{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:11:00Z","timestamp":1789002660695,"version":"build-2803163510"},"reference-count":60,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,4,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Rheumatic heart disease (RHD) poses a high burden in low\u2010income countries, as well as among indigenous and other socioeconomically disadvantaged populations in high\u2010income countries. Despite its severity and preventability, RHD receives insufficient global attention and resources. We conducted a qualitative policy analysis to investigate the reasons for recent growth but ongoing inadequacy in global priority for addressing RHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Drawing on social science scholarship, we conducted a thematic analysis, triangulating among peer\u2010reviewed literature, organizational documents, and 20 semistructured interviews with individuals involved in RHD research, clinical practice, and advocacy. The analysis indicates that RHD proponents face 3 linked challenges, all shaped by the nature of the issue. With respect to\n                      <jats:italic>leadership and governance<\/jats:italic>\n                      , the fact that RHD affects mostly poor populations in dispersed regions complicates efforts to coordinate activities among RHD proponents and to engage international organizations and donors. With respect to\n                      <jats:italic>solution definition<\/jats:italic>\n                      , the dearth of data on aspects of clinical management in low\u2010income settings, difficulties preventing and addressing the disease, and the fact that RHD intersects with several disease specialties have fueled proponent disagreements about how best to address the disease. With respect to\n                      <jats:italic>positioning<\/jats:italic>\n                      , a perception that RHD is largely a problem for low\u2010income countries and the ambiguity on its status as a noncommunicable disease have complicated efforts to convince policy makers to act.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">To augment RHD global priority, proponents will need to establish more effective governance mechanisms to facilitate collective action, manage differences surrounding solutions, and identify positionings that resonate with policy makers and funders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.119.014800","type":"journal-article","created":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T05:10:18Z","timestamp":1587359418000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":37,"title":["Generating Global Priority for Addressing Rheumatic Heart Disease: A Qualitative Policy Analysis"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9539-0341","authenticated-orcid":false,"given":"Yusra Ribhi","family":"Shawar","sequence":"first","affiliation":[{"name":"Department of International Health Bloomberg School of Public Health Johns Hopkins University Baltimore MD"},{"name":"Paul H. Nitze School of Advanced International Studies Johns Hopkins University Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Shiffman","sequence":"additional","affiliation":[{"name":"Department of International Health Bloomberg School of Public Health Johns Hopkins University Baltimore MD"},{"name":"Paul H. Nitze School of Advanced International Studies Johns Hopkins University Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603693"},{"key":"e_1_3_2_3_2","first-page":"191","author":"Watkins DA","year":"2017","unstructured":"Watkins DA, Hasan B, Mayosi B, Bunkman G, Marin\u2010Neto JA, Rassi A, Rassi A, Kumar RK. Structural heart diseases. Disease Control Priorities, Third Edition (Volume 5): Cardiovascular, Respiratory, and Related Disorders. 2017:191\u2013208.","journal-title":"Structural heart diseases. Disease Control Priorities, Third Edition (Volume 5): Cardiovascular, Respiratory, and Related Disorders"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66874-2"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2016.08.006"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2012.3310"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.324.5923.37b"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/trstmh\/trz014"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp078039"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3126\/njh.v6i1.18603"},{"key":"e_1_3_2_11_2","first-page":"251","article-title":"National advisory committee for the prevention and control of rheumatic fever and rheumatic heart disease in Namibia: cardio news","volume":"26","author":"Hugo\u2010Hamman C","year":"2015","unstructured":"Hugo\u2010Hamman C, Forster N. National advisory committee for the prevention and control of rheumatic fever and rheumatic heart disease in Namibia: cardio news. Cardiovasc J Afr. 2015;26:251.","journal-title":"Cardiovasc J Afr"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czw012"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.2307\/2939044"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0143814X00003068"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/1468-2451.00179"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2017.14"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/jopart\/mum015"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1752971909000128"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.17645\/pag.v3i1.78"},{"key":"e_1_3_2_20_2","first-page":"197","article-title":"Ideology, frame resonance, and participant mobilization","volume":"1","author":"Snow DA","year":"1988","unstructured":"Snow DA, Benford RD. Ideology, frame resonance, and participant mobilization. Int Soc Movement Res. 1988;1:197\u2013217.","journal-title":"Int Soc Movement Res"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31574-4"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/1468-2478.4702005"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1162\/002081898550789"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9256.1996.tb00039.x"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/9.4.353"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1010690908200"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.4135\/9781849208574.n4"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czu046"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61579-7"},{"key":"e_1_3_2_30_2","article-title":"Methodologische objectiviteit en kwalitatief onderzoek","author":"Smaling A","year":"1987","unstructured":"Smaling A. Methodologische objectiviteit en kwalitatief onderzoek. Swets Zeitlinger Lisse. 1987.","journal-title":"Swets Zeitlinger Lisse"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1014984232147"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000000388"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu507"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2013.08.009"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(13)62004-5"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.2174\/1573403X13666170116120828"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1086\/499812"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.5830\/CVJA-2015-037"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1124\/pr.109.002006"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001477"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa065085"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61972-8"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2069.79616"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2013.08.006"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-012-0343-1"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2010.02.021"},{"key":"e_1_3_2_47_2","unstructured":"Australian Institute of Health and Welfare . Rheumatic heart disease and acute rheumatic fever in Australia: 1996\u20132012. 2013. Cardiovascular disease series. Cat. no. CVD 60. Canberra: AIHW. Available at: https:\/\/www.aihw.gov.au\/getmedia\/5e2214db-c403-440e-a239-99d124dc640f\/13993.pdf.aspx?inline=true."},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.72.6.1155"},{"issue":"535","key":"e_1_3_2_49_2","first-page":"e1","article-title":"Rationale and design of a Global Rheumatic Heart Disease Registry: the REMEDY study","volume":"163","author":"Karthikeyan G","year":"2012","unstructured":"Karthikeyan G, Z\u00fchlke L, Engel M, Rangarajan S, Yusuf S, Teo K, Mayosi BM. Rationale and design of a Global Rheumatic Heart Disease Registry: the REMEDY study. Am Heart J. 2012;163(535\u201340):e1.","journal-title":"Am Heart J"},{"key":"e_1_3_2_50_2","first-page":"619","article-title":"Rheumatic fever and rheumatic heart disease: collaboration patterns and research core topics","volume":"25","author":"Salinas A","year":"2016","unstructured":"Salinas A, Gonz\u00e1lez G, Manuel Ramos J. Rheumatic fever and rheumatic heart disease: collaboration patterns and research core topics. J Heart Valve Dis. 2016;25:619\u2013627.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2012.7"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2013.34"},{"key":"e_1_3_2_53_2","first-page":"246","article-title":"The Drakensberg declaration on the control of rheumatic fever and rheumatic heart disease in Africa","volume":"96","author":"Mayosi B","year":"2006","unstructured":"Mayosi B, Robertson K, Volmink J, Adebo W, Akinyore K, Amoah A, Bannerman C, Biesman\u2010Simons S, Carapetis J, Cilliers A, et\u00a0al. The Drakensberg declaration on the control of rheumatic fever and rheumatic heart disease in Africa. S Afr Med J. 2006;96:246.","journal-title":"S Afr Med J"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70234-7"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.5830\/CVJA-2015-090"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2012.157"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002227"},{"key":"e_1_3_2_58_2","unstructured":"World Health Organization . Global action plan for the prevention and control of noncommunicable diseases 2013\u20132020. 2013. WHO. https:\/\/apps.who.int\/iris\/bitst\u200bream\/handl\u200be\/10665\/\u200b94384\/\u200b97892\u200b41506\u200b236_eng.pdf?seque\u200bnce=1. Accessed March 20 2020."},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.008731"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(15)00098-4"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czx078"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.014800","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:53:49Z","timestamp":1715586829000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.014800"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,21]]},"references-count":60,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,4,21]]}},"alternative-id":["10.1161\/JAHA.119.014800"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.014800","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,21]]},"assertion":[{"value":"2020-11-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e014800"}}