Center for Indigenous Health Research

Since 2007, Maya Health Alliance has been a leader in developing practical solutions to improve the quality of medical care in rural and indigenous communities in Guatemala. The Center for Indigenous Health Research (Centro de Investigación en La Salud Indígena or CISI) was founded by a multidisciplinary group of researchers at Maya Health Alliance, with the goals of advancing scientific investigations into the health needs of these communities.

Central Research Topics

The central CISI Research themes share methodological approaches, especially mixed methods, applied anthropology and implementation science:

Chronic Malnutrition and Food Security
Noncommunicable diseases, such as cancer, diabetes, and chronic kidney disease
Civil Society and the study of Development and Gender Equity in health
Early child development
Family planning
Midwifery and Emergency Obstetrics
Medical Anthropology

Research Projects
Summary of major current and recent projects

PROMOTING SAFE AND HEALTHY WORKPLACES IN HONDURAS, GUATEMALA, AND EL SALVADOR (2023-)

The Promoting Safe and Healthy Workplaces in Honduras, Guatemala, and El Salvador (PREP for Change) project seeks to improve occupational safety and health (OSH) conditions for workers in the sugar and garment (maquila) sectors. The project will focus on workplace illnesses and injuries, chronic kidney disease of non-traditional causes (CKDnt), and COVID-19

PARTNERS: La Isla Network

FUNDING: US DOL

AI-DRIVEN LOW-COST ULTRASOUND FOR AUTOMATED QUANTIFICATION OF HYPERTENSION, PREECLAMPSIA, AND IUGR (2023-)

In low-resource settings, high rates of perinatal mortality are due in part to challenges accessing affordable technologies to screen and monitor high-risk maternal-fetal conditions, such as intrauterine growth restriction and preeclampsia. To address these issues, we will use artificial intelligence to develop techniques for predicting intrauterine growth restriction and preeclampsia from low-cost hand-held maternal and fetal Doppler recordings.

PARTNERS: Emory University

FUNDING: NIH/NICHD

AFLATOXIN EXPOSURE, GROWTH FALTERING, AND THE GUT MICROBIOME AMONG CHILDREN IN RURAL GUATEMALA (2023-)

We will study the role of aflatoxin exposure on child growth, and whether the effect of aflatoxin is mediated by the gut microbiome and inflammation. We will evaluate aflatoxin exposure and examine markers of inflammation, gut microbiome composition and function, and microbial nutrient extraction and aflatoxin microbial biotransformation.

PARTNERS: ASU- Arizona State University

FUNDING: NIH/NIEHS

EXPLORING RISK FACTORS AND PREDICTORS OF ENDEMIC CKDU IN AGRICULTURAL REGIONS OF FOUR CENTRAL AMERICA COUNTRIES (2022-)

Chronic kidney disease of unknown origin (CKDu) has taken a terrible toll on young working families living in rural areas of Central America. This project aims to identify risk factors for CKDu and decline in kidney function in four Central American countries: Costa Rica, Panama, Nicaragua and Guatemala. This work will be conducted though the SALTRA (Central American Program for Health, Work and Environment) network connecting locally-based universities, NGOs, governmental organizations, public health authorities and local healthcare workers.

PARTNERS:Programa Salud, Trabajo y Ambiente (SALTRA) , (UNA) Universidad Nacional de Costa Rica

FUNDING: NIH/NIEHS/NIDDK

UNDERSTANDING VACCINE ACCEPTANCE AND MESSAGES AMONG INDIGENOUS POPULATIONS (2022-)

The objective of this project is to understand social networks in indigenous communities as a way to address vaccine concerns and increase confidence in COVID-19 vaccines.

PARTNERS: UCSF – University of California San Francisco, Stanford Center for Health Education | Digital Medic

FUNDING: Vaccine Confidence Fund

PUBLICATIONS:

Abascal L, Lopez E, Sanders K, Ann N, Johnston J, Vosburg K, Kraemer A, Diamond-Smith N. Evaluating the impact of a linguistically and culturally tailored social media ad campaign on COVID-19 vaccine uptake among indigenous populations in Guatemala: a pre/post design intervention study. doi: 10.1136/bmjopen-2022-066365

Ann N, Sanders K, Lopez E, Sotz M, Abascal L,Vosburg K, Johnston J,Diamond-Smith N, Kraemer A. Barriers to COVID-19 vaccine acceptance to improve messages for vaccine uptake in indigenous populations in the central highlands of Guatemala: a participatory qualitative study. doi: 10.1136/bmjopen-2022-067210

MOBILE HEALTH INTERVENTION TO PROMOTE POSITIVE INFANT HEALTH OUTCOMES IN GUATEMALA (2021-)

The objectives of this project are to develop and determine the effectiveness of an mHealth smartphone technology which can be used to engage primary caregivers directly in the active monitoring of their infants’ development, and to provide tailored feedback and support for the provision of nurturing care and positive infant developmental outcomes.

PARTNERS: CHLA-Children’s Hospital Los Angeles

FUNDING: NIH / NICHD (PI Beth Smith, Children’s Hospital Los Angeles) NCT05106894

A HYBRID EFFECTIVENESS/IMPLEMENTATION TRIAL OF THE INTERNATIONAL GUIDE FOR MONITORING CHILD DEVELOPMENT (2021-)

The aim of this study is to conduct a hybrid effectiveness/implementation assessment of the International Guide for Monitoring Child Development (GMCD) in two LMIC settings, India and Guatemala, within established rural CHW programs. The primary objectives are (a) to evaluate the real-world effectiveness of the GMCD; (b) to use an implementation science framework to understand barriers and facilitators to effective population coverage, provider implementation, and maintenance; (c) to conduct an economic evaluation of the GMCD.

PARTNERS: Brigham and Women’s Hospital

FUNDING: NIH / NICHD (PI Peter Rohloff, Brigham and Women´s Hospital, Inc.) NCT04665297

PUBLICATIONS:

Raut A, Mustafayev R, Srinivasan R, Chary A, Ertem I, Grazioso MDP, Gupta S, Krishnamurthy V, Lu C, Maliye C, Miller AC, Wagenaar BH, Rohloff P. Hybrid type 1 effectiveness/implementation trial of the international Guide for Monitoring Child Development: protocol for a cluster-randomised controlled trial. BMJ Paediatr Open. 2021 Sep 15;5(1):e001254. doi: 10.1136/bmjpo-2021-001254. PMID: 34604546; PMCID: PMC8444252.

EFFECTS OF COMPLEMENTARY FEEDING OF EGGS ON INFANT DEVELOPMENT AND GROWTH IN GUATEMALA (2020-)

Investigating the impact of daily egg consumption during the period of complementary feeding, in addition to the standard nutritional care provided by Wuqu’Kawoq, compared to the local standard of nutritional care alone on childhood development.

FUNDING: American Academy of Nutrition and Dietetics NCT04316221

PUBLICATIONS:

Wallace TC, Rohloff P, Jimenez EY, Proaño GV, Montenegro-Bethancourt G, McCabe GP, Steiber A. Academy of Nutrition and Dietetics Nutrition Research Network: The Saqmolo’ Project Rationale and Study Protocol for a Randomized Controlled Trial Examining the Influence of Daily Complementary Feeding of Eggs on Infant Development and Growth in Guatemala. J Acad Nutr Diet. 2021 May 4:S2212-2672(21)00226-4. doi: 10.1016/j.jand.2021.03.015. Epub ahead of print. PMID: 33962902.

WEARABLE SENSORS FOR EARLY IDENTIFICATION OF POOR NEURODEVELOPMENT IN GUATEMALA (2019-2022)

Evaluating new technology to detect early developmental delay in infants at risk.

PARTNERS: CHLA-Children’s Hospital Los Angeles

FUNDING: NIH / NICHD (PI Beth Smith, Children’s Hospital Los Angeles)

PUBLICATIONS:

Rosales MR, Rohloff P, Vanderbilt DL, Tripathi T, Valentini NC, Dusing S, Smith BA. Collecting Infant Environmental and Experiential Data Using Smartphone Surveys. Pediatr Phys Ther. 2021 Jan 01; 33(1):47-49.

Lobo MA, Hall ML, Greenspan B, Rohloff P, Prosser LA, Smith BA. Wearables for rehabilitation: how to optimally design and utilize products to meet the needs of users . Physical Therapy 2019; 99:647-657.

EVALUATING A FAMILY-BASED NUTRITION AND GARDEN INTERVENTION IN RURAL GUATEMALA (2019-2021)

Investigating integration of home gardening into nutrition interventions to improve growth and diet quality for stunted children.

FUNDING: Academy of Nutrition and Dietetics. NCT03689504

PUBLICACIONES:

Alajajian S, Guzman-Abril A, Proaño GV, Jimenez EY, Rohloff P. Mixed-methods implementation study of a home garden intervention in rural Guatemala using the RE-AIM framework. J Acad Nutr Diet. 2022 Mar 8:S2212-2672(22)00134-4. doi: 10.1016/j.jand.2022.03.005. Epub ahead of print. PMID: 35276414.

Guzmán-Abril A, Alajajian S, Rohloff P, Proaño GV, Brewer J, Jimenez EY. Academy of Nutrition and Dietetics Nutrition Research Network: A Home Garden Intervention Improves Child Length-for-Age Z-Score and Household-Level Crop Count and Nutritional Functional Diversity in Rural Guatemala. J Acad Nutr Diet. 2021 May 18:S2212-2672(21)00230-6. doi: 10.1016/j.jand.2021.04.002. Epub ahead of print. PMID: 34020932.

Alajajian S, Guzmán-Abril AP, Brewer J, Rohloff P. Patrones alimentarios y agrícolas de hogares con niños desnutridos en dos comunidades indígenas con distinto nivel socioeconómico en Guatemala. Estudios Sociales 2020; 30:55

Roquel E, Wilson K, Alajajian S, Guzmán A. La Realización de un Diagnóstico Agrícola en una Comunidad Rural de Guatemala. Wuqu Kawoq | Alianza Maya para la Salud, 2019.

SCALING-UP SELF-MANAGEMENT INTERVENTIONS FOR TYPE 2 DIABETES (2018-2021)

Using an implementation science framework to evaluate the impact of a home-based self management intervention for adults with type 2 diabetes in two health districts in central Guatemala.

FUNDING: World Diabetes Foundation

PUBLICATIONS:

Tschida S, Flood D, Guarchaj M, Milian J, Aguilar A, Fort MP, Guetterman T, Montano CM, Miller A, Morales L, Rohloff P. Implementation of a Diabetes Self-Management Education and Support Intervention in Rural Guatemala: A Mixed-Methods Evaluation Using the RE-AIM Framework. Prev Chronic Dis. 2021 Dec 9;18:E100. doi: 10.5888/pcd18.210259. PMID: 34882536; PMCID: PMC8673946.

Flood D, Hane J, Dunn M, Brown SJ, Wagenaar BH, Rogers EA, Heisler M, Rohloff P, Chopra V. Health system interventions for adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis. PLoS Med 2020 Nov 12;17(11):e1003434

Baird C, Rohloff P. Educación Para El Autocuidado de Diabetes Tipo Dos en Guatemala: Una Revision de la Literatura. Wuqu’ Kawoq | Alianza Maya para la Salud: Tecpan, Guatemala; 2019.

Flood D, Douglas K, Goldberg V, Martinez B, Garcia P, Arbour M, Rohloff P. A quality improvement project using statistical process control methods for type 2 diabetes control in a resource-limited setting. Int J Qual Health Care 2017; doi: 10.1093/intqhc/mzx051.

Flood, Hawkins J, Rohloff P. Evaluation of a Home-Based Type 2 Diabetes Self-Management Intervention in Rural Guatemala, 2014–2016. Preventing Chronic Disease 2017; doi: 10.5888/pcd14.170052.

POPULATION-BASED SURVEY OF CHRONIC KIDNEY DISEASE (2018-)

Representative, population-based study surveying prevalence and risk factors for traditional and nontraditional chronic kidney disease in adults in rural Guatemala.

FUNDING: NIH / FIC

PUBLICATIONS:

Steinbrook E, Flood D, Barnoya J, Montano CM, Miller AC, Rohloff P. Prevalence of Hypertension, Diabetes, and Other Cardiovascular Disease Risk Factors in Two Indigenous Municipalities in Rural Guatemala: A Population-Representative Survey. Glob Heart. 2022 Nov 22;17(1):82. doi: 10.5334/gh.1171. PMID: 36578912; PMCID: PMC9695220.

Chary AN, Nandi M, Flood D, Tschida S, Wilcox K, Kurschner S, Garcia P, Rohloff P. Qualitative study of pathways to care among adults with diabetes in rural Guatemala. BMJ Open. 2023 Jan 6;13(1):e056913. doi: 10.1136/bmjopen-2021-056913. PMID: 36609334; PMCID: PMC9827254.

Rohloff P, Miller AC, Barnoya J, Montano CM. Indexing Estimates of GFR to Body Surface Area in Low-Resource Settings With a High Burden of Malnutrition: Evidence From Guatemala. Kidney Int Rep. 2022 Apr 11;7(7):1707-1710. doi: 10.1016/j.ekir.2022.04.007. PMID: 35812277; PMCID: PMC9263247.

Miller AC, Tuiz E, Shaw L, Flood D, Garcia P, Dhaenens E, Thomson DR, Barnoya J, Montano CM, Rohloff P. Population Estimates of GFR and Risk Factors for CKD in Guatemala. Kidney Int Rep. 2021 Jan 1;6(3):796-805. doi: 10.1016/j.ekir.2020.12.015. PMID: 33732994; PMCID: PMC7938058.

Miller AC, Rohloff P, Blake A, Dhaenens E, Shaw L, Tuiz E, Grandesso F, Mendoza Montano C, Thomson DR. Feasibility of satellite image and GIS sampling for population representative surveys: a case study from rural Guatemala. Int J Health Geogr. 2020 Dec 5;19(1):56. doi: 10.1186/s12942-020-00250-0. PMID: 33278901; PMCID: PMC7718677.

Garcia P, Mendoza C, Barnoya J, Monzon J, Miller AC, Aguilar-Gónzalez A, Boj J, Cifuentes A, Dávila P, Flood D, Guzmán-Quilo C, Hernandez A, Lou-Meda R, Palacios E, Sánchez-Polo V, Sosa R, Rohloff P. CKD care and research in Guatemala: Overview and meeting report. Kidney Int Rep 2020 Jul 2; 5(9):1567-1575.

Nandi M, Kurschner S, Wilcox K, Flood D, Montano CM, Barnoya J, Rohloff P, Chary A. Perceptions of chronic kidney disease among at-risk adults in rural Guatemala. Glob Public Health 2020 Nov 8;1-16.

Flood D, Wilcox K, Ferro AA, Mendoza Montano C, Barnoya J, Garcia P, Lou-Meda R, Rohloff P, Chary A. Challenges in the provision of kidney care at the largest public nephrology center in Guatemala: a qualitative study with health professionals. BMC Nephrol. 2020 Feb 28;21(1):71. doi: 10.1186/s12882-020-01732-w.

Wilcox K, Flood D, Aguilar A, Dhaenens E, Garcia P, Miller A, Mendoza C, Lou-Meda R, Rohloff P, Chary A. Provision de servicios de diálisis en Guatemala: un estudio cualitativo.

Flood D, Garcia P, Douglas K, Hawkins J, Rohloff P. Screening for chronic kidney disease in a community-based diabetes cohort in rural Guatemala: a cross-sectional study. BMJ Open 2018 Jan 21:8(1):e019778.

CARE NAVIGATION TO IMPROVE OBSTETRICAL CARE (2017-2020)

Using a quality improvement framework and care navigation to improve patient satisfaction and emergency obstetrical referral outcomes.

FUNDING: Grand Challenges Canada

PUBLICATIONS:

Austad K, Juarez M, Shryer H, Hibberd PL, Drainoni ML, Rohloff P, Chary A. Improving the experience of facility-based delivery for vulnerable women through obstetric care navigation: a qualitative evaluation. BMC Pregnancy Childbirth. 2021 Jun 11;21(1):425. doi: 10.1186/s12884-021-03842-1. PMID: 34116648; PMCID: PMC8193958.

Juarez, M., Austad, K. and Rohloff, P., 2021. Out-of-Pocket Costs for Facility-Based Obstetrical Care in Rural Guatemala. Annals of Global Health, 87(1), p.75. DOI: http://doi.org/10.5334/aogh.3223

Perry MF, Coyote EI, Austad K, Rohloff P, Why women choose to seek facility-level obstetrical care in rural Guatemala: A qualitative study. Midwifery, Volume 103, 2021, 103097, ISSN 0266-6138, https://doi.org/10.1016/j.midw.2021.103097

Austad K, Juarez M, Shryer H, Morataya C, Rohloff P. Obstetric care navigation: results of a quality improvement project to provide accompaniment to women for facility-based maternity care in rural Guatemala. BMJ Qual Saf. 2019 Nov 2. doi: 10.1136/bmjqs-2019-009524. -Spanish translation-

Juarez M, Austad K, Rohloff P. Lay Midwives: On the Front Lines of the Fight Against Maternal Mortality in Rural Guatemala. Am J Trop Med Hyg. 2019 Feb;100(2):237-238.

Austad K, Chary A, Martinez B, Juarez M, Martin YJ, Ixen EC, Rohloff P. Obstetric care navigation: a new approach to promote respectful maternity care and overcome barriers to safe motherhood. Reprod Health. 2017 Nov 13; 14(1):148.

MHEALTH TECHNOLOGY TO SUPPORT OBSTETRICAL CARE (2015-2019)

Using smartphones and decision support mHealth applications to support identification and referral of high-risk pregnancies by lay midwives.

FUNDING: NIH / NICHD (PI Gari Clifford, Emory University). Registro: NCT02348849

PUBLICATIONS:

Kulkarni SS, Katebi N, Valderrama CE, Rohloff P, Clifford GD. CNN-Based LCD Transcription of Blood Pressure From a Mobile Phone Camera. Front Artif Intell. 2021 May 21;4:543176. doi: 10.3389/frai.2021.543176. PMID: 34095816; PMCID: PMC8177819.

Valderrama Cuadros CE, Katebi N, Marzbanrad F, Rohloff P, Clifford GD. A review of fetal cardiac monitoring, with a focus on low- and middle-income countries. Physiol Meas 2020 Oct 26. doi.org/10.1088/1361-6579/abc4c7

Valderrama CE, Marzbanrad F, Juarez M, Hall-Clifford R, Rohloff P, Clifford GD. Estimating birth weight from observed postnatal weights in a Guatemalan highland community. Physiol Meas. 2020 Mar 6;41(2):025008. doi: 10.1088/1361-6579/ab7350.

Valderrama CE, Stroux L, Katebi N, Paljug E, Hall-Clifford R, Rohloff P, Marzbanrad F, Clifford GD. An open source autocorrelation-based method for fetal heart rate estimation from one-dimensional Doppler ultrasound. Physiol Meas. 2019 Feb 26;40(2):025005. .

Martinez B, Ixen EC, Hall-Clifford R, Juarez M, Miller AC, Francis A, Valderrama CE, Stroux L, Clifford GD, Rohloff P. mHealth intervention to improve the continuum of maternal and perinatal care in rural Guatemala: a pragmatic, randomized controlled feasibility trial. Reproductive Health 2018;15:120.

Martinez B, Hall-Clifford R, Coyote E, Stroux L, Valderrama CE, Aaron C, Francis A, Hendren C, Rohloff P, Clifford GD. Agile Development of a Smartphone App for Perinatal Monitoring in a Resource-Constrained Setting. J Health Informatics in Dev Countries. 2017; 11:158.

Stroux L, Martinez B, Ixen EC, King N, Hall-Clifford R, Rohloff P, Clifford GD. (2016). An mHealth monitoring system for traditional birth attendant-led antenatal risk assessment in rural Guatemala, Journal of Medical Engineering & Technology.

INDIVIDUALIZED HOME-BASED INTERVENTIONS TO IMPROVE DIET QUALITY AND DEVELOPMENTAL OUTCOMES IN STUNTED CHILDREN (2015-2017)

Investigating optimal strategies for empowering caregivers and improving nurturing care for infants at risk.

FUNDING: Grand Challenges Canada. Registro: NCT02509936

PUBLICATIONS:

Webb MF, Martinez B, Rodas P, Gonzalez A, Rohloff P, del Pilar Grazioso M. Language Interpretation in the Administration of Bayley Scales of Infant Development III in an Indigenous Population in Guatemala. WAIMH Perspectives in Infant Mental Health. 2020. Epub 15 May 2020.

Martinez B, Cardona S, Rodas P, Lubina M, Gonzalez A, Webb MF, Grazioso MdP, Rohloff P. Developmental outcomes of an individualised complementary feeding intervention for stunted children: a substudy from a larger randomised controlled trial in Guatemala. BMJ Paediatrics Open 2018;2:e000314. doi:10.1136/bmjpo-2018-000314

Martinez B, Webb MF, Gonzalez A, Douglas K, Grazioso MdP, Rohloff P. Complementary feeding intervention on stunted Guatemalan children: a randomised controlled trial. BMJ Paediatrics Open 2018;2.

Martinez B, Webb MF, Rodas P, Gonzalez A, del Pilar Grazioso M, Rohloff P. (2016). Field report: Early child development in rural Guatemala. Perspectives in Infant Mental Health. 24(1-2):6-8.

Brown K, Henretty N, Chary A, Webb MF, Wehr H, Moore J, Baird C, Díaz AK, Rohloff P. Mixed-methods study identifies key strategies for improving infant and young child feeding practices in a highly stunted rural indigenous population in Guatemala. Matern Child Nutr. DOI: 10.1111/mcn.12141

Research Team

Researchers at CISI come from diverse backgrounds, but we share an interest in core themes (noncommunicable diseases, like cancer and diabetes; chronic malnutrition and food security; civil society and the study of “development”; and gender and health). We also share an interest in certain methodological approaches, especially in mixed methods, applied anthropology, and implementation science.

Research Leaders

Anita Chary, MD PhD
Researcher and Anthropologist

David Flood, MD
Co-Investigator and Physician

Gabriela Montenegro, PhD.
Co-Investigator and Research Fellow of the Academy of Nutrition

Peter Rohloff, MD PhD

Principal Investigator and Director of Science and Innovation

Research Team

Lilian Carolina Ajú Batz. Interests: diabetes, early childhood development, nutrition

Stephen Alajajian, RDN. Interests: diabetes, early childhood development, nutrition

Carlos Eliezer Bacajol Chapaz. Interests: nutrition

Liria Carina Batzibal Calí. Interests: nutrition

Julia Coxaj Interests: nutrition

Vilma Borón Surec. Interests: early childhood development, nutrition

Evelin Calel Borón. Interests: nutrition

Karyn Choy. Interests: nutrition, early childhood development

Ana Cordón, MD. Interests: pediatric nutrition, civil society, social entrepreneurship

Pablo Garcia, MD. Interests: chronic kidney disease

Magdalena Guarchaj. Interests: diabetes, early childhood development

Michel Juarez, MD. Interests: continuing obstetric care, neonatal care

Emily Lopez. Interests: vaccination

Lucrecia Lucia Morales Morales. Interests: nutrition

Irma Yolanda Piló Palax. Interests: nutrition, obstetric care.

Wendy Rodriguez, MD. Interests: child growth, nutrition, maternal and child health

Olga Marina Saloj Chiyal Interests: early childhood development, nutrition

Vanesa Sapon, MD Interests: obstetrics, maternal and child health

Scott Tschida. Interests: implementation science

Rosa Sirín Sirín. Interests: nutrition

Yolanda Raquec Teleguario Interests: nutrition, chronic kidney disease

Eva Leticia Tuiz Ordoñez. Interests: chronic kidney disease, early childhood development

Liz Willetts Interests: sustainable development, planetary health

Key Collaborators

Dr Aurora Aragon, Affiliate Research Scientist at Wuqu’ Kawoq

Dr. Joaquin Barnoya, Unidad Cardiovascular de Guatemala, Universidad Rafael Landivar. Affiliate Research Scientist at Wuqu’ Kawoq

Dr. Gari Clifford, Department of Biomedical Informatics, Emory University

Dr. Jennifer Crowe, El Instituto Regional de Estudios en Sustancias Tóxicas de la Universidad Nacional de Costa Rica

Dr. Alejandra Colom, Department of Anthropology, Universidad del Valle de Guatemala

Dr. Ilgi Ertem, Department of Pediatrics, Ankara University

Dr. Meredith Fort, Department of Family Medicine, University of Colorado

Dr. Marvin González Quiroz, Department of Renal Medicine, University College London. Affiliate Research Scientist at Wuqu’ Kawoq

Dr. Maria del Pilar Grazioso, Department of Psychology, Universidad del Valle de Guatemala. Proyecto Aigle Guatemala. Affiliate Research Scientist at Wuqu’ Kawoq

Dr. Subodh Gupta, Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences

MSc Pharm Carol Guzman, Department of Toxicology, Universidad de San Carlos de Guatemala. Affiliate Research Scientist at Wuqu’ Kawoq

Dr. Rachel Hall-Clifford, Department of Sociology, Emory University

Dr. Nasim Katebi, Department of Biomedical Informatics, Emory University. Affiliate Research Scientist at Wuqu’ Kawoq

Dr. Rosa Krajmalnik-Brown, Center for Health through Microbiomes, Arizon State University

Dr. Vibha Krishnamurthy, Ummeed Child Development Center

Dr. Indiana Lopez, Affiliate Research Scientist at Wuqu’ Kawoq

Dr. Carlos Mendoza, Instituto de Nutrición de Centro América y Panamá

Dr. Ann Miller, Department of Global Health and Social Medicine, Harvard Medical School

Dr. Manuel Ramirez, Centro de Investigación para la Prevención de las Enfermedades Crónicas, Instituto de Nutrición de Centro América y Panamá

Dr. Vicente Sánchez Polo, Universidad de San Carlos de Guatemala. Affiliate Research Scientist at Wuqu’ Kawoq.

Dr. Beth Smith, Department of Pediatrics, University of Southern California, Children’s Hospital Los Angeles

Dr. Alison Steiber, Academy of Nutrition and Dietetics

Dr. Lee Voth-Gaeddert, Center for Health through Microbiomes, Arizona State University. Affiliate Research Scientist at Wuqu’ Kawoq.

Dr. Bradley Wagenaar, Department of Global Health, University of Washington

Dr. Taylor Wallace, Think Healthy Group

Dr. Elizabeth Yakes Jimenez, Department of Pediatrics, University of New Mexico

Publications

2023

Yoo SGK, Chung GS, Bahendeka SK, et al. Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries. JAMA. 2023;330(8):715–724. doi:10.1001/jama.2023.12905

2022

2021

2020

2019

2018

2017

2016

2015

2014

2013 and earlier

Chary A, Messmer S, Sorenson E, Henretty N, Dasgupta S, Rohloff P. (2013). The normalization of childhood disease: An ethnographic study of child malnutrition in rural Guatemala. Human Organization 72:88-97.
Chary A, Kraemer Díaz A, Henderson B, Rohloff P. (2013). The changing role of indigenous lay midwives in Guatemala: New frameworks for analysis. Midwifery 29:852-858.
Kraemer A and Rohloff P. (2013). Guatemala. In Building Partnerships in the Americas: A Guide for Global Health Workers. (M Krasnoff, Ed). Dartmouth: University Press of New England.
Tummons E, Henderson R and Rohloff P. (2012). Language Revitalization and the Problem of Development in Guatemala: Case Studies from Health Care. Symposium on Teachng and Learning Languages of Latin America. University of Notre Dame.
Chary A, Greiner M, Bowers C, Rohloff P. (2012). Determining adult type 2 diabetes related health care needs in an indigenous population from rural Guatemala: A mixed methods preliminary study. BMC Health Services Research 12:476.
Rohloff P, Kraemer Diaz A, Ajsivinac Sian J. (eds). (2011). Nïm chuwäch k’iyirisanem: Tajin runuk’ik’ ruk’aslem ri chwa’q kab’ij pan Iximulew. Bethel, VT: Wuqu' Kawoq.
Tummons E, Henderson R and Rohloff P. (2011). “So that we don’t lose words:” Reconstructing a Kaqchikel medical lexicon. First Biennial Symposium on Teaching Indigenous Languages in Latin America. Indiana University.
Chary A, Messmer S, Rohloff P. (2011). Male Influence on Infant Feeding in Rural Guatemala and Implications for Child Nutrition Interventions. Breastfeeding Medicine 6:227-31.
Rohloff P, Kraemer Diaz A, Dasgupta S.(2011). “Beyond development “– A critical appraisal of the emergence of small health care non-governmental organizations in rural Guatemala. Human Organization 70:427-437.
Chary, A., Dasgupta, S., & Rohloff, P. (2011). Breastfeeding, subjugation, and empowement in rural Guatemala. In An Anthropology of Mothering (M Walks & N McPherson, Eds.). Toronto: Demeter Press.
Rohloff P and Sotz Mux M (2008). Tiqaq’omaj qi’. Bethel, VT: Wuqu’ Kawoq.

Center for Indigenous Health Research

Central Research Topics

The central CISI Research themes share methodological approaches, especially mixed methods, applied anthropology and implementation science:

Chronic Malnutrition and Food Security

Noncommunicable diseases, such as cancer, diabetes, and chronic kidney disease

Civil Society and the study of Development and Gender Equity in health

Early child development

Family planning

Midwifery and Emergency Obstetrics

Medical Anthropology

Research ProjectsSummary of major current and recent projects

PROMOTING SAFE AND HEALTHY WORKPLACES IN HONDURAS, GUATEMALA, AND EL SALVADOR (2023-)​

AI-DRIVEN LOW-COST ULTRASOUND FOR AUTOMATED QUANTIFICATION OF HYPERTENSION, PREECLAMPSIA, AND IUGR (2023-)

AFLATOXIN EXPOSURE, GROWTH FALTERING, AND THE GUT MICROBIOME AMONG CHILDREN IN RURAL GUATEMALA (2023-)

EXPLORING RISK FACTORS AND PREDICTORS OF ENDEMIC CKDU IN AGRICULTURAL REGIONS OF FOUR CENTRAL AMERICA COUNTRIES (2022-)

UNDERSTANDING VACCINE ACCEPTANCE AND MESSAGES AMONG INDIGENOUS POPULATIONS (2022-)​

MOBILE HEALTH INTERVENTION TO PROMOTE POSITIVE INFANT HEALTH OUTCOMES IN GUATEMALA (2021-)

A HYBRID EFFECTIVENESS/IMPLEMENTATION TRIAL OF THE INTERNATIONAL GUIDE FOR MONITORING CHILD DEVELOPMENT (2021-)

EFFECTS OF COMPLEMENTARY FEEDING OF EGGS ON INFANT DEVELOPMENT AND GROWTH IN GUATEMALA (2020-)

WEARABLE SENSORS FOR EARLY IDENTIFICATION OF POOR NEURODEVELOPMENT IN GUATEMALA (2019-2022)

EVALUATING A FAMILY-BASED NUTRITION AND GARDEN INTERVENTION IN RURAL GUATEMALA (2019-2021)

SCALING-UP SELF-MANAGEMENT INTERVENTIONS FOR TYPE 2 DIABETES (2018-2021)

POPULATION-BASED SURVEY OF CHRONIC KIDNEY DISEASE (2018-)

CARE NAVIGATION TO IMPROVE OBSTETRICAL CARE (2017-2020)

MHEALTH TECHNOLOGY TO SUPPORT OBSTETRICAL CARE (2015-2019)

INDIVIDUALIZED HOME-BASED INTERVENTIONS TO IMPROVE DIET QUALITY AND DEVELOPMENTAL OUTCOMES IN STUNTED CHILDREN (2015-2017)

Research Team

Research Leaders

Anita Chary, MD PhDResearcher and Anthropologist

Researcher and Anthropologist

David Flood, MDCo-Investigator and Physician

Co-Investigator and Physician

Gabriela Montenegro, PhD.​Co-Investigator and Research Fellow of the Academy of Nutrition

Co-Investigator and Research Fellow of the Academy of Nutrition

Peter Rohloff, MD PhD

Principal Investigator and Director of Science and Innovation

Research Team

Key Collaborators

Publications

Research Projects
Summary of major current and recent projects

PROMOTING SAFE AND HEALTHY WORKPLACES IN HONDURAS, GUATEMALA, AND EL SALVADOR (2023-)

UNDERSTANDING VACCINE ACCEPTANCE AND MESSAGES AMONG INDIGENOUS POPULATIONS (2022-)

Anita Chary, MD PhD
Researcher and Anthropologist

David Flood, MD
Co-Investigator and Physician

Gabriela Montenegro, PhD.
Co-Investigator and Research Fellow of the Academy of Nutrition