Brief Description of Scholarly Projects
Proposing development of a multilevel and mixed media educational intervention. Will interview 7-10 refugees living in RI, hopefully volunteers through the International Institute with goal of capturing their struggle and their healing process. From this experience will develop a series of portraits, narratives using their own words, and an informative essay on refugee survivors of trauma, the power of their story, and the process of self-healing of which all primary care providers should be aware. Lastly, I'd like to create a pamphlet for primary care providers with techniques to address trauma and ways to help guide their patients through such a difficult process.
Examined the rates of obesity in refugee populations across 10 years since establishment in Providence RI through monitoring BMI at several time points, as well as examining obesity related diagnoses. This has been previously noted in several specific refugee populations, specifically those who have undergone food scarcity prior to relocation By examining demographic data we will see if this is a problem for one or multiple refugee groups, and will develop an intervention/quality improvement project based on this data.
Refugee Health Week for Residents: Organizing with the department of pediatrics a week of lectures, grand rounds with a 1/2 day experience for residents where they talk with refugee families about their stories and use the refugees as teachers.
Assessed the current scope of child psychiatric treatment in Eldoret, Kenya and the surrounding areas, including who is providing child psychiatric care, what research is being undertaken, how referrals are made, and the barriers that exist to children obtaining psychiatric care. This was completed in preparation for the first class of psychiatry residents at Moi University who will matriculate in September 2012. Future directions include liaison with pediatric providers both in the inpatient and outpatient settings, and the collaborative development of a substance abuse treatment program for street children who attend the Tumaini Center, a local nonprofit organization.
Developed a series of morning report and noon conferences to the Pediatrics and Medicine-Pediatrics residents about screening and treatment for addiction. In addition, the project included work with the Medicine-Pediatrics Program Director to develop strategies to improve the care of patients requiring long-term opiate treatment. These strategies included: a new pain management policy, improved pain contract and templates to be used in the EMR for patients on long-term opiates.
Member of team developing partnership between Brown University Department of Pediatrics and St. Damien Children’s Hospital in Tabarre, Haiti. Traveled to site three times and spent total of two months there working on supporting a Pediatric rotation for Haitian medical students, providing clinical care in the Emergency Room, and partnering with Haitian pediatrician to support malnutrition program. Obtained Lifespan/Brown IRB and Haitian National IRB approval for research project entitled - Zel Pou Timoun Yo: Outpatient program for the treatment of severe acute malnutrition in Tabarre, Research goal to support program evaluation of community based therapeutic care program during the two years following the 2010 earthquake.
Conducted a needs assessment related to maternal health & mortality, and screening, incidence, and treatment of soil-based helminth infections in a community in rural Guatemala. While doing so, spent time working at a government-run health clinic, Centro de Atencción Permanente (CAP), in Chajul, Guatemala, that serves a large catchment area via a small rural town in the mountainous Quiche region. During this time, gathered information via focus groups, discussions with clinic staff, and attendance at activities held at the clinic, in regards to the use of the maternal health/obstetrics wing of the clinic and barriers to women using it. I also spent time understanding more specifics of the laboratory at CAP, the vaccination program, and the capabilities of their associated community health workers.
Conducted surveys at two independent sites and will include the pediatric clinic at University Teaching Hospital in Lusaka, Zambia and community health sites through the Department of Public Health to assess barriers to the use of hand sanitizers as a means of preventing diarrheal illness in children.
We aimed to determine young adult perspectives on violence as a health issue. Furthermore, we asked youth to describe how physicians can most effectively discuss violence and violence prevention in the health care setting. We conducted 5 focus groups of 3-10 adolescent/young adult (ages 12-24) to explore the aims of the study. Emerging themes included (1) violence is ubiquitous, (2) youth commonly worry about personal safety, (3) youth do not inherently trust their physician (4) youth do not identify violence as a health problem, (5) youth do not necessarily see their physician as someone who could help them, and (6) physicians do not ask about violence.
Developed a narrative review of endemic Burkitt's Lymphoma with focus on the burden of disease, development of treatment protocols and challenges for management of the disease in resource limited settings.
Adolescent refugees are an at-risk population. Mental health screening by Northstar refugee psychologists lead to about 1 out of 3 adolescents warranting psychological follow-up. Recent studies of refugee youth indicate that up to 65% are obese, have higher than average rates of sexually transmitted infections and unplanned pregnancies, and experience higher rates of victimization. In addition, adolescent refugees represented up to 7% of the suicides in RI teens under the grouping of recently immigrated youth (RI Child Death Survey 2005-2010). I submitted a proposal to the AAP and received a CATCH grant to start an adolescent refugee group this coming year, Adolescent Refugees of RI Valuing Excellence (A.R.R.I.V.E.). We will be studying the effects of a values-based therapy on the quality of life of RI adolescent refugees.
Susanna Winston, Jacquie Firth, together with Elizabeth Dufort developed the initial proposal for the BRIGHT pathway. As part of this effort, they performed a review of global health training pathways at sites, evaluated different strategies for integrating the training into the existing residency structure, and negotiated with the program directors to obtain buy-in for the program, identified supporting faculty who ultimately became the pathway directors. Together with the pathway directors and other interested residents including Vanessa Wolfman, Amanda Dumas, Raina Phillips and Natasha Rybak, they finalized the curricula, implementation plan, and application for approval through the hospital office of GME leading up to the implementation of the program.