Summer 2014 marks the end of program Year 3 for the Teen Outreach Program of Craven County, more commonly referred to as the TOP® Club of Craven County. This collaborative intervention between The Center for Health Policy and Inequalities Research at Duke University and the Craven County Health Department is funded through the PREPARE for Success grant initiated through the Affordable Health Care Act. This grant is administered through the North Carolina Department of Health and Human Services (DHHS) Women’s Health Branch.
According to the 2012 Craven County State of the County report, the pregnancy rate in 2011 for teenage women ages 15-19 in Craven County was 58.3 out of 1,000 women. In 2012, Craven County ranked 24th across the state for teenage pregnancy. However, for the past five years (2007-2012), Craven County has had the 14th highest rate of teenage pregnancies of all 100 counties. Designed to positively affect this alarming trend, TOP® Club of Craven County helps youth develop important life skills through participation in weekly peer meetings with trusted adults, enrichment activities and integral service learning opportunities. Major components of the program’s structure include values clarification, decision-making skills, and the dissemination of scientifically accurate information regarding both abstinence and contraceptive methods with an emphasis on the role that each plays in developing healthy behaviors. The research element of this program, developed by the curricula creators and the NC DHHS oversight department, seeks to quantify the impact of the program on participants by anonymously surveying them on a yearly basis. Surveys analyze students’ knowledge, attitudes, beliefs and behaviors regarding sexual behaviors and associated risks at the beginning and end of each program year.
This youth-oriented intervention compliments the rich legacy of addressing health disparities within CHPIR programming. While CHPIR has established many programs around the world, this initiative is the first and only domestic CHPIR-sponsored initiative that addresses youth health disparities in the state of North Carolina. TOP® Club fills a similar void for Craven County as the only community-based initiative to provide health education, including comprehensive sex education, to adolescents in the area.
TOP® Club of Craven County celebrates another successful year of programming, meeting or surpassing its established measurable objectives for Year 3. Notably, the program’s recruitment efforts set the tone for this year’s success. Increased community awareness and strengthened partnerships contributed to the program’s highest number of enrolled students since it began operation in 2012. To date, TOP® Club has served over 200 Craven County adolescents, and surpassed its Year 3 enrollment goal of 80 youth by 11%. TOP® Club of Craven County is committed to also addressing ethnic disparities in the county’s teenage pregnancy rates. Illustratively, over 75% of the students served through the program in Year 3 are youth of color.
Strong community partnerships have also supported the success of the program’s third operational year. The New Bern Chapter of the Continental Societies, Inc. is represented on the program’s Community Advisory Council, and partnered with TOP® to facilitate two of the program’s four Year 3 enrichment activities offered to TOP® participants. These activities, designed to cultivate student civic and social responsibility while building important life skills, expose participants to new experiences and offer exciting opportunities for self-discovery. This year, TOP® Club participants celebrated the legacy of Dr. Martin Luther King, Jr. in New Bern’s Annual MLK Heritage Parade while holding hand-made signs to remember Dr. King’s vision with slogans including, “Justice for All” and “End Racism.”
Learning through service to the community is an integral part of the TOP® program model. This program component largely parallels the helper therapy principle, developed by Frank Reissman. First published in a 1965 edition of Social Work, this frequently referenced model asserts that when a person helps or serves another person, that person gains an increased sense of self-efficacy, making the relationship beneficial for both the ‘helper’ and ‘helpee.’ Over the course of the TOP® 9-month program, students devote at least 20 hours to a service project that they design, implement, debrief and celebrate. TOP® Club participants completed several inspired service projects in Year 3 that served vulnerable populations in the area, including: animals, low-income elderly, homeless residents and youth with chronic illness.
Motivated by a passion to serve other youth in their community, the TOP® Club at New Bern High School, facilitated by CHPIR Project Coordinator, Genevieve Hunter, brought favorite childhood characters to life during a visit to the Vidant Maynard Children’s Hospital in Greenville, NC. The group’s project also included a toy drive, through which they collected over 75 toys to benefit the hospital’s courageous young residents.
The success of TOP® of Craven County collaboratively working with partners has garnered positive attention from teen pregnancy prevention advocates at the state level. The Adolescent Pregnancy Prevention Campaign of North Carolina, or APPCNC, is one such organization. APPCNC began as a grassroots initiative in 1985 to address climbing teen pregnancy rates in Charlotte, NC. Since then, the nonprofit organization has expanded its work to counties across the state to build capacity to prevent adolescent pregnancy through collaboration, advocacy and education.
With recent funding from the Duke Endowment, APPCNC is working to support and build on the success of TOP® Club operations in Craven County. APPCNC is working closely with TOP® staff and community members with hopes of mimicking great strides made in other North Carolina counties. Notably, Gaston Youth Connected (GYC), an APPCNC sponsored program, has seen tremendous achievements since its inception in 2010. According to GYC’s website, Gaston County dropped its teen pregnancy rate by 28% from 2010 to 2012 through this innovative initiative which unites stakeholders through the implementation of practical changes in the community. Gaston Youth Connect has started a Teen Wellness Center at the Health Department and has teen peer educators out in the community making appointments for youth on smart phones and tablets. CHPIR staff and TOP® facilitators Genevieve Hunter and Tova Hairston will do similar work with APPCNC this year to establish a community-wide coalition that will increase community awareness of teen pregnancy and prevention efforts. The coalition will connect key stakeholders, including schools, support agencies and small businesses in a structured, joint effort to increase teen pregnancy prevention efforts and garner community buy-in to support the efforts of TOP® Club of Craven County.
TOP® Club of Craven County is looking forward to growth and expansion in Year 4, with supplementary funding from the Teenage Pregnancy Prevention Initiatives program (TPPI) through the North Carolina Department of Health and Human Services Women’s Health Branch. The additional funding will support current CHPIR staff positions in the program, and will provide for additional program facilitators. With increased program capacity, TOP® Club will also add another site location in the county, serving students residing in rural Vanceboro and other parts of western Craven County. With a strong foundation, TOP® Club staff is excited to continue to reverse the trend of Craven County’s teenage pregnancy rate with increased support from state advocates, the Duke Global Health Institute and the Center for Health Policy and Inequalities Research.
What program stakeholders are saying about TOP® Club of Craven County:
“[Learning about abstinence in TOP] helped me… because it gave me information [about how] I would need to [say] no for when I get ready to have sex, like the risks [of teen pregnancy and HIV and STDs]
TOP® Club participant
“TOP is a club where kids can feel safe. It’s designed so that people can talk about themselves in a safe environment. It’s a group that can show you the ROPES …because no matter what situation you come from, everyone is equal!”
TOP® Club participant
“I love, love love, love, love love TOP…seeing you guys interact with the young people that are involved in [TOP® Club]…has just been the most rewarding thing for me…, and then [seeing] the participation of the parents and how excited they were, and how much they absolutely love and respect what you guys are doing for them.”
-Sandi R., TOP® Club
Community Advisory Council member
For more info and photos, check us out at: www.cravencountytop.org
The Duke Global Health Institute’s Center for Health Policy and Inequalities Research (CHPIR) is currently accepting applications for the Summer 2014 Internship Program. The internship encourages current undergraduate and first year graduate students to apply for an internship program exploring health inequalities through research, policymaking, and fieldwork in one of the various projects ongoing at the Center for Health Policy and Inequalities Research. The internship program requires 40 hours of work per week and runs for 10 weeks between May 27 – Aug 1, 2014.
Juntos, Spanish word for together, is a yearlong community-based research project working to improve the health of Latino men who have sex with men (MSM). As sexual and ethnic minorities, Latino MSM often experience stigma and discrimination, which are associated with poorer behavioral, social, mental health and physical health outcomes.
The Center for Health Policy & Inequalities Research and El Centro Hispano partner to create an interdisciplinary, vertically integrated research team through a Duke Bass Connections project (Global Health Theme). El Centro Hispano is a well-respected, services organization in Durham, whose work strengthens the local Latino/Hispanic community through education, service, and community organizing.
During the project, the team will adapt an existing internet and mobile phone based intervention designed to reduce sexual risk behaviors, create positive norms around health behaviors, promote health and wellness, and provide a platform for community building.
Juntos is seeking a summer intern with extensive experience and expertise in web design and development, to lead the program adaptation.
Summer intern roles & responsibilities:
- Identify and recommend best practices for a high functioning website
- Create a web intervention or adapt existing web intervention. The site will use responsive web design.
- Conduct routine quality assurance and quality improvement on intervention functionality
- Participate in team meetings
- Demonstrates understanding of responsive web design
- Demonstrates creativity in website design
- Demonstrates strong written communication skills
- Ability to manage multiple priorities
- Demonstrates cross-cultural awareness and sensitivity
Personal qualities: Applicant needs to have strong interpersonal and organizational skills, someone who can successfully engage with team members to effectively adapt a web-based health intervention.
- Clear, engaging communication
- High attention to organization and detail
- Self-motivated and professional
- Dedicated and persistent in problem solving
Preference is given to individuals with an interest in working with diverse racial and social groups, an interest in research, and has a passion for addressing health inequalities. Bilingual and bicultural individuals are encouraged to apply.
All applications should be sent to Kyle.Hamilton@chpir.org, and should include your resume, cover letter, and a copy of your academic transcript. Please provide us with 3-5 business days to respond to your submission. Applications for the Juntos: A digital health intervention internship are due: 4/28/2014 by 5pm.
Assistant Director of the DGHI Evidence Lab
The Duke Global Health Institute (DGHI) seeks to hire one full-time staff member (either Associate in Research or Research Scholar depending upon candidate qualifications) to support the work of the DGHI Evidence Lab.
DGHI is creating an Evidence Lab to: 1) support Duke faculty and their worldwide partners by offering skilled DGHI Evidence Lab staff as evaluation partners, particularly partners in program and technology evaluation, in translational and implementation research, and in cost effectiveness evaluation; 2) produce evidence-based knowledge to inform program and policies worldwide; and 3) provide educational opportunities for Duke students to learn rigorous evaluation methods in the classroom and field. The Evidence Lab was envisioned in DGHI’s five-year report and this key Evaluator position will help make the Evidence Lab a reality.
The DGHI Evidence Lab will engage in a variety of global health evaluation activities, including:
- Summative evaluation, e.g., program, intervention, and policy outcomes evaluation;
- Formative evaluation, e.g., contextual and cultural assessment prior to intervention implementation;
- Process monitoring combined with evaluation, e.g., quality of program components, who was reached, and how external factors affected program delivery when paired with outcomes evaluation;
- Cost effectiveness evaluation;
- Health policy recommendations and dissemination;
- Maintaining research databases and registries; and
- Teaching research methods.
It is hoped that the Evidence Lab will enable DGHI to have a greater impact on global health through rigorous evaluation. In addition, the Evidence Lab should result in a larger, global network of evaluation opportunities, which, in turn, may spawn more non-evaluation research opportunities. The Evidence Lab will have the opportunity to develop innovative methodologies, be both reactive and proactive to health technologies and funding opportunities, and create a stronger link between evaluation and health policy.
The Assistant Director’s work will initially focus on writing proposals to secure funding, and then will be a balance of conducting funded evaluation work combined with continued proposal writing. The specific work activities are:
Write proposals to secure additional funding
Write grant and contract proposals to secure funding.
Conduct project management of funded evaluations
- Travel to the evaluation site, connect with the program/intervention leaders, connect with the funders, and determine the project needs on the ground.
- Develop protocols and conduct training on protocols at all sites, adapting as needed to site and culture, and changes over time.
- Oversee IRB approval processes, such as supervising others to secure Duke IRB approvals and coordinating with in-country partners such that the partner gets the in-country approval.
- Hire or contract with needed staff (e.g., statisticians, database developers, data collectors), based on the specific project.
- Oversee data collection and conduct regular data review to ensure data quality.
- Analyze the data with statistical consultation as needed.
- Once staffing plan is in place, manage project budgets with DGHI staff.
- Write reports.
- Write dissemination materials. Publish in journals when possible. Consider policy implications and disseminate to stakeholders.
Mentor DGHI students on evaluation
- Meet with students who are considering conducting evaluation research and help them determine the best research design; review instruments and protocols; consider cultural issues.
- Mentor students who are placed at the field sites where the Evidence Lab is working, or ensure that the project coordinator and other Evidence Lab staff are providing appropriate mentorship.
- Potentially teach short courses or semester-long courses related to evaluation and methods.
Create methods products
Over the course of multiple evaluations, develop materials useful for DGHI staff and students when conducting diverse international evaluation projects. What tools are needed? What core structures, decision trees, etc., are helpful for most projects? How can these be tailored to various kinds of evaluations?
Give the Evidence Lab an external presence.
- Produce promotional materials.
- Create a “look” for materials.
- Promote the Evidence Lab through networking via associations and conferences.
Create a master Evidence Lab database that combines data from multiple Evidence Lab studies
- Create protocols of storage and use and seek IRB approvals.
- Maintain a listing of data available for cross-study analysis.
Qualifications: Master’s degree or PhD in a relevant specialty required. The ideal candidate will be well-networked with health monitoring and evaluation organizations and have extensive experience writing proposals and competing for grants and contracts from diverse government and foundation sources. The ideal candidate will also have conducted evaluation research in several different countries, and be skilled at making site visits to assess monitoring needs and viable research protocols. Excellent communication and writing skills are required, as is the ability to work well across cultures. We hope to grow the Evidence Lab; the ideal candidate will also possess an entrepreneurial spirit. International travel required.
How to apply: Interested applicants should submit via email a cover letter and CV to Tammy Sorrell at firstname.lastname@example.org. Applications will be reviewed upon receipt, and some applicants may be asked to submit reference letters. Please write “Evidence Lab” in the subject line of your email.
New Publication: Addressing social isolation within a technology-based HIV intervention for young black men who have sex with men
CHPIR faculty member, Dr. Sara LeGrand, co-authored a publication with AIDS CARE entitled, “Addressing social isolation within a technology-based HIV intervention for young black men who have sex with men.” Check it out!
Harvard School of Public Health
Department of Global Health and Population
Assistant or Associate Professor of Decision Science and Global Health
The Department of Global Health and Population at the Harvard School of Public Health seeks candidates for the position of assistant or associate professor in the area of decision science and global health. This is a tenure-ladder position, with the academic rank to be determined in accordance with the successful candidate’s experience and accomplishments.
The successful candidate will be expected to develop an independent research program, play a central role in the department’s research and teaching programs, and to fully engage as an active community member in the Center for Health Decision Science. S/he will teach on decision science as part of the global health curriculum, advise masters and doctoral students, and direct doctoral students in their dissertation research.
Candidates will hold a doctoral degree in health policy, economics, global health, public policy, operations research, or other related disciplines, with demonstrated expertise in decision sciences. The position is open to individuals with a variety of applied research interests, although there is a particular interest in candidates conducting quantitative policy research relevant to low- and middle-income settings. Prior research and/or programmatic experience relating to evaluation of health interventions and policies is highly desirable.
The deadline for applications is April 1, 2014. Please apply to:
For questions, please contact:
Aimee Fox, Director of Administration
Department of Global Health and Population
Harvard School of Public Health
665 Huntington Avenue, 1-1104
Boston, MA 02115
Harvard University seeks to find, develop, promote, and retain the world’s best scholars. Harvard is an Affirmative Action/Equal Opportunity Employer. Applications from women and minority candidates are strongly encouraged.
Information on resources for career development and work/life balance at HSPH can be found at: http://hsph.me/resources-career-development-and-work-life-balance
The position with Guide to Healing and NC LINK has been filled. For more information about other internship opportunities, please visit: http://chpir.org/internship/
CHPIR continues to partner with the Craven County Health Department (CCHD) in New Bern, NC to offer the Teen Outreach Project (TOP). In 2012, Genevieve Ankeny Hunter (GV), a CHPIR project coordinator, Tova Hairston, a native of Craven County, successfully led a program that reached over one hundred youth, ages 11-17, in Craven County. The TOP curriculum not only provided these youth with an essential education on teen pregnancy and HIV/STD transmission, it also promoted essential abilities to reduce future risk behavior by focusing on three important tenants in youth development: a sense of purpose, life skills and healthy behaviors.
CHPIR’s first and only project serving adolescents in North Carolina, the Teen Outreach Program of Craven County, had a tremendous year of growth. Since February of 2012, TOP® of Craven County has served over 200 youth, ages 11-17. Sites grew almost to capacity in year 2 of the grant and in year 3 (2013-2014), they are at full capacity at three sites. TOP® has also been approved to host a pilot TOP® at a new site, adjacent to a housing project in New Bern, NC. This is a high-risk area of the city, where previous after-school programs were maintained for many years, but recently were not funded. This is a wonderful opportunity to expand the program in an underserved area.
TOP® is funded by the Women’s Health Branch, which sponsors the program under the name, PREPare for Success or PREP. PREP, is known nationally as the personal responsibility education program and is designed to educate adolescents on both abstinence and contraception to prevent pregnancy and sexually transmitted infections, including HIV/AIDS. It also promotes adulthood preparation subjects such as, healthy relationships and parent-child communication.
TOP®, however, offers much more than the basics of teen pregnancy prevention. TOP® is youth-oriented and is focused on three important tenets of youth development: sense of purpose, life skills and healthy behaviors. For youth, this translates to a regular meeting place where they feel they have a voice. It is a safe place where youth have said they can ask questions “openly and honestly.” Furthermore, youth trust that they will get an honest and thoughtful answer back.
Learning through service or Community Service Learning is also an integral part of TOP®. This past year participants chose varied service projects including: a reading and art intervention with preschoolers, a letter writing and care package campaign for deployed military and a pennies for pets project for a local animal shelter. TOP® youth and staff thoroughly enjoyed their service work.
TOP® hosted many enriching trips in 2012-2013, including a college tour over spring break to six North Carolina colleges and universities, including two Historically Black Colleges and Universities. The end of year trip to Ft. Macon State Park and Atlantic Beach was a huge highlight for many participants who have never been to the regional landmark and do not often get a day at the beach.
TOP® staff continues its collaborative efforts and strong partnerships with many organizations and community members in Craven County. Community partners include: Craven County Health Department, City of New Bern/Parks and Recreation, Craven County Schools, Craven County Department of Social Services and St. John’s Missionary Baptist Church. All of these partners offer in-kind contributions, including office space and TOP® after-school meeting space.
In the summer of 2013, Genevieve and Tova attended a week long intensive training. The Training Institute for Sexual Health Educators or TISHE, is a nationally known training for sexuality educators, founded by Rutgers University and sponsored the Adolescent Pregnancy Prevention Campaign of North Carolina. It featured plenaries on topics including: learner diversity, creating a safe learning environment, exploring values, and broadening understanding of sexuality and sexuality education. It also featured daily small-group work with other professionals to enhance facilitation and training skills. It was the most comprehensive and effective training our TOP® staff has attended thus far.
Genevieve continued her work with the Southern Reach-AIDS United project working in collaboration with the Duke Legal AIDS Assistance Project. She continues to offer curriculum development and training to legal and medical staff serving people living with HIV/AIDS throughout North Carolina. The aim of this project is to reduce discrimination and breaches of confidentiality in legal and emergency room settings. In the spring of 2013, Genevieve trained a physician and his entire practice on HIV and confidentiality, after a Department of Justice lawsuit found the practice liable for discriminatory practices. In addition, this past summer, Genevieve and Carolyn McAllaster, Duke Professor of Law, trained two groups of Duke University Medical Center internal medicine and emergency department medicine residents in working to maintain confidentiality of patients living with HIV/AIDS.
Editor’s Note: This article was originally published at UNC Healthcare and UNC School of Medicine Newsroom.
UNC, Duke Team up with Carrboro-based Caktus Group on HIV Gaming App
CHAPEL HILL — The web application development company Caktus Group has teamed up with researchers at the UNC Institute for Global Health & Infectious Diseases and the Duke Global Health Institute to develop a mobile phone app that may help patients better adhere to their medication regimens.
The new venture is funded by a $150,000 Phase I Small Business Innovation Research (SBIR) grant from the National Institutes of Health. The study team will develop a novel mobile phone game app with the goal of improving medication adherence among HIV-infected young black men who have sex with men. In the United States, this is the demographic with the highest number of new HIV infections.
The Daily Dose app will utilize game mechanics and social networking features to improve adherence to HIV medication. In addition to scheduled medication reminders and adherence tracking, Daily Dose will use gaming features to create a compelling and engaging experience that will motivate and support behavior change. The app will also promote social interaction, which will allow users to share their successes and encourage others to maintain their adherence goals. Gamers will be awarded points for sharing their own successes and providing support and encouragement to their fellow gamers. The study team hopes this anonymous social network of peer support will drive patients to maintain their medication schedules.
While Caktus Group leads the development of the game, the usability studies will be conducted by Lisa Hightow-Weidman, MD, associate professor of medicine at UNC and Sara LeGrand, PhD, assistant research professor at the Duke Global Health Institute. The researchers will organize focus groups and conduct a series of in-person interviews with potential users to get feedback on the app’s design throughout the development process.
“Because the game will be designed, developed and refined based on consistent user feedback, we are confident that Daily Dose will be both engaging and effective,” said Tobias McNulty, principlal investigator and managing member at Caktus Group.
Ultimately, Daily Dose aims to improve drug adherence among a population disproportionately affected by HIV by developing an effective antiretroviral therapy adherence app tailored specifically for this group. Recent research has shown that treating HIV makes people less contagious and drastically reduces the spread of the virus to sexual partners. Through careful design and development, this new project hopes to improve patient outcomes and reduce the spread of HIV among a vulnerable population.
About Caktus Group
Caktus Consulting Group, LLC is a growing team of creative developers and designers based in Carrboro, North Carolina. The company was founded in August 2007 to serve the web needs of startups, researchers, health care organizations, and established businesses in the North Carolina Triangle region and beyond. Caktus Group’s specialty is creating web and mobile applications using Django, an open source web framework that is business friendly and easily customized. By listening carefully, Caktus Group develops products that clients consistently say are intuitive and fill needs they had not yet discovered.
About the UNC Institute for Global Health & Infectious Diseases
Founded in 2007, the Institute for Global Health & Infectious Diseases at UNC harnesses the resources of the University and its partners to solve local and global health problems, reduce the burden of disease, and inspire and train the next generation of leaders in global health.
About the Duke Global Health Institute
The Duke Global Health Institute, established in 2006, brings knowledge from every corner of Duke University to bear on the most important global health issues of our time. DGHI was established as a University-wide institute to coordinate, support, and implement Duke’s interdisciplinary research, education, and service activities related to global health. DGHI is committed to developing and employing new models of education and research that engage international partners and find innovative solutions to global health challenges.