% OF WOMEN.2 IN MAY 2015, THE TEAM IMPLEMENTED A JOINT OBSTETRICS/ HEMATOLOGY CLINIC, INSTITUTED CLOSE MATERNAL AND FETAL MONITORING, AND IMPLEMENTED CLINICAL GUIDELINES/ PROTOCOLS. IN ADDITION, THE SCD OB TEAM ESTABLISHED A WEEKLY COMMUNICATION SYSTEM TO ADJUDICATE THE MANAGEMENT OF CHALLENGING CASES. THESE INTERVENTIONS RESULTED IN AN 89.1% RISK REDUCTION IN MATERNAL MORTALITY (FROM 10,791 TO 1,176 DEATHS PER 100,000 LIVE BIRTHS; P=0.007) OVER 13 MONTHS.3 SINCE INITIATING OUR MULTIDISCIPLINARY SCD OB PROGRAM, WE HAVE CONSISTENTLY DECREASED MATERNAL MORTALITY IN THIS COHORT BY APPROXIMATELY 90% COMPARED TO BEFORE THE TEAM WAS ESTABLISHED.4,5 THIS PHYSICIAN-MENTORED APPLICATION AIMS TO CONDUCT AN EFFECTIVENESS-IMPLEMENTATION FEASIBILITY STUDY TO EXTEND OUR RESULTS OF DECREASING MATERNAL MORTALITY FROM AN ACADEMIC HOSPITAL TO A NON- ACADEMIC HOSPITAL SETTING IN ACCRA, GHANA WITH A CURRENT MATERNAL MORTALITY RATE OF 5,940 DEATHS/ 100,000 LIVE BIRTHS IN SCD WOMEN. OVER FIVE YEARS, THE APPLICANT WILL ACQUIRE THE SKILLS TO USE THE CONSOLIDATED FRAMEWORK FOR IMPLEMENTATION RESEARCH (CFIR)6 AND THE RE-AIM FRAMEWORK (REACH, EFFECTIVENESS, ADOPTION, IMPLEMENTATION, AND MAINTENANCE)7 TO INFORM THE STAGES OF THE STUDY. THE APPLICANT WILL TEST THE HYPOTHESIS THAT " IN A BEFORE AND AFTER STUDY DESIGN, THE APPLICANT WILL TEST THE HYPOTHESIS THAT MULTI- DISCIPLINARY CARE AND TASK-SHIFTING IN A NON-ACADEMIC HOSPITAL FOR PREGNANT WOMEN WITH SCD WILL HAVE AN 80% RELATIVE RISK REDUCTION IN DEATH COMPARED TO THE MORTALITY RATE IN THE SAME HOSPITAL BEFORE THE MULTI-DISCIPLINARY MEDICAL CARE." THE SPECIFIC AIMS FOR THIS MENTORED AWARD ARE: 1) IDENTIFY CONTEXTUAL DETERMINANTS (BARRIERS/ FACILITATORS) THAT INFLUENCE THE ADAPTABILITY OF THE EVIDENCE-BASED PRACTICE FOR ESTABLISHING A MULTIDISCIPLINARY SCD OB TEAM AS AN INTERVENTION IN THE NON-ACADEMIC HOSPITAL, INCLUDING THE IMPLEMENTATION PROCESS (YEARS 1-2); 2) BUILD CAPACITY FOR A MULTIDISCIPLINARY SCD OB PROGRAM IN A NON- ACADEMIC HOSPITAL (YEARS 3-5), AND 3) CONDUCT A HYBRID TYPE 1 FEASIBILITY STUDY COMPARING THE EFFECTIVENESS OF A TASK-SHIFTED MULTIDISCIPLINARY SCD OB PROGRAM IN A NON-ACADEMIC SITE (YEARS 3-5).