Heart and lung disease are the leading causes of illness and
death in the United States, and the disease burden is unequal
across groups defined by race/ethnicity, sex and/or gender, and
socioeconomic status. Numerous programs have been proven to
reduce heart and/or lung disease, but too often they are not put
into practice in the communities where they are most needed. The
National Heart, Lung and Blood Institute (NHLBI) recognized the
need to fund studies to identify implementation strategies to
effectively deliver evidence-based interventions and engage
diverse multidisciplinary stakeholders in communities with high
burdens of heart and/or lung disease.
In September 2020, the Disparities Elimination through Coordinated
Interventions to Prevent and Control Heart and Lung Disease Risk
(DECIPHeR) Alliance was initiated with funding from the
Translation Research and Implementation Science (CTRIS) Branch
of the NHLBI. The DECIPHeR Alliance is comprised of seven Implementation
Research Centers (IRC) hosted at:
- University of California at Los Angeles
- University of Colorado Denver
- University of Illinois at Chicago
- Johns Hopkins University/University of Michigan
- Northwestern University
- New York University School of Medicine
- Tulane University
In addition, a Research Coordinating Center (RCC) is located at the
University of North Carolina at Chapel Hill.
This 7-year (2020-2027) cooperative agreement is bi-phasic. The first
phase, UG3 (2020-2023), is exploratory. Activities at the IRCs are:
- Identifying high burden communities/populations
- Conducting needs assessments;
- Establishing community advisor boards;
- Identifying implementation strategies to be tested during the UH3 phase;
- Preparing to deliver the evidence-based intervention during the UH3 phase.
Community engagement is a key component of all the studies in the DECIPHeR Alliance. The DECIPHeR investigators will engage multiple types of community stakeholders including faith-based organizations, schools, community-based social services providing organizations, study participants and caregivers, health systems, payer organizations, government officials/ organizations, community health workers, advocacy organizations, large non-profit organizations, and institutional partners.
The second phase (UH3) is the implementation phase (2023-2027). During
that phase, the DECIPHeR Alliance will utilize connections made and
lessons learned in the UG3 phase to test implementation strategies for
optimally and sustainably delivering two or more proven-effective,
evidence-based multi-level interventions to reduce or eliminate
cardiovascular and/or pulmonary health disparities. The implementation
strategies, outcomes, interventions, and health outcomes vary across the
studies in the DECIPHeR Alliance. The implementation strategies include
(but are not limited to):
- economic incentives
- practice facilitation
- coaching and monitoring.
Implementation outcomes include
IRCs also examine health outcomes including hypertension
control/management, childhood asthma, cardiovascular health and smoking
To reduce mortality for people experiencing cardiovascular health disparities, new innovations in health care must be implemented with strategic partnerships that involve trusted organizations and community members.
Heart and lung disease are leading causes of illness and death in the United States, and the disease burden is unequal across groups defined by race/ethnicity, sex and/or gender, and socioeconomic status. Numerous programs have been proven to reduce heart disease, but too often they are not put into practice in the communities where they are most needed.
The National Institutes of Health awarded a $8.7 million grant to Tulane University to study whether churches can play a significant role in helping to eliminate cardiovascular health disparities among African Americans.