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Introduction: The Household Chronic Disease Risk Factor (CDRF) study (earlier referred to as “Household Cohort Study”) is a pilot study to evaluate the feasibility and scalability of recruiting rural households for a longitudinal cohort study, using collaborations in the SANCD network to represent various geographical regions in South Asia. In each site, we are collecting information on chronic disease risk factors and outcomes from all members of the household, aged 2 years and above, for a sample of 250 households or approximately 1200 persons per site (approx. 3500 total). We have used electronic data capture to collect a range of data, using interviewer-administered questionnaires, anthropometric measurements, blood pressure, visual acuity, lung function and blood/fasting glucose measurements. Data collection for the CDRF study began in 2011 with the following three partner sites.
Collaborative partners in CDRF Study:
1. South Asia Network for Chronic Disease – Professor Shah Ebrahim, Dr. Preet K. Dhillon, Dilip Jha, Dr. Vipin Gupta
2. International Center for Diarrheal Disease Research, Bangladesh (ICDDR,B) – Dr. Dewan Alam (co-PI)
3. Voluntary Health Services (VHS), Chennai – Dr. Joseph Williams (co-PI)
4. Sangath, Goa – Dr. Amit Dias (co-PI)
Source of funding: The CDRF study is funded by the Wellcome Trust strategic grant awarded to South Asia Network of Chronic Disease, as a collaborative venture between LSHTM, UK and PHFI, India. The implementation of the CDRF study addresses one of the original objectives of the SANCD center of excellence.
Study objectives:
1. To understand the prevalence of household and individual non-communicable disease (NCD) risk factors and outcomes in rural South Asian populations
2. To describe household and individual responses to illness and health care decision-making
3. To test the feasibility of point-of-care diagnostics, such as glucometers, electronic data capture, community-based interviews and data collection on healthy children and adults.
Data collection:
1. Household-level data: socioeconomic, sugar, salt & oil consumptions, exposure to cooking fuels, insurance, household expenditures
2. Interviewer-administered questionnaire data on adults: demographic, quality of health, use of health care services, mental health, social networks, tobacco, alcohol, physical activity, diet, urinary symptoms, pain, respiratory symptoms, neighborhood, suicide, medical history and family history, outpatient & inpatient care.
3. Interviewer-administered questionnaire data on children: demographic, quality of life, development, disability, physical activity, diet, medical history, outpatient and inpatient care,
4. Physical measurements (clinic- and home-based): blood pressure, lung function through spirometry, fasting glucose, anthropometrics, body fat percent, 24-hour urine samples, visual acuity and grip strength.
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In 2011, the CDRF study was launched in Matlab, Bangladesh (June), in Carambolim, Goa (August) and in Sirudhavur, Chennai (November). A total of 12 field investigators, 2 medical officers, 1 nurse and 3 project managers are collecting information on children >2 years and all adults in the community. Electronic data capture has resulted in real-time viewing and downloading of data, which has helped the SANCD team better understand and respond to challenges and complexities in each location. Creative solutions have been implemented to enhance participation – in Chennai, the laptops are used for interesting, multimedia presentations while in Goa, glucometer screening camps help raise awareness. As of February 1, 2011, 891 adults & children have been interviewed in Matlab (271 households), 259 in Carambolim, Goa (73 households) and 134 in Sirudhavur, Tamil Nadu (49 households).
Health cards/participant feedback forms are provided to participants on important clinical data, such as height, weight, blood pressure, fasting glucose and visual function. Abnormal spirometry readings are referred for further diagnostic work-up. We are also circulating newsletters to the field teams and network partners on the status of this study ( first edition on introductions to the project staff and second edition on electronic data capture). We have conducted a seminar on research writing at VHS in conjunction with a long-term SANCD Mentoring program with VHS & Sangath, to utilize research expertise at SANCD, readily available data through electronic data capture, and the field staff enthusiasm and expertise in the field.  |
