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Principal Investigator: Joseph Antony Cafazzo
Organization: YALE UNIVERSITY
Fiscal Year: 2024
Award: $235,580
Funding agency: National Heart Lung and Blood Institute
Project Summary
In Uganda, heart failure presents significant challenges due to limited resources and high prevalence. This
diversity supplement proposes an implementation adaptation study that aims to enhance HF diagnosis and
treatment through two main strategies. First, leveraging the parent R01's Community of Practice at each site,
investigators will co-design and evaluate an Echocardiography Training Intervention Package for non-
specialists across six Regional Referral Hospitals (Aim 1). This initiative builds upon existing local echo training
models and integrates advanced AI to improve early identification and management of heart failure, especially
heart failure with reduced ejection fraction, for which timely initiation of guideline-directed medical therapy
(GDMT) can significantly improve outcomes. Second, the project will analyze trends in GDMT prescribing
within a longitudinal cohort of symptomatic heart failure patients, using mixed effects logistic regression to
understand prescribing practices at the RRHs (Aim 2). By integrating advanced echocardiography training with
comprehensive analysis of GDMT prescribing, the project aims to improve clinical outcomes and establish
sustainable healthcare practices that address broad sociodemographic disparities in HF care across Uganda,
aligning with National Heart, Lung, and Blood Institute priorities and enhancing cardiovascular management in
a setting with profound healthcare delivery challenges. In this diversity supplement, the candidate, an assistant
professor medicine in the division of cardiovascular medicine, will apply her expertise in echocardiography and
global health. She will utilize her experience in echocardiography training of non-specialists, gained through
previous work in Haiti, to lead this implementation adaptation study aimed at enhancing heart failure diagnosis
and management. The supplement will provide the funding needed to support the candidate, giving her
mentorship and training in implementation science, while advancing the goals of the parent grant.
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