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Introduction Non-communicable diseases (NCDs) are a leading cause of morbidity and mortality in low-and middle-income countries (LMICs). Despite this, a lack of funding, training and mentorship for NCD investigators in LMICs exists. In an effort to gain knowledge and skills to address these gaps, participants from the Global Research on Implementation and Translation Science (GRIT), a consortium of studies in eight LMICs and their networks, attended the dissemination and implementation (D&I) massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases at the World Health Organization to strengthen D&I capacity building. Here, we report on the feasibility of this MOOC, which was implemented during the SARS COVID-19 pandemic from April- November 2020.Methods Participants completed pre- and post- training questionnaires to assess self-reported D&I competencies, general research skills, and research mentor access and quality. D&I competencies were measured by use of a scale developed for a US-based training program, with change in competency scores assessed by paired t test. We used univariate statistics to analyze the data for all other outcomes.Results Of the 247 participants enrolled, 32 (13%) completed all MOOC components. D&I competency scores suggest improvement for those who had complete pre- and post-assessments. Trainee’s average score on the full competency scale improved 1.45 points (0-5 scale) from pre- to post-test; all four subscales also showed evidence of improvements. There were small but not significant increases in competencies for grant writing, proposal/ manuscript writing and presentations from pre- to post-test assessment. 40% of trainees reported access to a research mentor and 12% reported access to a D&I specific mentor. Participants reported barriers (e.g., unstable internet access and challenges due to COVID-19) and facilitators (e.g., topical interests, collaboration with colleagues) to completing the MOOC.ConclusionsAlthough COVID-19 affected program usage and completion, the MOOC was feasible and effective, showing that among LMIC participants completing the course, there was improvement in D&I competency scores. Recommendations for future D&I trainings in LMICs should include 1) adding more topic specific modules (i.e., NCD research, general research skills) for scalability; 2) fostering more collaboration with participants across LMICs; and 3) establishing partnerships with D&I mentors for course participants.

Highlights NCD represent a serious challenge globally, particularly in LMIC.Implementation research capacity building are critical to inform the prevention and control of NCD in LMIC.Sustainable evidence-based strategies can reduce mortality and prevent avoidable illness from NCD.Strategic change agents (i.e., key stakeholders, institutions, communities, health systems, patients, and families) should work collaboratively to make the necessary advancements to reducing the burden of NCD in LMIC. Fil: Aifah, Angela. No especifíca; Fil: Iwelunmor, Juliet. No especifíca; Fil: Akwanalo, Constantine. No especifíca; Fil: Allison, Jeroan. Massachusetts Institute of Technology; Estados Unidos Fil: Amberbir, Alemayehu. No especifíca; Fil: Asante, Kwaku P.. No especifíca; Fil: Baumann, Ana. Washington University in St. Louis; Estados Unidos Fil: Brown, Angela. Washington University in St. Louis; Estados Unidos Fil: Butler, Mark. No especifíca; Fil: Dalton, Milena. No especifíca; Fil: Davila Roman, Victor. Washington University in St. Louis; Estados Unidos Fil: Fitzpatrick, Annette L.. No especifíca; Fil: Fort, Meredith. State University of Colorado at Boulder; Estados Unidos Fil: Goldberg, Robert. No especifíca; Fil: Gondwe, Austrida. No especifíca; Fil: Ha, Duc. No especifíca; Fil: He, Jiang. University of Tulane; Estados Unidos Fil: Hosseinipour, Mina. No especifíca; Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Kamano, Jemima. No especifíca; Fil: Karengera, Stephen. Washington University in St. Louis; Estados Unidos Fil: Karmacharya, Biraj M.. No especifíca; Fil: Koju, Rajendra. No especifíca; Fil: Maharjan, Rashmi. No especifíca; Fil: Mohan, Sailesh. No especifíca; Fil: Mutabazi, Vincent. No especifíca; Fil: Mutimura, Eugene. No especifíca; Fil: Muula, Adamson. No especifíca; Fil: Narayan, K.M.V.. University of Emory; Estados Unidos Fil: Nguyen, Hoa. No especifíca; Fil: Njuguna, Benson. No especifíca; Fil: Nyirenda, Moffat. No especifíca; Fil: Ogedegbe, Gbenga. No especifíca; Fil: van Oosterhout, Joep. No especifíca; Fil: Onakomaiya, Deborah. No especifíca; Fil: Patel, Shivani. University of Emory; Estados Unidos Fil: Paniagua-Ávila, Alejandra. No especifíca; Fil: Ramirez zea, Manuel. No especifíca; Fil: Plange Rhule, Jacob. No especifíca; Fil: Roche, Dina. No especifíca; Fil: Shrestha, Archana. No especifíca; Fil: Sharma, Hanspria. No especifíca; Fil: Tandon, Nikhil. No especifíca; Fil: Thu Cuc, Nguyen. No especifíca; Fil: Vaidya, Abhinav. No especifíca; Fil: Vedanthan, Rajesh. No especifíca; Fil: Weber, Mary Beth. University of Emory; Estados Unidos

Effectively tackling the growing noncommunicable disease (NCD) burden in low- and middle-income countries (LMIC) is a major challenge. To address research needs in this setting for NCDs, in 2009, National Heart, Lung, and Blood Institute (NHLBI) and UnitedHealth Group (UHG) engaged in a public-private partnership that supported a network of 11 LMIC-based research centers and created the NHLBI-UnitedHealth Global Health Centers of Excellence (COE) Program. The Program’s overall goal was to contribute to reducing the cardiovascular and lung disease burdens by catalyzing in-country research institutions to develop a global network of biomedical research centers. Key elements of the Program included team science and collaborative approaches, developing research and training platforms for future investigators, and creating a data commons. This Program embraced a strategic approach for tackling NCDs in LMICs and will provide capacity for locally driven research efforts that can identify and address priority health issues in specific countries’ settings.HighlightsA public-private partnership created the Program.Forming the Program captured all the elements of team science.The Program used best practices of collaborative science.Research training for future investigators was a high priority.

This chapter describes individual experiences during the initial years of the health-sector reform in Guatemala and their collective participation in a coalition of grassroots organizations called the Instancia Nacional de Salud. Instancia Nacional de Salud is a coalition of community-based organizations that responded to the Guatemalan government's top-down health care reform by creating an alternative program that integrated Mayan medicine into a comprehensive primary health-care structure.

Frost flowers are fragile ice crystals containing salt which grow to a height of 10–30 mm on the surface of young sea ice. Such flowers are observed all over the Arctic. The importance of the flowers and their accompanying slush layer is that they provide a rapid way to change the surface albedo and increase the surface roughness of young sea ice. This paper describes a laboratory technique for growing frost flowers and the physical processes which accompany the growth. The study was carried out in a saltwater tank located in a cold room. To grow frost flowers, we alternately cool the surface of the growing sea ice with a fan, then supply it with water vapor from a vaporizer. For these conditions and a room temperature of −22°C, the frost flowers begin to grow when the ice thickness reaches 5–8 mm. The flowers form at random locations on the ice and grow vertically to a height of 10–15 mm while spreading laterally from their original sites. Beneath the flowers, the surface is initially dry; then as the flowers spread laterally, a high-salinity slush layer forms beneath them. This layer, which forms only under the flowers, grows to a thickness of 5 mm in 48 hours and has a characteristic lateral scale of 100–200 mm. The salinity of the slush layer is about 80 psu, compared with a frost flower salinity of 100 psu. Within 24 hours of their appearance, the flowers grow to cover 75–90% of the surface. A surface water budget for the flowers and slush layer shows that most of the water in the flowers and slush layer comes from the ice interior, not from the vaporizer. This implies that an external vapor source may be important in determining the initial growth of the flowers but not in their subsequent development.