Graduate Research Internship Projects

Primary U-M Faculty Mentor. Dhanu Thiyag, Clinical Instructor; Global Women's Health Fellow, Obstetrics and Gynecology

Additional Collaborators. Emma Lawrence, Assistant Professor, Obstetrics and Gynecology

Description of the Research Project. Fetuses in the breech position are usually delivered via cesarean deliveries. But preventable cesarean deliveries have significant short- and long-term maternal and neonatal morbidity and mortality, including bleeding and infection. External cephalic versions (ECVs) are a proven, low-risk, cost-effective procedure, involving a trained provider to use a series of techniques to manually rotate the fetus from a breech position into a head-down position allowing for vaginal deliveries and thereby preventing cesarean deliveries. However, ECV is not commonly performed in low- and middle-income countries (LMICs), including Korle Bu Teaching Hospital in Ghana, due to a lack of provider training and experience. This project aims to evaluate acceptance and feasibility of ECVs and develop, evaluate, and clinically validate an ECV simulation program. Findings will inform an accessible solution to build capacity in safe and effective ECVs in Ghana. Ultimately, an ECV simulation program can decrease preventable cesarean deliveries in LMICs.

Internship Activities.

• Conduct prospective chart reviews of patients
• Administer validated surveys to patients and providers
• Host semi-structured interviews with patients and providers
• Assist with literature search to develop an external cephalic version educational video script
• Develop an evaluation plan for the simulation program consisting of a pre-test and post-test evaluation
• Assist with coordinating and managing a Delphi expert panel
• Collect and analyze data

Country(ies) of Focus. Ghana

Approach to Mentorship. We will meet at the beginning of the internship to discuss student interests and passions to ensure we develop a research plan that is aligned. This will also involve a discussion about how the student learns and communicates to determine the best mentorship plan forward. Based on these discussions, we will develop an expectation and internship goals. We will do twice a week check-ins in the beginning of the internship as they are learning the material and workflow. This may drop to once a week to allow for independence and self-control over the project. There will be several deliverables as check-ins throughout the internship, so we will do a two-way feedback session when reviewing this involving discussions about how the student feels they are doing as well. These meetings will be a combination of in-person while the faculty is located in Ann Arbor and virtual while they are in Ghana pursuing this research.

Primary U-M Faculty Mentor. Lee Schroeder, Clinical Associate Professor, Pathology

Description of the Research Project. This research is funded through a 5-year NIH R01 grant. In low- and middle-income countries, millions of cases of infectious diseases every year go undiagnosed and untreated due to suboptimal design of clinical laboratory networks. Focusing on 6 priority infectious diseases, we will characterize the existing laboratory network in Ghana and develop a detailed simulation model to estimate the impact and costs of several potential laboratory network strategies. Successful completion of these aims will have substantial public health and scientific impact by providing the understanding and tools to optimally allocate laboratory resources for diagnosing infectious diseases, thus reducing both country-level disease burdens and the likelihood of future pandemics.

Internship Activities. The intern will adapt our agent-based simulation model to characterize different diagnostic placement strategies for one of six priority diseases: HIV, TB, HCV, bacterial meningitis, measles, or yellow fever. This will involve literature searches and communications with our colleagues in Ghana Health Services to establish realistic model parameters and relevant laboratory network strategies. Additionally, the intern’s work will include coordinating with our programmer to incorporate these features into the model, analyzing model output, and interpreting results with the goal of abstract submission and publication of a manuscript.

Country(ies) of Focus. Ghana

Approach to Mentorship. We will provide an orientation to the team and overall initiative, and explain how the initiative fits into larger global health priorities. We will also identify a suitable project aligned to the student's interest and ability. The goal will be for the student to have ownership of the project and present results in weekly meetings. The intern will meet with the mentor on a weekly basis to share progress, troubleshoot analysis, and interpret findings. Mentoring meetings also assist with career development. Finally, interns will participate/describe results in weekly partnership-wide meetings with colleagues from Johns Hopkins Medicine Institute and University of Ghana. 

Primary U-M Faculty Mentor. Emily Treleaven, Assistant Professor, Institute for Social Research

Additional Collaborators. Gwenyth Lee, Rutgers University, CGHE Associate Member

Description of the Research Project. Global vaccine coverage has plateaued in the last decade. To achieve universal vaccine coverage and equity for routine childhood immunizations, it is necessary to reach children who are vulnerable to under- and non-vaccination. This requires high quality data that allows providers, health facilities, and governments to quickly identify and respond to gaps in coverage. Simultaneously, addressing equity also requires the development and implementation of tools that allow parents and caregivers to better access vaccines for their children in a timely manner. Our interdisciplinary team of investigators from U-M and the African Population and Health Research Centre will develop, implement, and evaluate a ‘digital vaccine card’ and registry that will facilitate the electronic collection of individual data at health facilities to allow improved monitoring of vaccine coverage and timeliness by both healthcare providers and parents/caregivers, in turn improving vaccine equity in urban Kenya and rural Uganda. We aim to design a tool that serves the needs of both parents/ caregivers—particularly those from groups that have historically lagged in vaccine completion and timeliness— and facilities and healthcare providers administering vaccines. To ensure that this tool is sustainable, we will center the needs and voices of marginalized groups and healthcare workers throughout the development and design process, and engage representatives of the Ugandan and Kenyan MOHs in tool development, deployment, and throughout the project.

Internship Activities. The intern will primarily support qualitative data analysis activities. This year, we will develop and carry out focus group discussion and semi-structured in-depth interviews with multiple types of participants in Kenya and Uganda (e.g., healthcare providers, parents, community health workers). Activities the intern will support and/or carry out will include, but not be limited to, reviewing interview transcripts, developing coding frames, and coding qualitative data. The intern may also support other project activities, such as quantitative dataset management and cleaning, literature reviews, and project management. Project activities will be conducted in Ann Arbor (mix of remote and in-person work), with engagement with our Kenyan and Ugandan collaborators. 

Country(ies) of Focus. Kenya, Uganda

Approach to Mentorship. We will work together at the beginning of the internship to set goals for work to be completed over the summer, discuss meeting norms and expectations, and identify learning goals related to the project or other global health-related areas of interest. We will have weekly one on one meetings at ISR to discuss project work, problem solve, and discuss any mentored readings related to learning goals. I will give readings and work with the student one on one to build qualitative analysis skills if a student does not have skills in this area. We can meet as needed to address other work-related issues that come up outside the weekly meeting. Workspace for the intern will be available at ISR. 

Primary U-M Faculty Mentor. Omolade Adunbi, Professor, Anthropology and Afroamerican and African Studies

Description of the Research Project. This research investigates the relationship between extractive practices and health outcomes in oil bearing communities. The project specifically examines the nexus between Detroit and Nigeria’s Niger Delta communities. With particular emphasis on the oil enclaves of the Niger Delta and Detroit Refinery operated by Marathon Oil Corporation, the project plans to unearth the effects of pollution and other forms of environmental degradation on the health of community members who live in close proximity to these oil enclaves. While Detroit might be thousands of miles away from the Niger Delta, the project plans to put into focus many similarities between the two communities---both are majority Black population and host to major oil corporations. Extraction by multinational oil corporations have resulted in the prominence of soot in many communities thereby exacerbating the precarious health situation of those communities. While there is a rich literature on oil extraction, there exists a dearth of literature on the impact of such extractive practices on the health of the oil bearing communities.

Therefore, this project is interested in asking the following questions: Is there any correlation between oil extraction and health outcomes? What are the causal explanations of the preponderance of soot in many Niger Delta communities? How might data gathering and disaggregation help in understanding the relationship between oil pollution and health? Are there correlations between Detroit and Niger Delta communities in terms of the impact of oil extraction? What can the literature tell us about the relationship between oil extractive practices and health of communities? 

Internship Activities. Some of the activities the intern would undertake include literature searches, project management, preparation of annotated bibliography, conduct of online surveys, site visit (where possible), identification and recruitment of research/survey participants, data gathering, data organization and analysis, communications and outreach, preparing and writing of occasional papers, etc.

Country(ies) of Focus. Nigeria

Approach to Mentorship. The mentor will organize weekly meetings with the intern where they plan to give feedback on materials submitted to a common google platform established for the project. Meetings will be in-person and zoom when necessary.

Primary U-M Faculty Mentor. Elizabeth Roberts, Associate Professor, Anthropology 

Additional Collaborators. Jackie Goodrich, Environmental Health Sciences; Belinda Needham, Epidemiology; Branko Kerkez, Associate Professor, Engineering; Krista Wigginton, Engineering; James Wagner, Research Professor, Institute for Social Research; Talia Gordon, Research Area Specialist, Anthropology.

Additional team members from the National Institute for Public Health in Mexico include Mara Téllez-Rojo (Epidemiology) and Jose Luis Figueroa (Health Economics), as well as Brisa Sanchez (Biostatistics) at Drexel University.

Description of the Research Project. As water scarcity increases globally and inequities in water supply worsen, it is imperative to adapt research about water access to measure intermittent water supply (IWS), an increasingly common phenomenon which refers to the condition of not having continuous household access to piped water. This project is an interdisciplinary collaboration which combines in-depth, qualitative research with quantitative, nationally representative data to examine the effects of IWS on health, economic, and gender inequality in Mexico. Our team aims to understand the effects of IWS on chronic disease and on economic and gender inequality globally, and to develop evidence-based approaches to address them for policy makers. Our research group is composed of health economists and public health researchers from Mexico’s National Institute of Public Health who work with the nationally representative health and nutrition survey, the ENSANUT, and UM researchers from anthropology, engineering, epidemiology, environmental health, biostatistics, and survey methods. Our working group combines in-depth, ethnographic, and water quality data from previous interdisciplinary work, and large-scale ENSANUT survey data in analyses that are both grounded in the quotidian realities of living with IWS and are statistically robust and nationally representative. 

Our IWS Working Group: (1) analyzes data from an existing interdisciplinary qualitative study in Mexico City to develop robust hypotheses about the causal pathways by which IWS may negatively impact health, socioeconomic status, and gender inequality; (2) analyzes nationally representative ENSANUT to test these hypotheses and document inequities in water distribution, and 3) disseminates our findings to national policymakers in Mexico to mitigate the health, social, and economic impacts of IWS. This work will lay the foundation to mitigate the negative impacts of water intermittency in Mexico and potentially to other Latin American nations.

Internship Activities. There is a large breadth of possible activities for a graduate student in this project depending on that student’s particular area of expertise and learning area of interest. We welcome students from a variety of disciplines, especially if they are interested in expanding and applying their existing skills within an interdisciplinary team. There is a preference for students with proficiency in Spanish. Opportunities for work on this project could include one or more of the following:

• Ethnographic analysis of existing qualitative data and critical analysis and integration of survey and statistical data.
• Assisting in organizing and analyzing nationally representative survey datasets to test hypotheses and associations of intermittent water supply characteristics to socioeconomic status and health outcomes.
• Assisting in report preparation, paper development, and policy recommendation from the analytical findings.
• Assisting in literature searches and analysis focused on water provisioning, infrastructure, as well as gender and health, economic outcomes.
• Assisting in data linkages of administrative datasets including geo-referenced data.

Country(ies) of Focus. Mexico

Link to Website: https://sites.lsa.umich.edu/mexican-exposures/people/

Approach to Mentorship. Liz Roberts (project PI) and Talia Gordon (project manager) will meet with our student intern at the beginning of the internship to discuss and establish the scope of the student's project-related activities and set expectations for their participation (weekly team meeting attendance, deadlines, deliverables, etc.). Talia will meet with the student weekly over Zoom to check in about their activities and to provide and receive feedback. The intern will also attend weekly research team meetings over Zoom.

Desired Student Qualifications. Proficiency in Spanish.

Primary U-M Faculty Mentor. Rouba Ali-Fehmi, Professor, Pathology 

Additional Collaborators. Amy Pienta, Research Scientist, Institute for Social Research; Elizabeth King, Associate Professor, Health Behavior and Health Education; Hala Darwish, Associate Professor, Nursing

Description of the Research Project. This project will be a part of the work done by the Michigan Global Collaborative Group (MGCG), which is a well-established partnership that includes investigators from the University of Michigan, Henry Ford Health (HFH), the American University of Beirut (AUB), and the AMEL Association in Lebanon.

The project's overall objective is to conduct a needs assessment of refugee women’s access to and utilization of reproductive and sexual health (RSH) services in Lebanon. It specifically focuses on the refugee populations from Syria, Iraq, and Palestine. The project has the following aims:

1. To determine the existing programs and policies related to women's RSH health, including maternal health, STI screening and treatment, knowledge, attitudes, and behavioral/emotional health resources within one district of Lebanon. It will focus on discerning the challenges and barriers to the utilization (social, political, economic, and structural-level barriers) and facilitators to access RSH services, development, and implementation of RSH training programs for healthcare workers and communities.
2. To identify education gaps and disparities in women’s RSH training among healthcare providers and communities about curriculum content, implementation, pedagogy, student evaluation protocols, and faculty development.

The findings will be used to make recommendations on strategies to address gaps in policies, programming, and professional training that are locally feasible and salient. In addition, the results could be utilized within the context of the medical education system and health infrastructure in Lebanon and the Middle East and North Africa (MENA) region. The results will also inform an RSH data registry for use in patient care, quality improvement, research, policy development and implementation, and future funding opportunities.

Internship Activities. The graduate student intern will be involved in all aspects of this project and will be expected to conduct literature searches, subject recruitment, meeting virtually with our partners in Lebanon, data gathering, organization and analysis, and report preparation.

Country(ies) of Focus. Lebanon

Links to Website: AMEL Association in Lebanon: AMEL works through twenty-eight centers, six mobile medical units, two mobile education units, and one protection unit from Beirut and its Southern Suburbs to Mount Lebanon, Bekaa, and South Lebanon. https://amel.org/ & American University of Beirut (AUB): collaborating with the Faculty of Health Sciences. https://www.aub.edu.lb/fhs/Pages/default.aspx 

Approach to Mentorship. The work with the student intern will be very interactive. The intern will be working one-on-one with the faculty lead and the team. We will provide weekly feedback on their performance and work. We will start every week by setting the plan for that week and discussing the main goals and how to approach them. 

The student intern and faculty lead will meet at least twice a week. Every Monday, we set the plan for the coming week, and every Friday, we evaluate the work done and the progress of the project. The meetings will be held at the North Campus Research Complex (NCRC), where the student will have his/her own workspace equipped with a desk, laptop, and monitors.

Primary U-M Faculty Mentor. Michelle Bellino, Associate Professor, Marsal Family School of Education

Description of the Research Project. Recent U.S. policy changes, both prior and in relation to COVID-19, have contributed to longer waiting periods for migrant families in Mexican border cities. Between December 2018 and January 2021, the Trump administration’s Migrant Protection Protocols (MPP) policy, popularly known as ‘Remain in Mexico,’ returned 71,044 asylum seekers to Mexico— including at least 16,000 children––to await their US immigration proceedings. Organizations advocating for migrant rights, journalists, researchers, and even the US Department of Homeland Security have confirmed that prolonged periods in Mexico exposed asylum seekers to elevated vulnerabilities, violence including kidnapping and extortion, discrimination, and homelessness. Yet despite these understandings, the policy continues to exist, albeit in new forms. 

The original MPP policy was rescinded by the Biden Administration in early 2021, resulting in many families being processed into the US to await their asylum processes, including focal families in this study. This policy dismantling was accompanied by recognition of MPP’s “substantial and unjustifiable human costs” on asylum-seekers. Though relieved to be one step further into the asylum process, at the time of their entry into the US, families enrolled in this program had been waiting for years in Mexico. These prolonged periods in-transit make up a critical portion of children’s lives and formative experiences that they will carry with them into their youth and adulthood. 

To date, young people and family experiences with MPP have been largely absent from scholarship, given the methodological challenges of identifying impacted families and gathering data during a global public health crisis. Based on research with refugees, asylum-seekers, and other displaced migrant young people, we might expect that experiences of prolonged displacement induced by the violence of national borders will be even more impactful on children, as trauma has distinct developmental consequences for young people’s physical and mental health. Prolonged waiting, uncertainty, and exposure to harm during childhood and adolescence has been associated with increased anxiety in the present and future. Other scholars emphasize the gendered vulnerability and resilience of women and children as they embody the routine violence of migration control and enforcement. Periods of forced immobility associated with transborder movement have been characterized as “slow harm” or “everyday violence” inflicted by states. Yet young people also show their potential for coping, learning, and organizing in these settings. 

This intern will work on one or more of three related research projects, all oriented around the transborder movement, including im/migration and forced displacement, education, and youth wellbeing. These projects are at various stages and will likely all involve substantial literature reviews and some early-stage coding/analysis. One project is centered on Honduran young people and their families who were enrolled in MPP from 2020-2021 and are now located in the US; another will examine young people’s educational experiences in Honduras, their country of origin and/or in Mexico, a country of transit; another will examine new policy initiatives to facilitate access to higher education for displaced young people. Across these studies, we will explore these questions: What do we know about how containment, detention, prolonged transit, and other forms of immobility associated with migrant experiences impact youth wellbeing in the short and long-term? What should educators understand about migrant youth’s transborder experiences, in order to support their learning and overall wellbeing?

Internship Activities. Conduct (and document) literature reviews on the MPP policy and short and long-term effects on children and youth, the relationship between education, violence, and migration in Honduras, or education of Central American migrants in transit in Mexico; analyze interview and observational data in Spanish, collaborate on a coding scheme, code data; communicate with and recruit involvement of US based schools for inclusion in this study; read and comment on scholarly draft texts and other artifacts. 

Spanish fluency is required to interact with data sources. 

Country(ies) of Focus. Honduras, Mexico

Link to Website: https://mjbellino.com

Approach to Mentorship. We will have an initial meeting to organize ourselves, get to know one another, and set some shared goals. I will organize an overview of the work and suggest weekly tasks through Google docs. We will likely check in after the first of one type of output (e.g., a record of a literature review) to be sure we’re both satisfied with the work and to ensure that we understand the time it took to create. We can modify tasks from there, and then set meetings as needed. (This back and forth would be a bit more intensive for coding or interacting with data, depending on whether we reach that stage.) I am generally happy to approach the work flexibly—e.g., more in one week, less in another, as long as the intern is self-directed and keeps good records of what they are doing. I am likely to meet virtually, rather than in person.

Required Student Qualifications. Spanish proficiency.

Primary U-M Faculty Mentor. Maria Muzik, Associate Professor, Psychiatry

Additional Collaborators. Angela Johnson, Senior Community Outreach Specialist, Program for Multicultural Health, Community Health Services, Michigan Medicine

Description of the Research Project. Depression among women of childbearing age is the single largest contributor to the global burden of mental health disorders. Poor maternal mental health has negative outcomes for both the mother and the child. Specifically, it is well documented that poor maternal mental health often leads to behavioral and emotional issues for children. These disorders have also been linked to poorer child growth and chronic undernutrition, which are in turn linked to increased risk of child mortality. For women living in low- and middle-income countries, rates of mood and anxiety disorders may be even higher than in HICs. Despite this, the prevalence of maternal depression and anxiety is likely underestimated in many contexts. Within the data that is available, research into maternal depression in low- and middle-income countries focuses on women of higher socioeconomic status. Relatively less is known about women living in poverty, and about women living in rural areas, compared to urban areas. The evidence that does exist is somewhat conflicting, with some reports suggesting that women living in rural areas are at an increased risk for untreated mental health disorders, while in other instances, rural residing women were at decreased risk compared to their urban counterparts. Relatively few reports have investigated the underlying factors that may drive these relationships, either in high-income countries or in LMICs. However, socioeconomic status, marital status, social support, and other recognized risk factors for maternal depression may vary between rural and urban geographies. Access to referral and counseling services may also vary widely.

Our study uses an Anthropological and Science and Technology (STS) approach to map the complexity of maternal depression among women in northwestern Ecuador. Anthropological and Science and Technology (STS) approaches to mental health concern themselves, as Catherine Lutz put it, with “what moves and matters in human life.” This means understanding human psychology in specific historical, cultural, and economic settings. Situating mental health within broader political and technological changes means seeing connections and ruptures within disciplinary understandings of mental health and depression, national mental health adaptations, and local perceptions of diagnoses and treatment. Recognizing the complexity of documenting mental health, this initial exploratory project aims at documenting women’s understandings of maternal depression to identify short-, medium- and long-term impact. Our pilot study (1) documents the multiple registers of mental health that traverse communal, familial, and individual understandings of depression. We are also interested in (2) recording how health professionals with whom women have direct interaction come to understand psychiatric disorders, how they diagnose illness and which guidelines, checklists, manuals, or psychiatric traditions are locally used to address mental health in medical practices. Finally, we are also interested in (3) registering forms of social medication or self-medication around mental health in the community, by tracking interactions between pharmaceutical consumption in day-to-day life. By disentangling how maternal depression is understood locally we expect to generate contextual information that will initially help raise awareness around mental health in the community and can more broadly provide ranked steps on potential medium- and longer-term responses to and interventions on mental health.

Internship Activities. The student would participate in qualitative and quantitative analysis of data collected during the Ecuador maternal depression project, write-up, as well as contribute to next stages of the project (intervention design workshop) based on the project: 

• Quantitative analysis of data related to maternal depression
• Qualitative analysis of previously collected data
• Grant writing (e.g. literature review)
• Searching for funding opportunities
• Manuscript development

Country(ies) of Focus. Ecuador

Approach to Mentorship. The student will receive clear tasks and goals at the beginning of the project. The student will have weekly meetings with the primary mentor and biweekly meetings with the larger team. There will be opportunities to collaborate and engage with other students and learn collaborative skills. We will also provide individualized mentoring based on the student’s professional interests (e.g. public health, psychiatry, sociology of health).

Primary U-M Faculty Mentor. Elisa Maffioli, Assistant Professor, Health Management and Policy

Description of the Research Project. Over 80% of the annual 6.4 million global deaths in children less than 14 years of age occur in low- and middle-income countries (LMICs). These deaths are predominantly a result of acute illnesses, including sepsis. Broad-spectrum antibiotics are the first-line medications, but low-quality antibiotics remain a problem especially in low-resource settings, putting patients at risk of antimicrobial resistance. Building on a large set of collaborations and previous research conducted across 47+ hospitals in Africa, North, Central, and South America, the Middle East, and South Asia, this project aims to understand health workers’ perceptions of low-quality antibiotics and learn about the procurement process of antibiotics. Findings from a survey of about 500+ health workers across 20+ countries will inform the design of a larger study aimed at investigating the link between low-quality antibiotics and sepsis, among the vulnerable population of children in LMICs.

Internship Activities. Support with overall project management, survey tool development, IRB, coordination with local partners, data monitoring, cleaning and analysis, report preparation

Country(ies) of Focus. 47+ hospitals in Africa, North, Central, and South America, Middle East, South Asia

Approach to Mentorship. 
The intern will be expected to meet weekly at the beginning and bi-weekly (depending on need for guidance). We will set a plan in advance and specific tasks. The intern can expect to receive an email in advance with an agenda for the meeting, updates on tasks completed or not, questions, etc., to discuss during the meeting. The mentor will revise material in advance of the meeting to make sure the meeting is productive. 

Primary U-M Faculty Mentor. Bilal Butt, Associate Professor, School for Environment and Sustainability

Additional Collaborators. Akbar Waljee, Professor, Learning Health Sciences

Description of the Research Project. Over 800 million pastoralists derive their livelihood from animal husbandry in remote African drylands. The effects of climate change in drylands will affect human health in profound ways.  The goal of this research is to investigate the causes, consequences, and drivers of climate-influenced Anthrax infections among pastoral populations. The proposed project with the student has two main activities. First, to coordinate an interdisciplinary team of students and researchers from Kenya and train them on how to conduct a preliminary investigation into Anthrax disease transmissions. Second, to conduct a systematic review of the literature on: (1) how much and what type of research has been conducted on Anthrax in pastoral landscapes or landscapes where livestock and wildlife are sympatric; (2) how prevalent is Anthrax transmission in localized areas; (3) how severe and with what consequences is Anthrax infection in pastoral populations.

Internship Activities. The proposed project with the student has two main activities. First, to coordinate an interdisciplinary team of students and researchers from Kenya and train them on how to conduct a preliminary investigation into Anthrax disease transmissions. This will include coordinate zoom meetings with collaborators in Kenya, Tanzania and Uganda, taking notes of meetings and compiling a google drive of resources that are needed by the project team. Second, to conduct a systematic review of the literature on: (1) how much research has been conducted on Anthrax in pastoral landscapes or landscapes where livestock and wildlife are sympatric; (2) how prevalent is Anthrax transmission in localized areas; (3) how severe is Anthrax infection in pastoral populations.

Country(ies) of Focus. Kenya, Uganda and Tanzania

Link to Website. https://envgeopolitics.com/

Approach to Mentorship. At the start of the project, the mentor and mentee will develop a mentoring plan that has been developed by the Rackham Graduate School which lays out the expectations and timelines for the project, as well as information on how to resolve issues and address them quickly. This information has been compiled in this document (https://rackham.umich.edu/downloads/student-mentoring-handbook.pdf). Specifically, the project will rely on the use of the "Developing Shared Expectations: STEM and Social Sciences Focus" to help guide the mentoring plan. 

The mentor and mentee will meet weekly, or bi-weekly in cases where the mentor is traveling. In cases where travel is involved, meetings will be on zoom, but largely in person on central campus.

Primary U-M Faculty Mentor. Elizabeth King, Associate Professor, Health Behavior and Health Education

Description of the Research Project. There are three specific projects that are all connected under the idea of thinking about gender-equitable approaches to improving access to care among women in LMICs. The student intern is welcome to devote their attention specifically to one of these projects or can divide their time across the projects based on their interests.

An intern will be able to contribute to the following projects: 

1. Gender-based violence research in Pakistan. With colleagues at U-M and The Aga Khan University in Pakistan, we are conducting formative research on online gender-based violence among university students and will be conducting a survey and in-depth interviews. 
2. Urban migration and female sex workers in Ethiopia. With colleagues at St. Paul's Millennium Medical College in Addis Ababa, Ethiopia, we are working on a research project and grant application to NIH that proposes to examine how urban migration influences female sex workers' susceptibility to gender-based violence, HIV, and other sexually transmitted infections. 
3. Women living with HIV in Kazakhstan. This is a pilot study that looks at the influence of gender and social norms on women’s engagement in HIV services in Kazakhstan. This includes a desk review of policies, interviews with key stakeholders, and interviews with women living with HIV. The student intern can assist in the policy review and preparation for the data collection with women living with HIV. 

Internship Activities. 

1. Pakistan project: assist with instrument design, IRB application material preparation, ongoing engagement with project team over the course of data collection, data organization and analysis. Deliverables will include: contribution to survey instrument design; data analysis plan for their own paper idea.
2. Ethiopia project: literature review, contribute to grant application writing and instrument design (including the opportunity to add their own questions for future data analysis).
3. Kazakhstan project: contribute to interview guide development and IRB application, literature review, engage in policy document review, and conducting interviews with stakeholders (pending language skills).

Country(ies) of Focus. Pakistan, Ethiopia, and Kazakhstan

Approach to Mentorship. The mentor prioritizes open communication, opportunities for feedback, and mutual learning in their mentorship approach with students, especially graduate students. The mentor will work with the intern to set realistic goals and expectations, make a timeline with specific deliverables, and discuss both what my expectations are of the student but also what their professional and personal development goals are for the summer internship. While we can communicate more frequently over email, we will have scheduled weekly check-in meetings that will occur either in person or via Zoom, as needed. 

Primary U-M Faculty Mentor. Douglas Wiebe, Professor, Emergency Medicine

Additional Collaborators. Ashley Rettman (project manager), Bernadette D'Alonzo (post-doctoral fellow)

Description of the Research Project. Botswana has the third highest suicide rate (16.1 per 100,000) in the region and ranks 14th highest among nations around the globe, and biological men experience rates four times higher than women. Because Botswana lacks a suicide surveillance system, suicide rates are estimates and likely undercount the true problem. This represents a critical barrier to preventing suicide in Botswana, given that understanding basic suicide epidemiology is required for knowledge of where and how suicide prevention efforts should start. In 2019, men in Botswana from 15-49 years of age were just as likely to die by suicide as by motor vehicle crash. Compared to the considerable research, public campaigns, and policy efforts focused on motor vehicle crashes, little work has been dedicated to developing a strategy to prevent suicide in Botswana.

Our study team, led by Dr. Molefi (MPI) at the University of Botswana and Dr. Wiebe (MPI) at the University of Michigan who since 2016 have directed our D43 Training Program funded by the NIH Fogarty International Center, has been collaborating to build injury science capacity in Botswana making us well-positioned to address suicide. Our long-term goal is to support Batswana investigators to lead research in Botswana that builds an evidence base and informs policy and public health programming to prevent injury morbidity and mortality. The objective of this ongoing project is to quantify the nature and magnitude of suicide in Botswana and engage stakeholders from diverse sectors in Botswana to adapt and implement evidence-based strategies. 

Our central hypothesis is that rates of suicide and circumstances will vary by demographics, methods, timing, and location across the country, and that the analyses including hierarchical clustering will reveal the most common suicide profiles to which we can tailor evidence-based interventions. This hypothesis is based on suicide research in other sub-Saharan African countries, our preliminary data, and forensic pathology data in Botswana. Dr. Mugoma, who is completing an epidemiology degree in our D43 training program, is a forensic pathologist employed by the Botswana Police Service (BPS), which by mandate conducts a medico-legal autopsy and forensic investigation for every suicide in Botswana. Ms. Solomon has worked together with Drs. Mugoma, Molefi and Wiebe for years and brings implementation and evaluation expertise to complement our expertise in injury epidemiology, forensic science, public policy, and mental health, with Dr. Olashore being a psychiatrist specialized in suicide. We will leverage the unique strengths of our team and our longstanding partnership in Botswana to work with our CGHE Summer Research Intern on aspects of the following Specific Aims: 

1. Aim: Pilot test a suicide surveillance system for Botswana by leveraging the nationwide forensic pathology investigations.
   1. Access BPS records, enter information into REDCap, and conduct basic analyses on the data to determine the incidence and trends of suicide in Botswana over 2014-2013. 
   2. Assess the feasibility of operating a suicide surveillance system that involves maintaining information access at BPS, data entry, and annual reporting moving forward (use surveys with BPS staff and leadership for our process).
2. Aim: Identify suicide prevention strategies that are evidence-based and that match the circumstances of the most common suicide typologies that occur in Botswana. 
   1. Develop an Evidence and Gap Map (EGM) that visually displays the available and relevant evidence of interventions that have been used for preventing suicide in either low- and middle-income countries (LMICs) or high-income countries (HIC).
   2. Determine the epidemiology and typologies of suicide that occurred in Botswana from 2014-2013 using the forensic pathology records accessed at the BPS.
   3. Working with our Advisory Board, identify prevention strategies from the EGM that appear to have promise for addressing the suicide typologies that our analyses found to be most common in Botswana. 
3. Aim: Adapt evidence-based interventions to fit the local needs and context of suicide in Botswana.
   1. Understand barriers, facilitators, and strategies for implementing those interventions in Botswana.
   2. Identify opportunities for interventions to be deployed in Botswana, considering where, how, and by whom and for whom.

Through this process, materially and scientifically we are putting Botswana in a better position to prevent suicide: we will have come up with adapted interventions that are ready to launch; we will have a ready surveillance system in place; and we will have the EGM results available -- together these will facilitate next steps to launch and adapt interventions in Botswana and also develop a national suicide prevention strategy. Throughout our process we are purposively building capacity in Botswana for injury science and for evidence-based policy and practice, and for supporting neighboring countries to also accomplish suicide prevention.

Internship Activities. Our graduate student intern, with our involvement and mentorship, will be involved in a range of activities that span the specific aims, and will have the opportunity to perform tasks including conducting analyses of the Botswana suicide data using statistical software (e.g., Stata, R, SAS); searching the literature to identify evidenced based strategies that have promise to adapt for Botswana and consider these in the context of the “Haddon Matrix”; collect information and visually display it as an evidence and gap map; talk with collaborators and community members in Botswana via Zoom or WhatsApp to discuss the feasibility and barriers to different suicide intervention possibilities.

Country(ies) of Focus. Botswana

Link to Website. https://injurycenter.umich.edu/ 

Approach to Mentorship. The intern will attend weekly meetings in person or remotely with members of the research team and work closely with project staff and other students and postdoctoral fellows involved in the project, both remotely and in person. The graduate student intern will be provided office space located in the U-M Injury Prevention Center where Dr. Wiebe and other team members have offices. We will also have written work plans, milestones, and goals that we touch on weekly, assess progress, and look for opportunities to enhance the training experience. We will also look for opportunities for the graduate student intern to present results of our work to date at local conferences to gain public speaking experience either in an oral presentation or poster presentation.

Primary U-M Faculty Mentor. Michelle Munro-Kramer, Assistant Professor, Nursing

Additional Collaborators. Maria Jose Baeza, Impact Scholar, CGHE

Description of the Research Project. The purpose of this project is to provide a comprehensive picture of university-based sexual and gender-based violence prevention interventions in low- and middle-income countries (LMICs). Specifically, this scoping review aims to identify and synthesize the available evidence regarding university-based sexual and gender-based violence prevention interventions in LMICs in terms of best practices, characteristics of available interventions, targeted populations, and nature of available studies. 

Review questions:

• RQ1: What are the best practices (what works) for sexual and gender-based violence prevention on LMIC university campuses?
• RQ2: What are the characteristics (what type) of the interventions that have been used to prevent sexual and gender-based violence on university campuses?
• RQ3: What specific populations have been targeted by these interventions?
• RQ4: What is the nature of the available studies regarding their research purposes, designs, and methodologies? 

This project is being undertaken by a multidisciplinary group of researchers from Chile, Ghana, Liberia, Nigeria, Rwanda, South Africa, the United States, and Zimbabwe that are par to a collaborative research network. The Sub-Saharan University Gender-Based Violence Prevention and Research (SUBVERT) meets on a weekly basis to discuss current works in progress and future plans.

Internship Activities. The student researcher would assist with the following:

• Networking: Participate in weekly SUBVERT network meetings (virtually) to meet international colleagues, report on project progress, and learn about other ongoing projects.
• Data analysis: Review the titles and abstracts of identified articles for the scoping review and then the full-text manuscripts of those that will be included in the scoping review.
• Dissemination: Assist with writing the manuscript for this project and consider other modalities for dissemination (e.g., conference presentations, webinar, etc.)
• Weekly Meetings with Mentor Team: Participate in weekly meetings with the research team to identify career development opportunities and other potential projects for collaboration/work.

Country(ies) of Focus. The scoping review is focused on all, but we specifically work with colleagues from Ghana, Liberia, Nigeria, Rwanda, South Africa, and Zimbabwe.

Approach to Mentorship. Our team usually uses Google Sheets to identify project goals and student goals at the beginning of the work period. We then create a timeline around the goals, which we use as a work plan. We check in two times per week - once as part of the large research group meeting (always virtual) and then individually on more project-specific questions (a mix of in-person and virtual). Our team is also always available via email, phone, and/or Zoom.

Primary U-M Faculty Mentor. Pam Jagger, Professor, SEAS 

Additional Collaborators. Joe Eisenberg, Professor, Epidemiology

Description of the Research Project. The Challenge: Climate risk is the defining environmental challenge of this century. Low-and- middle-income countries (LMICs) are particularly vulnerable to climate risks due to poverty, high reliance on agriculture and natural resources, concurrent demographic and epidemiological transitions, and weak institutions. Climate risk will affect environmental determinants of health including water and sanitation and air quality contributing to an increase in communicable diseases on top of an increasing burden of noncommunicable diseases. Climate risks and their relationship to environmental health burden needs to be characterized, defined, and measured at multiple scales. 

The central aim of the proposed research is to pilot a locally informed set of measures for understanding how climate risk affects environmental health burden in LMIC settings. We hypothesize that climate risk will increase the environmental health burden associated with water and air pollution, the highest environmental health risk factors in South Asia. Most LMICs lack effective monitoring mechanisms to track climate risk and population level impacts. Climate risk is typically measured at coarse resolution, monitoring of population impacts is weak or non-existent, and population representative surveys give only cursory attention to environment and environmental health related variables and outcomes. We propose establishing capacity and infrastructure for a fully integrated and locally informed surveillance system for communities in Bangladesh – the Climate, Health, and Environment Surveillance System for Bangladesh (CHESS-B). We have four specific aims designed to address deficits in data resolution and integration, outcome validation, and environmental measurement.  Each objective will contribute to the development of a framework and initial architecture for a harmonized Climate, Health, and Environment Surveillance System for Bangladesh (CHESS-B). This project focuses on Aim 1: Create a data directory and identify gaps in existing climate, environment, sociodemographic, and health geo-referenced data for Bangladesh.

Internship Activities. Literature reviews; systematic reviews; data dictionary development.

Country(ies) of Focus. Bangladesh

Link to Website. http://fuel.seas.umich.edu   

Approach to Mentorship. We will co-produce a structured mentoring plan that lays out expectations regarding work product, meeting times, deadlines, and learning objectives. The student will have regular engagement with Drs. Jagger and Eisenberg as well as engagement with a broader research team involving two postdocs. There will also be opportunities to engage with a local team in Bangladesh regarding data availability and acquisition. Meetings will be weekly throughout the summer.

Primary U-M Faculty Mentor. Sherri Sheinfeld Gorin, Professor, Family Medicine, Public Health

Description of the Research Project. Background/Objectives: The routine administration of the HPV vaccine could effectively reduce the burden of HPV-related cancers in both countries. In Israel, the overall rate of HPV vaccination in 2021 was 62.9%; yet, among religious subgroups, the rates were as low as 40%. The aim of this study is to evaluate multilevel (youths, parents, primary care physician/team, clinic, community (including schools), and policy influences on HPV vaccine hesitancy among vaccine hesitant subgroups across Israel and the West Bank. We will conduct a mixed methods analysis to integrate quantitative (cross-sectional primary care physician [PCP] survey, multiple linear regression analyses) and qualitative data (from  policy-level stakeholder interviews; youth and parent focus groups, inductive descriptive analysis) in joint display tables.The long-term goal of this study is to reduce HPV vaccine hesitancy as a risk factor for cervical, oral cavity, and pharynx cancers among adolescents, by influencing the vaccination behaviors of their primary care providers.

Internship Activities. Literature searches, participant recruitment, co-leading focus groups, data gathering (surveys and focus groups), data organization, and data analysis. The intern will also be involved in writing papers and presentations of the work. All work will be remote.

Country(ies) of Focus. Low income areas of Israel, the West Bank. While the median income across Israel is relatively high, incomes vary considerably across Israel and the West Bank. According to the National Insurance Institute’s 2021 data, 21% of the Israeli population lives in poverty: 28% of the population (almost 1 in every 3 children) lives in poverty. According to the World Fact Book, 18% (2011 est.) of the population in the West Bank is poor. Poverty in Israel and the West Bank particularly affects single mothers, elderly, the young in Orthodox Jewish communities and young Arabs from conservative religious schools. Two of these communities---the orthodox Jewish youths and the young Arab communities from conservative religious schools (Israeli Arabs and those in the West Bank)-- are of most interest to our project as they are less likely to have been vaccinated against HPV in school, and are between 9-26. We will focus on these underserved subgroups, not country-wide.

Link to Website. An extension of this work: https://medicine.umich.edu/dept/family-medicine/news/archive/202204/family-medicine%E2%80%99s-sherri-sheinfeld-gorin-receives-prestigious-fulbright-distinguished-scholar-award  
and this work: https://medicine.umich.edu/dept/family-medicine/research/cancer-screening-prevention/primary-care-rural-screening-project/multi-level-approaches-reducing-hpv-vaccine-hesitancy-rural-michigan 

Approach to Mentorship. The proposed internship would extend the research under the faculty lead’s Fulbright Distinguished Scholar Award. 

The faculty lead has been a successful and collaborative mentor of about 20 Master's and doctoral (as well as medical undergraduate and residents), all of whom have continued to pursue biomedical research study and/or practice and enjoys maintaining contact with mentees throughout their careers. The mentor will set reasonable expectations for the work together, provide task-oriented feedback in a supportive and collaborative manner, facilitating learning a flipped classroom model. Interns can expect to meet at least once a week, but more frequently as needed. 

Desired Student Qualifications. Knowledge of Hebrew or Arabic is a plus for the intern, but not required.

Primary U-M Faculty Mentor. Kevin Martinez-Folgar, Impact Scholar, Center for Global Health Equity

Description of the Research Project. This research project delves into the significant topic of race and ethnic disparities in health outcomes within Guatemala. Leveraging mortality data from 2018, the study will conduct an in-depth mortality analysis, focusing on the variances in health outcomes across different racial and ethnic groups. Furthermore, the project aims to extend this analysis through longitudinal projections, providing a dynamic view of how these disparities evolve over time.  A critical component of the study involves a comprehensive literature review on the categorization of race and ethnicity in Guatemalan census and surveys. This examination will not only detail the current categorization methods but will also explore the historical contexts and reasons behind these classifications. By understanding the historical underpinnings and the evolution of racial and ethnic categorization in Guatemala, the research will offer valuable insights into how these factors have shaped health outcomes. 

In 2009, the National Registry of Persons, a centralized center for vital and civil registries, was established. This marked a significant shift from the previous system where each municipality independently collected data, which often lacked harmonization and standardization. In this new system, ethnicity is categorized as “Ladino, Maya, Xinca, Garifuna.” Despite this, population projections for these subpopulations had not been computed due to reliance on the outdated 2002 census. However, the 2018 census has enabled the analysis of ethnic disparities in Guatemala for the first time. We can now use the 2018 mortality databases and census population counts as a denominator to calculate mortality rates.

Our primary objective is to estimate overall age-adjusted mortality by ethnicity, alongside determining the principal causes of death for each subgroup, utilizing the Global Burden of Disease classification. Additionally, we aim to estimate department-level mortality rates to explore spatial variations and potential correlations with causes of death. Time permitting, and with collaboration from a demographer at Drexel University and the National Institute of Statistics in Guatemala, we also plan to estimate population projections for following years for each subgroup, allowing us to assess temporal trends within each group. The statistical and epidemiological analysis will benefit from the theoretical review of the historical context behind the names and pertinence of each ethnicity along with potential social mechanisms, which help to explain the potential disparities by cause of death. 

Internship Activities. Compile and synthesize findings related to historical and current methods of racial/ethnic categorization in Guatemalan census and surveys. Collect secondary data from existing sources and databases. Perform statistical analysis of the collected data, under guidance. Draft sections of academic papers. Assist in developing outreach strategies to disseminate research findings. Participate in coordination meetings with partners at the Research Center for the Prevention of Chronic Diseases at the institute of Nutrition of Central America and Panama, and the National Institute of Statistics in Guatemala. 

Country(ies) of Focus. Guatemala

Approach to Mentorship. The mentor will hold an orientation session to set clear expectations regarding the project goals, the intern's responsibilities and his/her expectations and goals. The intern can plan to have weekly meetings to track progress, discuss any issues, and plan for the upcoming week. These meetings will also serve as a platform for mentoring and academic guidance. The meetings will primarily be held virtually, considering the convenience and flexibility it offers. However, if feasible and appropriate, occasional in-person meetings may be organized, especially for critical phases of the project (data analysis) or when hands-on guidance is necessary.

Additionally, the mentor will be available for impromptu discussions or queries via email or a messaging platform such as slack or Microsoft teams, ensuring that the intern feels supported and connected throughout their internship.

Desired Student Qualifications. While bilingualism is not a prerequisite for the internship, Spanish proficiency is certainly beneficial and will enable the intern to participate in virtual coordination meetings with partners in Guatemala.
 

Primary U-M Faculty Mentor. Rama Mwenesi Musalia, Assistant Professor, Learning Health Sciences

Additional Collaborators. Kelly Murdoch-Kitt, Associate Professor, STAMPS School of Art and Design

Description of the Research Project. Patient safety and patient experience are fundamental dimensions of healthcare quality, and their improvement is especially critical in resource-constrained settings. Unintentionally retained surgical items represent the #1 surgical patient safety issue and can lead to serious preventable adverse effects. This project builds upon an exploratory project on the Surgical Quality & Safety Infrastructures in Low-Resource Contexts. The work used an infrastructural inversion framework to develop a rich description of the surgical quality and safety infrastructure in Kenya, characterized by the (national/local) policies, (data/practice) standards, processes, technology, and patterns of behavior (i.e. safety culture, and norms) in place to ensure quality and safety. The project focuses on a multi-speciality surgical mission hospital located in the low resource community setting of South-west Kenya. It will explore and address: i) patient safety disparities due to a lack of standardized protocols and infrastructure, ii) cultural sensitivity due to a lack of involvement and participatory engagement of local community members and stakeholders to ensure their relevance and acceptability, and iii) access to care, due to variations in patient wait-times across phases of care. Recognizing the significance of culturally sensitive approaches, the project seeks to use participatory design and learning health systems methods to co-develop and pilot interventions tailored to the local context.

This project is enhanced by a cross-disciplinary collaboration with the STAMPS school. It will explore methods and tools to promote effective intercultural design collaboration, enhancing the project’s user/patient-centeredness.

Internship Activities. Literature searches, project management, research instrument design, data gathering, data synthesis and analysis, communications and outreach, report preparation, visual aid/material design.

Country(ies) of Focus. Kenya

Approach to Mentorship. The faculty lead’s dynamic approach to mentorship has been shaped through experiences supervising individual graduate students as well as student teams in the past, along with their own experiences as a graduate student mentee. The intern can expect clear expectations through an orientation to the project’s overall goals & intents, the intern’s role, and the significance of their anticipated contributions. Mentees are typically encouraged and supported to take ownership of their learning journey by exploring relevant literature and resources, and engaging in discussions/meetings with the primary faculty, in-country partners and other stakeholders.

The intern and mentor will meet on a weekly basis at first and the intern will be integrated into additional meetings with partners & collaborators as needed and as appropriate. The frequency and nature of meetings will naturally evolve based on project milestones and they may be conducted in person, virtually, or a combination of both, depending on the student's preferences and circumstances (i.e. travel). If in person, meetings may take place at the Medical or North Campus.

Primary U-M Faculty Mentor. Ivo Dinov, Professor, Nursing, Medicine

Description of the Research Project. The intern working on this R&D project will use new, real world data as well as synthetic simulated data, including clinical, socioeconomic, image, and demographic data to develop novel AI/ML algorithms. The project will focus on training and validating the AI/ML approaches to address health inequities and disparities (locally and globally). The research may also examine improved healthcare policies, prevention, diagnoses, and treatments and facilitate intervention and implementation strategies.

This Summer internship will focus on two complementary tasks – data acquisition (secondary data) and AI data analytics. It will advance work done through the Statistics Online Computational Resource (SOCR) on HIV and AIDS-related deaths among Uganda adolescents and young adults living with HIV (AYLHIV) in contrast to the substantial decline observed among younger children and adults over the past decade. Existing and prospective data will be aggregated, harmonized, modeled and used to forecast a wide range of clinical outcomes for marginalized communities. A key element of the training will involve training using the SOCR DSPA and TCIU ML/AI/Data Science protocols for representation, analysis and interpretation of heterogeneous, incomplete, high-dimensional, and complex data (on health (in)equity).

Internship Activities. Learn DSPA ML/AI (Data Science and Predictive Analytics Machine Learning/Artificial Intelligence) methods, formulate research hypotheses, search for appropriate data, practice health analytics with case-studies data, generate end-to-end electronic markdown notebooks, draft final term report (potentially submit for journal peer review). The intern will be engaged in the data aggregation (for specific cohorts) as well as with the AI forecasting and classification efforts to expose (latent) heterogeneous effects on health equity.

Country(ies) of Focus. Global

Link to Website. https://www.socr.umich.edu/html/SOCR_Research.html

Approach to Mentorship. The faculty lead will provide coaching, mentoring and advice, and encourage the intern to learn, immerse, innovate and customize SOCR/DSPA tools for tackling challenging global health equity problems. The mentor hopes that the background, interests, and aspirations of the intern will drive the specific application domain of the work.

Primary U-M Faculty Mentor. Terri Conley, Professor, Psychology

Description of the Research Project. Women, on average, are less interested in sex than men in almost all respects (see, e.g. Conley & Klein, 2022; Frankenbach et al. 2022).  A great deal of theorizing has surrounded these findings, which has often served to justify the status quo in heterosexual sexual encounters.  However, relatively little research has been dedicated to understanding why these gender differences are present or the circumstances in which these differences can statistically be eliminated. We have several ongoing projects designed to determine why women are less interested in sex. Currently, we are examining gender differences in sexual desire in Iran, Taiwan and the US (with an interest in expanding to other countries). We have a particular interest in the role that anticipation of orgasm plays in these gender differences. Our recent research has shown that women are less likely to anticipate orgasm in their encounters with men, and that this difference explains a large amount of the variance in gender difference in sexual desire. Dynamics surrounding sexual pleasure (or lack thereof) are similar to those surrounding access to other basic human needs. Bodies that are disregarded or neglected can interfere with self-respect. This work sheds light on reasons women avoid sex and can inform strategies to advance women’s sexual health and well-being in Iran. 

Internship Activities. Participant recruitment, literature reviews, development of studies and experiments, data analysis, supervision of undergraduates, networking with potential collaborators.

Country(ies) of Focus. Iran, with possible expansion to other Global South countries.

Approach to Mentorship. The mentor and intern will usually meet twice per week --one-on-one and/or with the summer research group. The mentor will provide lots of feedback during these meetings and always allot time for questions. The intern can expect to work on several different projects to get maximum exposure to different aspects of research design, implementation and interpretation.

Primary U-M Faculty Mentor. Michelle Bellino, Associate Professor, School of Education

Additional Collaborators. Drs. Julia Paulson and Robin Shields (Bristol University)  

Country of Focus. Colombia

Description of the Research Project. This project centers on enhancing young people’s wellbeing as conceived through the lens of human development, recognizing the complex, multidirectional relationship between health and education. Physical and mental health are prerequisites for learning, meanwhile, more years of high-quality education are correlated with longer, healthier lives (Hahn & Truman, 2015). The UN’s Sustainable Development Goals (SDGs) articulate the interdependent nature of education and other contributors to positive development, positioning education as both a contributor to positive development, and an outcome of development. SDG 4.7 advocates for all states to commit to implementing quality education, ensuring that students have opportunities to learn “the knowledge and skills needed to promote sustainable development, including among others through education for sustainable development and sustainable lifestyles, human rights, gender equality, promotion of a culture of peace and non-violence, global citizenship, and appreciation of cultural diversity and of culture’s contribution to sustainable development.” This global vision for education extends beyond academic learning and outcomes. Global citizenship, coexistence, and peace education are central to the commitments embedded in the SDGs, imagining a future in which all humans can live well, in peace with one another and the environment.

As Colombia transitions from more than fifty years of internal armed conflict, how will young people learn about the complex causes and consequences of protracted violence, and the fragile transition to peace? Negotiating an end to the conflict has polarized society, raising questions about security, accountability for past violence, and the potential for far-left and far-right political ideologies to divide Colombia’s democracy (Gomez-Suarez, 2017). Armed conflict has long impacted Colombia’s education system, resulting in school-based violence and political confrontations spilling into schools (Ardila-Rey, Killen, & Brenick, 2009; Chaux, 2009; Villar-Márquez, 2010). Public schools across Bogotá vary in their composition, including in terms of socioeconomic diversity and of ethnic minorities (Afro-Caribbean descendants and indigenous groups), as well as the proportion of student victims displaced by the armed conflict. Demographic shifts have been further impacted by growing numbers of Venezuelan migrants and refugees entering Colombia and accessing public schools (R4V, 2021). 

The mixed methods study for which I am seeking a CGHE summer intern draws from survey, observational, and interview data across a diverse sample of 45 secondary schools in Bogotá to examine how teachers approach conversations about peace, conflict, and justice, as well as how students experience conversations about such “charged” topics. In this stage of the analysis, we plan to examine interactions between student demographics and young people’s expressed interest in learning about the armed conflict and peace and transitional justice process in school spaces. We ask: Are teachers working in schools with high proportions of victims more or less likely to cover topics such as peace, conflict, and justice, than their colleagues working in schools with fewer victims? Are students who self-identify as victims of the conflict more or less likely to desire these conversations or to feel that they are sufficiently covered in schools? Our qualitative data allows us to complement our claims about these interactions with an exploration of the conditions that enable classroom-based conversations about violence that are sensitive to the lived experience of victim-survivors, and how and what students learn about themselves and living in peace with others. 

Trauma-informed educational practice emphasizes that young people “must feel safe and connected with others in order to be neurologically, emotionally and cognitively engaged in their learning” (Howard et al., 2020, p. 7). Education can mitigate the impact of trauma relating to displacement and exposure to violent conflict, but the protective nature of school is not a given (Bellino & Williams, 2017). Educational interactions can also negatively impact young people’s health, safety, and sense of self, contributing to intergroup conflict (Bush & Saltarelli, 2000; Davies, 2004). Looking across children’s experiences with conflict, displacement, and schooling in multiple country contexts, Winthrop and Kirk (2008) found that education was linked to children’s well-being, but only when students saw themselves as engaged in meaningful learning. That is, merely attending school was not enough to help young people “cope and hope” with challenging conditions and trust in a better future (also see Mosselson et al., 2017; UNESCO, 2019). Thus, the knowledge, skills, and attitudes for engaging in inclusive, open, and respectful learning opportunities about peace, conflict, and justice are critical in supporting young people’s overall wellbeing in democratic societies (Davies, 2004; UNESCO, 2015). 

In contrast to other post-conflict/ post-peace settings, there is a strong national initiative and educational policy context for Colombia’s Cátedra de Paz (CdP), a cross-curricular effort to implement peace education, as formal peace and transitional justice processes have continued to evolve (Chaux & Velazquez, 2016). Yet few studies have examined the extent to which this policy has prompted or expanded classroom-based conversations about peace, conflict, and justice. On the one hand, there are concerns that historical coverage risks retraumatizing students, negatively impacting their health and relationships to school; on the other hand, acknowledgement of historical injustice is central to societal reconciliation processes (Barkan, 2000). Lack of knowledge about the armed conflict’s history, political dimensions, and widespread impact serves to emotionally distance, divide populations, and distort understandings of armed conflict dynamics and individual and community experiences with violence (Padilla & Bermúdez, 2016; Sánchez Meertens, 2017). 

This study allows us to explore the extent to which young people, including those who self-identify as victims, express an interest in addressing violent conflict, peace, and justice in formal curriculum, and the conditions required to enable open dialogue of such topics. As classrooms and communities become more diverse and complex due to insecurity and global im/migration, greater demands are placed on educators, learners, and schools to adapt. Deepening our understanding of educators’ and students’ perspectives within and across classroom contexts will inform efforts aimed at better supporting difficult conversations during times when peace and justice are topics of vital civic—and often personal—significance, and potentially a matter of safety. Peace education aims to protect the right to life and dignity, while contributing to sustainable, equitable, and just peace (Bajaj & Hantzopoulos, 2016). Knowledge about the conditions that mobilize mass violence, skills such as the ability to engage in evidence-based reasoning and nonviolent conflict-resolution, as well as socioemotional dimensions such as self-regulation are critical components of health and wellbeing, particularly in settings impacted by violence, displacement, and their legacies. 

Throughout the study, we have been in dialogue with collaborators in Colombia, including the Secretaría de Educación del Distrito de Bogota, school administrators, teachers, and educational advocacy groups. We have made efforts to disseminate findings (in Spanish) to participants and those for whom this work is most relevant, and to prioritize these dissemination efforts over scholarly endeavors. At this stage, my goal is to systematically review our dataset in order to answer these important questions, situate them in scholarly literature, and contribute to research on trauma as it relates to young people’s learning, socioemotional development, and wellbeing in contexts impacted by armed conflict and displacement. A summer intern would provide support to empirically explore how educational initiatives can better respond to protracted conflict and displacement, urgent global threats to health and wellbeing, and concerns that extend beyond the context of Colombia.

Internship Activities. 

• Refine hierarchical linear modeling analysis and interaction terms for existing model, testing the relationship between exposure to conflict, presence of peace education curriculum, and interest in learning about peace, conflict, and justice 
• Selectively reanalyze qualitative interviews with teachers for relevant themes and data (n=46)
• Analyze selected open-ended questions for student surveys (n=3000+) in order to identify relevant data and themes
• Analyze ethnographic fieldnotes for school observations and focus group data (n=~20)
• Review methodological literature cross-nationally to explore how young people are asked about violence exposure and processes of self-identification 
• Review literature on self-identification and legal registration for victims in Colombia
• Review literature on trauma in school settings as linked to curriculum coverage, particularly addressing violent pasts
• Write and respond to draft paper sections 
• Draft conference abstract for Comparative and International Education Society meeting 
• Prepare slides for presenting research findings and implications 
• Communicate with local partners in Colombia
• Preparation of 1-3 page report in Spanish for circulation to school administrators, teachers, and Secretaría de Educación staff 

Link to project. https://mjbellino.com/research/teaching-peace/

References.

Ardila-Rey, A., Killen, M., & Brenick, A. (2009). Moral Reasoning in Violent Contexts: Displaced and Non-displaced Colombian Children’s Evaluations of Moral Transgressions, Retaliation, and Reconciliation. Social Development, 18(1), 181-209. 

Bajaj, M. and Hantzopoulos, M. (2016). Peace Education: International Perspectives. London: Bloomsbury.

Barkan, Elazar. 2000. The guilt of nations: Restitution and negotiating historical injustices. Baltimore, MD: Johns Hopkins University Press.

Bellino, Michelle J., and James H. Williams. 2017. Introduction. In (Re)constructing memory: Education, identity, and conflict, edited by Michelle J. Bellino and James H. Williams, 1-20. Rotterdam, The Netherlands: Sense Publishers.

Bush, K.D. and Saltarelli, D. (2000). The Two Faces of Education in Ethnic Conflict: Towards a Peacebuilding Education for Children. Florence, Italy: UNICEF Innocenti Research Centre.

Chaux, E. (2009). Citizenship Competencies in the Midst of a Violent Political Conflict: The Colombian Educational Response. Harvard Educational Review 79(1), pp. 84-93. 

Chaux, E., & Velásquez, A.M. (2016). Orientaciones generales para la implementación de la Cátedra de la Paz en los establecimientos educativos de preescolar, básica y media de Colombia. Bogotá: Ministerio de Educación. 

Davies, L. (2004). Education and conflict: Complexity and chaos. London: Routledge.

Gomez-Suarez, A. (2017). Peace Process Pedagogy: Lessons from the no-vote victory in the Colombian Peace Referendum. Comparative Education, 53(3), 462-482. 

Hahn, Robert A. & Truman, Benedict I. (2015). Education Improves Public Health and Promotes Health Equity. International Journal of Health Services 2015; 45(4), pp. 657–678. DOI: 10.1177/0020731415585986

Howard, Patrick, Michael Corbett, Andrea Burke-Saulnier, and David Young. 2020. "Education futures: Conservation and change." Background paper for the Futures of Education initiative.

Mosselson, J., Morshed, M. M., & Changamire, N. (2017). Education and Wellbeing for Refugee Youth. Peace Review, 29(1), 15-23. 

Padilla, A. L., & Bermúdez, A. N. (2016). Normalising conflict and de-normalising violence: Challenges and possibilities of critical teaching of the history of the Colombian armed conflict. Revista Colombiana de Educación, 71(1), 187-218. 

(R4V) Inter-agency Coordination Platform for Refugees and Migrants from Venezuela. (2021). Regional Refugee and Migrant Response Plan, January - December 2021.

Sánchez Meertens, A. (2017). Los saberes de la guerra: Memoria y conocimiento intergeneracional del conflicto en Colombia: Siglo del Hombre Editores S.A.

UNESCO. (2019). Education as healing: Addressing the trauma of displacement through social and emotional learning [Policy Paper 38].

Villar-Márquez, E. (2010). School-Based Violence in Colombia: Links to State-Level Armed Conflict, Educational Effects and Challenges. Background paper prepared for the Education for All Global Monitoring Report 2011, The hidden crisis: Armed conflict and education. London, UK: Overseas Development Institute.

Winthrop, Rebecca, and Jackie Kirk. (2008). Learning for a Bright Future: Schooling, Armed Conflict, and Children’s Well‐Being." Comparative Education Review 52 (4): 639-661.

Primary U-M Faculty Mentor. Omolade Adunbi, Professor, Afroamerican and African Studies

Country of Focus. Nigeria

Description of the Research Project. This research investigates the relationship between extractive practices and health outcomes in oil bearing communities. With particular emphasis on the Niger Delta region of Nigeria, the project plans to unearth the effects of pollution and other forms of environmental degradation on the health of community members whose livelihood practices depend on land and water. Since the discovery of oil in Nigeria in the 1950s, many oil bearing communities have faced the consequences of persistent oil spills, gas flaring and what many scholars have described as ecological catastrophe in the region. In recent times, many youths in the region have also taken to building artisanal refineries used in extracting and refining crude oil. There are over 2000 such refineries in the creeks of the Niger Delta. Extraction by the youths and multinational oil corporations have resulted in the prominence of soot in many communities thereby exacerbating the precarious health situation of those communities. While there is a rich literature on oil extraction in Nigeria, there exists a dearth of literature on the impact of such extractive practices on the health of the oil bearing communities.

Therefore, this project is interested in asking the following questions: Is there any correlation between oil extraction and health outcomes? What are the causal explanations of the preponderance of soot in many Niger Delta communities? How might data gathering and disaggregation help in understanding the relationship between oil pollution and health? What can the literature tell us about the relationship between oil extractive practices and health of communities?

Internship Activities. Some of the activities the intern would undertake include literature searches, project management, preparation of annotated bibliography, conduct of online surveys, identification and recruitment of research/survey participants, data gathering, data organization and analysis, communications and outreach, preparing and writing of occasional papers, etc.

Desired Qualifications. Excellent written and verbal communication.

Country of Focus. Kenya

Primary U-M Faculty Mentor. Ravi Anupindi
Professor, Ross School of Business

Description of the Research Project. Data is an important asset to health care providers and decision makers. Almost all activities in a modern health system generate data – demographic, clinical, administrative, and financial. These data contain valuable information, including how treatments, drugs, medical devices and medical products perform in routine clinical use. Research shows that data plays in ensuring efficiency, effectiveness and equity in delivery of healthcare.

This study aims at assessing the level of utilization of data for decision making and potential effects on the performance of the health supply chains in Vihiga and Kisumu Counties of Kenya. Specifically, the objectives of the study include a) comparative assessment of current practices in data gathering, data quality, and use of data for decision making at various levels (Facility, Sub-county, County) in Vihiga and Kisumu Counties, b) evaluation of their impact on decisions that impact delivery of health including on health equity, and c) development of recommendations.

The project will be conducted in collaboration with the Head of Division Health Information, Monitoring, Evaluation and Research Development in Vihiga County (Kenya) and Director of Medical Services, Kisumu County (Kenya) and their respective teams.

Internship Activities. Interns will conduct literature searches, do research instrument design, perform data gathering and analysis, and prepare reports.

Desired Qualifications. Experience in reading academic and grey literature in the areas of global health, supply chains, and/or information systems; Experience conducting advanced literature searches in databases such as Pub-Med, Embase, etc.; Familiarity with grey literature sources relating to global health programs; ability to conduct remove interviews for information gathering; Ability to work independently while proactively seeking help when needed; Exellent written and verbal communication skills; Strong interest in global health supply chains. 

Country of Focus. Kenya

Primary U-M Faculty Mentor. Gary W. Harper, Professor, Health Behavior and Health Education, School of Public Health

Additional U-M Faculty/Staff Mentor. Laura Jadwin-Cakmak, Health Behavior and Health Education, School of Public Health

Description of the Research Project. Young gay and bisexual men and other men who have sex with men (Y-GBMSM) in Kenya are disproportionately impacted by HIV infection, and mental health concerns can negatively influence their progression through both the HIV prevention and HIV care continua. The Uzima Bora study aims to: a) explore how mental health challenges negatively influence progression through both the HIV prevention and HIV care continue for Y-GBMSM in Kisumu, Kenya; b) explore how to integrate mental health promotion program components into community-based HIV prevention and care continua interventions for Y-GBMSM; and develop a conceptual model to guide integration efforts; and c) design mental health promotion program components that could be integrated into community-based HIV prevention and care continua interventions for Y-GBMSM at four socio-ecological levels: individual, group, clinic/organization, and community. We anticipate that results from this study will have high impact by creating both a framework for mental health promotion integration into HIV prevention and care, as well as creating testable designs for mental health promotion program components that can be delivered at four different socio-ecological levels of influence.

Internship Activities. The graduate student intern for this project will be involved in the following tasks: (a) analyze qualitative data from in-depth individual interviews with HIV service providers along with a team of analysts from both Kenya and UM; (b) analyze qualitative data from focus group discussions with both HIV service providers and Y-GBMSM along with a team of analysts from both Kenya and UM; (c) present analyzed data to our Service Provider Development Team and Community Participatory Development Team in Kenya via zoom for the purposes of member checking the data; (d) work with a collaborative team both in Kenya and US on the development of mental health integration models based on the qualitative data; (e) potentially work with a collaborative team both in Kenya and US on the initial design of blueprints for mental health promotion components.

Desired Qualifications. Preference will go to an intern with interest in LGBTQ+ health and mental health. Preference will go to an intern with some experience in qualitative data collection or analysis, though this is not a requirement.

Primary U-M Faculty Mentor. Jody Lori, Professor, School of Nursing

Additional U-M Faculty/Staff Mentor. Nancy Lockhart, Program Manager

Countries of Focus. Ghana, Liberia

Description of the Research Project.
Ghana—More than 300,000 women die from complications related to pregnancy and childbirth each year. Another 2.6 million babies are stillborn and 2.8 million newborns die during their first 28 days of life. This is in a context where most women—even in low-resource countries—receive at least some antenatal care. Yet routine antenatal care may not be enough. While 87.3% of women in Ghana surveyed had attended the recommended minimum of four antenatal care (ANC) visits, 30% of women could not identify any of the seven pregnancy danger signs for which care-seeking is recommended. Similarly, less than a third of women in one study in northern Ghana were considered “prepared for birth,” including such things as saving money, arranging transportation, or identifying nearby skilled birth attendants. Such findings suggest the current standard of ANC is often ineffective, with inadequate understanding of health messages by pregnant women and a lack of effective communication between providers and clients. Limited health literacy (the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions) greatly hinders the identification and prompt management of complications, contributing to poor maternal and newborn outcomes. Without question, improving women’s ability to acquire, understand, and use health messages to promote and maintain health could save the lives of countless mothers and babies.

To address the enormous gaps in health literacy and the resulting poor outcomes among pregnant women in Ghana, we propose a bold, new approach to antenatal care that takes ANC out of exam rooms and brings care to small groups of women of similar gestational age at primary care, community health centers.  Patient education is a key component of all routine antenatal care (ANC), yet the information provided is often inconsistent and lacks fidelity. Teaching women about the danger signs of pregnancy and the critical elements of Birth Preparedness and Complication Readiness (BPCR) (i.e. problem recognition; reducing delay in care-seeking; choosing a birth location in advance; obtaining basic safe birth supplies; and identifying someone to accompany them to the facility when labor begins) is essential to antenatal care. While standard ANC focuses on the individual provider-patient interaction to increase women’s knowledge, group-based ANC relies upon presenting health information in a culturally appropriate way that builds upon the strength of the group. Group ANC, facilitated by a nurse or midwife and a health extension worker (HEW), cultivates a safe space where women’s experiences are acknowledged, and messages are positively reinforced through peer support, allowing time for women to share their concerns, ask questions, and learn from others’ questions—substantially improving health literacy and promoting self-care and early problem recognition among low- and non-literate pregnant women.

Liberia—The overall objective of this study is to develop an obstetric emergency triage system to reduce preventable, obstetric-related deaths. We propose to reach our objective through the following specific aims: (1) increase timely care seeking along the referral pathway for pregnant women through implementation of a WhatsApp Triage, Referral, and Transfer WAT-RT System between Community Health Assistants (CHAs), rural clinic midwives, and hospital staff; and (2) establish a midwife-led triage system to increase the quality and safety of cesarean sections (CS) at one referral hospital in Bong County, Liberia.

The purpose of this research is to increase access to CS by decreasing referral time, improving obstetrics triage methods and decision making, and decreasing the Decision-to-Delivery (DDI) time.  We will develop and implement a WhatsApp Triage, Referral, and Transfer (WAT-RT) System. The WAT-RT System combines two previously studied and proven low cost interventions, to increase access to CS by decreasing referral time, improving obstetrics triage methods and decision making, and decreasing the Decision-to-Delivery (DDI) time. We hypothesize that proper and timely triaging of obstetrics emergencies, both before and after arrival at the hospital, will increase the quality and safety of CS, in addition to reducing the number of non-medically indicated CS. To achieve these goals, nurses and midwives in rural health facilities in Bong County, Liberia and community health assistants (CHAs) from their respective catchment communities will utilize a WhatsApp platform to communicate and triage obstetrics emergencies with the nursing/midwifery/medical staff at referral hospitals, CB Dunbar and Phebe. Upon arrival at the hospital, a hospital-based obstetric triage system previously developed in Ghana will be utilized.

Internship Activities. Develop a data dictionary for the Liberia study, data analysis (qualitative and quantitative) for both Liberia and/or Ghana studies, manuscript development, team meetings with in-country partners via zoom, team meetings for statistical analysis.

Desired Qualifications. The ideal candidate will have substantial skills in conducting literature reviews, basic statistical and analytical skills, and an introduction to scientific writing.

Project Websites. Maternity Waiting Home Alliance, Group Antenatal Care Collaborative

Primary U-M Faculty Mentor. Prashant Mahajan, Professor, Medical School

Additional U-M Faculty/Staff Member. Apoorva Belle, Project Manager, EMERGE

Countries of Focus. This project will compare emergency care delivery systems across the globe. The following low- and/or middle-income countries (LMICs) will be involved: Brazil, China, Costa Rica, Tanzania, India, Nepal, Lebanon

Description of the Research Project. Emergency care extends from pre-hospital settings to the emergency department (ED) and defined as a system designed to organize “personnel, facilities, and equipment for the effective and coordinated delivery of health-care services” to individuals and populations who are acutely ill or injured, whether surgical, medical or as a result of large scale man-made or natural disasters. EDs, an integral part of healthcare systems worldwide, provide vital, uninterrupted, and universal access to healthcare for all patients. EDs are the first point of contact and often serve as a safety net for the disadvantaged. Emergency medicine is increasingly recognized as an independent medical specialty globally, although, primarily in developed countries, with standardized curricula and comprehensive training. However, there is substantial variation in the organization of emergency services, resource allocation, and provider training, all of which negatively impact the quality of care and patient outcomes across the world. As emergency care systems develop and evolve, there are important opportunities to learn from each other and possibly adopt and/or adapt existing systems to optimize emergency care globally. The PI of this project is the Chair of Emergency Medicine Education and Research by Global Experts (EMERGE) network which has 22 participating emergency departments across 6 continents, in 17 countries, 7 of which are in LMIC countries (Brazil, China, Costa Rica, Tanzania, India, Nepal, Lebanon). The long-term goal of this project is to describe, compare, and contrast emergency care delivery systems across the globe to identify opportunities to learn from each other. The specific goal for the Graduate Summer Research Internship and Training Program is to develop a comprehensive survey instrument that will be sent to Emergency Medicine Professional Societies of individual countries identified via the International Federation for Emergency Medicine (www.ifem.org) whose mission is to advance the growth of high-quality emergency care.

Internship Activities. The intern will perform a literature search with the help of an informatician to identify papers/books that have described country specific description of emergency care delivery systems. Simultaneously, we will identify country specific emergency care providers who will be stakeholders and collaborators to facilitate the development, deployment, and collation of responses. The graduate intern will help in developing the initial draft of the survey based on the literature survey and input from the identified country specific thought leaders. Project activities will be conducted in Ann Arbor (mix of remote and in-person work) and include meeting with the UM faculty mentor and the EMERGE Project manager. The UM faculty mentor will meet with the intern and project manager in the first week to map out the timeline of the entire long-term project and narrow down the scope for the intern by limiting it to (a) literature survey and (b) developing the initial draft of the survey instrument.

Project Website. EMERGE Network

Primary U-M Faculty Mentor. Michelle Munro-Kramer, Suzanne Bellinger Feetham Professor of Nursing

Additional U-M Faculty/Staff Members. Sarah Compton, Research Assistant Professor, Obstetrics and Gynecology; Lisa Fedina, Assistant Professor, Social Work

Countries of Focus. Ghana, Nigeria, Liberia, Rwanda, South Africa, Zimbabwe

Description of the Research Project. Gender-based violence (GBV) constitutes a global public health crisis, occurring across geographic and cultural contexts, with attendant consequences on acute and chronic physical, psychological, emotional, and reproductive injury. Evidence from across the globe suggest that one in three women and girls will suffer some form of intimate partner violence or non-partner physical or sexual violence in their lifetime.3 Specific to female youth enrolled in educational institutions, a systematic review found the overall prevalence of GBV ranged from 42.3% to 67.7% within sub-Saharan Africa. Increasing attention has been paid to GBV on university campuses where it is pervasive, but research and collaboration has been limited, particularly in low- and middle-income countries. Past research has investigated different approaches for the prevention of GBV; although much of this work has occurred in the United States and is not culturally and contextually appropriate for sub-Saharan Africa.

At this time, systematic and comparable data at universities across sub-Saharan Africa are not being collected. These data could both illuminate the magnitude of the problem and provide a baseline from which to compare knowledge, attitudes, and experiences before and after prevention interventions are implemented as well as to understand some of the systemic issues that can influence interventions. The proposed study is a continuation of a pre-existing project that brought together six universities to investigate stakeholder descriptions of programs and policies, barriers, and opportunities related to GBV on university campuses across sub-Saharan Africa. It became evident from that preliminary work that a large-scale evaluation of student knowledge, attitudes, and behaviors (e.g., experiences with victimization and perpetration and use of resources) was necessary to inform future interventions.

Overall, this project aims to conduct a cross-country campus climate survey to gather the baseline data necessary to inform the development of culturally and contextually appropriate interventions for universities in sub-Saharan Africa.

• Specific Aim 1. Develop a campus climate survey and an anonymous sampling methodology unique to the sub-Saharan African context and culturally appropriate for each individual university site.
• Specific Aim 2. Deploy a multinational GBV Campus Climate Survey to serve as a preliminary systematic examination of sexual violence, intimate partner violence, and stalking knowledge, attitudes, and experiences among a large sample of sub-Saharan African university students.
• Specific Aim 3. Compare data across sites to inform the development/adaptation of prevention interventions and best practices.

Internship Activities.

Data management and analysis

1. All campus climate survey data should be collected by May 2023; however, there will be extensive data cleaning and analysis needed

2. The University of Michigan will be providing training and support to each individual university for university-specific analysis. We will also be responsible for cross-university comparisons.
3. Analysis could be completed using SPSS, SAS, or Stata

Attend biweekly team meetings

1. The network currently meets every other Monday from either 9–10am or 10–11am
2. These meetings allow group conversation about current projects, future plans, and important considerations regarding the cultural and contextual aspects of GBV in each setting

Assist with manuscript writing/project dissemination

1. The Campus Climate Survey Data will be disseminated locally (via summaries to each respective university, forums with key stakeholders, as well as research manuscripts).
2. The group is also interested in conducting a Scoping review of campus-based GBV interventions in LMICs (or sub-Saharan Africa) that will begin in the Spring of 2023

Primary U-M Faculty Mentor. Maria Muzik, Associate Professor, Medical School

Additional U-M Faculty/Staff Members. Rebecca Hardin, Associate Professor, Environment and Sustainability; Gwenyth Lee, Rutgers University, CGHE Associate Member

Country of Focus. Ecuador

Description of the Research Project. Depression among women of childbearing age is the single largest contributor to the global burden of mental health disorders. Poor maternal mental health has negative outcomes for both the mother and the child. Specifically, it is well documented that poor maternal mental health often leads to behavioral and emotional issues for children. These disorders have also been linked to poorer child growth and chronic undernutrition, which are in turn linked to increased risk of child mortality. For women living in low- and middle-income countries, rates of mood and anxiety disorders may be even higher than in HICs. Despite this, the prevalence of maternal depression and anxiety is likely underestimated in many contexts. Within the data that is available, research into maternal depression in low- and middle-income countries focuses on women of higher socioeconomic status. Relatively less is known about women living in poverty, and about women living in rural areas, compared to urban areas. The evidence that does exist is somewhat conflicting, with some reports suggesting that women living in rural areas are at an increased risk for untreated mental health disorders, while in other instances, rural residing women were at decreased risk compared to their urban counterparts. Relatively few reports have investigated the underlying factors that may drive these relationships, either in high-income countries or in LMICs. However, socioeconomic status, marital status, social support, and other recognized risk factors for maternal depression may vary between rural and urban geographies. Access to referral and counseling services may also vary widely.

Our study uses an Anthropological and Science and Technology (STS) approach to map the complexity of maternal depression among women in northwestern Ecuador. Anthropological and Science and Technology (STS) approaches to mental health concern themselves, as Catherine Lutz put it, with “what moves and matters in human life.” This means understanding human psychology in specific historical, cultural, and economic settings. Situating mental health within broader political and technological changes means seeing connections and ruptures within disciplinary understandings of mental health and depression, national mental health adaptations, and local perceptions of diagnoses and treatment. Recognizing the complexity of documenting mental health, this initial exploratory project aims at documenting women’s understandings of maternal depression to identify short-, medium- and long-term impact. Our pilot study (1) documents the multiple registers of mental health that traverse communal, familial, and individual understandings of depression. We are also interested in (2) recording how health professionals with whom women have direct interaction come to understand psychiatric disorders, how they diagnose illness and which guidelines, checklists, manuals, or psychiatric traditions are locally used to address mental health in medical practices. Finally, we are also interested in (3) registering forms of social medication or self-medication around mental health in the community, by tracking interactions between pharmaceutical consumption in day-to-day life. By disentangling how maternal depression is understood locally we expect to generate contextual information that will initially help raise awareness around mental health in the community and can more broadly provide ranked steps on potential medium- and longer-term responses to and interventions on mental health.

Internship Activities. There are several activities a graduate intern could conduct in support of this project, depending on their specific interests and needs. For example, qualitative analysis, quantitative analysis, or review of medical guidelines could all be options depending on whether the students are more interested in statistical analysis, social science, or if they are clinical. Project activities will be conducted in Ann Arbor (mix of remote and in-person work) and include the following:

• Assist the research team in conducting thematic analysis of previously collected interviews of women and healthcare providers in coastal Ecuador.
• Compile and analyze guidelines, checklists, manuals, or psychiatric traditions used by healthcare providers in Ecuador.
• Compile and analyze content of news articles from the Ecuadorian media about mental health, especially during the pandemic.
• Conduct quantitative analyses of data sets describing maternal depression in Ecuador.
• Assist in the development of project outreach materials.

Language Requirement. Reading and speaking Spanish is not required. However, the scope of potential ways a student can be involved would expand if the student does read and speak Spanish. 

Primary U-M Faculty Mentor. Elizabeth Roberts, Associate Professor, Anthropology

Additional U-M Faculty/Staff Members. Zoe Boudart, Project Manager; Jackie Goodrich, Environmental Health Sciences; Belinda Needham, Epidemiology; Branko Kerkez, Associate Professor, Engineering; Krista Wigginton, Engineering; James Wagner, Research Professor, Institute for Social Research.
Additional team members from the National Institute for Public Health in Mexico include Mara Téllez-Rojo (Epidemiology) and Jose Luis Figueroa (Health Economics), as well as Brisa Sanchez (Biostatistics) at Drexel University.

Country of Focus. Mexico, and potentially other Latin American nations

Description of the Research Project. As water scarcity increases globally and inequities in water supply worsen, it is imperative to adapt research about water access to measure intermittent water supply (IWS), an increasingly common phenomenon which refers to the condition of not having continuous household access to piped water. This project is an interdisciplinary collaboration which combines in-depth, qualitative research with quantitative, nationally representative data to examine the effects of IWS on health, economic, and gender inequality in Mexico. Our team aims to understand the effects of IWS on chronic disease and on economic and gender inequality globally, and to develop evidence-based approaches to address them for policy makers. Our research group is composed of health economists from Mexico’s National Institute of Public Health who work with the nationally representative health and nutrition survey, the ENSANUT, and UM researchers from anthropology, engineering, epidemiology, environmental health, biostatistics, and survey methods. Our working group combines in-depth, ethnographic, and water quality data from previous interdisciplinary work, and large-scale ENSANUT survey data in analyses that are both grounded in the quotidian realities of living with IWS and are statistically robust and nationally representative. Our IWS Working Group: (1) analyzes data from an existing interdisciplinary qualitative study in Mexico City to develop robust hypotheses about the causal pathways by which IWS may negatively impact health, socioeconomic status, and gender inequality; (2) analyzes nationally representative ENSANUT to test these hypotheses and document inequities in water distribution, and 3) disseminates our findings to national policymakers in Mexico to mitigate the health, social, and economic impacts of IWS. This work will lay the foundation to mitigate the negative impacts of water intermittency in Mexico and potentially to other Latin American nations.

Internship Activities. There is a large breadth of possible activities for a graduate student in this project depending on that student’s particular area of expertise and learning area of interests. We welcome students from a variety of disciplines, especially if they are interested in expanding and applying their existing skills within a interdisciplinary team. There is a preference for students with proficiency in Spanish. Opportunities for work on this project could include one or more of the following:

• Ethnographic analysis of existing qualitative data and critical analysis and integration of survey and statistical data.
• Assisting in organizing and analyzing nationally representative survey datasets to test hypotheses and associations of intermittent water supply characteristics to socioeconomic status and health outcomes.
• Assisting in report preparation, paper development, and policy recommendation from the analytical findings.
• Assisting in literature searches and analysis focused on water provisioning, infrastructure, as well as gender and health, economic outcomes.
• Assisting in data linkages of administrative datasets including geo-referenced data.

Project Website. Mexican Exposures: A Bioethnographic Approach to Health and Inequality

Primary U-M Faculty Mentor. Lee Schroeder, Clinical Associate Professor, Medical School

Additional U-M Faculty/Staff Members. David Dowdy, Johns Hopkins University

Country of Focus. Ghana

Description of the Research Project. This research is funded through a 5-year NIH R01 grant. In low- and middle-income countries, millions of cases of infectious diseases every year go undiagnosed and untreated due to suboptimal design of clinical laboratory networks. Focusing on 6 priority infectious diseases, we will characterize the existing laboratory network in Ghana and develop a detailed simulation model to estimate the impact and costs of several potential laboratory network strategies. Successful completion of these aims will have substantial public health and scientific impact by providing the understanding and tools to optimally allocate laboratory resources for diagnosing infectious diseases, thus reducing both country-level disease burdens and the likelihood of future pandemics.

Internship Activities. The intern will adapt our agent-based simulation model to characterize different diagnostic placement strategies for one of six priority diseases: HIV, TB, HCV, bacterial meningitis, measles, or yellow fever. This will involve literature searches and communications with our colleagues in Ghana Health Services to establish realistic model parameters and relevant laboratory network strategies. Additionally, the intern’s work will include coordinating with our programmer to incorporate these features into the model, analyzing model output, and interpreting results with the goal of abstract submission and publication of a manuscript.

Primary U-M Faculty Mentor. Emily Treleaven, Assistant Professor, Institute for Social Research

Additional U-M Faculty/Staff Members. David Hutton, Associate Professor, School of Public Health; Emily Martin, Associate Professor, School of Public Health; Geoffrey Siwo, Research Assistant Professor, Michigan Medicine; Gwenyth Lee, Rutgers University, CGHE Associate Member

Countries of Focus. Kenya, Uganda

Description of the Research Project. Global vaccine coverage has plateaued in the last decade. To achieve universal vaccine coverage and equity for routine childhood immunizations, it is necessary to reach children who are vulnerable to under- and non-vaccination. This requires high quality data that allows providers, health facilities, and governments to quickly identify and respond to gaps in coverage. Simultaneously, addressing equity also requires the development and implementation of tools that allow parents and caregivers to better access vaccines for their children in a timely manner. Our interdisciplinary team of investigators from U-M and the African Population and Health Research Centre will develop, implement, and evaluate a ‘digital vaccine card’ and registry that will facilitate the electronic collection of individual data at health facilities to allow improved monitoring of vaccine coverage and timeliness by both healthcare providers and parents/caregivers, in turn improving vaccine equity in urban Kenya and rural Uganda. We aim to design a tool that serves the needs of both parents/ caregivers—particularly those from groups that have historically lagged in vaccine completion and timeliness— and facilities and healthcare providers administering vaccines. To ensure that this tool is sustainable, we will center the needs and voices of marginalized groups and healthcare workers throughout the development and design process, and engage representatives of the Ugandan and Kenyan MOHs in tool development, deployment, and throughout the project.

Internship Activities. The intern will primarily support qualitative data analysis activities.This year, we will develop and carry out focus group discussion and semi-structured in-depth interviews with multiple types of participants in Kenya and Uganda (e.g., healthcare providers, parents, community health workers). Activities the intern will support and/or carry out will include, but not be limited to, development of interview guides and data collection protocols, developing coding frames, literature reviews, and reference management. Depending on the timing of data collection, the intern may assist with coding qualitative data. The intern may also support other project activities, such as quantitative dataset management and cleaning. Project activities will be conducted in Ann Arbor (mix of remote and in-person work).