{
  "abstract": "This article describes how a structured lifestyle modification intervention for hypertension and diabetes was scaled within Kerala’s health system, focusing on how implementation knowledge was generated and embedded in routine practice. Grounded in an implementation research approach, the work documents how evidence-informed strategies were continuously adapted through stakeholder engagement, peer-led delivery, and supportive institutional processes. Drawing on qualitative data from stakeholder consultations, document review, and field observations in Janakeeya Arogya Kendrams (basic unit of primary health care centres in Kerala), the article shows how local context, social learning, and power dynamics shaped iterative learning cycles. The findings outline key facilitators and barriers to knowledge use in practice. It offers practical insights for strengthening sustainable non-communicable disease prevention and control programmes in similar settings.",
  "abstract_shown": true,
  "affiliations": [
    "Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram",
    "International Institute for Population Sciences (IIPS), Mumbai",
    "Airport Health Organisation (APHO), Trivandrum",
    "Centre for Chronic Disease Control (CCDC), New Delhi",
    "Department of Health & Family Welfare, Government of Kerala, Trivandrum",
    "P K Das Institute of Medical Sciences, Palakkad",
    "Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences, Kochi"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nabil Abdul Majeed",
      "orcid": "0009-0000-5064-7310"
    },
    {
      "affs": [
        1
      ],
      "name": "Sandra Sebastian",
      "orcid": "0009-0004-0912-2351"
    },
    {
      "affs": [
        0
      ],
      "name": "Henna Kondeth",
      "orcid": "0009-0001-2335-8676"
    },
    {
      "affs": [
        2
      ],
      "name": "Kripa Selvarajan Valsa Shiby",
      "orcid": "0000-0001-5327-0600"
    },
    {
      "affs": [
        3
      ],
      "name": "Akshay Parambilan Kandi",
      "orcid": "0009-0000-7079-7623"
    },
    {
      "affs": [
        4
      ],
      "name": "Renu Vijayakumaran Nair Prasanna"
    },
    {
      "affs": [
        5
      ],
      "name": "Sonu Soman Ammariparambil",
      "orcid": "0009-0001-1885-4181"
    },
    {
      "affs": [
        4
      ],
      "name": "Bipin Gopal",
      "orcid": "0000-0003-2765-3792"
    },
    {
      "affs": [
        4
      ],
      "name": "Abey Sushan",
      "orcid": "0000-0002-7652-4770"
    },
    {
      "affs": [
        4
      ],
      "name": "Muraleedharan Sarojini Manu",
      "orcid": "0000-0003-3416-3185"
    },
    {
      "affs": [
        6
      ],
      "name": "Kavumpurathu Raman Thankappan",
      "orcid": "0000-0002-4536-2684"
    },
    {
      "affs": [
        0
      ],
      "name": "Panniyammakal Jeemon",
      "orcid": "0000-0003-4172-4307"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9vrgsxnshftew.bib",
  "cited_by": 0,
  "doi": "10.5334/gh.1585",
  "fulltext_url": "https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1585",
  "id": "9vrgsxnshftew",
  "issns": [
    "2211-8179"
  ],
  "landing_url": "https://doi.org/10.5334/gh.1585",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RA1-1270"
    ],
    [
      "lcc",
      "RC666-701"
    ],
    [
      "openalex",
      "3600|Health Policy Implementation Science"
    ]
  ],
  "openalex": "W7214717794",
  "pdf_url": "https://globalheartjournal.com/articles/1585/files/6abbc2fb03e76.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-01",
  "publisher": "Ubiquity Press",
  "ris": "https://research.draconitic.com/paper/9vrgsxnshftew.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T14:22:05Z",
      "native_id": "0507d760dbf74a9fbb1242d65afefdd3",
      "source": "doaj",
      "url": "https://doi.org/10.5334/gh.1585"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC666-701",
      "subfield": "cardiovascular"
    },
    {
      "field": "medicine",
      "origin": "lcc:RA1-1270",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Generating Implementation Research Knowledge for Scaling Lifestyle Modification Intervention to Control Hypertension and Diabetes: Lessons from the CoCo-HD Study in Kerala",
  "title_text": "Generating Implementation Research Knowledge for Scaling Lifestyle Modification Intervention to Control Hypertension and Diabetes: Lessons from the CoCo-HD Study in Kerala",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:22:05Z",
  "url": "https://research.draconitic.com/paper/9vrgsxnshftew",
  "venue": "Global Heart",
  "versions": []
}