I can’t believe how fast this summer has gone by! I am now entering my last two weeks with the Durham County Department of Public Health, and it has been a great experience. I have been lucky to meet some great people who really care about the community of Durham. Most of my previous experiences up until now have been direct services, working with clients one on one, or with families. It has been good to branch out a bit and see more of a bird’s eye view of a community, and the Population Health Division has provided that this summer.
During this experience, I learned what a health department’s reaccreditation entails, and part of my work was thinking of ways to involve and teach the employees of the health department about accreditation. I made games and presentations about the accreditation process for employees to bring them into accreditation in a fun way. I also worked on newsletters for July, August, and September that will go out to staff to review important parts of accreditation like HIPAA policies, trainings, and how to prepare for a site visit. I do not have as much experience in communications, and it was fun to learn a new skill and think of fun ways to get employees involved.
Durham County Human Services Complex
I have also been able to see what goes into making a strategic plan for a health department and the importance of writing a good mission and vision to guide that strategic plan. I read different strategic plans from health department across the country and was able to see the great work that health departments do within communities.
I have enjoyed getting to know the staff that works in Population Health. They are all great and I have learned a lot from my preceptor. This internship has also been a great reminder to remain flexible as projects and timelines may change, and we must learn to roll with that.
I am going into my last two weeks where I will be wrapping up my final projects, leading a presentation and game about accreditation, and giving a final presentation to my division about what I have done this summer.
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!
A picturesque sunset at Lake Malawi
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.
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!
