IMPROVING HEALTH OUTCOMES AMONG AMERICAN INDIAN GIRLS: A Spotlight on Healthier World Planning GrantEE

A key element of the Alliance for a Healthier World mission is to bring together multidisciplinary researchers, students and partners around the world to focus attention on the complex challenges in health equity, globally and locally.

We launched the Healthier World Challenge Planning Grants in 2017 as one strategy to achieve this mission. These planning grants provide funding of up to USD $25,000 for research teams of Johns Hopkins faculty, students and external partners to refine a research question and conduct initial formative work on the topic. To date, the Alliance has provided funding for 14 teams over two grant cycles to accomplish their foundational research as a stepping stone toward a potential Healthier World Challenge Implementation Grant, or to seek other funding opportunities with preliminary data in hand.

Spotlight on Recent Grant Awardee

One group awarded a planning grant is led by Dr. Allison Barlow, Director of the Johns Hopkins Center for American Indian Health and Dr. Teresa Brockie. Barlow and Brockie, along with co-investigators, Jacquelyn Campbell, Emily Haroz, Tak Igusa, and Lauren Tingey set out to explore strategies for reducing gender-based violence and risks to adolescent girls of the Fort Peck Sioux & Assiniboine tribe and White Mountain Apache tribe. The approach taken by the team involves adapting an existing mobile phone and website application to target the needs of the two tribal communities.

  Research investigators and stakeholders Emily Haroz, Rayann Chee-Amos, Allison Barlow, Breann Clarkson, Tak Igusa, Lauren Tingey, Francene Larzelere (Left to right) gather at an interview site in a parking lot on the White Mountain Apache reservation in November 2017 to test women’s response to the new app.  Photographer unknown.

Research investigators and stakeholders Emily Haroz, Rayann Chee-Amos, Allison Barlow, Breann Clarkson, Tak Igusa, Lauren Tingey, Francene Larzelere (Left to right) gather at an interview site in a parking lot on the White Mountain Apache reservation in November 2017 to test women’s response to the new app.  Photographer unknown.

The original application, known as MyPlan, was designed by AHW Gender Equity and Justice leader Dr. Nancy Glass to address gender-based violence. Read our previous article about the MyPlan application. The team also re-named the application “Safe Passage” for the tribal communities to message the desired impact of helping the girls to have a safe passage from adolescence to adulthood.

  Female participants connect during an adolescent health program in Whiteriver, AZ/Fort Apache in 2016. Photo credit: Ed Cunicelli

Female participants connect during an adolescent health program in Whiteriver, AZ/Fort Apache in 2016. Photo credit: Ed Cunicelli

Dr. Barlow’s proposal impressed the planning grant review panel with its focus on an “at risk” subgroup within the broader context of two American Indian communities who are typically at higher risk for social and structurally driven determinants of illness as compared with the overall U.S. population. From Dr. Barlow and colleagues, we learn that American Indian adolescent girls experience the highest rate of sexual assault in the U.S., with approximately 1 in 3 reporting being raped in their lifetime. Furthermore, we learn that victims of sexual assault, including intimate partner violence, are also at greater risk for substance use, sexually transmitted infections (STI’s) and suicide. And this trend is confirmed among Native American youth and young adults who have the highest rate of substance abuse, STI’s and suicide in our country.

With a clear health equity issue defined, the team set to optimize MyPlan for the communities at the center of the research project. As part of the planning grant process, the team discovered that the Safe Passage application would need to include social networking elements that connected adolescent girls with trusted advisors to help make key decisions. They also found that further information about sexual health and contraception would be an essential component of Safe Passage. They identified an additional application called Crush, produced by Healthy Teen Network, that contained much of the information required and began conversations to partner for Safe Passage.

“The grant provided the impetus for rich multi-disciplined interactions and collaboration. The AHW initiative’s emphasis on convening, planning and design sparked exceptional creativity and comradery.”
— Dr Allison Barlow, 2017 Planning Grant Awardee

Highlighting Successful Collaboration

In a period of four months, Dr. Barlow and her team created the design for a sexual health and violence prevention application that holds potential not only for the Fort Peck Sioux & Assiniboine and White Mountain Apache tribes, but for adolescent girls living around the world. In reflecting on how the planning grant helped get the idea off the ground Dr. Barlow said: “The grant provided the impetus for rich multi-disciplined interactions and collaboration. The AHW initiative’s emphasis on convening, planning and design sparked exceptional creativity and comradery.”

Dr. Barlow’s project illustrates how a team is working collaboratively to understand contexts and identify solutions for a sustainable impact on the health and wellbeing of disadvantaged populations. The Healthier World Challenge Planning Grants are shaping up to be an effective approach for convening diverse expertise and interests to stimulate innovation and impact for addressing health equity. Stay tuned for further stories about our grantees.

 

Further Details

Recommended Reading