Browsing by Author "Litzelman, Debra"

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    127 Reciprocal Innovation Workshops: Identify Shared Health Challenges for Mutual Benefit in Global Health
    (Cambridge University Press, 2022) Sors, Thomas; Wools-Kaloustian, Kara; O’Brien, Rishika Chauhan; Bermel, Luanne; Kiplagat, Jepchirchir; Lieberman, Marya; Morales-Soto, Nydia; Nyandiko, Winstone; Litzelman, Debra; Medicine, School of Medicine
    OBJECTIVES/GOALS: Our concept of reciprocal innovation (RI) supports global health (GH) research partnerships that address shared health challenges for mutual benefit in both high and low- and middle-income (LMIC) settings. To advance this GH approach, the Indiana CTSI launched a RI program building on longstanding global health partnerships in East Africa. METHODS/STUDY POPULATION: A core component of the program is annual RI workshops to promote reciprocal approaches in GH, identify priority areas for reciprocal research, and link investigators and stakeholders across settings. The first meeting in 2019 was in-person and focused on identifying health priority areas from the perspective of Indiana stakeholders. The second meeting was held virtually and focused on priority areas in East Africa. The third meeting focused on shared priority areas and discussing potential RI research projects. Agenda sessions include (1) presenting successful examples of funded RI projects; (2) breakout groups to share proposal ideas in preparation for the RI grants program; (3) building partnerships with colleagues in similar fields. RESULTS/ANTICIPATED RESULTS: As of 2021, three RI workshops have been held with an average of 60 attendees at each workshop. Participants identified several overlapping priority areas for research and RI in Indiana and East Africa, including research in chronic disease, substance abuse, infant and maternal health, and access to healthcare. A Global Health Innovation Exchange of RI projects was created to support connections between locally- and globally-focused investigators. The repository is used to share updates on project progress, outcomes, and published materials. Workshops have also been used to explore a reciprocal innovation virtual platform to facilitate and foster more regular collaborations between globally and locally-focused investigators and pursue research projects on shared health challenges for mutual benefit. DISCUSSION/SIGNIFICANCE: The collaboration at the stakeholder meetings set the foundation for continued partnership building, strong proposals for RI grants, and dissemination and translation of successful RI projects. To leverage momentum from the meetings, we are building a virtual RI platform to connect PIs across multiple CTSAs and increase the footprint of RI efforts
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    Developing Ethical and Sustainable Global Health Educational Exchanges for Clinical Trainees: Implementation and Lessons Learned from the 30-Year Academic Model Providing Access to Healthcare (AMPATH) Partnership
    (Ubiquity Press, 2020-10) Turissini, Matthew; Mercer, Tim; Baenziger, Jenny; Atwoli, Lukoye; Einterz, Robert; Gardner, Adrian; Litzelman, Debra; Ayuo, Paul; Medicine, School of Medicine
    Background: There is strong interest among healthcare trainees and academic institutions in global health rotations. There are a number of guidelines detailing the ethical principles for equitable and ethical global health rotations and bilateral exchanges, but it is often challenging to know to implement those principles and develop longstanding partnerships. Objectives: The Academic Model Providing Access to Healthcare (AMPATH) is a 30-year continuous partnership between a consortium of 12 universities in North America and Moi University in Kenya. The AMPATH bilateral educational exchange has had 1,871 North American and over 400 Kenyan clinical trainees participate to date. The article describes the bilateral exchange of trainees including curriculum, housing, and costs and discusses how each is an application of the principles of ethical global engagement. Findings: The article takes the experiences of the AMPATH partnership and offers practical strategies for implementing similar partnerships based on previously published ethical principles. Conclusions: AMPATH provides a model for developing an institutional partnership for a bilateral educational exchange grounded in cultural humility, bidirectional relationships, and longitudinal, sustainable engagement.
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    Health Care Perspectives from Burmese Refugees
    (Office of the Vice Chancellor for Research, 2015-04-17) McHenry, Megan S.; Dixit, Avika; Holliday, Rachael; Umoren, Rachel; Litzelman, Debra
    Background: Indianapolis is home to one of the largest Burmese Chin refugee populations outside of Myanmar. Out of the 10,000 Burmese in Indianapolis, over 8,000 are of Chin ethnicity, which is 20% of all Burmese Chin living in the United States. Providers caring for these refugees share concerns that this population may have difficulty accessing care because of language barriers. The goal of this study was to better understand Burmese adult and adolescent views of the U.S. healthcare system Methods: This was a qualitative study that used the phenomenological approach to understand the experience of Burmese refugees. Six focus groups were held from March to May 2013. Discussions were facilitated by MM, in the presence of a trained Burmese interpreter. Any Burmese refugees living in Indianapolis were eligible to participate and were recruited from the Southport Public Library, Burmese-specific ESL courses, and the Burmese community center. Transcripts from focus groups were individually coded by three authors (MM, AD, RH) using NVivo10 (QSR International). Codes with kappa agreements of 96% or more were the foundation for thematic analysis. Findings: Participants were predominantly Chin in ethnicity consisting of 16 adults (all females) and 17 adolescents (10 females, 7 males). Each focus group had between 2-10 participants. Qualitative data analysis identified themes relating to their experience accessing the healthcare system: 1) Time (long wait times at the clinic, pharmacy, and emergency departments) 2) Language barriers (heavy reliance on English-speaking community members, preferences in interpreting services) 3) Relationships with heath care providers (traditional medicines, trust in physicians). Adults often ask adolescents to interpret for them. Adolescents felt comfortable with this responsibility, and some noted frustration when they were not allowed to interpret in clinics or emergency rooms. Concerns with long wait times were common and compounded by difficulties in obtaining an appropriate interpreter. Many of the adult participants preferred an internet-based video interpreting service over in-person interpreters because of increased dialect options, as well as shorter wait times. Although traditional medicines and healing techniques were used in refugee camps and occasionally in Indianapolis, most Burmese place trust with western medicine and report valuing and complying with physician recommendations. Many have a basic understanding of good health practices and the causes of illness. This is seen most consistently in the adolescent groups. Interpretation: Overall, Burmese Chin have adapted to their new home. Although they experience common frustrations with the healthcare system, these frustrations were exacerbated by long waits for an interpreter. Resources, such as a phone or video-based interpreter, are available in most health care facilities and preferred by the Burmese. More research is needed to better understand the challenges of the Burmese population residing in the United States. Funding:AAP Resident CATCH Grant: McHenry
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    PREVALENCE of psychiatric morbidity in a community sample in Western Kenya
    (BioMed Central, 2017-01-18) Kwobah, Edith; Epstein, Steve; Mwangi, Ann; Litzelman, Debra; Atwoli, Lukoye; Department of Medicine, IU School of Medicine
    BACKGROUND: About 25% of the worldwide population suffers from mental, neurological and substance use disorders but unfortunately, up to 75% of affected persons do not have access to the treatment they need. Data on the magnitude of the mental health problem in Kenya is scarce. The objectives of this study were to establish the prevalence and the socio-demographic factors associated with mental and substance use disorders in Kosirai division, Nandi County, Western Kenya. METHODS: This was a cross sectional descriptive study in which participants were selected by simple random sampling. The sampling frame was obtained from a data base of the population in the study area developed during door-to-door testing and counseling exercises for HIV/AIDS. Four hundred and twenty consenting adults were interviewed by psychologists using the Mini International Neuropsychiatric Interview Version 7 for Diagnostic and Statistical Manual 5th Edition and a researcher-designed social demographic questionnaire. RESULTS: One hundred and ninety one (45%) of the participants had a lifetime diagnosis of at least one of the mental disorders. Of these, 66 (15.7%) had anxiety disorder, 53 (12.3%) had major depressive disorder; 49 (11.7%) had alcohol and substance use disorder. 32 (7.6%) had experienced a psychotic episode and 69 (16.4%) had a life-time suicidal attempt. Only 7 (1.7%) had ever been diagnosed with a mental illness. Having a mental condition was associated with age less than 60 years and having a medical condition. CONCLUSION: A large proportion of the community has had a mental disorder in their lifetime and most of these conditions are undiagnosed and therefore not treated. These findings indicate a need for strategies that will promote diagnosis and treatment of community members with psychiatric disorders. In order to screen more people for mental illness, we recommend further research to evaluate a strategy similar to the home based counseling and testing for HIV and the use of simple screening tools.