Chronic cardio-metabolic (diabetes, cardiovascular diseases) and neuropsychiatric conditions (cognitive and mental health disorders) are rapidly growing public health problems in low- and middle-income countries (LMIC). LMICs such as India and Ethiopia are experiencing rising chronic diseases while still contending with residual burdens of under-nutrition and environmental pollution. Responses to chronic conditions in LMICs are constrained by limited research capacity. We propose to address shortages in research and implementation capacity for chronic conditions in India and Ethiopia. Teams from Emory University (Ali, Program Director [PD]), the Center for Chronic Disease Control, India (Prabhakaran, co-PD), and Addis Ababa University, Ethiopia (Mariam, co-PD) co-designed the ?COllaborative Research, Implementation, And LEadership Training to AddresS Chronic Conditions across the Life CoursE? (COALESCE) program. We draw from two previous successful training programs and added key innovations. To progress towards sustainable in-country research training, we will provide mentor training to 12 mid-stage researchers to develop in-country capacity for more effective mentoring of young researchers. Moreover, prior D43 program alumni will be participants of the mentor training and serve as research mentors for COALESCE trainees. This approach capitalizes on previous investments and provides career advancement and support for previous trainees in new mentor roles. We will then recruit and train four cohorts of six post-doctoral trainees (three each from India and Ethiopia) annually (total n=24) in an 18-month fellowship. The fellowship includes two months at Emory University to complete coursework, engage in US research culture, and develop project concepts; over the next 16 months, trainees will complete projects in their home country with guidance from in-country and US mentors. We will promote an integrated perspective of chronic conditions across the life course, and connect trainees with resources (e.g., cohort studies, affiliated centers) with wide-ranging content and methodological expertise. To strengthen our partner LMIC institutions from within, we will deliver our successful annual short-course on implementation science and leadership that can cultivate organizational management skills. To accelerate translation and implementation of evidence into practice, we will open the implementation science and leadership course to public health, government, and clinical practitioners (n=80) that are on the frontline of prevention and control program and policy implementation. Jointly engaging researchers and practitioners will directly connect these usually siloed stakeholders and promote collaboration. We will leverage Emory University's longstanding partnerships in India and Ethiopia and open opportunities for South-South collaboration. The COALESCE program is designed to promote high in-country retention of trainees by providing stipends, local mentorship, embedding trainee projects in existing platforms, and motivating a culture of productivity. The program aspires to facilitate locally-driven research to shape chronic disease priorities, practices, programs, and policies.
PROGRAM NARRATIVE Low- and middle-income countries (LMIC) face huge and growing burdens of chronic conditions like diabetes, heart disease, strokes, dementia, and mental health disorders, but also contend with extremely limited investments in research and leadership development that can inform and strengthen prevention and control programs and policies. This training program in research, implementation science, and leadership will train 116 researchers and practitioners from India and Ethiopia, and serve as a stepping stone for them to build independent careers focused on designing, implementing, and evaluating interventions, programs, and policies to address chronic conditions. This program will train previous trainees to become mentors of the future; is integrated across content areas and methodological approaches; is feasible based on our previous successful training models; and will have sustainable impacts by retaining and motivating trainees and mentors to become future leaders and strengthen our partner institutions in India and Ethiopia from within.
