February 2020
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ICHAD and the SMART Africa Center are proud to bring you our February Newsletter. While February may have fewer days than other months, our team was as productive as ever. Our SMART Africa-Uganda team is working on a cost-effectiveness component, the SMART Africa-Kenya and Ghana Teams continue to make great strides in study implementation and data collection, and groundbreaking progress has been made on the Anzansi study after team members traveled to Ghana to train the in-country team members on Multiple Family Group (MFG) delivery, financial literacy, and income-generating activities. ICHAD is also gearing up for our new Suubi4STEM study, a collaboration with MillporeSigma, Washington University Institute for School Partnership and the Africa Initiative. Finally, four new publications were accepted to prominent journals highlighting findings from our Suubi+Adherence study and the SMART Africa study. 
Enjoy the Read! 

Best Regards,
ICHAD and SMART Africa Teams
 

UPDATES FROM THE FIELD

 
SMART Africa-Uganda participants showing off their completion certificates
SMART Africa-Uganda

SMART Africa-Uganda is a scale-up study in Uganda that utilizes an adapted version of the evidence-based Multiple Family Group (MFG) intervention. This intervention has 16 sessions that aim to address behavioral health challenges in children and adolescents. Following a field visit by ICHAD affiliate Dr. Yesim Tozan and Dr. Fred Ssewamala in January, the SMART Africa-Uganda team worked on a summary of cost-effectiveness data for the Control arm of the study. Eight-week follow-up assessments (for both children and caregivers) were completed in 8 public primary schools enrolled in the treatment condition. A total of 1351 assessments were completed which accounts for 96.5% of the expected numbers (1400). Following these assessments, MFG sessions delivery resumed with session 9 (Dealing with stress in families), which had an average attendance rate of 81%. Guardians and children were thrilled to learn about family stressors and strategies to deal with these stressors to create a conducive family environment for everyone. MFG Session 10 delivery will be completed by the end of this month as well. Congratulations to the Uganda field team for all their hard work!

 
A Multiple Family Group (MFG) session faciliated by the SMART Africa-Kenya Team
SMART Africa-Kenya

SMART Africa-Kenya is a pilot study that tests the effectiveness of the Multiple Family Group (MFG) intervention amongst approximately 180 children and their caregivers in Kiambu County, Kenya. The Kenya team has finalized the MFG intervention in both treatment schools, both with great attendance. Families from these schools appreciated the intervention and stated that this has helped improve family functioning and has made their families happier. In addition to MFG sessions, the team collected the fidelity measures and in the coming weeks will enter them into the dataset. The team will also prepare for the 16-week assessments in all their schools. Congratulations to our Kenya team for completing the MFG sessions and we look forward to seeing more outcomes out of the study!

 
A Multiple Family Group (MFG) session facilitated by the SMART Africa-Ghana Team
SMART Africa-Ghana

SMART Africa-Ghana is a pilot study that tests the effectiveness of the Multiple Family Group (MFG) Intervention amongst approximately 180 children and their caregivers in northern Ghana. Currently, the team is completing the six-month follow up for the control school, which received mental health literature. The school where the MFG sessions were facilitated by School Health Education Program (SHEPS) workers, recently had their 16-week follow-up and are preparing for the six-month follow-up that will be concluded in May. Families greatly appreciated the intervention and were excited to have been part of these groups. In the second school, where MFG is delivered by Parent Peers, the sessions are going well and the attendance has been strong. Thanks to the team in Ghana for their wonderful work and for keeping us moving ahead smoothly!

 
Suubi4Cancer Poster presented at 3rd Annual Institute of Clinical and Translational Sciences Symposium
Suubi4Cancer

Suubi4Cancer seeks to identify confirmed and suspected cancer cases among a cohort of more than 3,000 youth living with HIV/AIDS in Uganda. This month the team continued to work on data cleaning and preparing for the upcoming clinical trial phase. The team is also preparing a publication which details the prevalence of cancer cases in our study cohort. On February 14, ICHAD Student Research Assistant, Abass Babatunde presented a poster entitled “Using REDCap for Data Collection in Resource Poor Settings” at the 3rd Annual Institute of Clinical and Translational Sciences Symposium and Poster Session at Washington University in St. Louis. Overall, the conclusion of the presentation was that despite some challenges around local server requirements, REDCap has proved to be an effective data collection tool for use in resource-poor settings in the greater Masaka region, Uganda. Health facilities in this region commonly use paper-based records and are often characterized by unreliable internet connections.

 
A Multiple Family Group (MFG) session facilitated by the ICHAD Team
Suubi4Her

Suubi4Her seeks to examine the impact and costs associated with an innovative combination intervention that aims to prevent HIV risk behaviors in communities heavily impacted by HIV/AIDS. Our team in Uganda has completed the delivery of multiple family group (MFG) sessions in ten secondary schools enrolled in the treatment condition. These ten schools are receiving MFG plus an innovative economic empowerment intervention that includes financial literacy sessions, income-generating activities, and youth development accounts. These MFG sessions have been well attended and received. Preparations for the second phase of MFG training are going well. The team met with extension workers - who will be training the study participants in income-generating activities, to brief them about the study and to discuss their roles and responsibilities in this next phase of intervention delivery. In addition, the team has registered an impressive follow-up record at the 12-month (Wave 2) data collection. There is a 97% retention rate thus far (n=1,219 participants out of the 1,260 participants recruited). All the 1,219 participants were interviewed for Wave 2. The team plans to embark on Wave 3 interviews (24-months follow-up) during the first week of April. Preparations in the field, including with schools are underway, and the field team is ready!

 
Suubi4STEM

Congratulations to the ICHAD team on being awarded a grant focused on advancing science education in Africa. ICHAD, in collaboration with the Africa Initiative and the Institute for School Partnership (ISP) at Washington University, has received funding from MilliporeSigma for a new project called “Suubi4STEM.” This 4-year study will examine the impact and cost associated with an innovative combination intervention to improve access, engagement with and delivery of STEM (Science, Technology, Engineering, and Mathematics) education in Uganda. The study is in line with the Government of Uganda’s increased policy attention to promoting science and technology, as reflected in on-going government initiatives. Suubi4STEM, to be led by ICHAD, will be pilot-tested among students aged 10-14 years enrolled in Primary 5 to Primary 7 in 20 public primary schools located in seven political districts of Kampala, Wakiso, Masaka, Rakai, Kyotera, Lwengo and Kalungu in Uganda. We are excited about this new study and partnership, and we look forward to the official launch. Stay tuned!

ICHAD team member, Betina Nabisere leading an HIV Risk Reduction training session
Kyaterekera

The Kyaterekera Project is focused on reducing new incidences of sexually transmitted infections and HIV, among women engaged in sex work in Uganda, through a combination of economic empowerment, vocational skills training, and HIV risk reduction (HIVRR) sessions. In February, the Kyaterekera team continued with study recruitment. A total of 517 participants from 18 HIV/AIDS hot spots have been recruited. All the recruited participants have completed baseline assessments and biological testing. In addition, delivery of study interventions is ongoing and the team recently completed delivery of HIV Risk-Reduction sessions at three HIV/AIDS hot spot sites. In addition, financial literacy training sessions, a component of the intervention in the Kyaterekera study, have been conducted at six sites. The team also started vocational skills training (for participants in treatment arm II) at two sites with an average attendance of 81%. We are pleased to note that a total of 136 (76%) study participants had matchable savings in the month of February and their match totaling to 9,224,000 Uganda Shillings (~USD 2,600) was disbursed into their respective savings accounts. In addition, the team began data collection for the six-month post-intervention completion assessments. Preparations for the third Community Collaborative Board quarterly meeting scheduled to take place on March 27 at the Hotel Brovad in Masaka are under way. Congratulations to the Kyaterekera field team for keeping this busy project moving so smoothly!

 
Drs. Abdallah, Mwebembezi, and Nabunya and Mrs. Nabisere and Mr. Nsubuga meeting with Anzansi study team members/collaborators
Anzansi Family Program

The ANZANSI Family Program seeks to pilot test the feasibility of an innovative combination intervention (Family economic empowerment and MFG) amongst adolescent girls at risk of dropping out of school in Northern Ghana. This February, Dr. Proscovia Nabunya (Study Co-Investigator) and a team from Uganda, which included Dr. Abel Mwebembezi, Betina Nabisere, and Edward Nsubuga, traveled to Ghana where they conducted a number of activities. Among the activities included training of trainers who will train the facilitators for  MFG, financial literacy training (FLT), and income-generating activities (IGA). During the visit, Drs. Abdallah (in-country Multiple Principal Investigator) and Nabunya met with the stakeholders (BasicNeeds Ghana, BIBIR Ghana, community members and school officials) to collect feedback on the MFG and FLT content. In addition, they laid the groundwork for study implementation by meeting with banks that will house participant savings accounts. The team also met with the Ghana Education Services Office to obtain approval to work with the schools in the Tamale District. We are also happy to announce that Kingsley Kumbelim will be coordinating the Anzansi Family Program. Kingsley has gained a lot of research experience through coordinating the SMART Africa Ghana study, and we believe that this experience will be beneficial to this new project. Congratulations Mr. Kingsley and the ANSANZI team!

 
Kayayei Project team meeting
Kayayei Project

The Kayayei Project seeks to provide insights into female adolescents’ unaccompanied migration for labor in Ghana. Following the translation of qualitative interviews, the U.S. team is currently cleaning the data and doing data quality checks to make sure it is ready for analysis. In addition, Dr. Abdallah (in-country Principal Investigator) traveled to Ghana and met with communities to report back and to discuss the next steps. During his meetings with the community members, they appreciated the project for going back to them and ensured a wonderful collaboration on future plans.

 
 
A Warm Welcome to Robert Kasumba, the Newest Member of ICHAD-Uganda

We are excited to welcome Robert Kasumba, who recently joined the ICHAD/SMART Africa family as the Field Study Coordinator for Suubi4STEM. This study seeks to examine factors that improve science educational performance among Primary and Secondary School students in Uganda. The study is aimed at building a pipeline for young scientists beginning with Primary School. A trained Software Engineer from Makerere University in Uganda, Mr. Kasumba is one of ICHAD’s former field Research Assistants who worked as one of the interviewers and data entrants for Bridges to the Future study during his senior six vacation. We are excited to have Robert back with us as a full-time employee, coordinating a study in his area of training and expertise: Science Education. He will be stationed in the ICHAD/ SMART Africa’s Uganda Field office where he will be supporting the research team at Washington University and schools in Uganda to roll out and coordinate the study. We congratulate Mr. Kasumba for accepting this offer and pleased he is willing to blaze the way as the study’s first coordinator.

 
 

CAPACITY BUILDING

 
ICHAD, SMART Africa and Brown School Career Services workshop series for African Students

This month’s Career workshop series for African Students was focused on Awareness of Cultural Differences. The discussion included sharing experiences about cultural differences based on beliefs, language, behavior, practice, biases and what impact this had. The group brainstorms ideas on how to address these impacts. Understanding different communication styles that are uniform to most cultures across the world was also discussed and these included; linear versus circular conversations, direct versus indirect communication, detached versus attached communication, concrete versus abstract conversations, and intellectual engagement versus relational engagement. The session also featured four panelists who shared diverse experiences in regards to how they coped with students and work-life given the cultural differences. See our events below for upcoming workshops.

Kurt Dirks Discusses Building Trust at the ICHAD and SMART Africa February Speaker Series

In February, the ICHAD and SMART Africa teams welcomed Kurt Dirks, the Vice-Chancellor of International Affairs and the Bank of America Professor of Leadership to speak about “Developing Trust: Implications across Different Cultures.” In his engaging talk, we learned that while different cultures may have varying degrees on which trust is built (in India, this may involve bringing your mother to dinner, wherein Uganda, trust is often built over meals) there are three elements of trust that are generally found across all cultures “Caring, Character, and Competence.” How to engage these three elements, have important implications for collaboration and leadership across work context and countries. Many thanks to Dr. Dirks for earning the trust of many more through this excellent presentation!

 
The Global LEAD Program Gets off to a Strong Start

The T37 LEAD Global Training Program received nearly twenty applications from trainees across the country committed to conducting health disparities research, with a specific focus on global mental health prevention, intervention, services, and implementation research within resource-constrained settings. Earlier this year, the Program’s External Advisory Board reviewed all applications, and seven candidates have been selected for the first LEAD Trainee Cohort. The team is currently in the process of reaching out to these candidates and their mentors. This summer, the trainees will come to St. Louis for two weeks for an orientation period and will then travel to a site in Sub-Saharan Africa, where they will work with their mentors on a research project for up to six-weeks. Stay tuned for more news from our LEAD Trainees!

 

FELLOWS CORNER

 
Tyrone Parchment
Congratulations to SMART Africa Global Fellow, Dr. Tyrone M. Parchment who was recently selected as a
 LEAD Global Training Program fellow. This NIMH-funded program is designed for early-career researchers from underrepresented backgrounds who are interested in global mental health disparities research. Dr. Parchment’s research is centered on family behavioral interventions focused on engaging fathers and male caregivers. He will be working with his mentors, Dean Mary McKay and Dr. Theresa S. Betancourt on a community engagement project in Sierra Leone. In addition, in 2019 Dr. Parchment published two articles, one focused on South African adult caregivers as “protective shields” to buffer between stressful neighborhood conditions and youth risk behavior and another highlighting caregiver perceived benefits of a multiple family group for children with behavioral challenges. We congratulate Dr. Parchment for his many recent accomplishments!

 


 
 
 
The long-term effects of a family based economic empowerment intervention (Suubi + Adherence) on suppression of HIV viral loads among adolescents living with HIV in southern Uganda: Findings from 5-year cluster randomized trial

Recently, a paper co-authored by six members of the ICHAD and SMART Africa centers was published in PLoS One. These authors included Dr. Fred Ssewamala, Dean Mary McKay, Dr. Proscovia Nabunya, Dr. Ozge Sensoy Bahar, and Brown School Doctoral students Darejan Dvalishvili, and William Byansi. This article titled “The long-term effects of a family based economic empowerment intervention (Suubi + Adherence) on suppression of HIV viral loads among adolescents living with HIV in southern Uganda: Findings from 5-year cluster randomized trial”, assesses the family economic empowerment (EE) intervention on retention and viral suppression of adolescents living with HIV (ALWHIV) in Uganda. In this paper, the authors analyzed data from a total of 288 adolescents aged 10 to 16 with detectable HIV viral loads (VL)  All participants received the medical standard of care (SOC) from the Uganda Ministry of Health involving information about adherence and support delivered by lay counselors and individuals with HIV. Further, all participants received a bolstered version of the SOC which included eight information sessions on antiretroviral therapy (ART) adherence using print cartoons to create relatable material for youth and eight one-hour group sessions led by a trained research assistant. The intervention group received the bolstered SOC and the family-based EE intervention which included incentivized matched savings accounts and microenterprise workshops with sessions on financial management and microenterprise development training for youth and their caregivers. The funds acquired from the matched savings accounts and microenterprise could be used for medical or education-related expenses only. Participants in the treatment arm condition were compared to the bolstered standard of care condition and evaluated using viral suppression using HIV VL. The authors found that there was a significant intervention effect on VL suppression among adolescents who had detectable VL compared to participants in the control condition. This finding suggests that the family EE intervention improved treatment outcomes for ALWHIV and contribute to a growing body of literature that suggests that there is a need for effective ART to include VL monitoring when monitoring health outcomes among ALWHIV. Further, financial stability in the home may impact medication-adherence and should be addressed through further research to improve care for ALWHIV. You can find the full publication here.

From “4Rs and 2Ss” to “Amaka Amasanyufu” (Happy Families): Adapting a U.S.‐based Evidence‐Based Intervention to the Uganda Context

Congratulations to the SMART Africa team of Drs. Fred Ssewamala, Ozge Sensoy Bahar, Apollo Kivumbi, Dean Mary McKay and students Phionah Namatovu, Joshua Kiyingi and Thabani Nyoni for their recent publication in the Family Process Journal documenting the process of adapting an evidence-based intervention to a different context. The process involved: initial meetings with headteachers and teachers to introduce the study and the main concepts of the intervention; initial manual review focusing on 4Rs and 2Ss content by the Uganda team; engagement of community stakeholders for additional feedback on content and cultural relevance; final revision of the manual; and collection of children’s drawings for the illustration of the manual. The team describes both similarities and differences between the original and adapted intervention content and methods of delivery. The findings also highlight the importance of involving community stakeholders in the adaptation process. Congratulations team for sharing this process to allow others to learn from your experiences! You can find the full publication here.

The Role of Family Factors in Antiretroviral Therapy (ART) Adherence Self-Efficacy Among HIV-Infected Adolescents in Southern Uganda

Congratulations to ICHAD team members Drs. Proscovia Nabunya, Ozge Sensoy Bahar, and Fred Ssewamala, along with Bin Chen, Daji Dvalishili, and Christopher Damulira for their latest paper addressing the role of family when adhering to ART medications. This paper, which was recently accepted in BMC Public Health, explored protective family factors, measured by family cohesion, child-caregiver communications and perceived child-caregiver support. Controlling for sociodemographic and household characteristics, family cohesion, and child-caregiver communication were significantly associated with adherence self-efficacy to ART. These findings point to the need to strengthen family cohesion communication within families in order to enhance adherence self-efficacy among adolescents living with HIV.

Social and Economic Equity and Family Cohesion as Potential Protective Factors from Depression Among Adolescents Living with HIV in Uganda

Using data from ICHAD’s recently completed Suubi+Adherence study, team members William Byansi, Drs. Ozge Sensoy Bahar and Fred Ssewemala, along with ICHAD Affiliate Dr. Patricia Cavazos-Rehg and her team, published an article in the journal AIDS and Behavior. This paper examines how social and economic equity, family cohesion, and social support factors may be related to incidences of depressive symptoms, as measured by the child depression inventory (CDI)—a widely used symptom measure of depression among adolescents. The team found that social and economic equity are associated with lower depressive symptoms, pointing to the importance of understanding the role that social and economic determinates have on depressive symptoms as an important step toward developing HIV-related policy and treatment protocols for HIV positive adolescents. You can find the full publication here.

 

SOCIAL CORNER

 
Baby Sprinkle

This month the ICHAD and SMART Africa Teams, along with our close collaborator the Africa Initiative, celebrated the soon to be newest members of our team. ICHAD and SMART Africa PhD Student William Byansi and his wife Anette, along with Africa Initiative Program Coordinator Bethel Mandefro and her husband Azaryas were “sprinkled” with baby items. This will be the second son for the Byansi family and fourth daughter for the Mandefro family. Baby Bingo, Baby Price is Right (did you know you can buy diapers for as low as $2.49?) and cupcakes were enjoyed by all. We look forward to welcoming these newest team members later this Spring!

 

UPCOMING EVENTS

 

ICHAD Events

ICHAD and SMART Africa are hosting a speaker series even on March 17, 2020 from 12:00-1:00PM in the Brown Lounge, Brown School. Dr. Elvin Geng will discuss “Adaptive Strategies for Retention in HIV care in Africa.” You can register for the event here.

ICHAD and SMART Africa are now accepting abstracts for our upcoming conference on Global Adolescent Health and Economic Strengthening in Low-Resource Settings. This conference is being held at Washington University in St. Louis on June 23-24, 2020, full conference details can be found on our website. The deadline for abstracts is April 1, 2020. You can register for the conference and submit your abstract here.

ICHAD and SMART Africa in collaboration with Hazina, Career Services, and Washington University Career Services are offering a free series of workshops for African students to promote personal career development and management. All classes will be facilitated by Catherine Nkonge, MSW, MEd, LPC.
These classes will take place from 2:00 - 3:30 PM on the following dates.
March 5 - Fine-tuning Your Job Search Strategy
March 23 - Networking - Essential for Professional Growth
April 16 - Acing the Job Interview
April 27 - Strategize for Your Professional Growth

You can register for the event
here.

External Events

 

OPPORTUNITIES

 

ICHAD Opportunities

The T37 LEAD Global Fellowship Program is accepting applications for a 1 to 2-year postdoctoral fellow. The LEAD Global Fellowship supports trainees from underrepresented groups committed to conducting health disparities research, with a specific focus on global mental health prevention, intervention, services, and implementation research within resource-constrained settings. Eligible candidates should be a U.S. citizen, non-citizen national, or permanent resident, and be from a disadvantaged or underrepresented population in biomedical, behavioral, clinical & social science research as outlined by the NIH.

The postdoctoral fellow will be in residence at Washington University in St. Louis. The postdoc will engage in writing publications using study data and proposal development to explore new opportunities related to HIV/AIDS or global mental health disparities. The postdoctoral fellowship also includes a summer training program at Washington University and 6-8 weeks of mentored research at a Sub-Saharan Africa study site with a current NIH-funded Mental Health Intervention. 

Applications will be accepted on a rolling basis and can be completed on the
T37 LEAD Global Fellowship website at https://sites.wustl.edu/lead/apply/. For more information, contact Betsy Abente at eabente@wustl.edu

External Opportunities

Research Program on Children and Adversity
Boston College School of Social Work

Supervisory Health Scientist Administrator
NIMH Center for Global Mental Health

Assistant, Associate or Full Professor in Global Mental Health
Columbia University's Mailman School of Public Health

STRENGTH program designed for postdoctoral scholars, junior faculty, and fellows (PhDs and/or MDs) who are still in training and interested in pursuing patient-oriented cancer research
Washington University in St. Louis

Summer Training Institute - System Science for Social Impact
Washington University in St. Louis

Research Associate (Implementation Science)
Boston College School of Social Work

Research Associate (Gender)
Boston College School of Social Work

Data Analyst
The Kaiser Family Foundation’s Global Health Policy Program

Post-Doctoral Fellowship in Adolescent in Behavioral Health
The Indiana University School of Medicine

Post-Doctoral Fellow for Research Program on Children and Adversity
Boston College School of Social Work

Post-Doctoral Diversity Supplement - Evidence-based Mental Health Interventions
National Institute of Mental Health