Summer 2022 – Page 9 – Gillings Around the globe

A journey…hopefully to be continued!

Posted on August 2, 2022July 27, 2022 by

It feels very surreal to be writing about my practicum experience as I prepare to leave Malawi. Time has gone by so quickly this summer, and yet I feel as though I’ve been here for years, not months. Working with the incredible group at UNC Project-Malawi and the amazing HIV-Engagement and Adolescent Depression Support (HEADS-UP) team in Chapel Hill and Lilongwe has been such a great experience. While in Lilongwe, I have been assisting in the preparation of the HEADS-UP formative study. HEADS-UP is an adaptation of the Friendship Bench intervention for adolescents living with HIV (ALWH) in Lilongwe, Malawi. I have worked on research projects before, but this experience was especially exciting because I was able to learn the process of what needs to happen before the study can officially start with participants. I have worked on creating forms (screening, enrollment, checklist, etc.), writing a standard operating procedure (SOP) for the formative interviews, and working with the research coordinator, Steve, to meet and discuss HEADS-UP with members of the ministry of health (MOH) and district health management teams (DHMT). As I’m winding down, I am able to work on assisting a teammate, who has just arrived and will be at UNC Project-Malawi for a year, transition to working for the study on site.

Me (back left) hiking Mulanje Mountain with some new friends!

This practicum experience gave me more clarity on what I would like to continue pursuing in the future after my MPH at Gillings. I have been in the research field for about 5 years, and particularly love working with participants. I’ve found that research is usually not able to provide direct benefit to participants, but the outcome could be beneficial to many in the future. I feel that I would like to work more directly with people and communities to provide more immediate assistance, if possible. I am coming out of my practicum with deep appreciation and love for the research field, but I also feel confident that I would like to pursue other options in the global health field such as international development or humanitarian aid work. Without my time here I may have not come to the same understanding of my future career goals and what I would like to pursue further. I am incredibly grateful to the HEADS-UP team, UNC Project-Malawi, and UNC Gillings School of Global Public Health for such an amazing opportunity.

All the best,

-Amiah

Design and Rapid Iteration of a PrEP Decision Aid Prototype

Posted on August 1, 2022July 28, 2022 by

I got to do lots of hiking while visiting Washington State this summer!

Wow, this summer has really flown by! It seems like just yesterday I was getting acquainted with my practicum and responsibilities, and now, two months later, I am already wrapping up and about to begin the second year of my MPH program. Reading over my initial blog post made me smile thinking about how much I have grown over the course of this experience. To recap, my main responsibilities during my practicum involved developing, user testing, and rapidly iterating upon a shared decision-making (SDM) aid prototype to better help cisgender women in North Carolina make a decision about starting pre-exposure prophylaxis, or PrEP. I worked with both Dr. Lauren Hill and the PrEP SDM team at Gillings as well as Laura Wagner and the Semblie team at RTI International.

A risk assessment feedback page: “I had multiple sex partners in the past six months”

Coming into my practicum experience, my main goal was to gain confidence implementing human-centered design thinking processes in a public health setting. Luckily, I was able to do just that! The first month of my practicum involved familiarizing myself with and modifying the tool that was eventually going to be user tested. During this time, I was also able to obtain feedback on the tool from PrEP healthcare providers. This provider feedback informed the first round of iteration and modifications prior to user testing. The middle half of my practicum was dedicated to conducting qualitative user testing interviews followed by rapid iteration of the PrEP decision aid. The final few weeks of my practicum were dedicated to continued iteration of the tool and analysis for my deliverables.

One of the introductory education slides about HIV statistics among women, and specifically women of color

We analyzed the results of the user-testing process using three outcome measures: feasibility (usability/user-friendliness), acceptability (satisfaction with the tool), and appropriateness (relevance to the user and intended demographic). Feasibility and usability varied by participant, as there was a large range in how tech-savvy the participants were. Overall, though, participants were able to navigate through the tool, knew how to interact with the content and elements on the page, and understood the content that was being presented to them. Acceptability was very consistent across all interviews, as all participants really loved the tool and thought it was educational and informative. Given that our participants were all sexually transmitted infections (STI) clinic patients, the tool was also very appropriate and relevant for all of our users.

After each interview, I conducted a “Download Your Learnings” activity using a Rapid Analysis Matrix. In this document, I would analyze the user testing session using the three outcome measures listed above (feasibility, acceptability, and appropriateness) and record my overall observations about how the user navigated and interpreted the tool. Based on user feedback, I would then make changes to the tool such as editing the reading and comprehension level of certain pages, adding graphics and videos, and adjusting the flow of the overall decision aid. This experience was a wonderful opportunity to practice rapid iteration and human-centered design–the most current version of the tool is a product of the thoughts, emotions, and suggestions of each and every participant we interviewed. How cool is that?!

I had the privilege of gaining so many new skills during this summer practicum experience. I learned more about what PrEP is, who it helps, how it works, and how marketing for PrEP has historically missed cisgender women. I learned how to write research standard operating procedures (SOPs) related to participant recruitment and interview processes. I learned how to conduct qualitative interviews, including how to obtain informed consent and how to probe in specific situations. I learned what rapid iteration and rapid analysis look like during user testing. I also gained more experience working on a public health team alongside like-minded professionals who are passionate about sexual and reproductive health and increasing health care access for women in our region.

My new chicken daughters: Frittata, Omelette, and Quiche!

I will be forever grateful for this experience and I will never forget it. Special thanks to Lauren Hill & Laura Wagner for being wonderful co-preceptors and contributing to my learning this summer!

Side note: The chickens have nothing to do with my practicum; they were just the new additions to our family!

-Chloe

Exploring Sanitation Planning

Posted on July 29, 2022July 27, 2022 by

Hello, my name is Rachel Beardsley and for my practicum I have been working with the Citywide Inclusive Sanitation Technical Assistance (CWIS TA) Hub to help record and report the experiences developing their Water Supply and Sanitation Master Plan which is used for cities to plan for years to come and to guide efforts and investment. For my practicum, I wanted to take on a topic I knew little about, sanitation systems, grow in my research skills, and create deliverables with the goal of informing programs and policies. This has been a very rewarding time as I have learned a lot about sanitation systems as a whole and management of the sanitation chain as well as developed skills such as those in making effective presentations and research. I also grew a lot in my ability to create research for programs without a predestined research plan. In the past when I have done research, I was attached to a program that was intended to be researched and had a clear methodology and research strategy prepared. For this project, the development of the masterplan was done without this paper, or any papers, in mind. Nevertheless, I am glad I got to work on this project because it helped me learn to adapt to roadblocks I will likely face in the future. This practicum helped me gain new skills and taught me more about sanitation holistically. I am very grateful that I had the opportunity to assist the CWIS TA Hub this summer.

Coming up, I will deliver my presentation on how to improve master plan development to the African Development Bank soon. I am excited to share my findings and hopefully provide useful knowledge to experts that will inform their work. I will also be finishing up my manuscript, disseminating my findings, and looking into publishing.

Before I end, I would like to give a special thanks to Dr. Manga and Dr. Najib who were both incredibly kind, thoughtful, and helpful in developing my skills during this practicum. I am incredibly lucky to have worked with them.

-Rachel B.