2025
Factors associated with the adoption of the WHO Package of Essential Non-Communicable Diseases (PEN) Protocol 1 in primary healthcare settings in Nepal: a cross-sectional study
Timalsena D, Nakarmi C, Mali S, Dhakal A, Bharati A, Bishwokarma A, Adhikari A, Poudel B, Kulung B, Baral P, Bhattarai S, Dixit L, Pokharel Y, Rhodes E, Xu D, Spiegelman D, Shrestha A. Factors associated with the adoption of the WHO Package of Essential Non-Communicable Diseases (PEN) Protocol 1 in primary healthcare settings in Nepal: a cross-sectional study. BMJ Open 2025, 15: e090923. PMID: 40935428, DOI: 10.1136/bmjopen-2024-090923.Peer-Reviewed Original ResearchConceptsWHO packageNon-communicable diseasesPrimary healthcareBody mass indexCardiovascular disease risk-prediction chartsHealthcare workersCardiovascular diseaseRisk prediction chartsPrimary healthcare settingsPrimary healthcare facilitiesPrimary healthcare centresBlood glucose screeningCardiovascular disease riskLow-resource settingsCross-sectional studyAssociated with accessBMI assessmentHealthcare settingsSystemic barriersProvider motivationBlood pressure measurementsAvailability of metforminRisk chartsPrediction chartsHealthcare facilitiesBarriers and facilitators to patient utilization of noncommunicable disease services in primary healthcare facilities in Nepal: a qualitative study
Mali S, Rhodes E, Nakarmi C, Shrestha S, Dhakal A, Bharati A, Bishwokarma A, Adhikari A, Poudel B, Rai B, Manandhar S, KC S, Timalsena D, Silwal S, Dhimal M, Baral P, Teufel F, Bhattarai S, Spiegelman D, Shrestha A. Barriers and facilitators to patient utilization of noncommunicable disease services in primary healthcare facilities in Nepal: a qualitative study. BMC Health Services Research 2025, 25: 863. PMID: 40598095, PMCID: PMC12217986, DOI: 10.1186/s12913-025-13050-8.Peer-Reviewed Original ResearchNon-communicable diseasesPrimary healthcare facilitiesPatient utilizationNon-communicable disease interventionsHealthcare facilitiesWorld Health OrganizationPurposive sample of patientsQualitative studyPurposive samplingNoncommunicable disease servicesCardiovascular diseaseNCD servicesChronic respiratory diseasesSample of patientsDisease servicesHealth OrganizationDisease interventionRespiratory diseaseFacilitationServicesFacilitiesBarriersNepalInterventionDiseaseValidation of sexually transmitted disease-related stigma and shame scale in Nepalese women
Poudel L, Stangl A, Paneru B, Timsina P, Spiegelman D, Shakya S, Sheth S, Shrestha A. Validation of sexually transmitted disease-related stigma and shame scale in Nepalese women. International Journal Of Surgery Global Health 2025, 8: e00571. DOI: 10.1097/gh9.0000000000000571.Peer-Reviewed Original ResearchConfirmatory factor analysisNepali womenChi-square/degrees of freedom ratioInternal consistencyRoot mean square error of approximationDisease-related stigmaFit indicesEvaluate construct validityNormed fit indexPsychosocial Well-BeingComparative fit indexItem-total correlationsTucker-Lewis indexCronbach's aError of approximationMeasure stigmaNepali versionModel fitTwo-factor structureTelephone interviewsConstruct validityKavrepalanchok district of NepalDistrict of NepalNepalese womenStigmaCorrection: Association between cancer stigma and cervical cancer screening uptake among women of Dhulikhel and Banepa, Nepal
Paneru B, Karmacharya A, Bharati A, Makaju S, Adhikari B, Kafle D, Shakya S, Donna S, Seth S, Stangl A, Shrestha A, Shrestha A. Correction: Association between cancer stigma and cervical cancer screening uptake among women of Dhulikhel and Banepa, Nepal. PLOS ONE 2025, 20: e0318367. PMID: 39854385, PMCID: PMC11759993, DOI: 10.1371/journal.pone.0318367.Peer-Reviewed Original Research
2024
Socio-economic factors associated with cancer stigma among apparently healthy women in two selected municipalities Nepal
Paneru B, Karmacharya A, Makaju S, Kafle D, Poudel L, Mali S, Timsina P, Shrestha N, Timalsena D, Chaudhary K, Bhandari N, Rai P, Shakya S, Spiegelman D, Sheth S, Stangl A, Eastment M, Shrestha A. Socio-economic factors associated with cancer stigma among apparently healthy women in two selected municipalities Nepal. PLOS ONE 2024, 19: e0301059. PMID: 39680514, PMCID: PMC11649127, DOI: 10.1371/journal.pone.0301059.Peer-Reviewed Original ResearchConceptsCancer Stigma ScaleCancer stigmaMean stigma scoreGeneralized Estimating EquationsStigma scoresDomains of stigmaPublic health researchSocio-demographic factorsCross-sectional studyStigma ScaleMultivariate linear regressionHealthy womenLower educationHealth researchMarital statusCause of deathStigmaLow overall prevalenceEstimating EquationsFemale populationLikert scalePrimary cause of deathOverall prevalenceOlder ageScoresEffects of a dietary intervention on cardiometabolic risk and food consumption in a workplace
Shrestha A, Tamrakar D, Ghinanju B, Shrestha D, Khadka P, Adhikari B, Shrestha J, Waiwa S, Pyakurel P, Bhandari N, Karmacharya B, Shrestha A, Shrestha R, Bhatta R, Malik V, Mattei J, Spiegelman D. Effects of a dietary intervention on cardiometabolic risk and food consumption in a workplace. PLOS ONE 2024, 19: e0301826. PMID: 38656951, PMCID: PMC11042715, DOI: 10.1371/journal.pone.0301826.Peer-Reviewed Original ResearchConceptsConsumption of whole grainsHealthy foodPre-post intervention studyWhole grainsMedian consumptionCardiovascular risk factor profileRisk factor profileBlood pressureWorksite settingWorksite interventionsUnhealthy foodsHealth programsMeasured blood pressurePre-hypertensionCardiometabolic riskDiastolic blood pressureIntervention studiesFactors dietPaired-t testFactor profileFasting glucose levelsDhulikhel HospitalHospital premisesEmployee healthHospital employeesBarriers and Facilitators of Implementing a Healthy Lifestyle Intervention at Workplaces in South Africa
Singh S, Naicker A, Grobbelaar H, Singh E, Spiegelman D, Shrestha A. Barriers and Facilitators of Implementing a Healthy Lifestyle Intervention at Workplaces in South Africa. International Journal Of Environmental Research And Public Health 2024, 21: 389. PMID: 38673303, PMCID: PMC11050208, DOI: 10.3390/ijerph21040389.Peer-Reviewed Original ResearchFocus group discussionsHealthy lifestyle interventionIn-depth interviewsLifestyle interventionIntervention programmeDesigning lifestyle interventionsImplement lifestyle interventionsCardiovascular risk factor profileLifestyle intervention programmeImprove health outcomesImplementing health programmesLack of willpowerSemi-structured in-depth interviewsRisk factor profileImplementing intervention programmesFood environmentHealth outcomesImplement interventionsHealth programmesWorkplace stakeholdersWellness programmesWorkplace supportLifestyle choicesFactor profileGroup discussions
2021
Health system gaps in cardiovascular disease prevention and management in Nepal
Shrestha A, Maharjan R, Karmacharya BM, Bajracharya S, Jha N, Shrestha S, Aryal A, Baral PP, Bhatt RD, Bhattarai S, Bista D, Citrin D, Dhimal M, Fitzpatrick AL, Jha AK, Karmacharya RM, Mali S, Neupane T, Oli N, Pandit R, Parajuli SB, Pradhan PMS, Prajapati D, Pyakurel M, Pyakurel P, Rai BK, Sapkota BP, Sapkota S, Shrestha A, Shrestha AP, Shrestha R, Sharma GN, Sharma S, Spiegelman D, Suwal PS, Thapa B, Vaidya A, Xu D, Yan LL, Koju R. Health system gaps in cardiovascular disease prevention and management in Nepal. BMC Health Services Research 2021, 21: 655. PMID: 34225714, PMCID: PMC8258928, DOI: 10.1186/s12913-021-06681-0.Peer-Reviewed Original ResearchConceptsHealth systemCardiovascular disease preventionCause of deathHealth system gapsQuality of careResource-limited settingsNational health policyHealth system performanceBackgroundCardiovascular diseaseCVD preventionCVD careCVD servicesHealth outcomesDisease preventionHealth policyHealth insuranceHealth spendingCarePreventionKey informant interviewsTask ForceSystem gapsInformant interviewsService deliverySafetyFacilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study
Stern D, Blanco I, Olmos LA, Valdivia JJ, Shrestha A, Mattei J, Spiegelman D. Facilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study. BMC Public Health 2021, 21: 973. PMID: 34022846, PMCID: PMC8141192, DOI: 10.1186/s12889-021-11004-3.Peer-Reviewed Original ResearchConceptsHigher health awarenessHealthy eatingWorksite cafeteriasCardiometabolic disease preventionFocus group discussionsHealthy food choicesHealthy food optionsNutrition interventionsQualitative studyDietary behaviorsDisease preventionLack of timeHealth awarenessFatty foodsHealth of employeesExploratory qualitative studyEatingHealthy foodsFood optionsFood choicesLarger worksitesJob categoriesUnpleasant tasteWorkplace cafeteria and other multicomponent interventions to promote healthy eating among adults: A systematic review
Naicker A, Shrestha A, Joshi C, Willett W, Spiegelman D. Workplace cafeteria and other multicomponent interventions to promote healthy eating among adults: A systematic review. Preventive Medicine Reports 2021, 22: 101333. PMID: 33732606, PMCID: PMC7937753, DOI: 10.1016/j.pmedr.2021.101333.Peer-Reviewed Original ResearchMulticomponent interventionHealthy eatingWorkplace cafeteriasDietary intakeWorkplace health interventionsEnglish-language articlesImproved health outcomesFood choicesHealth risksWeb of ScienceCOM-B systemHealth risk indicatorsVegetable intakeHigh intakeElectronic searchHealth outcomesSystematic reviewHealth interventionsNarrative summaryReview protocolIntakeInterventionCafeteria interventionsRisk indicatorsBehavioral changes
2020
Worksite intervention study to prevent diabetes in Nepal: a randomised trial protocol
Pyakurel P, Shrestha A, Karmacharya BM, Budhathoki SS, Chaudhari RK, Tamrakar D, Shrestha A, Karmacharya RM, Shrestha A, Sharma S, Sharma SK, Spiegelman D. Worksite intervention study to prevent diabetes in Nepal: a randomised trial protocol. Open Heart 2020, 7: e001236. PMID: 32847993, PMCID: PMC7451278, DOI: 10.1136/openhrt-2019-001236.Peer-Reviewed Original ResearchMeSH KeywordsAdultBiomarkersBlood GlucoseDiabetes MellitusGlycated HemoglobinHealth BehaviorHealth Knowledge, Attitudes, PracticeHealthy LifestyleHumansMaleMiddle AgedMulticenter Studies as TopicNepalOccupational Health ServicesPatient Education as TopicPrediabetic StatePrimary PreventionRandomized Controlled Trials as TopicRisk Reduction BehaviorTime FactorsTreatment OutcomeConceptsBehavioral interventionsControl periodDiabetes risk reductionMonth control periodNepal Health Research CouncilBehavioral intervention groupWorksite intervention studiesT-testHealth Research CouncilInstitutional review boardTwo-sample t-testBlood sugarTrial protocolIntervention groupEthical approvalControl groupIntervention studiesType 2More monthsReview boardInterventionDiabetesParticipant changesPublic healthRisk reductionCardiovascular disease trends in Nepal – An analysis of global burden of disease data 2017
Bhattarai S, Aryal A, Pyakurel M, Bajracharya S, Baral P, Citrin D, Cox H, Dhimal M, Fitzpatrick A, Jha AK, Jha N, Karmacharya BM, Koju R, Maharjan R, Oli N, Pyakurel P, Sapkota BP, Shrestha R, Shrestha S, Spiegelman D, Vaidya A, Shrestha A. Cardiovascular disease trends in Nepal – An analysis of global burden of disease data 2017. IJC Heart & Vasculature 2020, 30: 100602. PMID: 32775605, PMCID: PMC7399110, DOI: 10.1016/j.ijcha.2020.100602.Peer-Reviewed Original ResearchBurden of CVDCardiovascular diseaseGlobal burdenBlood pressureTotal DALYsRisk factorsDiet lowTotal deathsHigh low-density lipoprotein cholesterolHigher systolic blood pressureLow-density lipoprotein cholesterolMajor public health problemCardiovascular disease trendsPredominant cardiovascular diseasesCardiovascular disease incidenceDensity lipoprotein cholesterolSystolic blood pressureHigh blood pressureIschemic heart diseaseBody mass indexEvaluation's Global BurdenPublic health problemOlder age groupsLipoprotein cholesterolMiddle-income countriesDrivers of healthy eating in a workplace in Nepal: a qualitative study
Tamrakar D, Shrestha A, Rai A, Karmacharya BM, Malik V, Mattei J, Spiegelman D. Drivers of healthy eating in a workplace in Nepal: a qualitative study. BMJ Open 2020, 10: e031404. PMID: 32102804, PMCID: PMC7045197, DOI: 10.1136/bmjopen-2019-031404.Peer-Reviewed Original ResearchConceptsHealthy eatingHealth personnelDhulikhel Hospital-Kathmandu University HospitalHealthy foodsHospital administratorsHealthy food optionsAffordable healthy foodsFocus group discussionsUniversity HospitalHospital settingQualitative studyCapital KathmanduIndividual food preferencesHospital sitesHealth awarenessHealthy optionsHospital administrationHour shiftsEatingFood optionsGroup discussionsCafeteria operatorsLevel of educationOffice hoursThematic analysis method
2019
Stakeholder Engagement in Planning the Design of a National Needs Assessment for Cardiovascular Disease Prevention and Management in Nepal
Archana S, Karmacharya BM, Rashmi M, Abhinav V, Meghnath D, Natalia O, Rajeev S, Prajjwal P, Annette F, David C, Swornim B, Roman XD, Donna S, Rajendra K. Stakeholder Engagement in Planning the Design of a National Needs Assessment for Cardiovascular Disease Prevention and Management in Nepal. Global Heart 2019, 14: 181-189. PMID: 31324373, PMCID: PMC7003959, DOI: 10.1016/j.gheart.2019.05.002.Peer-Reviewed Original Research
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