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

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

Health Sciences Enrollment

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

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 Faculty Scholarship

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

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Republic of Haiti Occupies the western portion of the island of Hispaniola, in the Greater Antillean archipelago. Borders the Dominican Republic.HispaniolaGreater AntilleanDominican 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. factbook/geos/ha.htmlhttps:// factbook/geos/ha.html

Haiti Population ̴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. Accessed 2/12/14.

Notice anything about these kids?

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

Staff and Volunteers

Sleeping Quarters

The Maternal Care Team

Visiting in the Villages - Annette

The Med Box

Singing with friends.

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

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

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

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,

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

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.

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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): viii. doi: /j.idc Dunlap, R.K. (2013). Nursing Theory and the Clinical Gaze: Discovery in Teaching Theory Across a Cultural Divide. Nursing Science Quarterly, 26, 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] Reisch R, Boggis TL, 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.

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?

“From here to anywhere” Thank You!