Emmanuel Peprah

Associate Professor of Global and Environmental Health

Professional overview

Dr. Emmanuel Peprah’s research interests lie at the confluence of understanding what, why, and how some evidence-based interventions work in some populations and not others. The programattic focus of his research is understanding the contextual factors that influence the burden of co-morbidity in people living with HIV/AIDS (PLWH), with a particular focus on cardiovascular disease risk factors and mental health. As the burden of non-communicable diseases (NCDs) continues to increase, there is an opportunity to integrate NCD management into HIV care with implemention strategies that leverage the global infrasturcture designed to improve care delivery for PLWH. Dr. Peprah has built collaborations with multidisciplinary teams of investigators, both nationally and internationally, to address the high burden of comorbidity in PLWH globally.  He is also the founder of the Baakoye Foundation, a nonprofit philanthropic organization dedicated to serving people in sub-Saharan Africa, and co-founder of the Washington Leaders Index (WLI), which aims to empower the next generation of emerging leaders through active, innovative, and inclusive leadership programs. Both nonprofit organizations serve the needs of children and people globally within the domains of education and health.

Before joining GPH, Dr. Peprah was a senior program official at the National Institutes of Health (NIH), where he worked with senior leadership to oversee strategic planning, initiative development, and implementation of research priorities in the areas of translational research, implementation science, and global health. He led and managed HIV/AIDS programs and a $10 million portfolio as part of the National Heart, Lung, and Blood Institute’s Trans-Omics for Precision Medicine Program. He was instrumental in launching the Human, Heredity, and Health in Africa (H3Africa) Initiative, a multimillion trans-NIH program, and served on its executive board. Dr. Peprah has received several awards for strategic planning, management, and implementation of large-scale NIH programs.

Education

BS, Biology, Texas A&M University, Commerce, TX

PhD, Molecular Biology & Biomedical Science, Meharry Medical College, Nashville, TN

Honors and awards

NIH Director’s Award for Leadership H3Africa Stage II Team: For exceptional leadership and dedication in implementing Stage II of the Human Heredity and Health in Africa program (2018)

NHLBI’s Director's for Outstanding Service (2018)

NHLBI’s Director's for Outstanding Service Partnership/Collaboration Award for bringing multiple disciplines together to understand HIV-related co-morbidities and prepare for the challenges presented by the complex conditions of the new HIV era (2018)

NHLBI’s Director's for Outstanding Translational Science Award for demonstrating exemplary leadership and service in advancing translation research (2017)

Federal Service Career Promotion (2016)

NHLBI’s Director's for Outstanding Translational Science Award as part of the Center for Translational Research and Implementation Science (CTRIS) Leadership Team for demonstrating exemplary leadership and service in advancing CTRIS’s translation (2016)

NHLBI’s Director's for Breath of Fresh Air (Innovation) award for exemplary work evaluating NHLBI’s support for multi-project research grants and proposing creative and innovative enhancements to the NHLBI’s program project grants (PPG) (2016)

NHLBI’s Director's for Learning Environment Award for fostering a learning environment through effective administration, knowledge sharing, and thoughtful implementation of the NHLBI R35 Program (2016)

NHLBI’s Director's for Partnership/Collaboration in recognition of outstanding collaborative efforts in developing a conceptual framework for the NHLBI R35 program to provide greater funding stability and flexibility to investigators (2015)

NIH Director's Common Fund Leadership Award for the NIH Common Fund Early Independence Award Program (2013)

NIH Director's Award as a member of the Common Fund Global Health Leadership Team for outstanding service in the coordination of the Common Fund Global Health Initiatives (2012)

Certificate of Appreciation for Invited Presenter, NIH Seminar Series, STEM Careers (2012)

Certificate of Appreciation for Invited Presenter, Washington Mathematics Science Technology Public Charter High School, Washington, DC (2012)

Leadership Award, Postdoctoral Fellows Research Symposium Committee, Emory University, Atlanta, GA (2008)

Areas of research and study

Dissemination and Implementation of Evidence-based Programs

HIV/AIDS

Implementation science

Inter-organizational Networks

Translational science

Publications

Publications

Etornam Amesimeku, Himani Chhetri, Brian Angulo, Christina Ruan, Cong Wang, Judy Fordjuoh, Chukwuemeka Iloegbu, John Patena, Joyce Gyamfi, Jonathan Odumegwu, Nessa Ryan, Emmanuel Peprah. Association between the level of concern for COVID-19 and informati

Evidence-based interventions to reduce maternal malnutrition in low and middle-income countries : a systematic review

Shenoy, S., Sharma, P., Rao, A., Aparna, N., Adenikinju, D., Iloegbu, C., Pateña, J., Vieira, D., Gyamfi, J., & Peprah, E. (n.d.).

Publication year

2023

Journal title

Frontiers in Health Services

Volume

3

10.3389/frhs.2023.1155928

Abstract

Abstract

Introduction: Despite remarkable strides in global efforts to reduce maternal mortality, low-and middle-income countries (LMICs) continue to grapple with a disproportionate burden of maternal mortality, with malnutrition emerging as a significant contributing factor to this enduring challenge. Shockingly, malnourished women face a mortality risk that is twice as high as their well-nourished counterparts, and a staggering 95% of maternal deaths in 2020 occurred within LMICs. The critical importance of addressing maternal malnutrition in resource-constrained settings cannot be overstated, as compelling research studies have demonstrated that such efforts could potentially save thousands of lives. However, the landscape is marred by a scarcity of evidence-based interventions (EBIs) specifically tailored for pregnant individuals aimed at combatting maternal malnutrition and reducing mortality rates. It is against this backdrop that our study endeavors to dissect the feasibility, adoption, sustainability, and cost-effectiveness of EBIs designed to combat maternal malnutrition. Methods: Our comprehensive search encompassed eight prominent databases covering the period from 2003 to 2022 in LMICs. We began our study with a comprehensive search across multiple databases, yielding a total of 149 studies. From this initial pool, we eliminated duplicate entries and the remaining studies underwent a thorough screening process resulting in the identification of 63 full-text articles that aligned with our predefined inclusion criteria. Results: The meticulous full-text review left us with a core selection of six articles that shed light on interventions primarily centered around supplementation. They underscored a critical issue -the limited understanding of effective implementation in these countries, primarily attributed to inadequate monitoring and evaluation of interventions and insufficient training of healthcare professionals. Moreover, our findings emphasize the pivotal role of contextual factors, such as cultural nuances, public trust in healthcare, the prevalence of misinformation, and concerns regarding potential adverse effects of interventions, which profoundly influence the successful implementation of these programs. Discussion: While the EBIs have shown promise in reducing maternal malnutrition, their true potential for feasibility, adoption, cost-effectiveness, and sustainability hinges on their integration into comprehensive programs addressing broader issues like food insecurity and the prevention of both communicable and non-communicable diseases.

Evidence-based interventions to reduce maternal malnutrition in low and middle-income countries: a systematic review

Global Burden of Cardiovascular Diseases and Risks, 1990-2022

Global Burden of Cardiovascular Diseases and Risks, 1990-2022

Implementation of non-insulin-dependent diabetes self-management education (DSME) in LMICs : a systematic review of cost, adoption, acceptability, and fidelity in resource-constrained settings

Implementation of non-insulin-dependent diabetes self-management education (DSME) in LMICs: a systematic review of cost, adoption, acceptability, and fidelity in resource-constrained settings

Implementation outcomes and strategies for delivering evidence-based hypertension interventions in lower-middle-income countries : Evidence from a multi-country consortium for hypertension control

Gyamfi, J., Iwelunmor, J., Patel, S., Irazola, V., Aifah, A., Rakhra, A., Butler, M., Vedanthan, R., Hoang, G. N., Nyambura, M., Nguyen, H., Nguyen, C., Asante, K. P., Nyame, S., Adjei, K., Amoah, J., Apusiga, K., Adjei, K. G., Ramierz-Zea, M., … Ogedegbe, G. (n.d.).

Publication year

2023

Journal title

PloS one

Volume

18

Issue

5 May

10.1371/journal.pone.0286204

Abstract

Abstract

Guidance on contextually tailored implementation strategies for the prevention, treatment, and control of hypertension is limited in lower-middle income countries (Lower-MIC). To address this limitation, we compiled implementation strategies and accompanying outcomes of evidence-based hypertension interventions currently being implemented in five Lower-MIC. The Global Research on Implementation and Translation Science (GRIT) Coordinating Center (CC) (GRIT-CC) engaged its global network sites at Ghana, Guatemala, India, Kenya, and Vietnam. Purposively sampled implementation science experts completed an electronic survey assessing implementation outcomes, in addition to implementation strategies used in their ongoing hypertension interventions from among 73 strategies within the Expert Recommendations for Implementing Change (ERIC). Experts rated the strategies based on highest priority to their interventions. We analyzed the data by sorting implementation strategies utilized by sites into one of the nine domains in ERIC and summarized the data using frequencies, proportions, and means. Seventeen implementation experts (52.9% men) participated in the exercise. Of Proctor's implementation outcomes identified across sites, all outcomes except for appropriateness were broadly assessed by three or more countries. Overall, 59 out of 73 (81%) strategies were being utilized in the five countries. The highest priority implementation strategies utilized across all five countries focused on evaluative and iterative strategies (e.g., identification of context specific barriers and facilitators) to delivery of patient- and community-level interventions, while the lowest priority was use of financial and infrastructure change strategies. More capacity building strategies (developing stakeholder interrelationships, training and educating stakeholders, and supporting clinicians) were incorporated into interventions implemented in India and Vietnam than Ghana, Kenya, and Guatemala. Although robust implementation strategies are being used in Lower -MICs, there is minimum use of financial and infrastructure change strategies. Our study contributes to the growing literature that demonstrates the use of Expert Recommendations for Implementing Change (ERIC) implementation strategies to deliver evidence-based hypertension interventions in Lower-MICs and will inform future cross-country data harmonization activities in resource-constrained settings.

Implementation outcomes and strategies for delivering evidence-based hypertension interventions in lower-middle-income countries: Evidence from a multi-country consortium for hypertension control

John Pateña J, Daliya Ali, Kiera Bloch, Marsha Williams, Dorice Vieria, Deborah Adenikinju, Chukwuemeka Iloegbu, Joyce Gyamfi, Emmanuel Peprah. A systematic review of the facilitators and barriers for implementing hypertension interventions among displaced persons in low- and middle-income countries. American Heart Association Scientific Sessions 2023. November 11–13, 2023. Philadelphia, Pennsylvania 

Peprah, E. (n.d.).

Publication year

2023

Abstract

Abstract

~

Judy Fordjuoh, Himani Chhetri, Rodina Mohamed, Chloe Ambrose, Khady Ndiaye, Shreya Meda, Dorice Vieria, Chukwuemeka Iloegbu, John Patena, Joyce Gyamfi, Emmanuel Peprah. The intersection between female-related cancer screenings and improving maternal health in LMIC: A systematic review. APHA 2023. Nov 12-16 2023: Atlanta, GA (Poster)

Peprah, E. (n.d.).

Publication year

2023

Abstract

Abstract

~

Reducing Dietary Sodium Intake among Young Adults in Ghana: A Call to Action

Scaling-up Evidence-based Interventions for Communities of Color With Marked Health Disparities: Lessons Learned From COVID-19 Can Be Applied to Reduce Morbidity and Mortality and Achieve Health Equity

Shivani Shenoy, Priyanka Sharma, Aishwarya Rao, Nusrat Aparna, Deborah Adenikinju, Chukwuemeka Iloegbu, John Pateña, Dorice Vieira, Joyce Gyamfi, Emmanuel Peprah. Evidence-based interventions to reduce maternal malnutrition in low and middle-income countries: A systematic review. APHA 2023. Nov 12-16 2023: Atlanta, GA (Poster)

Peprah, E. (n.d.).

Publication year

2023

Abstract

Abstract

~

Shreya Meda, Joyce Gyamfi, Farha Islam, Dorice Vieira, Deborah Adenikinjuku, Christina Ruan, Kahini Patel, Himani Chhetri, Etornam Amesimeku, Sukruthi Thunga, Amy Diawara, Jumoke Opeyemi, Temitope Ojo, John Patena, Emeka Iloegbu, Carlos Chrinos, Olajide Williams, Gbenga Ogedegbe, Emmanuel Peprah. Music Interventions for Blood Pressure Reduction in the United States: A Systematic Review. American Heart Association Scientific Sessions 2023. November 11–13, 2023. Philadelphia, Pennsylvania 

Peprah, E. (n.d.).

Publication year

2023

Abstract

Abstract

~

Systematic review of end stage renal disease in Pakistan : Identifying implementation research outcomes

Systematic review of end stage renal disease in Pakistan : Identifying implementation research outcomes

Systematic review of end stage renal disease in Pakistan: Identifying implementation research outcomes

AlRashed, H., Miele, J., Prasad, J., Adenikinju, D., Iloegbu, C., Patena, J., Vieira, D., Gyamfi, J., & Peprah, E. (n.d.).

Publication year

2023

Journal title

PloS one

Volume

18

Issue

12

Page(s)

e0296243

Abstract

Abstract

The aim of this study was to conduct a systematic review analysis to identify and evaluate the available literature on implementation science outcomes research in relation to End Stage Renal Disease (ESRD) in Pakistan.

Arvin Karbasi, Judy Fordjuoh, Dorice Vieria, Joyce Gyamfi, Temitope Ojo, Emmanuel Peprah. An evolving HIV epidemic in the Middle East and North Africa (MENA) region amongst People Who Inject Drugs (PWID): A scoping review. American Public Health Associa

Assessing descriptions of scalability for hypertension control interventions implemented in low-and middle-income countries : A systematic review

Gyamfi, J., Vieira, D., Iwelunmor, J., Watkins, B. X., Williams, O., Peprah, E., Ogedegbe, G., & Allegrante, J. P. (n.d.).

Publication year

2022

Journal title

PloS one

Volume

17

Issue

7

10.1371/journal.pone.0272071

Abstract

Abstract

BACKGROUND: The prevalence of hypertension continues to rise in low- and middle-income- countries (LMICs) where scalable, evidence-based interventions (EBIs) that are designed to reduce morbidity and mortality attributed to hypertension have yet to be fully adopted or disseminated. We sought to evaluate evidence from published randomized controlled trials using EBIs for hypertension control implemented in LMICs, and identify the WHO/ExpandNet scale-up components that are relevant for consideration during "scale-up" implementation planning.METHODS: Systematic review of RCTs reporting EBIs for hypertension control implemented in LMICs that stated "scale-up" or a variation of scale-up; using the following data sources PubMed/Medline, Web of Science Biosis Citation Index (BCI), CINAHL, EMBASE, Global Health, Google Scholar, PsycINFO; the grey literature and clinicaltrials.gov from inception through June 2021 without any restrictions on publication date. Two reviewers independently assessed studies for inclusion, conducted data extraction using the WHO/ExpandNet Scale-up components as a guide and assessed the risk of bias using the Cochrane risk-of-bias tool. We provide intervention characteristics for each EBI, BP results, and other relevant scale-up descriptions.MAIN RESULTS: Thirty-one RCTs were identified and reviewed. Studies reported clinically significant differences in BP, with 23 studies reporting statistically significant mean differences in BP (p < .05) following implementation. Only six studies provided descriptions that captured all of the nine WHO/ExpandNet components. Multi-component interventions, including drug therapy and health education, provided the most benefit to participants. The studies were yet to be scaled and we observed limited reporting on translation of the interventions into existing institutional policy (n = 11), cost-effectiveness analyses (n = 2), and sustainability measurements (n = 3).CONCLUSION: This study highlights the limited data on intervention scalability for hypertension control in LMICs and demonstrates the need for better scale-up metrics and processes for this setting.TRIAL REGISTRATION: Registration PROSPERO (CRD42019117750).

Barriers to Therapeutic Use of Hydroxyurea for Sickle Cell Disease in Nigeria : A Cross-Sectional Survey

Determinants of hydroxyurea use among doctors, nurses and sickle cell disease patients in Nigeria

Development of the ASSESS tool : a comprehenSive tool to Support rEporting and critical appraiSal of qualitative, quantitative, and mixed methods implementation reSearch outcomes

Ryan, N., Vieira, D., Gyamfi, J., Ojo, T., Shelley, D., Ogedegbe, O., Iwelunmor, J., & Peprah, E. (n.d.).

Publication year

2022

Journal title

Implementation science communications

Volume

3

Issue

1

10.1186/s43058-021-00236-4

Abstract

Abstract

Background: Several tools to improve reporting of implementation studies for evidence-based decision making have been created; however, no tool for critical appraisal of implementation outcomes exists. Researchers, practitioners, and policy makers lack tools to support the concurrent synthesis and critical assessment of outcomes for implementation research. Our objectives were to develop a comprehensive tool to (1) describe studies focused on implementation that use qualitative, quantitative, and/or mixed methodologies and (2) assess risk of bias of implementation outcomes. Methods: A hybrid consensus-building approach combining Delphi Group and Nominal Group techniques (NGT) was modeled after comparative methodologies for developing health research reporting guidelines and critical appraisal tools. First, an online modified NGT occurred among a small expert panel (n = 5), consisting of literature review, item generation, round robin with clarification, application of the tool to various study types, voting, and discussion. This was followed by a larger e-consensus meeting and modified Delphi process with implementers and implementation scientists (n = 32). New elements and elements of various existing tools, frameworks, and taxonomies were combined to produce the ASSESS tool. Results: The 24-item tool is applicable to a broad range of study designs employed in implementation science, including qualitative studies, randomized-control trials, non-randomized quantitative studies, and mixed methods studies. Two key features are a section for assessing bias of the implementation outcomes and sections for describing the implementation strategy and intervention implemented. An accompanying explanation and elaboration document that identifies and describes each of the items, explains the rationale, and provides examples of reporting and appraising practice, as well as templates to allow synthesis of extracted data across studies and an instructional video, has been prepared. Conclusions: The comprehensive, adaptable tool to support both reporting and critical appraisal of implementation science studies including quantitative, qualitative, and mixed methods assessment of intervention and implementation outcomes has been developed. This tool can be applied to a methodologically diverse and growing body of implementation science literature to support reviews or meta-analyses that inform evidence-based decision-making regarding processes and strategies for implementation.

Global, regional, and national burden of diseases and injuries for adults 70 years and older : Systematic analysis for the Global Burden of Disease 2019 Study

GBD 2019 Ageing Collaborators, A., Tyrovolas, S., Stergachis, A., Krish, V. S., Chang, A. Y., Skirbekk, V., Dieleman, J. L., Chatterji, S., Abd-Allah, F., Abdollahi, M., Abedi, A., Abolhassani, H., Abosetugn, A. E., Abreu, L. G., Abrigo, M. R., Abu Haimed, A. K., Adabi, M., Adebayo, O. M., Adedeji, I. A., … Peprah, E. (n.d.).

Publication year

2022

Journal title

BMJ

Volume

376

10.1136/bmj-2021-068208

Abstract

Abstract

Objectives To use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) to estimate mortality and disability trends for the population aged ≥70 and evaluate patterns in causes of death, disability, and risk factors. Design Systematic analysis. Setting Participants were aged ≥70 from 204 countries and territories, 1990-2019. Main outcomes measures Years of life lost, years lived with disability, disability adjusted life years, life expectancy at age 70 (LE-70), healthy life expectancy at age 70 (HALE-70), proportion of years in ill health at age 70 (PYIH-70), risk factors, and data coverage index were estimated based on standardised GBD methods. Results Globally the population of older adults has increased since 1990 and all cause death rates have decreased for men and women. However, mortality rates due to falls increased between 1990 and 2019. The probability of death among people aged 70-90 decreased, mainly because of reductions in non-communicable diseases. Globally disability burden was largely driven by functional decline, vision and hearing loss, and symptoms of pain. LE-70 and HALE-70 showed continuous increases since 1990 globally, with certain regional disparities. Globally higher LE-70 resulted in higher HALE-70 and slightly increased PYIH-70. Sociodemographic and healthcare access and quality indices were positively correlated with HALE-70 and LE-70. For high exposure risk factors, data coverage was moderate, while limited data were available for various dietary, environmental or occupational, and metabolic risks. Conclusions Life expectancy at age 70 has continued to rise globally, mostly because of decreases in chronic diseases. Adults aged ≥70 living in high income countries and regions with better healthcare access and quality were found to experience the highest life expectancy and healthy life expectancy. Disability burden, however, remained constant, suggesting the need to enhance public health and intervention programmes to improve wellbeing among older adults.

HIV, Tuberculosis, and Food Insecurity in Africa—A Syndemics-Based Scoping Review