1075-Peru-ANDES: Addressing Hypertension and Diabetes through Community Engaged Systems

The overall objective of ANDES is to evaluate the effectiveness of a home-based CHW-led intervention in reducing blood pressure and improving hypertension control in patients from under-resourced communities in Puno, Peru.

Potential ANDES study participants are being identified, screened, and recruited via 2 different mechanisms: 1) community health fairs and 2) healthcare facility-based enrollment. Potential participants are screened for blood pressure measurements and type 2 diabetes (HbA1c). Recruitment is rolling over 24 months during which a total of 1068 participants will be enrolled, 534 assigned to the intervention arm and 534 to a control arm. Participants in the control arm are referred to their local healthcare facility for evaluation and/or to receive medical therapy per typical standard of care and at the discretion of the treating physician for the entirety of the ANDES study. Participants in the intervention arm receive monthly CHW home visits for 12 consecutive months. After month 12, intervention participants will be advised to obtain standard care from their local healthcare facility. The primary outcome is to determine if ANDES participants randomized to the intervention arm have an average reduction in SBP of at least 2.5 mmHg relative to the usual care arm 12 months after randomization. As secondary outcomes, we are also assessing changes in diet, physical activity, quality of life, treatment adherence, mental health, sleep, and tobacco/alcohol consumption as a result of our intervention. Study outcome measures will be obtained in both the usual care (control) and ANDES intervention arms at baseline and months 12 and 18 post-randomization. 

The student will primarily support the following study components, based on interest and expertise: 1) conducting and analyzing qualitative interviews to understand factors influencing intervention acceptability and effectiveness among CHWs and patients, and 2) assist in analysis of quantitative data on intervention implementation and effect on lifestyle modification (i.e., diet, exercise, smoking, alcohol consumption), among other quantitative analyses of study results. The student would be responsible for supporting day to day activities in Puno and ensuring that these study components are carried out according to the study protocol and milestones. The student would help troubleshoot issues that arise related to field activities, accompany fieldworkers on data collection visits, assist the data managers with data quality checks and data cleaning, and carry out quantitative and qualitative data analysis. Tasks may include but are not limited to the following:

-        Assist in training and overseeing daily activities of field staff
-        Accompany field staff on household visits to support and oversee study visits
-        Assist field staff in conducting in-depth interviews with participants and CHWs
-        Carry out routine data cleaning and work closely with the data manager to build local data management capacity
-        Compile updates for weekly reports on activities and analyses completed
-        Participate in weekly meetings with the local and JHU team and assist with documenting key decisions and follow-up actions
-        Conduct preliminary statistical analyses on intervention implementation and impact of the intervention on lifestyle modifications (i.e., changes from baseline to endline in diet, physical activity, smoking, alcohol consumption), among other quantitative analyses
-        Conduct qualitative analysis of patient and CHW interviews, including codebook development, interview coding, and content analysis
-        Contribute to reports and manuscripts on the study findings

The Puno team exemplifies a culture of collaboration and respect in a casual atmosphere. They are diligent and team-oriented. Their open-mindedness is evident, and they actively engage in both learning from others and sharing their experiences to educate their peers. The team promotes a supportive and inclusive atmosphere. The student will also be supported by an established infrastructure of research in Puno where various other projects are currently ongoing. The student will be able to form a community with other students and researchers (both from Peru and the US) working on ANDES as well as other projects in Puno.

This position is ideal for someone with a keen interest in implementation science, chronic disease research, and/or qualitative research. It offers the unique chance to learn how to conduct mixed methods analyses on program implementation and the behavioral impacts within the context of a randomized control trial. The ideal student would have a proactive and independent work ethic with a collaborative spirit. We are looking for someone with a desire to gain on-the-ground experience carrying out research in an LMIC context and willing to collaborate with a supportive and open-minded team of local staff who are eager to learn and share experiences.

-        Strong written and verbal communication skills
-        Ability to collaborate effectively with team members
-        Demonstrated ability to identify and solve problems independently
-        Ability to adapt to changing circumstances and environments with a desire to continuously learn and improve
-        Experience with REDCap data collection software, desired but not required
-        Quantitative research experience (some knowledge of R programming preferred)
-        Qualitative research experience, desired but not required
-        Attentive to detail with strong time management skills

Name: Kendra Williams, kendra.williams@jhu.edu 

I would describe my communication and mentorship styles as... 

I aim to cultivate a welcoming and encouraging atmosphere that promotes independence and initiative. My philosophy involves offering guidance that empowers students to proactively contribute to project goals. I am easily accessible for questions and discussions, fostering a collaborative and open environment. I strongly believe in the effectiveness of hands-on experiences guided by practical application, as this approach enhances the learning process for students.

A complementary student would have a working style and mentorship expectations that are..

This position would be best suited for a student who has an autonomous work approach and is open to guidance and feedback from both peers and mentors. They should demonstrate a proactive ability to identify tasks that need attention, displaying a strong sense of responsibility, inquisitiveness, and a collaborative mindset.

Estimated costs:

Housing will be provided in the student quarters of the study site office. Puno is a small town and most places can be reached on foot or in short taxi rides that cost ~$2-3. There is a kitchen available at the office where students can cook. For lunches, various restaurants around town are open for “menu” (choice between several lunch options) that costs around ~$2-3. Nicer restaurants are also available where a meal costs ~$10-20. 

Additional support from PI:

We will provide housing and cover the costs of all study-related transportation at the field site.