Chronic Diseases of Lifestyle Research Unit

Research programme of the unit

Past research of the Unit
Until 1996, research focussed on a series of cross-sectional surveys in different settings to describe the pattern of chronic diseases of lifestyle and their risk factors in South Africa. This included the identification of target groups, of all ages, at the highest risk to develop chronic diseases of lifestyle so that policy makers could ascertain at whom intervention programmes should be aimed. In addition, community-based risk factor intervention programmes were undertaken in communities with high levels of chronic diseases of lifestyle risk. These studies developed successfully tested models for intervention that could be implemented by health services in various settings. The research Unit has recently been extended to include health service research, which attempts to understand the determinants of many chronic conditions catered for in the primary health-care setting. Along with service providers these modules are developed and tested to produce evidence-based intervention programmes that can be implemented in the primary health care sector and improve patient care.

Process of priority setting
The process of identifying priority topics for research projects and activities of the CDL Unit is an ongoing open system, which has the objective of primarily identifying those areas that require information to improve chronic diseases of lifestyle prevention and care in the country. The primary source of this information is our major stakeholders in the National Department of Health. Furthermore, the Unit maintains an extensive network with South African and international scientists, particularly those from other developing countries. Whenever distinguished international scientists visit the CDL Unit, our research is presented and discussed to identify priorities and improve methodologies.

As the Unit has a major thrust in the area of implementation research, the second source of information comes from previous research results, which identified further questions to be addressed. These questions are always verified with stakeholders and other experts.

Implementation of research results and policy development
CDL has close links with policymakers in determining their priorities and in planning most of the research studies. The Unit also has input on a variety of professional bodies nationally and internationally, providing data for the planning of other needed studies. CDL researchers are constantly consulted for expert opinions on activities around chronic diseases of lifestyle in the public, private and NGO sectors. The media frequently consult the Unit. The Unit has been involved in the writing of some MRC policy briefs and will in future continue to participate in these activities. The CDL Unit maintains a high level of publications in peer-reviewed, indexed journals and participation at scientific meetings. All CDL researchers are required to participate at national and international scientific meetings to establish them as experts in the field, and keep up to date with new developments.

Chronic Diseases of Lifestyle Current Research

Unit Objectives
To undertake priority research in the field of CDL through effective partnerships with national and international collaborators:

Monitor trends of CDL risk factors nationally
The Chronic Diseases of Lifestyle Unit has been central in developing the adult health module for the South African Demographic and Health Survey (SADHS) and needs to continue providing technical support with the strategic national surveillance programme of the National DOH. Small studies will not be done unless there are very specific target groups that need to be evaluated.

Consolidate and review ongoing epidemiological studies in collaboration with the Burden of Disease Research Unit.

Develop and validate appropriate CDL research tools applicable to all South Africans
We have a record of accomplishment in developing tools for example, The Dietary Assessment and Education Kit (DAEK), HealthKick schools project, SADHS adult health module, structured records with prompts for hypertension and diabetes management, multiple questionnaires.

Evaluate the determinants of CDL risk factors and their impact
This Unit has many years of experience in this field and can offer this expertise to those in need. Evaluation is done with a view to prioritise interventions, which have an impact on target groups. Such as cardiovascular risk factors in black South Africans: The CRIBSA study; the PURE study.

Develop priority CDL interventions, relevant to South Africans and to evaluate their effectiveness
Many cross-sectional surveys and determinant studies have been completed so far, resulting in identification of the high-risk groups and the required interventions.
The Unit has a record of accomplishment re community-based, facility-based, to individual-based interventions. Over the next five years, this will be an increasingly important focus. Projects include the Smoking in pregnancy study; Worksite audit and the HealthKick study in Primary schools in the Western Cape.

Conduct health systems research to improve the primary level health-care services for CDL in South Africa
Review lifestyle intervention tools, development of protocol and guidelines for health workers to implement lifestyle interventions, development of training programmes, monitoring quality of care.

Communicate results to policy makers and other stakeholders, with the purpose of improving health policy in managing CDL
Protocol development for public engagement and dissemination of findings.

Research Capacity Development
The Unit has an ongoing capacity development programme. This is in the form of interns (master or doctoral students) who are mentored by staff members while they undertake projects on chronic diseases. The intern programme is financed by the Research Development Office of the MRC.