Professor Lisa Thompson, PhD, FNP, FAAN (right), catches up with project participant Soila Elizabeth Cruz. (Photo by Michael Kodas/Inside Climate News)
4 Research Projects Advancing Health Worldwide
How do you begin to address some of the most persistent public health concerns in the world? You start one project at a time, with the goal of finding scalable, proven interventions to meet the vast need.
Here are four ways in which UCSF School of Nursing researchers are working across the globe to find innovative solutions to significant health challenges.
Cleaner Air in Guatemala
According to the World Health Organization (WHO), more than 3 million people die worldwide each year due to the effects of household air pollution.
Professor Lisa Thompson, PhD, FNP, FAAN, has studied household air pollution in low-resource countries for more than 25 years. She is currently working on a National Institute of Environmental Health Sciences project that delves deeper into a problem plaguing rural Guatemalan villages: women burning plastic in household fires.
In the Ecolectivos trial, she and her team are monitoring women’s exposure to air pollution and harmful plastic byproducts using air-filter measurements and urinary biomarkers. They are also deploying silicone wristbands as passive samplers to detect cumulative exposures.
The team has collected urine samples to compare with the wristbands in tracking plastic-associated chemicals, and Thompson is planning additional assessments of the samples to better understand the effects of plastic exposure on the metabolome, the collection of small-molecule chemicals in the human body.
The team is also working with participants to explore the infrastructural challenges that continue to bring plastic into the villages with no safe and sustainable way to dispose of it.
The women in the community are eager to organize community cleanups and recycling initiatives, and Thompson is excited to explore creative fixes, such as working with city leaders in charge of the municipal dump in Jalapa, Guatemala, to see if plastic can be collected and remade into bricks.
“People, especially women, in these villages are very involved and want to find solutions that work for their community,” she said.
Treatment Adherence in Jamaica
Associate professor Orlando Harris, PhD, MPH, FAAN, uses community-based participatory research methods in the United States and Caribbean region to inform culturally relevant interventions that improve the lives of vulnerable sexual and gender minorities.
With Jamaica CARES, funded by a K23 Career Development Award from the National Institute of Mental Health, Harris has been helping to address the Caribbean’s severe HIV epidemic by investigating why people with the disease struggle to engage with health care.
“It’s one thing to say, ‘Oh, people are not adherent to their medication and we need to develop an intervention,’” he said. “It’s another to say, ‘What are the social conditions that prevent them from adhering to their medications?’"
Harris' research has illuminated several of these conditions, including the social isolation that often follows an HIV diagnosis. Over the next year, Harris will perform a clinical trial for the intervention he's designed. Created specifically for sexual minority men living with HIV in Jamaica, Gwan Enjoy Life is led by trained peer mentors who are also living with HIV, allowing participants to learn from people who understand their experiences.
The program combines this emotional support with practical coping skills and strategies for managing the effects of trauma and stress to help participants stay connected to care.
"People who are diagnosed at a younger age are more likely to have depression and anxiety," said Harris. By building connections with people who have lived with HIV much longer, participants can see firsthand that life continues after diagnosis.
HIV Prevention in Uganda
Assistant professor Lila Sheira, PhD, MPH, works to improve health care for young women and adolescent girls, and other populations not reliably served by current delivery models.
Among her latest efforts is PHARMA-GIRL, funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The project aims to offer adolescent girls and young women in Uganda — a group disproportionally impacted by HIV — easier access to pre-exposure prophylaxis (PrEP) by widening the scope of services available at local pharmacies.
In this part of the world, pharmacies are easier to find than health clinics, and they already tend to serve an expanded role.
“People go to the pharmacy for diverse health needs,” said Sheira. “If we can get PrEP to pharmacists, they might be able to reach people who otherwise would not be reached.”
The researchers meet regularly with their two local advisory boards — one for pharmacists and one for youth — to ensure their scientific priorities are aligned with the community’s requirements and the providers’ capabilities.
They're also keeping a close eye on the PrEP pharmaceutical landscape so they can adjust their plans if a more favorable treatment comes to market.
“We want to launch something that will be sustainable and will actually meet the needs of adolescent girls and young women,” Sheira said.
Community-Based Therapy in Zambia
Assistant professor Charisse Ahmed, PhD, RN, became interested in community-based approaches to mental health care, particularly the role of trained lay counselors, during her doctoral research.
“I found that this concept of having lay people provide mental health care in a culturally appropriate way was intriguing,” she said.
In a new project in Zambia, Ahmed has partnered with a local nongovernmental organization and the University of Zambia to bring community-based care into one of the region’s most trusted spaces: the church.
The work is funded by an NIH award to the UCLA–Charles R. Drew University of Medicine and Science Center for AIDS Research, as well as the Rita & Alex Hillman Foundation, UCSF's Center for Global Nursing, and the School of Nursing's Department of Family Health Care Nursing.
In a pilot trial, Ahmed’s research team is evaluating Mpata Yathu (meaning “Our Space” in Nyanja), a trauma-informed, church-based counseling intervention. The study examines how well the treatment addresses symptoms of depression among adolescent girls and young women who have experienced gender-based violence and are living with or at risk of acquiring HIV.
Following data collection, the next phase of Mpata Yathu, supported by Ahmed’s UCSF Hellman Fellowship, will involve following up with participants to explore their experiences and investigate whether counseling has influenced their willingness to engage in HIV prevention and mental health services.
“I see myself as someone that’s providing a resource," Ahmed said. “This work is for the community, and it’s a privilege for me to be a part.”
