Expanding Academic Engagement in Global Health

1. Expanding Academic Engagement in Global Health TPHA Annual Meeting Franklin, Tennessee September 11, 2014 Cathy R. Taylor, DrPH, MSN, RN Dean and Professor Gordon E. Inman College of Health Sciences and Nursing Belmont University cathy.taylor@belmont.edu

2. Objectives • Describe successful expansion of global health and service learning efforts in one University • Discuss facilitators and challenges to global health education, practice and research • Discuss next steps and new opportunities for global health education, practice and research

8. Health Sciences Enrollment

9. Health Sciences at Belmont • Undergraduate • Nursing • Social Work • Other • Graduate • Nursing • Occupational Therapy • Doctorate • Nursing • Occupational Therapy • Pharmacy • Physical Therapy • Historic faith-based missions

10. Faculty Scholarship • Applied, translational research • Youth sports-related concussion • Veterans with TBI • Compassionate care of the older adult • Safe transportation for seniors • Ballet-related injury • Safe, effective team-based care • Scholarship of teaching • Student transition to practice

11. The Future of Health Sciences and Nursing at Belmont • Interprofessional teams • Global health focus • Sustainable academic, practice and research partnerships • BU – Live Beyond Partnership in Thomazeau, Haiti

12. X

13. Republic of Haiti • Occupies the western portion of the island of Hispaniola, in the Greater Antillean archipelago. Borders the Dominican Republic. • Language • French & French Creole • Religion • 80% Catholic sometimes combined with voudou • 16% Protestant • Population* • 80% of the population below the poverty line • 54% in “abject poverty” • 75% of the population lives on $2 or less per day • Ineffective reforms and aid because of widespread corruption and the inefficient judicial framework. Source: The World Factbook. https://www.cia.gov/library/publications/the-world-factbook/geos/ha.html

14. HaitiPopulation ̴10.3 million • 35% of the population is < 15 years old • Median age – 22 years • Adult literacy rate – about 50% adults • Professionally attended births – 25% • Use of modern contraceptive methods – 25% • Infant mortality rate 52/1000 live births • Birth – 5 years death rate 76/1000 • Life expectancy – 61 female/64 male Source: WHO Global Health Observatory. http://apps.who.int/gho/data/node.country.country-HTI Accessed 2/12/14.

16. Notice anything about these kids?

17. Community-based Health Impact Programs • Clean Water Project • Mother & Infant Care • Special Needs Care • Mobile Medical Clinics • Sustainable Agriculture • Education • Vocational Training • Orphan Care

18. Staff and Volunteers

19. Sleeping Quarters

20. The Maternal Care Team

21. Visiting in the Villages - Annette

22. The Med Box

23. Singing with friends.

24. Facilitators: Education • Faculty/administration “buy in” and support • Incorporating global engagement in strategic plans • Faculty/student interest • Accessible & reliable internet resources • Compatible expectations

25. Challenges: Education • Time constraints and overloaded curricula • Faculty workload • International travel costs • Varied time zones and schedules make it hard to schedule interprofessional educational experiences • Increasing scope of existing global activities • Safety • Infectious disease • Civil unrest

26. Facilitators: Research • Administrative support and funding • Institutional Review Board support • Engaged faculty champions • Measurement, data collection and research staff expertise and capacity

27. Challenges: Research • IRB and research ethics review differences • Authorship issues • Data ownership • Cultural differences and expectations • Indirect costs Dr. Ruby Dunlap conducts research on adapting nursing standards in austere conditions in Uganda. Dunlap, R.K. (2013). Nursing Theory and the Clinical Gaze: Discovery in Teaching Theory Across a Cultural Divide. Nursing Science Quarterly, 26, 176-180.

28. Facilitators: Practice • Administrative support • Local partnerships • Cultural competence • Standardized practice and competencies

29. Challenges: Practice • Infrastructure • Differences in practice standards • Quality oversight • Language/translation • Access to information • Currency & transfer of funds • Competition and challenges with partners and governmental and NGOs working in the same country.

30. X

34. References • Ablah E, Biberman DA, Weist EM, et. al., (2014). Improving Global Health Education: Development of a Global Health Competency Model. American Journal of Tropical Medicine and Hygiene. [Epub ahead of print]. • Calhoun JG, Spencer HC, Buekens P. (2011). Competencies for global health graduate education. Infectious Disease Clinics of North America. 25(3):575-92. viii. doi: 10.1016/j.idc.2011.02.015. • Dunlap, R.K. (2013). Nursing Theory and the Clinical Gaze: Discovery in Teaching Theory Across a Cultural Divide. Nursing Science Quarterly, 26, 176-180. • Fitzpatrick J, Shultz C, Aiken T. eds. (2010). Giving through teaching: how nurse educators are changing the world. NY: Springer. • Harless N. (2010). Nurses beyond borders: true stories of heroism and healing around the world. NY: Kaplan. • Peluso MJ, Hafler JP, Sipsma H, Cherlin E. (2104). Global health education programming as a model for inter-institutional collaboration in interprofessional health education. Journal of Interprofessional Care. [Epub ahead of print] • ReischR, BoggisTL, Shaffer K, Brown S, Black A. (2011). Description of a model of interprofessional global education for allied health students. Health and Interprofessional Practice 1(1):eP1001.

35. Questions • What’s missing from this discussion of critical challenges and facilitators to academic engagement in global health education, research and practice? • What are the most critical global health competencies?

36. “From here to anywhere” Thank You!