Objectively measured moderate-to-vigorous physical activity does not attenuate prospective weight gain among African-origin adults spanning the epidemiological transition.

Traditional obesity-related public health messaging often includes physical activity (PA) recommendations. However, at the population level, the data are conflicting, especially when comparing different self-reported vs measured techniques across different settings and populations. We measured the association between moderate-to-vigorous intensity PA (MVPA) and prospective weight change across five African-origin populations and the extent to which MVPA attenuated weight change over time.

The utility of physical activity questionnaires among African origin populations; lost in translation?

Background: Physical activity (PA) is an important preventive factor of non-communicable diseases (NCDs), particularly cardiovascular disease, yet progress towards reducing physical inactivity in populations is slow. Population-levels of PA are most often estimated using self-report questionnaires in population surveys, such as the Global PA Questionnaire (GPAQ), which may not accurately reflect objectively measured PA, such as accelerometers. The aim of the current study was to compare self-report vs objectively measured PA across 5 African-origin populations.

Training in eight low-and middle-income countries: lessons learned from a pilot study using the WHO-TDR dissemination and implementation massive open online course.

Introduction: Non-communicable diseases (NCDs) are a leading cause of morbidity and mortality in low-and middle- income countries (LMICs). Despite this, a lack of funding, training and mentorship for NCD investigators in LMICs exists. In an effort to gain knowledge and skills to address these gaps, participants from the Global Research on Implementation and Translation Science (GRIT), a consortium of studies in eight LMICs and their networks, attended the dissemination and implementation (D&I) massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases at the World Health Organization to strengthen D&I capacity building.

Global implementation research capacity building to address cardiovascular disease: An assessment of efforts in eight countries.

Cardiovascular diseases are the leading causes of morbidity and mortality worldwide, but implementation of evidence-based interventions for risk factors such as hypertension is lacking, particularly in low and middle income countries (LMICs). Building implementation research capacity in LMICs is required to overcome this gap. Members of the Global Research on Implementation and Translation Science (GRIT) Consortium have been collaborating in recent years to establish a research and training infrastructure in dissemination and implementation to improve hypertension care.

Implementation outcomes and strategies for delivering evidence-based hypertension interventions in lower-middle-income countries: Evidence from a multi-country consortium for hypertension control.

Guidance on contextually tailored implementation strategies for the prevention, treatment, and control of hypertension is limited in lower-middle income countries (Lower-MIC). To address this limitation, we compiled implementation strategies and accompanying outcomes of evidence-based hypertension interventions currently being implemented in five Lower-MIC. The Global Research on Implementation and Translation Science (GRIT) Coordinating Center (CC) (GRIT-CC) engaged its global network sites at Ghana, Guatemala, India, Kenya, and Vietnam.

The WHO-TDR Dissemination and Implementation Massive Open Online Course (MOOC): Evaluation and Lessons Learned from Eight Low-and Middle-Income Countries.

Introduction: Non-communicable diseases (NCDs) are a leading cause of morbidity and mortality in low-and middle-income countries (LMICs). Despite this, a lack of funding, training and mentorship for NCD investigators in LMICs exists. In an effort to gain knowledge and skills to address these gaps, participants from the Global Research on Implementation and Translation Science (GRIT), a consortium of studies in eight LMICs and their networks, attended the dissemination and implementation (D&I) massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases at the World Health Organization to strengthen D&I capacity building.

Uptake of Task-Strengthening Strategy for Hypertension (TASSH) control within Community-Based Health Planning Services in Ghana: study protocol for a cluster randomized controlled trial.

Background: Physician shortage is a major barrier to hypertension (HTN) control in Ghana, with only one physician to 10,000 patients in 2015, thus limiting its capacity for HTN control at the primary care level such as the Community Health Planning and Services (CHPS) compounds, where most Ghanaians receive care. A Task-Shifting Strategy for HTN control (TASSH) based on the WHO Cardiovascular (CV) Risk Package is an evidence-based strategy for mitigating provider- and systems-level barriers to optimal HTN control. Despite its effectiveness, TASSH remains untested in CHPS zones.

Application of the Consolidated Framework for Implementation Research to examine nurses' perception of the task shifting strategy for hypertension control trial in Ghana.

Background: The burden of hypertension in many low-and middle-income countries is alarming and requires effective evidence-based preventative strategies that is carefully appraised and accepted by key stakeholders to ensure successful implementation and sustainability. We assessed nurses' perceptions of a recently completed Task Shifting Strategy for Hypertension control (TASSH) trial in Ghana, and facilitators and challenges to TASSH implementation.

Methods: Focus group sessions and in-depth interviews were conducted with 27 community health nurses from participating health centers and district hospitals involved in the TASSH trial implemented in the Ashanti Region, Ghana, West Africa from 2012 to 2017.

Capacity and Readiness for Implementing Evidence-Based Task-Strengthening Strategies for Hypertension Control in Ghana: A Cross-Sectional Study.

Background: Assessing the practice capacity for hypertension management and control within community-based health planning and services system is an important step toward implementing evidence-based interventions to reduce uncontrolled hypertension at the community level.

Objectives: To assess the capacity and readiness of community health workers to implement a task-strengthening strategy for hypertension control (TASSH) at the community level.

Methods: This was a cross-sectional study guided by the Consolidated Framework for Implementation Research conducted among community health workers in 6 contiguous districts within the Brong-Ahafo Region of Ghana.

Adopting Task-Shifting Strategies for Hypertension Control in Ghana: Insights From a Realist Synthesis of Stakeholder Perceptions.

Background: The adoption, intention, initial decision or action to implement evidence-based strategies for hypertension control in real-world settings is a challenge in low- and middle-income countries. Although stakeholders are essential for the adoption of evidence-based interventions, data on how to engage them to improve uptake of these strategies is lacking. Using a realist synthesis of stakeholder perspectives, the authors describe a process for engaging stakeholders to identify facilitators and barriers to the adoption of an evidence-based task-strengthening strategy for hypertension control in Ghana.

Health insurance coverage with or without a nurse-led task shifting strategy for hypertension control: A pragmatic cluster randomized trial in Ghana.

Background: Poor access to care and physician shortage are major barriers to hypertension control in sub-Saharan Africa. Implementation of evidence-based systems-level strategies targeted at these barriers are lacking. We conducted a study to evaluate the comparative effectiveness of provision of health insurance coverage (HIC) alone versus a nurse-led task shifting strategy for hypertension control (TASSH) plus HIC on systolic blood pressure (SBP) reduction among patients with uncontrolled hypertension in Ghana.

Training nurses in task-shifting strategies for the management and control of hypertension in Ghana: a mixed-methods study.

Background: Nurses in Ghana play a vital role in the delivery of primary health care at both the household and community level. However, there is lack of information on task shifting the management and control of hypertension to community health nurses in low- and middle-income countries including Ghana. The purpose of this study was to assess nurses' knowledge and practice of hypertension management and control pre- and post-training utilizing task-shifting strategies for hypertension control in Ghana (TASSH).

A cluster-randomized trial of task shifting and blood pressure control in Ghana: study protocol.

Background: Countries in sub-Saharan Africa (SSA) are experiencing an epidemic of cardiovascular disease (CVD) propelled by rapidly increasing rates of hypertension. Barriers to hypertension control in SSA include poor access to care and high out-of-pocket costs. Although SSA bears 24% of the global disease burden, it has only 3% of the global health workforce.