Two collaborations between Indiana University (IU) School of Medicine pediatric faculty members and their colleagues in Kenya received Global Health Reciprocal Innovation grants to implement interventions aimed at improving the lives of both young Hoosiers and young Kenyans.
The grants from the Indiana Clinical and Translational Sciences Institute (CTSI) and the IU Center for Global Health provide $50,000 for a period of two years to address common priority areas for global partners and Indiana with innovations that can work in diverse settings around the globe.
“In global health research, reciprocal innovation is a collaborative process to exchange lessons learned and co-develop technology and health innovations with mutual benefit to health partners in both low- and middle-income countries (LMIC) and the United States,” said Kara Wools-Kaloustian, MD, director of research for the IU Center for Global Health.
Investigators from the Indiana CTSI partner institutions (IU, Purdue and Notre Dame) lead the grants with collaborators from both the U.S. and their partners in LMIC.
Matthew C. Aalsma, PhD, professor of Pediatrics and Psychology and director of the Adolescent Behavioral Health Research Program, and Florence Jaguga, MBChB, MMed, consultant psychiatrist at Moi Teaching and Referral Hospital (MTRH) are principal investigators (PI) for the selected grant entitled “Feasibility & acceptability of a peer-mentor delivered substance use screening and brief intervention (SBI) for adolescents in Kenya.” Multiple co-investigators from the Academic Model Providing Access to Healthcare (AMPATH), MTRH and IU comprise the research team.
Aalsma expressed that despite adolescent substance use being prevalent in both Kenya and the U.S., there is limited access to substance use treatment for adolescents in both settings because services are costly and scarce.
“One way to address the need for substance use treatment is by utilizing peer mentors. Our group is piloting substance use treatment with case managers in the U.S. and are excited to learn from our colleagues at MTRH care for adolescents,” said Aalsma.
Participants at an outpatient clinic in Kenya will complete a brief screening tool about alcohol, smoking and substance use. Those with moderate to high risk will engage in a 20–30-minute motivational interview delivered by a trained peer mentor.
“If the SBI and its delivery are found to be feasible and acceptable, we will use the lessons learned to continue these innovations to treat adolescents. We will also work with our colleagues for a full-scale multi-site randomized control trial,” said Aalsma.
The work builds on the Fogarty Fellowship research recently conducted by Jaguga.
Megan McHenry, MD, assistant professor of Pediatrics, is the PI for the selected grant entitled, “Caregiver interventions to improve the quality-of-life and social support for families caring for children with autism in Kenya and Indiana.” She has a team of nationally renowned autism and disability experts to serve as co-investigators to support the development of the curriculum and co-lead the Indiana-based implementation of the caregiver-led curriculum for autism. These experts include Mandy Rispoli, PhD, BCBA-D, former associate professor of Special Education at Purdue University and now Quantitative Foundation Bicentennial Professor of education and human development at the University of Virginia; Rebecca McNally Keehn, PhD, HSPP, assistant professor of Pediatrics and the director of the Autism Hubs in Indiana; and Judith Gross, PhD, director of Community Living and Careers and the Indiana Institute on Disability and Community, among other community disability advocates and partners.
Collaborators in Kenya include Saina Chelagat, MBChB, MMED, consultant psychiatrist who leads the child psychiatry clinic at MTRH; Eren Oyungu, MBChB, MMED, MPH, pediatrician at MTRH who specializes in children living with disabilities; Barnabas Kigen, MBChB, MMED, pediatrician and pediatric neurology fellow at Aga Khan University in Nairobi; Naphtali Yego, head of occupational therapy department at MTRH; and Omari Felicita Wangechi, MBChB, MMED, former consultant psychiatrist and associate lecturer at MTRH.
McHenry said that autism is one of the most common neurodevelopmental disabilities.
“Early diagnosis and engagement in interventions improve developmental outcomes and reduce care costs for many children with autism, yet there are many barriers to accessing these services,” said McHenry. “Disparities are greater for children from diverse sociocultural groups and under-resourced regions such as rural Indiana and western Kenya. There is a critical need for locally adapted, community-based autism programs that train family caregivers to support their children with autism.”
The research group received a reciprocal innovation planning grant last year and identified new collaborative partners as well as a one-on-one family caregiver curriculum for autism care in Indiana. The Kenyan partners advocated for group sessions to build a sense of community to support caregivers and enhance the potential for sustainability. The group sessions in Indiana will be held virtually via Zoom and the sessions in Kenya will be held in person.
Based on the information learned from the planning grant, the objectives of this demonstration grant are to design a functional core curriculum to be implemented within a group-based setting with families of children with autism in western Kenya and Indiana and perform a pilot evaluation of its impact on family quality of life and parental distress.
“This shared solution to a shared challenge has the potential to be implemented within Autism Evaluation Hubs in Indiana and the Academic Model Providing Access to Healthcare (AMPATH) program in Kenya,” said McHenry.
Over the last six years, the Indiana CTSI and IU Center for Global Health have awarded more than $710,000 through the Global Health Reciprocal Innovation grant program. The planning and demonstration grants are awarded annually. A request for applications for the $10,000 planning grants will be released in September, followed by a request for applications for the demonstration grants later in the year.
For more information, contact Rish O’Brien.
