1. CAPCoD Projects Research in Action Mahmood Adil MD, MPH, MHSM, FFPH Visiting Scholar Yale School of Public Health Deputy Regional Director of Public Health Department of Health, England

2. 2 CAPCoD Community action to prevent chronic disease (CAPCoD) Practical idea – generated by Oxford Health Alliance (formally Oxford Vision 20:20) Yale is going to steer and deliver on this

3. 3 Why CAPCoD? Major epidemiological trends: –35 million mortality/ 80% developing countries / 2% reduction challenge for next 10 years to save 36 million lives Evidence: –Where reductions in chronic diseases were seen, primary prevention accounts for 50-70% of these reductions Impediments to change: –a massive under-investment in health research that directly addresses the health problems of low- and middle-income countries (10/90 Gap) Research in Action: –To make the difference on the ground by researching and working with local communities Global problem – global solution –International collaboration

4. 4 Individualresponsibility Change in the environment Puska 2001 Health Promoting Policy Why CAPCoD? Need to transfer evidence to action Behavioral determinants are known

5. 5 A CAPCoD Project Envisaged to deal with the reduction of the three prime risk factors together i.e. tobacco, unhealthy diet and the lack of physical exercise. Cover community settings in developing countries and underserved or historically disadvantaged populations in developed world.

6. 6 Sustainability plan that consider broad range of resources and local factors Builds on current body of knowledge and local data Experienced group of multi-disciplined investigators & implementers

7. 7 Project Objectives Utilise the evidence that concerted actions at community level involving workplaces, schools, health services and selected other settings can reduce the level of major risks for chronic diseases in target communities over a period of five years Demonstrate the value of innovative forms of creative public-private- academic-civil society interactions to improve community health Develop models of how successful projects could be sustainable and replicated over time

8. 8 Project Objectives (continued) Ensure that progress and results are effectively communicated to key decision makers and the media. Develop a network of chronic disease prevention and research sites worldwide to act as regional training centres for chronic disease work in the future.

9. 9 UNITED STATES Anchorage (Alaska) Arlington (Illinois) Dorchester (Massachusetts) Brooklyn (New York) Dallas (Texas) La Crosse (Wisconsin) GLOBAL Australia Indonesia India (3 projects) Brazil Pakistan Latin America Bulgaria Philippines -Buenos Aires Cameroon Russia -Mexico City China South Africa -Barquisimeto Croatia Tunisia Israel Vietnam CAPCoD PROJECTS

10. 10 Salient Features Develop world class research protocol for prevention by dealing with all 3 risk factors at the same time. A comprehensive approach to involve countries in community based project Unique opportunity to use the standard research & surveillance tools (e.g. STEPS/BRFSS) to collect baseline data from all different projects at the same time and make a meaningful comparison Putting developing countries on the chronic diseases intervention map by bringing researcher and funders together and to make a difference on the ground

11. 11 Salient Features Built-in outcome evaluation leading to local, national and international ploicy implications Opportunity to develop strong relationship with government, NGOs, private sector, academia civil society based on the common ground to improve health Development of strong international network permitting sustainability and capacity building to deal with chronic disease at community level

12. 12 Process January 05 – Request for Application (67 application received) Feb 05: Selection of 18 global and 6 US projects Criteria –Important & clearly defined research need –Impact/Scale –An outlined plan to address that need –Community/partnership opportunities March 05 – informed the selected teams (24) to develop detailed proposal May 05 – 10 Days intensive Research Protocol Development Workshop at Yale and teams evolved into 2 groups

13. 13 initial project planning and information gathering provide academic support to develop scientifically and economically sound projects, provide professional support to write competitive and high quality research proposals Provided a platform for international exposure and networking among the global researchers Protocol Development Workshop 11 th – 20 th May 2005

14. 14 August 05: Multi-setting group met at Yale September 05: Uni-setting (School-based) group met in South Africa October 05: High quality research protocols have been developed by the 2 groups for funding + individual countries improved their local protocols through this learning experience

15. 15 –Generate the questions and deal with challenges (local data + tailor-made interventions) –Develop high quality proposals & securing research funding for community intervention –Build research capacity and capability –Support the Dissemination & implementation of good programmes and policies to deal with burden of Chronic Diseases globally Summary

16. “Never doubt the capacity of a few dedicated individuals to change the world: in fact it is the only way it ever has” Margaret Mead Thank you