1. After reading the article by Thomas et al., comment on where your research, or your research interests, fit into the generational framework for health disparities research. If your work is 1rst or 2nd generation, comment on how your work could lead in the future to 3rd or 4th generation work. If your work is 3rd or 4th generation, comment on what 1rst and 2nd generation work was necessary as a foundation for your current work (or current interests).
My research on neurologic/developmental outcomes in children post cerebral malaria has helped me identify my research interest in attempting to learn more about childhood morbidity in low resource settings in general. I think my research to date has been mostly second generation—attempting to describe neurologic/developmental outcomes in children (the kids post CM + controls from the same community/hospital catchment area). Currently grappling with how to turn what we’re learning about developmental delay, learning challenges, and disability in this population subset into low cost, reproducible, user/family friendly interventions. We have recently done some qualitative work to better understand caregiver’s experience, concerns, and needs while caring for a child with disability. We hope some combination of the cohort data and the caregiver qualitative data will help inform what areas of neurocognitive disability we could highlight first and how we may adapt current interventions in a culturally appropriate way.
2. The barbershop hypertension intervention, while essentially a clinical services intervention operating at either the fence or safety-net level as described by Jones, has some engagement with the social determinants of health. Interventions like that described in the Gottleib article are designed to mitigate the impact of social determinants. How could you apply one of these two types of interventions to your area of research? Propose one or two interventions that engage with social determinants on some level.
The approach described in Gottleib’s article requires there be a lot of resources available to families in the community. Unfortunately, these resources seem to be limited and often transient in Blantyre. We are attempting to catalog current available resources and we do refer families to these resources when they are available. Also as part of the qualitative work described above, we are asking caregivers if they have used any local resources in the past 1-2 years and if those resources have been helpful/what their experience was like engaging with that particular resource/organization. At some point, this understanding of the local landscape could be an intervention in itself for children admitted to Queen Elizabeth Hospital as it could allow a health leads type approach to social services. It also may inform potential future interventions we design as it would allow us to partner with existing community organizations or to focus on areas caregivers have identified gaps in services.