Online Training

Dorairaj Prabhakaran, MD, DM

Summary: Importance of asking answerable, valuable research questions and capacity required to pursue such research.

Learning objectives:
Be able to ask answerable, hypothesis-driven research questions.

Pre-reading:
1. Kahn CR, New England Journal of Medicine 1994
2. Dhillon P, International Journal of Epidemiology 2012

Post-module work:
Write three hypothesis-driven research questions related to your area of interest and “25 x 25”.

Rank the following subject areas by order of preference for the team-based project following the Think Tank seminar:

• Implementation science: measuring and improving adherence to essential cardiovascular medicines
• Health systems: procurement and distribution of essential cardiovascular medicines
• Health policies: universal health coverage policies for improving payment for, access to essential cardiovascular medicines

This assignment does not need to be emailed to the program staff.

Darwin Labarthe, MD, PhD, MPH

Summary: Description of training resources for cardiovascular disease epidemiology and prevention and importance of mentorship for success of Emerging Leaders.

Learning objectives:
1. Compare and contrast primordial, primary, and secondary prevention strategies to achieve “25 x 25”.
2. Identify importance of mentorship to help achieve “25 x 25”.

Pre-reading:
1. Labarthe DR, Circulation Cardiovascular Quality and Outcomes 2012
2. Straus SE, Sackett DL, Clinical Trials 2011

Post-module work:
Identify one local mentor and one international mentor to help you work on projects to help achieve “25 x 25”.

Amir Attaran, MD, JD

Summary: Concepts of medicine, law, and social determinants of health reviewed, including safety of global medication supply.

Learning objectives:
1. Understand fundamentals of social determinants of health and apply social strategies to contribute to “25 x 25”.
2. Incorporate the current state of global medication safety standards into broader strategies to improve adherence for.

Pre-reading:
1. WHO Report 2008
2. Attaran A et al., British Medical Journal 2012

Post-module work:
Describe and estimate potential effects of three non-medical strategies to help achieve “25 x 25”.

Donald Lloyd-Jones, MD ScM

Summary: Concepts of risk estimation introduced, including long-term or lifetime risks of cardiovascular disease, competing risks, and the “low-risk” phenotype for cardiovascular disease reviewed.

Learning objectives:
1. Use short- and long-term risk calculators to explore their strengths and limitations and the effects of changes to modifiable and non-modifiable risk factors.
2. Identify metrics used to define the “low-risk” phenotype outlined by Stamler and colleagues and compare with cardiovascular health metrics defined by the American Heart Association.

Pre-reading:
1. Berry JD, et al., New England Journal of Medicine 2012
2. Stamler J, et al., Journal of the American Medical Association 1999
3. Lloyd-Jones DM, et al., Circulation 2010

Post-module work:
Access the AHA/ACC Pooled Risk Calculator (here) and explore differences in risk based on changes in modifiable and non-modifiable risk factors.

Vasanthi Srinivasan, PhD

Summary: Review of the importance of early and consistent engagement of patients, policymakers, and other stakeholders and fundamental communication skills required for successful influence and change toward “25 x 25”.

Learning objectives:
Identify differences in strategies for addressing shared problems between researchers and policymakers, including differences in timelines, metrics, and communication to bridge those differences.

Pre-reading:
1. Guyatt GH, et al., British Medical Journal
2. Lavis JN, et al., PLoS Medicine 2012

Post-module work:
1. Practice your academic pitch for achieving “25 x 25” to at least one policymaker (governmental or non-governmental) and one patient representative.
2. Identify and contact at least one policymaker with whom you can network on an ongoing basis to help drive progress toward “25 x 25” on a local, regional, or national level.

John Lavis, MD, PhD

Summary: Review of the potential health systems effects on getting cost-effective programs, services, and drugs to patients to improve health; importance of and tools for evidence-informed policymaking across a wide range of interventions and countries; and GRADE methodology for evaluating the quality of evidence and strength of recommendations.

Learning objectives:
1. Learn how to access evidence synthesis reports through healthsystemsevidence.org.
2. Learn how to use SUPPORT tools for evidence-informed policymaking.

Pre-reading:
1. Bosch-Capblanch X, et al., PLoS Medicine 2012
2. Lavis JN, et al., Health Research Policy and Systems 2009

Post-module work:
1. Use the Health Systems Evidence site (here) to see if there has been an evidence synthesis for your area of interest related to “25 x 25”.
2. Use the SUPPORT tools (here) for development of a policy brief related to your area of interest related to “25 x 25” to prepare for a policy dialogue.

Clara Chow, MD, PhD

Summary: Review importance of and instruments for the evaluation of the environmental and societal influences on cardiovascular health.

Learning objectives:
1. Understand how local environmental and societal factors can affect cardiovascular health
2. Learn the basics of using an environmental profile research instrument.

Pre-reading:
1. Chow CK, et al., PLoS ONE 2010
2. Chow CK, et al., International Journal of Epidemiology 2009

Post-module work:
Use once section within EPOCH 1 (instrument and manual are freely available via PLoS ONE) to evaluate your local community:

• Community characteristics’
• Community observation walk
• Assessment of a tobacco retail outlet
• Assessment of a local restaurant.

Alvaro Avezum, MD, PhD

Summary: Review on the principles of building and scale a cardiovascular research career and local, national, and global network with an emphasis on research efficiency and implementation research.

Learning objectives:
1. Understand the importance of and strategies for local research network development and research efficiency for scalability.
2. Incorporate the competencies of implementation science into research training activities.

Pre-reading:
1. Straus SE, Sackett DL, Clinical Trials 2012
2. Straus SE, Sackett DL, Implementation Science 2011

Post-module work:
Identify and contact at least five new researchers or at least five members of an existing research network within your region/country who are either already working on or would be interested in working on research related to “25 x 25” with you.

Dina Balabanova, MSc, PhD

Summary: Review of health systems and the effects of health systems change in the context of political and social change.

Learning objectives:
1. Understand the potential effects and domains of health systems on cardiovascular health.
2. Use the WHO building blocks of health systems as a framework for implementing and evaluating health system interventions and changes.

Pre-reading:
1. WHO Report 2007
2. WHO Report 2010
3. Balabanova D, et al., Lancet 2013

Post-module work:
Use Health Systems Global (here) to identify and contact health system actors/collaborators in your region/country who can help in your work on “25 x 25”.

David Wood, MD, MSc

Summary: Review of the components and potential effects of cardiovascular prevention programs, including cardiac rehabilitation programs for individuals identified as high-risk for cardiovascular disease events.

Learning objectives:
1. Compare and contrast population- and individual-based strategies for cardiovascular disease prevention and identify those strategies within the WHO Global Action Plan for NCD Prevention and Control.
2. Understand the range of health professionals who care for patients with cardiovascular disease and who pursue research to achieve “25 x 25” beyond doctors and cardiologists.

Pre-reading:
1. Rose G, British Medical Journal 1981
2. WHO Report 2013
3. Wood DA. et el., Lancet 2008

Post-module work:
Begin your research projects to help contribute to “25 x 25”!