# Pilot-testing and Implementation of an Integrated Sickle-cell Screening and Violence Prevention Program in Antenatal Care Settings in India (PIVOT)

> **NIH NIH K01** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2024 · $167,560

## Abstract

PROJECT SUMMARY
The National Heart, Lung, and Blood Institute (NHLBI) is committed to improving the quality of life for people
with sickle cell disease (SCD) globally. India is home to the world’s second largest population with SCD or
asymptomatic sickle cell trait (SCT). Unlike the more widely studied African SCD, most Indian women do not
know if they have either SCT or SCD until they are screened during antenatal care, as mandated by the Indian
Government. In India, the process of screening for SCT/SCD during pregnancy is complicated, involving using
the cheap and easily available “solubility test,” to detect the presence of sickle hemoglobin (HbS). The test is
positive in those with SCT as well as those with SCD. Pregnant women with a positive solubility test and their
partner undergo hemoglobin electrophoresis to determine their actual sickle cell status and the risk of unborn
child having SCD. We hypothesized that the women who inform their partner about a positive solubility test
may be at increased risk of intimate partner violence (IPV), because sickle cell literacy is low and IPV is
accepted and normalized. Using a Boston University Early Career Catalyst Award, I recently compared the
rates of IPV in the six months before and after 182 pregnant women in Nagpur, India learned that their
solubility test result. Pregnant women with a positive test (n=91) were twice as likely to experience IPV
compared to women with a negative test (n=91). Women who experienced IPV were three times as likely as
those who experienced no IPV to deliver low birthweight babies, especially when they also reported symptoms
of depression or anxiety. For this K01 award, my training objectives include gaining expertise in: (1) clinical and
psychosocial aspects of SCT/SCD; (2) intervention development and evaluation; and, (3) implementation
science theory and methods. I will use these skills to advance my research objective of implementing and pilot-
testing a couple-based HIV screening and disclosure intervention adapted for SCT/SCD, with an explicit focus
on IPV prevention and mental-health promotion. I propose using the 8-phased ADAPT-ITT framework and the
Consolidated Framework for Implementation Research (CFIR) to guide adaptation and implementation of the
Jamii Bora intervention developed by mentor Dr. Janet Turan (R34MH102103). The three aims of this study
include: conducting formative research to inform Jamii Bora adaptation (AIM 1); adapting the Jamii Bora
intervention using ADAPT-ITT (Phases 2-7) (AIM 2), and pilot-testing the adapted intervention for feasibility,
acceptability, and preliminary efficacy (AIM 3). I will leverage the infrastructure of the Nagpur site of NICHD’s
Global Network for Women and Children’s Health Research, directed by my primary mentor, Dr. Hibberd and
co-mentor Dr. Patel (UG1HD078439).

## Key facts

- **NIH application ID:** 10808507
- **Project number:** 1K01HL168214-01A1
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Nafisa Halim
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $167,560
- **Award type:** 1
- **Project period:** 2024-08-01 → 2029-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10808507

## Citation

> US National Institutes of Health, RePORTER application 10808507, Pilot-testing and Implementation of an Integrated Sickle-cell Screening and Violence Prevention Program in Antenatal Care Settings in India (PIVOT) (1K01HL168214-01A1). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10808507. Licensed CC0.

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