Browsing by Author "Turissini, Matthew"

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    A framework for reinitiating global academic exchange in the context of the COVID-19 pandemic
    (IJME, 2022-09-09) Kelly, Caitrin M.; Some, Fatma; Guiles, Daniel A.; Turissini, Matthew; Gardner, Adrian; Litzelman, Debra K.; Medicine, School of Medicine
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    A qualitative pilot study exploring the acceptability of a peer provider delivered substance use brief intervention from the perspective of youth in Kenya
    (Springer Nature, 2025-02-11) Jaguga, Florence; Aalsma, Matthew C.; Enane, Leslie A.; Turissini, Matthew; Kwobah, Edith Kamaru; Apondi, Edith; Barasa, Julius; Kosgei, Gilliane; Olando, Yvonne; Ott, Mary A.; Pediatrics, School of Medicine
    Background: Substance use disorders are prevalent among youth in sub-Saharan Africa (SSA), yet treatment resources are scarce. Peer provider delivered brief interventions (BIs) represent an affordable and potentially scalable strategy for addressing youth substance use disorders. The goal of this study is to assess the acceptability of a peer provider delivered substance use BI from the perspective of youth in Kenya. Methods: We conducted qualitative semi-structured interviews with youth participants (n = 25) to explore acceptability of a substance use BI. Youth were participants in a two-arm mixed-methods pilot randomized controlled trial (RCT) investigating the feasibility of a peer provider delivered single-session substance use BI for youth aged 15-24 years with moderate-risk substance use. The semi-structured interviews were conducted three months after the BI was delivered and were guided by the Theoretical Framework of Acceptability (TFA). Qualitative data were analyzed through thematic analysis. Results: We interviewed 25 of 38 participants in the BI arm, 18 males and 7 females; 15 were ages 18-24 years, and 10 ages 15-17 years. Affective attitude: Most youth reported that they enjoyed the session content and enjoyed interacting with the peer provider. Burden: Most youth felt that it was easy to understand the session and participate in it. Perceived effectiveness: Most of the youth perceived the intervention to be effective in helping them reduce substance use and improve their well-being. Ethicality: All youth perceived that the counselling session fit in with their goals and values. Intervention coherence: Most youth understood the overall goal of the intervention. They reported that the goal of the intervention was to help youth stop substance use, and to bring about behavior change. Opportunity costs: Some youth reported that they had to forgo other activities to attend the session, such as work, school, sports, gaming, visiting family, or house chores. Self-efficacy: Most youth felt confident about being able to cut down or stop using substances following the intervention. Conclusion and recommendations: Our findings indicate that the peer provider delivered single-session substance use BI was acceptable to youth. The youth recommended that follow-up sessions be provided to ensure sustained behavior change. This study supports the utility of the TFA in exploring acceptability of a substance use intervention from the perspective of young people.
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    A Cross-Sectional Study of Disclosure of HIV Status to Children and Adolescents in Western Kenya
    (2014-01) Vreeman, Rachel C; Scanlon, Michael L; Mwangi, Ann; Turissini, Matthew; Ayaya, Samuel O; Tenge, Constance; Nyandiko, Winstone M
    Introduction Disclosure of HIV status to children is essential for disease management but is not well characterized in resource-limited settings. This study aimed to describe the prevalence of disclosure and associated factors among a cohort of HIV-infected children and adolescents in Kenya. Methods We conducted a cross-sectional study, randomly sampling HIV-infected children ages 6–14 years attending 4 HIV clinics in western Kenya. Data were collected from questionnaires administered by clinicians to children and their caregivers, supplemented with chart review. Descriptive statistics and disclosure prevalence were calculated. Univariate analyses and multivariate logistic regression were performed to assess the association between disclosure and key child-level demographic, clinical and psychosocial characteristics. Results Among 792 caregiver-child dyads, mean age of the children was 9.7 years (SD = 2.6) and 51% were female. Prevalence of disclosure was 26% and varied significantly by age; while 62% of 14-year-olds knew their status, only 42% of 11-year-olds and 21% of 8-year-olds knew. In multivariate regression, older age (OR 1.49, 95%CI 1.35–1.63), taking antiretroviral drugs (OR 2.27, 95%CI 1.29–3.97), and caregiver-reported depression symptoms (OR 2.63, 95%CI 1.12–6.20) were significantly associated with knowing one’s status. Treatment site was associated with disclosure for children attending one of the rural clinics compared to the urban clinic (OR 3.44, 95%CI 1.75–6.76). Conclusions Few HIV-infected children in Kenya know their HIV status. The likelihood of disclosure is associated with clinical and psychosocial factors. More data are needed on the process of disclosure and its impact on children.
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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.