1076-Peru-Characterizing the acute impact of air pollution exposures on blood pressure and implications for clean cooking

The overall objective of the Discovery Award is to quantify the acute effects of air pollution exposure on blood pressure.

Hypertension affects nearly one-third of adults worldwide, with its prevalence rising rapidly in low- and middle-income countries (LMICs). Air pollution, particularly from household biomass fuel use, is a key risk factor for hypertension and cardiovascular disease. While clean cooking interventions like liquefied petroleum gas (LPG) have shown potential for reducing blood pressure (BP), randomized trials have failed to demonstrate significant impacts, potentially due to limitations with one-time BP measurements. To address this gap, we are evaluating the acute effects of air pollution exposure on BP in patients in Puno, Peru who are participating in the ongoing ANDES trial, which is evaluating the impact of a community health worker-led intervention on BP control. This Discovery project is enrolling approximately 600 participants from the ANDES trial for personal exposure monitoring and ambulatory blood pressure (ABP) assessment over a 24-hour period. Exposure to fine particulate matter (PM2.5) and ambulatory blood pressure (systolic and diastolic) are being measured using wearable devices. Statistical analyses will employ mixed-effects linear models to assess the acute and lagged impacts of PM2.5 exposure on BP, as well as linear regression to evaluate factors influencing BP and BP variability. Models will control for factors such as stove type used, physical activity, medication use, and diet. This research will provide critical evidence on the acute cardiovascular effects of air pollution and the potential for clean cooking interventions to mitigate BP variability, informing future intervention trials and policies to enhance cardiovascular health in vulnerable LMIC populations.

The student will primarily support collection and analysis of data on exposures and blood pressure. 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 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 data collection visits
-        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
-        Collaborate on statistical analyses of exposure and blood pressure data, including development of data visualizations
-        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 the Discovery study as well as other projects in Puno. 

This position is ideal for someone with a keen interest in environmental health, chronic disease research, and/or quantitative analysis. It offers the unique chance to learn how to conduct exposure and health monitoring 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
-        Some knowledge of quantitative data collection and analysis, with a preference for knowledge of R statistical software
-        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.