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Evaluating health system interventions to support hypertension care in rural areas

Award Number: F31HL180030
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS
PERIOD OF PERFORMANCE START DATE: 08/07/2025
PERIOD OF PERFORMANCE END DATE: 08/06/2028

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Evaluating health system interventions to support hypertension care in rural areas - PROJECT ABSTRACT / SUMMARY Noncommunicable diseases (NCDs), including cardiovascular diseases (CVD), now represent the leading cause of death and disability in the United States (US). As of 2023, an estimated 29.1% of deaths were attributable to cardiovascular diseases. Hypertension, a central risk factor for CVD, has also increased in prevalence in recent decades. In 2024, an estimated 48.1% of US adults had hypertension. Management of high blood pressure through pharmacotherapy and modifications to diet and physical activity can prevent CVD. However, most people with hypertension do not receive effective treatment. Among adults with hypertension, only 22.5% have achieved control of their blood pressure. Reported barriers to management of hypertension occur at multiple levels, including low uptake of screening by patients, insufficient time and knowledge of health workers, and poor geographic access to facilities, particularly in rural areas. Improving hypertension management will require new strategies to address these barriers and scale services to the population in need. India offers a unique context to explore such strategies, due to the large rural population and opportunity to trial management approaches for hypertension at scale through the healthcare system. Two examples of such strategies are the Andhra Pradesh Family Doctor Programme and the Integrated Tracking, Referral, and Electronic Decision Support, and Care Coordination (I-TREC) study (U01HL138635, PI: Tandon). Both strategies have been tested at the population level but have not yet been evaluated. This F31 proposal leverages longstanding research partnerships to evaluate health system interventions for hypertension management in Andhra Pradesh and Punjab states. We will use the RE-AIM framework to assess the reach, effectiveness, and implementation fidelity of hypertension services delivered through the Andhra Pradesh Family Doctor Programme, a statewide health system initiative to screen and refer people with hypertension to village health clinics (Aim 1). In Aim 2, we will develop a Markov model to estimate the cost-effectiveness of the I-TREC model of hypertension care in primary health facilities in Punjab state in terms of lifetime health outcomes. Finally, we will conduct qualitative interviews to understand how decisions around health service delivery are made (Aim 3). This dissertation will leverage innovative implementation science and mixed-methods approaches to evaluate population-wide hypertension programs. We expect findings from these evaluations to be primed for uptake to inform the scale up of these programs in Andhra Pradesh and Punjab, and lessons learned to be applicable to strengthening rural hypertension care in the US. .


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $50,114 )
2026	2026	EMORY UNIVERSITY	201 DOWMAN DR NE	ATLANTA	GA	30322	DEKALB	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	2	8/6/2026	NON-COMPETING CONTINUATION	$50,114
														Subtotal = $50,114

Issue Date FY: 2025 ( Subtotal = $49,538 )
2025	2025	EMORY UNIVERSITY	201 DOWMAN DR NE	ATLANTA	GA	30322	DEKALB	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	1	8/6/2025	NEW	$49,538
2025	2025	EMORY UNIVERSITY	201 DOWMAN DR NE	ATLANTA	GA	30322	DEKALB	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	1	8/6/2025	NEW	$0
														Subtotal = $49,538

Grand Total All Awards = $99,652

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Evaluating health system interventions to support hypertension care in rural areas

Award Number: F31HL180030

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

PERIOD OF PERFORMANCE START DATE: 08/07/2025

PERIOD OF PERFORMANCE END DATE: 08/06/2028

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