Browsing by Author "Etling, Mary Ann"

Now showing 1 - 5 of 5
  • Thumbnail Image
    Item
    Creating the Map of Interactive Services Aiding and Assisting Persons With Disabilities (MSAADA) Project: Tutorial for the Novel Use of a Store Locator App
    (JMIR, 2022-12-08) Etling, Mary Ann; Musili, Michael; Eastes, Kaytlin; Oyungu, Eren; McHenry, Megan S.; Pediatrics, School of Medicine
    Background: An estimated 15% of the global population is living with a disability. In Kenya, children with disabilities remain among the most vulnerable populations, experiencing substantial barriers to wellness and inclusion. Smartphone ownership and internet access have been increasing across sub-Saharan Africa, including in Kenya. Despite these advances, online or mobile resources remain limited and difficult to find and navigate. Objective: This paper aims to describe the novel use of a store locator app to develop an interactive map of organizations that provide medical, educational, and socioeconomic resources to individuals with disabilities in Kenya. The target audience is individuals with disabilities, medical professionals, and organization leaders. Methods: A comprehensive list of organizations, government county offices, educational assessment and resource centers, and institutions was compiled. Organizations were contacted via email, WhatsApp, or in person for semistructured interviews. Based on the services offered, each organization was assigned categorical search tags. The data were entered into a third-party store locator app. The resulting map was inserted into a page on the Academic Model Providing Access to Healthcare (AMPATH) website. Results: The Map of Interactive Services Aiding and Assisting Persons With Disabilities (MSAADA; this abbreviation is also Swahili for "help") was launched in July 2020 in both English and Swahili. The map included 89 organizations across Kenya. Of these, 51 were reached for an interview (for a 57% response rate). Interviewees cited limited paid staff and dependence on grant-based funding as primary challenges to growth and sustainability. Conclusions: MSAADA is an interactive, virtual map that aims to connect individuals with disabilities, medical professionals, and organization leaders to resources in Kenya. The novel use of a store locator app to compile resources in remote settings has the potential to improve access to health care for a wide variety of specialties and patient populations. Innovators in global health should consider the use of store locator apps to connect individuals to resources in regions with limited mapping.
  • Thumbnail Image
    Item
    Fostering Leadership in a Student-Run Free Clinic Medical Executive Board and Across Interdisciplinary Partners.
    (2022-03-30) Haddad, Aida; Khan, Maria; Gensel, Annie; Barber, Mckenzie; Aksu, Eric; Klipsch, Eric; Class, Jon; Brown, Lucy; Kabir, Jason; Etling, Mary Ann
    Background: Being a member of a healthcare executive board requires a unique sense of resolve and passion for service. Not only are these leaders operating a student-run free clinic, but they are also full-time professional students while balancing extracurricular activities to discern their healthcare vocation. Board members feel pulled in many directions, resulting in imposter syndrome and possibly untapped leadership potential. Leadership succumbing to this pressure in 2021 might have resulted in the permanent closure or dysfunction of a clinic after COVID-19 required closure for one year. This study will discuss the interventions employed by the clinic’s Chair, Vice-Chair, Women’s Health co-chairs, and Operations chair to overcome the burden felt when faced with reopening a large, interdisciplinary, free clinic serving approximately 34 patients per weekly clinic day. Though fostering interpersonal relationships best encompasses the theme with which the above leaders encouraged hope during a time of global suffering, relationships were encouraged through multiple discrete interventions forming camaraderie and trust within and between interdisciplinary executive boards. Interventions: Medical Executive Board: In anticipation of the added pressures of reopening the clinic amid COVID-19, the Chair took special care to create a culture of collegiality and mutual vulnerability by facilitating various ways to ‘check-in’ with her board. She hosted preterm and midterm check-ins with each leader to discuss their vision for their role on the board. The Chair and Chair-elect also hosted the clinic’s first annual leadership retreat to support each member in finding their leadership style, and in turn, becoming familiar with their colleagues’ leadership styles. The Chair and Chair-elect will also perform exit interviews with all graduating board members. Partners: Reopening during the pandemic meant reorganizing the entire clinic flow and limiting the number of volunteers present. As a result, many interdisciplinary partners could not participate in the initial reopening and had to be brought in slowly throughout the year. Partner participation was encouraged by monthly meetings with all partners (regardless of clinical presence), and an active group chat with leaders. The Vice-Chair also emphasized alternate means of participation. Some partners organized winter clothes and food drives, while others fundraised for the clinic. All partners were encouraged to develop telehealth plans. The fall partners’ retreat fostered community, during which all partners brainstormed 2022 goals. Results/Conclusion: Medical Executive Board: As a result of the above interventions, clinic leadership not only reopened the free clinic but fulfilled many years-long goals, which include rolling out a weekday telehealth protocol, serving record numbers of patients during a time of immense need, publishing the inaugural clinic-wide monthly newsletter, and formulating the clinic’s first-ever mistreatment policy. The leadership retreat inspired our Women’s Health Coalition to host a retreat; a check-in with the Women’s Health chair led to a midterm co-chair election to sustain the coalition long-term. Finally, the Operations chair spearheaded changes to clinic flow to avoid COVID-19 outbreaks–in doing so, she inspired a record turnout for this position at the 2022 elections. Partners: By the end of 2021, all interdisciplinary partners had resumed in-person care. However, the regular monthly meetings, alternate projects, and retreats fostered community and interest in the clinics even when all could not physically participate.
  • Thumbnail Image
    Item
    Global Health Partnerships During the COVID-19 Pandemic: Perspectives and Insights from International Partners
    (ASTMH, 2021-08) McHenry, Megan S.; Tam, Reena P.; Nafiseh, Amira A.; Etling, Mary Ann; Barnes, Adelaide E.; Rule, Amy R. L.; Crouse, Heather L.; Haq, Heather; Morris, Lee E.; Murray, Brittany L.; Umphrey, Lisa A.; Keating, Elizabeth M.; Pediatrics, School of Medicine
    Global health partnerships (GHPs) have encountered many challenges during the coronavirus disease 2019 (COVID-19) pandemic. New perspectives and insights are needed to guide GHPs when navigating current and future collaborations. This study aimed to understand perspectives and insights of international partners regarding how the COVID-19 pandemic impacted their GHPs with institutions in the United States. We performed a cross-sectional qualitative study conducted through virtual semi-structured interviews performed between June 12, 2020 and July 22, 2020. We queried academic institutions based in the United States to refer individuals from their corresponding international GHP organizations. We invited these individuals to participate in virtual interviews that were audio-recorded and transcribed. We analyzed data qualitatively to identify themes. Eighty-four United States partners provided e-mail addresses for international partners. Ten individuals from these GHPs completed the interview. Participants reported overall positive experiences with their United States-based partners during the pandemic. The following themes emerged: imbalanced decision-making; worry about partnership continuity; opportunity to optimize communication within partnerships; interest in incorporating technology to facilitate engagement; and a desire for increased bilateral exchanges. Several challenges appeared to exist before COVID-19 and were highlighted by the pandemic. Most respondents were optimistic regarding the future of their GHPs. However, concerns were expressed regarding the implications of fewer in-person international experiences with United States trainees and the desire for stronger communication. Although our results do not represent the perspectives and insights of all GHPs, they provide considerations for the future. We urge institutions in the United States to re-examine and strive for equitable relationships with their international partners.
  • Thumbnail Image
    Item
    "If We Manage Early, We Can Get It Right": A Descriptive Study of Healthcare Workers' Experiences Managing Sepsis at a Kenyan Referral Hospital
    (Springer Nature, 2025-02-14) Srour, Maria; Ali, Shamim; Hodge, Matthew; Kwobah, Charles; McHenry, Megan; Etling, Mary Ann; Nafiseh, Amira; Khan, Babar; Prohaska, Clare C.; Navuluri, Neelima; Medicine, School of Medicine
    Background and objectives: Sepsis and septic shock are conditions of high mortality across the globe. Despite the efforts of the Surviving Sepsis Campaign, improvements in outcomes for patients with sepsis and septic shock have been mostly seen in high-income countries (HICs), leaving low- and middle-income countries (LMICs) to bear most of the global disease burden. This paper utilizes a socio-ecological model to describe the lived experiences of local healthcare workers treating sepsis and septic shock at a large referral hospital in Western Kenya. These perspectives shed light on barriers and strengths in care, gaps in knowledge, and areas of high-yield improvement. Materials and methods: This is a descriptive analysis focused on providers caring for patients with sepsis and septic shock. Twenty-seven interviews with a wide variety of purposively sampled patient-facing and ancillary medical staff were performed. Concurrent thematic analysis took place as interviews were being conducted. The concept presented was inductively and deductively reasoned and analyzed using a socio-ecological framework. We chose to present three levels of influence on the individual provider. Results: We present our results using a socio-ecological model. At the health system level, we found that most patients do not have healthcare coverage, which drives up out-of-pocket expenses for individuals. At the hospital level, capacity limits, particularly personnel shortages and small intensive care unit (ICU) spaces, influence care. At the interdisciplinary level, relationships between providers and other members of the healthcare team can present challenges. Lastly, these system-, hospital-, and interdisciplinary-level challenges make guideline adherence difficult and not always feasible for individual providers. Conclusions: To our knowledge, this is the first study to give voice to local providers treating patients with sepsis at a referral center in Western Kenya. By presenting findings in the socio-ecological model, we are able to organize potential interventions for the improvement of care at various levels. We found high-yield areas for improving care including establishing clear protocols for task assignments and communication, increasing the number of trained personnel both in the general wards and in the ICU, and, on a broader scale, advocating for expanded healthcare coverage for all Kenyans. This work provides a framework for further investigation into elements of sepsis care and the creation of locally relevant treatment guidelines in sub-Saharan Africa and across LMICs.
  • Thumbnail Image
    Item
    The continuing evolution of a cancer prevention, screening, and survivorship ECHO: A second year of implementation
    (Wiley, 2023) Etling, Mary Ann; Vik, Terry A.; Janota, Andrea D.; Liang, Kaley L.; Kryder-Reid, Caroline L.; Robertson, Mary; Scanlon, Caitlin; Carson, Anyé; Agley, Jon; Severance, Tyler S.; Pediatrics, School of Medicine
    Introduction: An estimated 39,010 Indiana residents were diagnosed with cancer in 2021. To address the cancer burden, Project ECHO (Extension Community Healthcare Outcomes) was launched in 2019 in Indiana to build specialty healthcare capacity among non-specialists. Due to positive outcomes from the pilot year, the Cancer Prevention, Screening, and Survivorship ECHO was implemented for a second year. The purpose of this study was to measure the participation and regional impact of this ECHO. Methods: ECHO sessions occurred twice monthly from October 2020 to October 2021. Changes were implemented in response to feedback from the pilot year, including making the curriculum more practical for learners and adding accreditation opportunities. Participant information and feedback was extracted from electronic surveys for review. Results: There were 24 ECHO sessions with 213 unique participants, increased from 140 unique participants in the pilot year. An average of 23.5 individuals attended each session, increased from 15.5 individuals per session. Enrolled participants served in a diverse set of roles and represented 247 zip codes, 30 Indiana counties, and 32 states across the United States, each of which increased from the pilot year. Discussion: In this second year, this ECHO expanded to reach more participants with increased attendance and a more diverse distribution of roles within healthcare, which may be attributed to feedback-driven curriculum design. Cancer care is multi-disciplinary, with health educators, nurses, and administrators, each acting within the cancer care continuum. As a result, this ECHO has been adapted to serve an increasingly broad distribution of professionals. Conclusion: The second year of the Cancer Prevention, Screening, and Survivorship ECHO displayed increased overall enrollment and participation, greater diversity among participant roles, and a wider reach across Indiana and the United States.