Clinicians specializing in cardiovascular health at the Unit have recently partnered with The AIDS Support Organization in Uganda, the University of California – San Francisco (USA), and the University of British Columbia in Canada to implement a study titled the "Family-Centered Approach to Enhance Lifestyle Change and Behavioral Modification for the Prevention of Cardiovascular Diseases among Adolescents and Their Families" (FaCe-D). This 5-year study aims to adapt and implement an evidence-based, family-centered intervention to evaluate its effectiveness in reducing cardiovascular disease risk among adolescents and their families in Uganda.

A social intervention study

FaCe-D is an implementation science project that builds on a family-based lifestyle intervention previously implemented by the iHealth-Type 2 Diabetes trial team in India, Pakistan, Sri Lanka, and the UK. This intervention effectively reduced weight and waist circumference among South Asians families at 12 months, with potential long-term benefits for preventing Type 2 Diabetes.

The three-phase study will be conducted in both urban and rural settings to provide a comparative analysis, with Kampala city serving as the urban site and Jinja district as the rural site. Stakeholders will be engaged to ensure that the intervention is effectively adapted to the Ugandan context.

Dr. Josephine Birungi, a senior scientist at the Unit and study Principal Investigator, emphasized the significance of this study. She said,

" Cardiovascular Diseases have overtaken HIV in causing death and disability in many developing countries. With over 50% of the population in Uganda below the age of 30 years, the study’s uniqueness stands in targeting adolescents, young people and their families and engaging community health workers to deliver the package on lifestyle change for reduction of cardiovascular disease risk. Adolescents establish health behaviors that can impact their future well-being, while also exhibiting an increase in risky behaviors that may lead to adverse outcomes. It is time to think outside the box and search for solutions/evidence from all places and from different categories of population including adolescents. Findings from the study will be critical in contributing evidence to support formulation of policies related to prevention of cardiovascular diseases.”

Anticipated Impact

The study will provide evidence on the effectiveness of a family-centered approach in modifying lifestyles to reduce cardiovascular disease risk and prevent related diseases. The findings could identify the most effective strategies for engaging both adolescents and their family members in health-promoting behaviors, guiding policy formulation and practice in cardiovascular disease prevention.

The study also aims to provide valuable insights into the barriers and facilitators of implementing such programs at a community level, highlighting the importance of culturally sensitive adaptations to intervention programs to ensure relevance and effectiveness within the community.

According to Professor Rachael King, Professor of Epidemiology and Biostatistics at the University of California and Co-Principal Investigator (Co-PI),

"There is a paucity of information on how to reduce CVD risk among adolescents and young people in African settings. The FaCe-D study will contribute to the body of knowledge on the role of family dynamics and the engagement of community health workers in the uptake, adoption, and maintenance of lifestyle changes necessary to mitigate CVD risk in resource-limited settings."

About the Funders

Canadian Institutes Health Research (CIHR) is Canada's federal funding agency for health research. Composed of 13 Institutes, we collaborate with partners and researchers to support the discoveries and innovations that improve our health and strengthen the global health care system.

The Global Alliance for Chronic diseases (GACD) brings together major international research funding agencies specifically to address the growing burden of non communicable diseases (NCDs) in local and middle-income countries (LMICs) and in underserved groups experiencing health disparities such as indigenous populations, in high-income countries (HICs) by building evidence to inform national and international policies. The GACD invests in impactful NCD implementation research, builds implementation science capacity and capability in relation to NCD, and facilitates collaborations and partnerships to support GACD investment and impact.

About the Implementing Institutions:

The Medical Research Council/Uganda Virus Institute/ London School of Hygiene & Tropical Medicine Uganda Research Unit (MRC/UVRI & LSHTM) is an internationally recognized centre of excellence for research and training. Its mission is to conduct high-quality research that adds knowledge and leads to improved control of infectious and non-communicable diseases in Uganda, Africa and globally, through translation of scientific findings into policy and practice, and rigorous research capacity building.

Uganda Virus Research Institute (UVRI)

UVRI is a world-class center of excellence in health research pertaining to human infections and disease processes associated with or linked to viral etiology and provides expert advice, enables partnerships and communication, and serves as a center for training and education. It contributes to knowledge, policy, and practice and builds capacity.

TASO (The AIDS Support Organization) is a non-governmental Ugandan organization that provides comprehensive care and support services to individuals and families affected by HIV/AIDS. Established in 1987, TASO was one of the first organizations in Uganda to respond to the HIV/AIDS epidemic. Our mission is to contribute to the process of preventing HIV infection, restoring hope and improving the quality of life of persons, families and communities affected by HIV infection and disease by offering medical care, counselling and pyschosocial support, community education and economic empowerement.TASO has also led campaigns dedicated to reducing stigma and discrimination associated with HIV/AIDS and improving the lives of thousands of Ugandans living with the disease.

The University of California, San Francisco (UCSF) is a global leading institution in health sciences and biomedical research. Founded in 1864, UCSF has evolved into a renowned center for medical education, patient care, and cutting-edge scientific discovery and dedicated exclusively to graduate education in health and biomedical sciences.UCSF comprises of several renowned schools and institutes, including the School of Medicine, School of Pharmacy, School of Nursing, and School of Dentistry. Our schools consistently rank among the best in the nation for their research output and the quality of education they provide. The University's medical center is also widely respected for its advanced clinical care and innovative treatments.UCSF plays a pivotal role in advancing global health through its extensive research initiatives and partnerships. We collaborate with industry leaders, healthcare providers and community organizations to address pressing health challenges and improve patient outcomes worldwide.

The University of British Columbia is a global centre for teaching, learning and research, consistently ranked among the top public universities in the world.UBC embraces innovation and transforms ideas into action. Since 1915, UBC has been opening doors of opportunity for people with the curiosity, drive and vision to shape a better world. A world-leading centre of teaching, learning and research excellence, UBC transforms personal initiative into innovation, and new ideas into impact.

About The Key Scientists

Dr. Josephine Birungi, Principal Investigator,  is a senior scientist at the Medical Research Council/Uganda Virus Research Institute and LSHTM Uganda Research Unit. Her research focuses on HIV/AIDS, diabetes and hypertension. 
She has a bachelor’s degree in medicine and surgery from Makerere University Medical School, a postgraduate diploma in public health from the University of Manchester and a master’s degree in international business administration from ESLSCA Business School in Paris. She trained in implementation science at the University of San Francisco.

In partnership with the TASO Uganda, Dr. Birungi successfully implemented the INTE-AFRICA trial, that evaluated integrated care for persons with HIV, diabetes and Hypertension in Uganda. The results from this trial informed the development of the Uganda national consolidated guidelines for HIV and Antiretroviral therapy.

Before joining the Unit, Dr. Birungi worked at The AIDS Support Organization (TASO) in Uganda, where she helped implement antiretroviral therapy (ART) in a rural clinic in 2004 after the WHO's 3 by 5 declaration.With over 20 years of research experience, Dr. Birungi co-chairs the research scale-up group at the Global Alliance for Chronic Diseases (GACD), is a member of the Non-Communicable Diseases (NCD) technical working group at the Ministry of Health in Uganda and is part of the Uganda Society for Health Scientists.

Professor Racheal King Co–PI is a Professor of Epidemiology and Biostatistics at the University of California, San Francisco (UCSF), with an affiliation to the Institute for Global Health Sciences. With formal training in public health behavioral sciences and anthropology, she has over 30 years of international public health experience, focusing on HIV research and programming. Her work primarily targets HIV prevention, care, and treatment in sub-Saharan Africa, particularly Uganda, utilizing both qualitative and quantitative research methodologies to address complex public health issues among highly vulnerable populations.

In her role, Professor King has conducted significant studies on the perceptions of HIV self-testing, the mobility patterns of sex workers, and the impact of COVID-19 on children with disabilities in Uganda. Her research findings contribute valuable insights into public health, often appearing in respected journals. Additionally, she serves as the Theme Lead for Adolescents at the HASH Project, focusing on health interventions for vulnerable groups. Dr. King's extensive experience and innovative approach make her a key figure in global health, particularly in HIV prevention and care.

Prof David Moore (Co-PI) is a prominent research scientist at the British Columbia Centre for Excellence in HIV/AIDS and a Professor in the Department of Medicine, Division of AIDS at the University of British Columbia (UBC). He serves as the physician lead of the provincial health services agency HIV Program at the British Col Centre for Disease Control

He completed his undergraduate studies in cell biology at UBC and later earned his MDCM degree from McGill University's Faculty of Medicine. His research primarily focuses on health service research in British Columbia and Uganda, aiming to maximize the treatment and prevention benefits at a population level. He is actively involved in several research projects, including two CIHR-funded projects in Uganda. These projects examine outcomes of long-term HIV treatment without expensive laboratory monitoring and conduct secondary analyses from a large randomized trial on HIV patient monitoring.

Professor Moore is also a member of the Canada-Africa HIV Prevention Trials Network. His research contributions extend to various publications and studies related to HIV treatment and prevention