NIHR Global Health Research Unit on Respiratory Health (RESPIRE)

Prevention, detection and treatment of adult lung disease

This project was based at Christian Medical College (CMC) Vellore in India


  • Project title:  Prevention, detection and treatment of adult lung disease (with a focus on lung cancer) in a poor, rural population in Tamil Nadu: Feasibility study for a cluster randomised controlled trial
  • Acute or chronic:  Chronic
  • Based at:  Rural Unit for Health and Social Affairs (RUHSA), CMC Vellore
  • Start date:  October 2018
  • End date:  September 2020
  • Principal investigator:  Rita Isaac
  • Project team:  Biswajit Paul, Deepa Das, David Weller, Liz Grant, John Norrie


Chronic respiratory diseases (CRDs) in low resource settings are neglected and often poorly diagnosed, leading to missed opportunities for early initiation of treatment and poor patient pathways.

For example, in India, lung cancer often emerges on a background of chronic respiratory symptoms and is often not diagnosed at all – or at a very late stage. Because of late presentation and a range of other factors, survival from lung cancer in India is very low.

At present we know very little about how knowledge and attitudes relating to CRD in poor, rural populations in India might be influenced by health and behavioural interventions. Similarly, compliance with treatments offered is poorly understood.

Psychological theory-based interventions must be culturally appropriate and grounded in the local context. As such, it’s vital we develop our understanding if we are to change behaviours and reduce exposure to common risk factors, such as smoking and indoor cooking smoke.

Aim and impact

The project is developing an innovative community-based programme to raise awareness of chronic respiratory disease amongst rural communities in Vellore.

The study will have tested an intervention which could be implemented in the local population and in other low-resource, low-health-literacy settings to improve CRD outcomes.

It will also contribute to advancing knowledge on the design and delivery of respiratory intervention studies in these challenging environments.

Key developments

  • A continuing medical education workshop on “Challenges of Chronic Lung Diseases in General Practice” was organised for the 80 participants, including the physicians from both public and private health sector in Vellore district, as part of the stakeholder engagement to update their knowledge on management of CRD.
  • Held a National Community Health Nursing Conference 2020, themed “Community Health Nurses – Trendsetters for Universal Health Coverage to combat NCDs” on 13- 14th February 2020 at CMC, Vellore. 400 participants from 52 institutions across 17 India states attended the conference.
  • Community engagement materials and events were organised, including health melas (fairs), pictorial handouts, periodic demonstrations of inhaler use and respiratory health exercises and folk media like puppet shows and videos.
  • Designing an online course on stakeholder engagement for health research and policy for health-based organisations in India which is to be rolled out in 2020 given the COVID-19 pandemic and the lack of face-to-face interaction due to government imposed lockdowns.
  • Formed a Community Advisory Group (consisting of local panchayat (village council) leaders, teachers, farmers, self-help group members) to inform and guide the team throughout the implementation of the study.

Project data

Download the project Data Management Plan

View the project metadata on the Health Data Research Innovation Gateway

Embedded PhD project

RESPIRE PhD student Biswajit Paul is conducting an embedded project as part of this wider study.

Find out more about Biswajit's PhD