About GRIT

Our projects form a shared network that fosters cross-country interaction between scientists working in 8 different low and middle income countries

Researchers in circle discussing together

If we do something that works and we have done it only once, there is no guarantee that the same strategy will work in a different place or population. With implementation science and capacity building, we get to fully understand the process and fully develop interventions to overcome context specific challenges. With implementation science we can arrive at a robust strategy that can be cost-effective overtime for the entire population

Our Mission

To foster a collaborative platform advancing implementation science research targeted at building capacity and reducing the burden of cardiovascular diseases in low and lower middle income countries.

Why GRIT

Low and lower-middle income countries (LLMICs) are experiencing a non-communicable diseases (NCD) epidemic which are now the leading causes of mortality in these countries. Nearly 85% of deaths from NCDs occur in LLMICs that are also grappling with competing burden of communicable diseases, fragmented and poorly-equipped health care systems.

Particularly, cardiovascular disease (CVD) is the largest cause of death in developing regions with the exception of Sub-Saharan Africa, where it is the leading cause of death in those over the age of 45.

As a result, LLMICs face significant challenges in managing the complexities that accompany multiple risk factors attributable to chronic NCDs. Although numerous effective evidence-based interventions for NCD prevention and control exist, the implementation of these interventions are challenging, thus leading to under-utilization in LLMICs.

A meeting of the research team sitting around a table
Our projects form a shared network that fosters cross-country interaction between scientists working in 8 different countries

Identifying, implementing and sustaining innovative strategies to reduce the burden of NCDs in LLMICs

Given the lack of widespread implementation of existing evidence-based strategies, there is a clear and pressing need to identify, implement and sustain innovative strategies that will have beneficial effects in reducing the burden of NCDs in LLMICs. Therefore in 2017, the National Heart, Lung and Blood Institute (NHLBI) funded 8 programs in LMICs to address this growing burden and the lack of utilization of these implementation strategies in these settings.

Additionally, there is an insufficient exchange of ideas between scientists of different disciplines who are working to improve the late stage phase 4 translational research in LLMICs.

Due to this gap, a shared network in the form of a consortium was established to foster cross-country interaction between scientists working in these 8 countries funded by the NHLBI.

The Global Research on Implementation and Translation Science (GRIT) is a consortium of researchers that support late stage phase 4 translational research Hypertension Outcomes for T4 Research in Lower Middle-Income Countries (Hy-TREC) and the Translation Research Capacity Building Initiative in Low Middle-Income Countries (TREIN).

Our strategy

Global Research on Implementation and Translation Science (GRIT) defines and establishes a strategy that connects consortium members to capacity-building initiatives which enhance sustained uptake of evidence-based interventions for non-communicable disease prevention and control in low and lower-middle income countries (LLMICs). This strategy is built on three pillars capacity building, implementation research, and dissemination which works in hand to support the work of the 8 funded country projects

Nepal team trainees brainstorming

With administrative support from coordinating center the consortium seeks to build capacity at three levels: individual, institutional and system level.

  • Individual capacity
    Building capacity by training and supporting graduate, post-doctoral students, and junior faculty.
  • Institutional capacity
    Building capacity by training LMIC-specific institutions to develop and obtain grants to train (i.e.build capacity) within the institution’s setting
  • System level capacity
    Building capacity at the national or regional level within a country.

The National Heart, Lung and Blood Institute (NHLBI) funded countries in Rwanda, Malawi and Nepal (TREIN) utilize capacity building initiatives and approaches to advanced late-stage phase 4 translational research skill development in LMICs.

Implementation Research integrates research and practice to enhance the development and delivery of public health approaches and interventions.

Implementation research uses multiple disciplines and methods that emphasize partnerships between community members, implementers, researchers, and policymakers.

The NHLBI funded countries in Ghana, India, Kenya, Vietnam and Guatemala (Hy-TREC) utilize implementation research to identify and evaluate strategies for evidence-based interventions targeted to prevent, treat and control hypertension within the context of each country.

The consortium seeks to implement and disseminate evidence based strategies for CVD burden reduction through implementation and translation research.

The coordinating center for the consortium creates a collaborative platform which fosters the dissemination of research findings.

Consortium members are able to share best practices for implementation outcome research, special issue publications, conferences, and trainings.

GRIT Components

There are four major components of the GRIT consortium. These include NHLBI, Hy-TREC, TREIN, and the Coordinating Center

Planning meeting using whiteboard and notes

National Heart, Lung and Blood Institute (NHLBI) provides global leadership:

For scientific research, training, and education programs to promote the prevention and treatment of heart, lung, and blood disorders and enhance the health of all individuals.

This institute works to advance scientific discoveries, improve public health and fund groundbreaking research. The NHLBI funds all 8 country projects participating in the GRIT consortium.

Hypertension outcomes for T4 research within lower middle income countries (Hy-TREC) tests implementation strategies:

To deliver evidence-based interventions within the regional (sub-national within one country) or national levels (among several countries) for the prevention, treatment, and control of hypertension utilizing a suitable theoretical or conceptual implementation framework.

Five countries (Ghana, Kenya, India, Vietnam, and Guatemala) have been funded by the NHLBI to conduct research that helps understand the barriers to scale-up of evidence-based hypertension interventions in low and middle income countries.

T4 Translational Research Capacity Building Initiative in low income countries (TREIN) builds in-country capacity:

Through the creation of a trans-disciplinary investigative team to guide the conduct of late-stage translation phase 4 research in low-income countries through skills development programming, needs assessment, and capacity building.

Three countries (Nepal, Malawi and Rwanda) have been funded by the NHLBI to conduct this research.

GRIT Coordinating Center (GRIT-CC) is an established platform funded by NHLBI to support late-stage phase 4 translational research for Hy-TREC and TREIN (i.e. GRIT) consortium members.

The coordinating center helps consortium members across the 8 project countries to collaborate and engage in order to develop and exchange ideas and strategies that tackle the burden of hypertension in LMICs and build capacity in these contexts.

The coordinating center maintains the consortium website, coordinates bi-annual consortium meetings and supports the communication between consortium members across countries.