Goal 2: Reduce Human Disease

How do we address health disparities especially in our most vulnerable populations?

How do we address health disparities especially in our most vulnerable populations, including children?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : Research Advocacy Committee, American Thoracic Society

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Goal 3: Advance Translational Research

Interventions to Eliminate Health Inequities

There is a need to identify effective interventions for heart, lung, blood, and sleep diseases that could have a transformative population level impact on health inequities if expanded at the national level.

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

• Provide new knowledge for implementing strategies that will tackle inequities

• Provides opportunity to create multidiscipline research communities focused on health inequities

• Will gain momentum from federal and national implementation institutions to promote effective interventions to address health inequities

Feasibility and challenges of addressing this CQ or CC :

• Capitalizing on new methods, metrics and tapping big data could provide a promising platform to use systems science to better understand the barriers to eliminating health inequities in a short timeframe

• Identifying barriers will allow investigators to devise innovative implementation strategies that can reduce health inequities

• NHLBI could encourage communities of researchers to use team science to both identify barriers and link with other teams to implement strategies to reduce and eliminate barriers

• Established NHLBI health inequities Think Tank and space for developing innovative strategies to address health inequities.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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32 net votes
47 up votes
15 down votes
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Goal 3: Advance Translational Research

Leveraging Networks of Federally Qualified Healthcare Centers

How best do we leverage the existing Federally Qualified Healthcare Center’s (FQHC) infrastructure to study T4 Implementation Research for heart, lung, blood, sleep diseases and conditions among high risk and vulnerable populations?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• Develop strategies to reduced Health Inequities

• Potentially be scaled up across an entire health system with huge population impact

• Studies would be done in the environment and context where the findings with be implemented leading to better uptake and sustainability.

Feasibility and challenges of addressing this CQ or CC :

• Formative FQHC groups are already being organized but do not have strong leadership and support

• FQHCs have ready access to the high risk and vulnerable populations that would benefit most from the research

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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7 up votes
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Goal 1: Promote Human Health

Mechanism of dietary polysaccharide/ sugars in averting CVD and cancer

CQ

Submitted by (@mayaraman)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Non-communicable diseases and their preventive measure are always of interest. But we always, face side-effects because of these new applications. And at times, these techniques fail.

Diet today is a attractive area of discussion. Everyday, we read or hear that control of diet has cured severe conditions.

In fact, as the saying goes, we are what we eat. Today, scientific communities can lay emphasis on the researches concerning these topics. Dietary polysaccharides/ polyphenols etc. have a promising role in deciding our health. We can include these in our diet but the mechanism of the action of these factors in preventing diseases has not be explored in detail. The role of specific factors in diet at specific sites, may assist in pin-point treatment with better results and no side-effects. Can this topic be considered for research!

Feasibility and challenges of addressing this CQ or CC :

Challenges include creating teams of researchers with basic research expertise and experienced researchers to collaborate and come up with plans to understand the action of system and to design strategies utilizing dietary carbohydrates to have healthier and long term benefits.

Name of idea submitter and other team members who worked on this idea : Raman M

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6 up votes
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Goal 2: Reduce Human Disease

Can Psychological Science Improve Weight Loss?

Will sensitivity to the psychological aspects of obesity, including lifestyle priorities and motivations, improve the efficacy of long-term effectiveness of weight loss and obesity prevention interventions?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

A primary focus on principles of psychology may result in significantly improved control of the obesity epidemic. Effective interventions could reduce the risk of diabetes, sleep apnea, and hypertension. This research could also affect clinical practice guidelines for weight loss and obesity treatment.

Feasibility and challenges of addressing this CQ or CC :

Psychological science has been successful in developing effective treatments for a number of conditions, including sleep disorders, depressive symptoms, anxiety and phobias. Many of the behavioral principles employed in such interventions (e.g., cognitive restructuring, motivational methods) could be translated for the prevention and treatment of obesity within a reasonable time frame. Additional attention should be directed to the needs of population subgroups in which obesity is most prevalent.

In their Viewpoint article on weight loss intervention research, Pagoto and Appelhans (JAMA, 2013, see attachment) question whether a continued focus on dietary factors in research on weight loss and obesity is warranted. Their commentary raises the importance of attention to the individual psychological characteristics that influence adherence to weight loss interventions rather than dietary composition.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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51 net votes
104 up votes
53 down votes
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Goal 3: Advance Translational Research

Improve patient compliance through community health workers

What are effective strategies for community-based participatory dissemination and implementation research initiatives in rural settings? • Limited number of studies that adapt evidence- or practice-based interventions to rural settings • Needs innovative approaches to engaging the rural community • New intervention approaches needs testing in rural communities • Building a team would have to involve of local community ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• Nearly 60 million Americans living in rural communities face additional barriers to receiving effective prevention and treatment services.

• Rural residents often enter care later in the course of their illness than their urban peers, enter care with more serious symptoms, and require more intensive and expensive treatment.

• The rural communities in the US are closely connected and can be leveraged to disseminate heart, lung, blood, and sleep relevant preventive and/or treatment options within those communities.

• Enhance understanding of community resilience factors, cultural, and individual factors that may enhance the provision and utilization of prevention and treatment services in these communities.

• Generate knowledge to improve the organization, efficiency, effectiveness, quality, and services for rural and frontier populations.

• Support movement of evidence-based effective health care and prevention and the public health knowledge base in rural communities in the US.

• Stimulate implementation science in rural and frontier communities

• High return on investment.

Feasibility and challenges of addressing this CQ or CC :

• NHLBI investigators could initiate controlled trials that would maximize the opportunities available in rural communities.

• Documented sustainable interventions and scientific research could serve to reduce morbidity and mortality in high-risk rural populations.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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7 net votes
15 up votes
8 down votes
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Goal 2: Reduce Human Disease

What about the impact of regulation of genes in response to external stimulation on human health

We are focusing a lot on the genes that may be protective or harmful to our lives. But what about the regulation of genes in response to external stimulations, such as psychosocial and/or environmental, that are probably more accountable for whether we live healthier or not.

Submitted by (@jiang001)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Rationale: Years of research in the mind-heart field have set examples that looking at changes during dynamic stimulations (chronic, acute, and acute superimposed on chronic) are more meaningful for us to better understand how the body truly works. Therefore, research design in mimicking real dynamic process is necessary to truly capture the healthy or harmful phenotypes driven by genotypes. I suggest the NHLBI to establish a platform gathering resources to promote more sophisticated research from basic to clinical to better understand the underlying mechanisms of psychosocial impact on cardiovascular diseases that has come to a sizable problem for the human being in US and world wide.

Feasibility and challenges of addressing this CQ or CC :

We have performed researches that allow us to identify phenotypes that are only appearing under emotional stress testing. Currently we are examining whether certain intervention may modify these kinds of changes. Even our studies fail to demonstrate changes with intervention, the findings support future studies focusing on testing dynamic changes under stress that reflects daily living. Resting data obtained in laboratory does not truly represent what human beings experiences.

Name of idea submitter and other team members who worked on this idea : Wei Jiang from Duke University

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5 up votes
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Goal 3: Advance Translational Research

Develop common-sense standards for obesity research

Obesity research is riddled with methodological problems that are rarely challenged, leading to the perpetuation of misinformation and interventions that do harm. Given the two-thirds of the population who are classified as higher weight and thus subject to these interventions, it is past time to clean up the basic scientific flaws in this research area. For a quick summary of a couple of these issues, see Poodle Science: ...more »

Submitted by (@dbdb00)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

This subject really is both CG and CC. The CQ aspect is to see past the weight bias and stigma we are all subject to in order to see diversity of weight as normal, even as people across the weight spectrum suffer health insults from sources that are rarely investigated within the medical model (cf social determinants of health). The CC aspect is the enormous economic and cultural pressures to maintain the valuing of some bodies over others in order to sell products and create a group of people who have fewer ways to defend themselves from oppression.

Feasibility and challenges of addressing this CQ or CC :

Several key areas could make a big difference and they are quite feasible.

1. Require researchers to have studied weight bias and stigma so they are more aware of their own potential proclivities to frame research questions or results according to the status quo.

2. Require any study that claims a weight loss finding to have, report, and publish followup data on all participants at least 2-5 years post-intervention.

3. Require any study claiming a health issue related to weight to compare not higher and lower weight people, but rather higher weight people who have pursued weight loss and higher weight people who have not, since there is no way for higher weight people to be always-been-thinner.

4. Require weight/health research to control for obvious confounders such as weight cycling, SES, exposure to weight stigma, exposure to weight discrimination, exposure to racism, exposure to stress, lack of access to unbiased medical care, etc.

5. Require that journals allowing statements in the abstract or discussion or conclusions that generalize beyond the data be accountable, and that journals provide an accurate translation of the findings for journalists complete with statements about limitations of findings and possible alternative interpretations.

6. Fund projects which are about listening, especially to people who are rarely asked about their lived experience, in order to generate better research that actually improves quality of life for higher-weight people.

Name of idea submitter and other team members who worked on this idea : Deb Burgard, PhD

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44 up votes
20 down votes
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Goal 2: Reduce Human Disease

Use of health communication principles in management of obesity

What approaches can utilize current knowledge on health literacy/health communications as a research development tool and/or strategy to enhance obesity prevention and treatment efforts?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Allow the use of non-activity and non-dietary based approaches for managing overweight and obesity

Feasibility and challenges of addressing this CQ or CC :

Health communication and health literacy are of interest in the US Healthy People 2020 goals. The methodology and principles of health communications and the relationship between health literacy and health outcomes are emerging especially for obesity. There is a sufficient pool of scientists trained to conduct this type of work.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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22 net votes
49 up votes
27 down votes
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Goal 3: Advance Translational Research

Translation Research Dissemination & Implementation Frameworks

We need to identify and test the proven effective dissemination and implementation frameworks that are relevant to heart, lung, and blood disorders in order to scale up evidence-based interventions in real world settings, ultimately improving health equity among minority populations, including low income minority residents living in public housing.

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

• Ability to determine how much of an evidence based intervention can be sustained in real world settings.

• Add utilization of D&I frameworks to researcher’s core competency training skills.

• Promote long term sustainability of evidence based interventions.

Feasibility and challenges of addressing this CQ or CC :

• Researchers from the 2014 NIH’s Annual Conference on the Science of Dissemination and Implementation: Transforming Health Systems to Optimize Individual and Population Health presented compelling evidence that dissemination and implementation frameworks are an effective means to scaling up evidence based interventions.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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4 net votes
13 up votes
9 down votes
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Goal 3: Advance Translational Research

Expand the H3Africa Partnership Model to Decrease HLB diseases

Is there a way to decrease the risks for HLB disease leveraging the H3Africa genomics platform? • Leverage partnerships providing resources to the H3African populations • Identify the best collaborative partners to reach out to the low resource population • Find the best mechanism for collaborations to facilitate the interventions in low resource settings • Merge NHLBI research objectives and goals with those of potential ...more »

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• Leverage the existing infrastructure (NHLBI & UnitedHealth investment in the Centers of Excellence in Kenya and South Africa; NIH and Wellcome Trust investment in H3Africa) to decrease the burden of HLB using genomics in low resource settings

• Proof of concept: H3African countries & affiliated sites can be used to create a T4 model

• Extension: expand the H3Africa model to other LMICs

Feasibility and challenges of addressing this CQ or CC :

• Existing NHLBI investment in capacity building in some of the H3African countries can be leveraged to address heart, lung, blood, sleep diseases

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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6 up votes
12 down votes
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