Community Health Assessment Program in the Philippines (CHAP-P) – DM04 Principal Investigators: Gina Agarwal (Canada NPI)1, Fortunato Cristobal (Philippines NPI)2, Lisa Dolovich1, Janusz Kaczorowski3, Ricardo Angeles1 McMaster University Department of Family Medicine, Canada Ateneo de Zamboanga University School of Medicine, Philippines University of Montreal Department of Family & Emergency Medicine, Canada

Aims & Objectives To adapt the Canadian-based Cardiovascular Health Awareness Program (CHAP) to a low- to middle-income country (LMIC) setting as the Community Health Assessment Program in the Philippines (CHAP-P) To determine the effect of CHAP-P on HbA1c of residents from selected communities of the Zamboanga Peninsula, Philippines

CHAP-Philippines: A 5-year, 4-phase, mixed methods project Project Status CHAP-Philippines: A 5-year, 4-phase, mixed methods project Phase 1 (complete) – qualitative adaptation to sociocultural & economic setting Phase 2 (complete) – pilot studies Phase 3 (in progress) – 26-community parallel cluster randomized controlled trial (RCT) 100 participants per community; n = 2600 Phase 4 (upcoming; 2019) – analysis & knowledge translation

Community blood pressure testing Conducting questionnaires via tablet

Milestones 2017-2018 Full pilot completed 296 participants in 3 communities: Higher participation rate in rural communities Higher diabetes incidence in urban communities 15.1% of those without diabetes had a high or very high risk of developing it 59.6% of those with diabetes were untreated CHAP-P feasible & acceptable locally

Challenges & Solutions Challenge: HbA1c kits are sensitive to the heat & humidity of the Philippines Solution: Changed processes to conduct all A1C tests at a community location (with refrigeration) instead of in the homes

Challenges & Solutions Challenge: some survey questions – e.g., physical activity examples – were not applicable to the setting Solution: interviewers supplied locally-relevant examples Community coordination

Challenges & Solutions Challenge: starting in Month 3, community health workers had some lapses in fidelity to the 15-step CHAP-P protocol Solution: volunteers were re-trained on CHAP-P protocol Training community health workers

Stakeholder Engagement Presenting Pilot results Giving certificates of appreciation to CHAP-P volunteers Meeting in City Health Office, Zamboanga City

Acknowledgments Thank you to all of our participants, stakeholders, research & implementation teams, Project Advisory Team, and sponsors!