Abstract Currently, Lebanon has the highest per capita concentration of refugees in the world, where one in four persons in Lebanon is displaced from Syria. While several studies have focused on the occurrence of communicable diseases among refugees, data are extremely limited about the effects of forced displacement on chronic, noncommunicable diseases (NCDs) such as type 2 diabetes (T2D). We hypothesize that forced displacement leading to adverse changes in lifestyle is associated with T2D and other NCDs development. Our objective is to plan for the establishment of a sustainable collaborative research platform by building a unique prospective longitudinal cohort of individuals belonging to refugee and host population, providing opportunities to conduct a multitude of multidisciplinary studies investigating the short and long-term health effects of forced displacement on T2D. Accordingly the proposed project is not only relevant to an urgent and growing Low and Middle Income Countries (LMIC) priority, but will improve the capacity in the LMIC to conduct such research studies. We plan to achieve our objective by: 1) providing a detailed plan for establishing a prospective cohort that will include approximately 8,000 men and women with a wide age range, who will be recruited from a selected subset (n=70) of Primary Health Care Centers (PHCs) serving 49,023 patients including 7,733 Syrian refugees and 2) conducting a pilot study assessing the impact of forced displacement and adverse lifestyle changes on T2D development in a subset of refugee and host population patients. The proposed project would provide an ideal setting to apply analytic tools grounded with a life-stage, holistic approach and a multidisciplinary strategy that integrates epidemiology and population health sciences to advance our understanding of the determinants of T2D and other NCDs. The proposed project will prepare the research infrastructure (data, networking, capacity building) required for more comprehensive research programs that enhance the knowledge base and add to the long-term goals of sustainably strengthening research capacity in LMICs to address NCDs. Accordingly, it will result in better diagnostics, prevention, and treatment strategies.

Project Narrative The proposed project presents a unique opportunity to create a sustainable research collaborative platform by planning a unique cohort of individuals belonging to refugee and host populations, with a diverse psychosocial and medical background. It, provides opportunities to conduct multitude of interdisciplinary studies investigating the short and long-term health effects of forced displacement on type 2 diabetes (T2D). Investigating the impact of adverse lifestyle changes in susceptible individuals on T2D and other non-communicable diseases development is expected to lead to new strategies to identify subjects at high risk for T2D, and to initiate effective management and preventive strategies to reduce the harm caused by psychosocial stressors on disease risk.