Chronic Disease Clinical Trial
Official title:
A Longitudinal Survey of Health in Bolivia
The purpose of the study is to gather baseline surveillance data about the current health status of adults with chronic health conditions in La Paz and El Alto, Bolivia and identify barriers to the management of NCDs during face-to-face outpatient encounters as well as via novel mobile health services.
Within Latin America, there is a significant lack of data about the medical management and
self-care for patients with non-communicable diseases (NCDs), such as diabetes and
hypertension. In an effort to improve availability of such data in the Latin American region,
the World Health Organization (WHO) created and tailored a survey tool that has been used in
various countries throughout Central and South America. Our own research team has extensive
experience surveying clinic-based populations in Latin America regarding their chronic
disease burden and the potential effectiveness of novel approaches to self-care support via
mobile phones. The objective of the planned project is to gather baseline surveillance data
for non-communicable diseases in urban and peri-urban Bolivian communities, using the WHO
instrument as a foundation with modifications to reflect local public health priorities and
the goal of developing mobile health services that improve self-management support.
This project will be conducted by investigators and students of the University of Michigan
Schools of Medicine, Public Health, and Information, in partnership with the Catholic
University of Bolivia, San Pablo (UCB-San Pablo). The over-arching aim is to conduct a
longitudinal survey of health indicators in a variety of primary and ambulatory care sites
within clinics associated with Universidad Católica Boliviana, including SEDES La Paz and
Universidad Mayor San Andres, in La Paz and El Alto, Bolivia. The survey is based on: a) the
World Health Organizations' Division of Disease Prevention and Control's Program on
Non-Communicable Diseases' (NCD) Surveillance Toolkit: Risk Factors for Non-Communicable
Diseases, with the addition of b) the 8 Item Patient Health Questionnaire (PHQ-8) to screen
for Depression, c) the Alcohol Use Disorders Identification Test (AUDIT), d) the Patient
Assessment of Chronic Illness Care (PACIC) Questionnaire, e) questions developed by our
research team regarding the feasibility and desirability of mobile health monitoring and
self-care support and f) 8 item Morisky Medication use questions. By using validated survey
instruments, the investigators will be able to compare health indicators across countries and
provide the participating Bolivian government agencies and universities information crucial
to understanding the factors contributing to the development and maintenance of NCD services
in Bolivia. Specifically, this study will provide baseline data, which does not exist to
date, identifying the prevalent risk factors for NCDs and the barriers to those patients'
care. More generally, the investigators will gain invaluable experience regarding the
feasibility of enrolling large representative samples in various outpatient sites for use in
subsequent observational studies of NCD management and in randomized trials.
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