Publications by authors named "Namratha R Kandula"

Evaluation of benefits beyond quantitative academic outputs is essential in determining translational research value. We used the Translational Science Benefits Model (TSBM) to examine the impact of the QUARTET USA trial using 30 benefits across 4 domains: Clinical, Community, Economic, and Policy. We found that the QUARTET USA trial demonstrated impact in six areas within the Clinical, and Community domains and had potential impact in two additional areas within the Community and Economic domains.

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  • DBP (Diastolic Blood Pressure) is linked to atherosclerosis and cardiovascular disease, particularly in South Asians, who have elevated risks.
  • The study assessed the relationship between DBP levels and coronary artery calcium (CAC) scores, indicating a higher prevalence of CAC in participants with higher DBP, especially among those not taking antihypertensive medication.
  • The findings suggest that elevated DBP is a significant cardiovascular risk factor in South Asian adults, highlighting the need for awareness and potential interventions.
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Food pantries are promising community partners in health promotion. This study explored client perspectives in food pantries to inform new approaches to improve client experience, reach, and access. We interviewed 52 adult clients who visited participating food pantries two or more times over 12 months in Cook County, Illinois in English, Spanish, or Cantonese.

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Background: South Asians (SA) represent the fastest growing US immigrant group, and previous studies have indicated that they face disproportionately high burden of cardiometabolic disease. Cardiometabolic disease manifests as a syndemic or synergistic epidemic encompassing multiple disease clusters influenced by biological, social, and psychological factors stemming from the acculturative process. This process may exacerbate morbidity within immigrant subgroups.

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  • South Asian adults in the U.S. have a higher prevalence of cardiovascular risk factors like pre-diabetes, diabetes, and hypertension compared to other racial and ethnic groups at younger ages (45-55 years).
  • The study combined data from two major cohort studies to analyze ASCVD risk factors across different races and ethnicities, using participants who were free of clinical ASCVD.
  • Results indicated that at age 45, South Asian men and women exhibited the highest rates for various risk factors and had poorer diet quality compared to other groups, highlighting significant health disparities.
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  • The study looked at how friends and family affect heart health choices for South Asian adults in the U.S. who participated in a health program called SAHELI.
  • Interviews with 24 participants showed that they supported each other and their families in making healthier choices, but some people in their communities didn’t support these changes.
  • The researchers concluded that understanding a person's social circle is important for making health changes, and factors like gender and language skills can impact this support.
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To achieve cardiovascular health (CVH) equity in the United States, an understanding of the social and structural factors that contribute to differences and disparities in health is necessary. The Asian American population is the fastest-growing racial group in the United States but remains persistently underrepresented in health research. There is heterogeneity in how individual Asian American ethnic groups experience CVH and cardiovascular disease outcomes, with certain ethnic groups experiencing a higher burden of adverse social conditions, disproportionately high burden of suboptimal CVH, or excess adverse cardiovascular disease outcomes.

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  • South Asian Americans face significant challenges related to atherosclerotic cardiovascular disease (ASCVD), and the study examines the sustainability of the South Asian Healthy Lifestyle Intervention (SAHELI), which is designed to improve dietary habits, physical activity, and stress management within this population.
  • The research utilized a mixed-methods approach involving surveys and thematic analysis with 17 partners from various organizational settings, revealing that the program is well-received for its cultural responsiveness but faces barriers like financial support and infrastructure.
  • The findings highlight that while SAHELI is effective in addressing community-specific health needs and perceptions about research, ensuring its long-term sustainability will require overcoming identified challenges in resources and leadership.
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  • South Asian adults in the US have higher cardiovascular disease (CVD) risk compared to other groups, and the effectiveness of lifestyle interventions specifically for them had not been previously assessed.
  • A clinical trial aimed to determine if a culturally adapted group lifestyle intervention would more effectively improve CVD risk factors compared to basic written health education materials for South Asian adults aged 18 to 65.
  • The intervention involved a 16-week program focusing on lifestyle changes, delivered in multiple languages, with follow-up support, while the control group only received written materials; outcomes focused on changes in key health metrics and self-reported behaviors.
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Background: National-level differences in myocardial infarction (MI) quality of care among Asian patients in the United States are unclear. We assessed the quality of MI care in the 6 largest US Asian ethnic groups.

Methods: Patients aged ≥18 years with ST-segment-elevation MI or non-ST-segment-elevation MI in the Get With The Guidelines-Coronary Artery Disease registry (711 US hospitals, 2015-2021) were assessed.

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Background: Healthcare workers (HCWs) including community health extension workers (CHEWs) in the Federal Capital Territory, Nigeria participated in a hypertension training series following the Extension for Community Healthcare Outcomes (ECHO) model which leverages technology and a practical peer-to-peer learning framework to virtually train healthcare practitioners. We sought to evaluate the patient-level effects of the hypertension ECHO series.

Methods: HCWs from 12 of 33 eligible primary healthcare centers (PHCs) in the Hypertension Treatment in Nigeria Program (NCT04158154) were selected to participate in a seven-part hypertension ECHO series from August 2022 to April 2023.

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  • - The text emphasizes the need for comprehensive approaches to combat hypertension, highlighting the importance of high-quality treatment and stakeholder collaboration to improve care services and retention in treatment.
  • - The study aims to evaluate how different simulated interventions can affect retention rates in hypertension care within the primary health care system in Nigeria, using system dynamics modeling that includes insights from diverse stakeholders.
  • - Results from stakeholder workshops showed that training health care workers could significantly enhance retention rates in hypertension care, suggesting it is a key strategy for addressing the issue in Nigeria.
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Few prospective studies examine multilevel resilience resources and psychosocial factors in relation to cardiovascular health and disease. Recent research indicates that resilience resources are associated with a reduction in the incidence of cardiovascular disease-related events, but few studies have examined this relationship across different racial/ethnic populations or in large cohorts. Harmonization may address these limitations because it allows data from several cohorts to be analyzed together, potentially increasing sample size and in turn power overall and in minority populations.

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Importance: Persistent symptoms and disability following SARS-CoV-2 infection, known as post-COVID-19 condition or "long COVID," are frequently reported and pose a substantial personal and societal burden.

Objective: To determine time to recovery following SARS-CoV-2 infection and identify factors associated with recovery by 90 days.

Design, Setting, And Participants: For this prospective cohort study, standardized ascertainment of SARS-CoV-2 infection was conducted starting in April 1, 2020, across 14 ongoing National Institutes of Health-funded cohorts that have enrolled and followed participants since 1971.

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  • New strategies are essential to improve blood pressure control rates, prompting the QUARTET USA trial to assess a four-drug combination therapy for hypertensive patients.
  • The study involved 62 participants, who were randomly assigned to receive either a quadpill with lower doses of four blood pressure medications or a single higher dose of one medication over 12 weeks.
  • Results showed no significant difference in systolic blood pressure between the two groups, though the quadpill led to greater reductions in diastolic blood pressure, indicating its potential effectiveness without increased adverse events.
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  • - This study examines how social and psychosocial factors influence cardiovascular health (CVH) among different racial/ethnic groups, including Black, Chinese, Hispanic, South Asian, and White participants in the US.
  • - Using data from nearly 8,000 adults, researchers used a specific statistical method to analyze how income, place of birth, and education contribute to differences in CVH scores across these groups.
  • - Findings reveal that improved income and educational equality could potentially raise CVH scores for Black, Hispanic, and South Asian participants, highlighting the impact of social factors on health outcomes in diverse populations.
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Background: South Asians are at higher risk for type 2 diabetes (T2D) than many other race/ethnic groups. Ectopic adiposity, specifically hepatic steatosis and visceral fat may partially explain this. Our objective was to derive metabolite risk scores for ectopic adiposity and assess associations with incident T2D in South Asians.

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Background: This convergent parallel-design mixed-methods process evaluation of the QUARTET USA (Quadruple Ultra-Low-Dose Treatment for Hypertension USA) clinical trial (NCT03640312) explores patient and health care professional perceptions about the use of low-dose quadruple therapy (LDQT) as a novel strategy for hypertension management.

Methods And Results: A survey of all 62 patients enrolled in the QUARTET USA trial was conducted. A subsample of 13 patients and 11 health care professionals, recruited via purposive sampling, took part in semistructured interviews.

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Background: The Extension for Community Health Outcomes (ECHO) model has been used extensively to link care providers in rural communities with experts with the aim of improving local patient care.

Objective: The aim of this qualitative research study was to assess the feasibility, acceptability, perceived needs, and contextual factors to guide implementation of a hypertension focused ECHO program for Community Health Extension Workers (CHEWs) in the Federal Capital Territory, Nigeria.

Methods: From September 2020 to December 2020, key informant interviews were performed with seven global organizations (hubs) providing ECHO training focused on cardiovascular disease or nephrology to identify contextual factors and implementation strategies used by each hub.

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Aims: We examined associations between lipoprotein subfractions and prevalent and incident T2D in two race/ethnically diverse cohort studies.

Methods: Adults self-identifying as White, Black, Chinese, Hispanic and South Asian-American without cardiovascular disease, with fasting serum, demographic, and clinical data at enrollment and after 5 years of follow-up were included. Lipoprotein subfractions were measured at enrollment using NMR spectrometry.

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Little is known about food insecurity and the extent of Supplemental Nutrition Assistance Program (SNAP) participation in the heterogeneous Asian American population. Using California Health Interview Survey data from the period 2011-20, we examined both issues among low-income Asian American adults from six origin groups: Chinese, Filipino, Japanese, Korean, South Asian, and Vietnamese. We found high and varied levels of overall food insecurity, with the highest burden among Filipino adults (40 percent).

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Background: Children of South Asian (SA) origin in the UK have lower levels of physical activity (PA), compared to their White counterparts. Parents play an important role in establishing PA habits among young children. The aim of this study was to compare PA and television (TV) viewing parenting practices for young children between SA British (SAB) and White British (WB) parents living in the UK.

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Objective: Assess trusted sources of information, perceived message effectiveness, and preferred dissemination strategies regarding adolescent HPV vaccination among U.S. Vietnamese parents.

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We examined relationships between resilience resources (optimism, social support, and neighborhood social cohesion) and cardiovascular disease (CVD) incidence and assessed potential effect-measure modification by psychosocial risk factors (e.g., stress, depression) among adults without CVD in 3 cohort studies (2000-2018): the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study.

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