Rutgers Global Health Institute awards Global Health Seed Grants to faculty conducting collaborative, interdisciplinary activities that address health inequities in New Jersey and around the world. These grants are awarded in one of two categories: 1) Education, Training, and Capacity Building and 2) Research.
Research projects that have been funded by Global Health Seed Grants are listed below. For projects funded in the Education, Training, and Capacity Building category, visit this page.
Development of a Mobile Health App to Improve the Safe Use, Storage, and Disposal of Opioid Medications (2020)
Ann D. Bagchi, Division of Nursing Science, School of Nursing
Collaborative Partners: Department of Rehabilitation and Movement Sciences, Rutgers School of Health Professions; North Jersey Community Research Initiative
Between 1999 and 2017, the United States saw nearly five times as many drug overdose deaths involving prescription opioid medications. A key driver of the epidemic is the misuse of legitimately prescribed opioid medications, such as more frequent dosing than prescribed and sharing prescribed medications with others. Education provided to patients via mobile technology may help to increase their knowledge of appropriate use of opioid medications; however, knowledge does not always translate into behavior modification. This study will use input from patients and providers to develop and test three versions of a mobile health app designed to improve appropriate opioid use. A goal of the study is to understand how patient-facing technology can be deployed to increase both knowledge and behaviors consistent with safe opioid use, storage, and disposal. Additionally, because the COVID-19 pandemic has dramatically increased reliance on telehealth technologies, this study will provide evidence on how to ensure that telehealth solutions can be made more accessible and user-friendly for all consumers, beyond the opioid epidemic.
Development of an HIV Prevention Group Intervention for MSM Migrants in South Africa (2020)
Edward J. Alessi, School of Social Work
Collaborative Partners: Department of Biostatistics and Epidemiology, School of Public Health; McGill University School of Social Work; People Against Suffering, Suppression, Oppression, and Poverty
HIV prevalence among South African men who have sex with men (MSM) is among the highest in the world. Yet, the country’s robust HIV/AIDS response over the years has tended to overlook MSM migrants, which is a significant population due to the country’s constitutional guarantees of nondiscrimination on the basis of sexual orientation. The resulting disparities MSM migrants face present a serious challenge to reducing new HIV infections in South Africa and globally. The COVID-19 pandemic may magnify this risk because existing structural and psychosocial drivers of HIV—such as housing insecurity, lack of health care access, and perceived homophobia within their diaspora communities—will likely intersect with pandemic-related stressors. These increasingly complicated dynamics have the potential to create unprecedented health inequities for MSM migrants in South Africa. This pilot study will develop a group intervention and test its potential to increase knowledge about HIV prevention, increase self-efficacy in managing HIV risk, and reduce HIV-related stigma among MSM migrants in South Africa. This will lay the empirical foundation for testing the intervention on a larger scale, which could involve multiple languages, peer facilitators, and a control group.
Development of an Ultrasensitive COVID-19 (Coronavirus) Detection Method Using Upconversion Nanoparticle-Based Biosensing (2020)
KiBum Lee, Department of Chemistry and Chemical Biology, School of Arts and Sciences
Collaborative Partner: Sogang University
Testing remains a linchpin in worldwide efforts to control and understand the COVID-19 pandemic. Fast, selective, and highly sensitive tests for SARS-CoV-2 infection are critical for rapid and effective disease management as well as for monitoring the disease’s global spread. Biosensor technology, which measures biological or chemical reactions by generating signals proportional to the concentration of a substance in the reaction, offers promise for a new testing method that would provide clinicians and researchers with even more resources to battle COVID-19. This project aims to develop a biosensor that is luminescent resonance energy transfer-based and uses upconversion nanoparticle constructs to detect SARS-CoV-2 in blood samples. The outcome will feature the design and synthesis of a highly uniform technique for measuring the fluorescence intensity of graphene oxide emissions, a biochemical reaction that occurs when the coronavirus RNA’s aptamer changes structurally, thereby indicating the presence of SARS-CoV-2.
Development of Valid and Reliable Dietary and Physical Activity Assessments for a Birth Cohort Study in Kathmandu, Nepal (2018)
Shristi Rawal, Department of Nutritional Sciences, School of Health Professions
Collaborative Partners: Rutgers School of Public Health; Harvard T.H. Chan School of Public Health; Kathmandu University
In Nepal, rates of cardiovascular diseases and type 2 diabetes have been rising rapidly against a backdrop of limited health care infrastructure and resources. Because accumulating evidence suggests that predisposition to these diseases begins as early as in utero, pregnancy may be an opportune time for prevention and early intervention. While the Nepalese have many traditional beliefs and practices surrounding diet and physical activity during pregnancy and postpartum, research examining their impact on pregnancy and infant outcomes is sparse. Establishing an urban birth cohort study in Nepal will provide a unique opportunity to examine risk factors of pregnancy complications and the intergenerational influences of diet and lifestyle during pregnancy on the country’s growing epidemics of cardiovascular diseases and type 2 diabetes. The goal of this pilot project is to lay the necessary groundwork for such a study by developing valid and reliable dietary and physical activity assessments that are suitable for use in a Nepalese birth cohort, and by demonstrating the need and feasibility of implementing a longitudinal birth cohort study in an urban hospital in Kathmandu, Nepal.
Ectoparasites and Diseases of Poverty in Low-Income Urban Communities (2022)
Alvaro Toledo, Department of Entomology, School of Environmental and Biological Sciences
Collaborative Partner: Laboratory of Changlu Wang, Rutgers Department of Entomology
Low-income communities are disproportionately affected by neglected infectious diseases of poverty, such as leptospirosis, trench fever, and rickettsialpox. These diseases are responsible for a hidden health burden in poor communities, but surveillance programs to address their impact are lacking. To advance knowledge in this area, the project team will collect mice and arthropods from apartment buildings in four New Jersey cities (Jersey City, New Brunswick, Paterson, and Trenton) to screen for zoonotic and arthropod-borne human pathogens. Methodologies that combine urban pest control, insect taxonomy, and molecular techniques will be used to determine the role of arthropods in serving as sentinels to facilitate epidemiologic surveillance and inform disease prevention strategies.
Examining the Influence of Food Environments on Infant and Young Child Feeding among Subsistence Farming Communities in Senegal (2022)
Shauna Downs, Department of Urban-Global Public Health, School of Public Health
Collaborative Partners: Rutgers School of Health Professions; Institut de Recherche en Santé de Surveillance Epidemiologique et de Formation; Cheikh Anta Diop University
Suboptimal infant and young child feeding practices in the first 1,000 days, from the time a child is conceived until they are 2 years old, directly contribute to high rates of malnutrition and child mortality in Senegal. Most Senegalese children (93 percent) are not fed according to international infant and young child feeding (IYCF) guidelines, leading to growth faltering and micronutrient inadequacies. This project will assess dimensions of food environments, such as food availability, affordability, and acceptability, among subsistence farming communities in Senegal to better understand how their environments influence IYCF practices. The project team will use a combination of food environment mapping and tools to assess the diversity of foods available, prices, and promotion within markets. These data will be linked to dietary data being collected via another project in Senegal, providing insight into the environmental barriers to food access among the country’s subsistence farming communities. The findings have the potential to inform interventions and policies aimed at improving the availability, affordability, and acceptability of nutrient-rich foods within communities experiencing a high burden of malnutrition.
Exploring Scalable Multimodal Approaches to Identify Vulnerable Populations in the Congo (2021)
Woojin Jung, School of Social Work
Collaborative Partners: Microsoft; World Food Programme
This project will use artificial intelligence technologies to more accurately and rapidly identify areas of extreme poverty in the Republic of the Congo, informing humanitarian responses to the country’s surging food insecurity in the wake of COVID-19. The research will incorporate daytime satellite imagery, nighttime luminosity, and social media data to create algorithms that estimate the wealth and livelihood of geographic regions. The robust and objective information that is produced will allow for more precise targeting of social safety net programs.
Exploring the Role of Women’s Sanitation Practices on Physical and Mental Health: A Pilot Study in Mathare Valley, Kenya (2018)
Francis Barchi, Edward J. Bloustein School of Planning and Public Policy
Collaborative Partners: University of Nairobi; Village Voices
Inadequate access to safe sanitation is associated with negative health outcomes for women around the world, but is a particularly persistent problem for women living in informal settlements. Women in settlements often only have access to unhygienic and unsafe toilets, increasing their risk of contracting infections and/or risking violence when they use such facilities. This pilot study involves a quantitative assessment of sanitation-related health outcomes for women in Mathare Valley informal settlement in Nairobi, Kenya. In conjunction with Village Voices, a local community-based organization in Kenya, we will conduct household-level surveys with 550 women to capture information on a range of self-reported health indicators that may be associated with women’s sanitation practices in informal settlements. These indicators include mental health, sanitation- and menstrual hygiene-related illnesses and conditions, and experiences of non-partner violence. Findings will support future grant proposals to build on this work in conjunction with women’s health clinics in Kenya.
Health System Inequalities: An Empirical Assessment of São Paulo, Brazil (2017)
Michael Gusmano, Department of Health Systems and Policy, School of Public Health
Collaborative Partners: Rutgers School of Public Health; New York University; Columbia University; Centro de Criogenia
In 1988, the Constitution of Brazil established a right to health care, and the country adopted the Unified Health System, also known as SUS, which is funded by taxes and social contributions. The program expanded, and by 1999, 82 percent of the country was covered by health insurance. SUS provides free health care at primary, secondary, and tertiary levels through a national health system. The project is investigating the degree to which Brazil’s commitment to universal access to health care, regardless of ability to pay, is reflected in access to public health and health care services within São Paulo, Brazil. This project involves an analysis of health system inequalities within São Paulo through examination of four health system performance indicators: infant mortality, amenable mortality, avoidable hospitalizations for ambulatory care sensitive conditions, and rates of revascularization adjusted for morbidity. The initial results from the project indicate that investments in the public health and health care system since 2000 have generated improvements in access to care in São Paulo, but geographic inequalities in access within the city have actually increased during this time period.
Impact of Social Factors and Birth Weight on Mental Health, Self-Efficacy, and Parent-Infant Bonding among Postpartum Mothers in Nepal (2022)
Sangita Pudasainee-Kapri, School of Nursing–Camden
Collaborative Partners: Maharajganj Nursing Campus and Maharajgunj Medical Campus, Tribhuvan University; Rutgers School of Nursing–Camden
Mental health issues, such as depression and anxiety, affect approximately 14–30 percent of postpartum mothers in Nepal, a prevalence that is higher than global estimates of 8–17 percent. Such issues may contribute to poor parenting self-efficacy and impaired parent-infant bonding, which is foundational for long-term neurodevelopmental outcomes among children, more specifically among low birthweight children. In Nepal, which has the world’s third-highest prevalence of low birthweight children, research examining these dynamics is sparse. Knowledge about specific challenges facing mothers during the postpartum period in Nepal also is limited. This project will collect and analyze quantitative and qualitative data about postpartum mothers from immunization clinics at public hospitals in the capital city, Kathmandu. This pilot study will support the need for ongoing evaluation of low birthweight infants and screening for mental health issues among postpartum mothers in Nepal. It also will offer preliminary data to develop interventions in Nepal for reducing disparities in perinatal mental health and health care and improving the health and well-being of children.
Impacts of Air Pollution Exposure on M.tb Transmission in an Urban Slum Community in Kampala, Uganda – A Pilot Study (2017)
Stephan Schwander, Department of Environmental and Occupational Health, School of Public Health
Qingyu Meng, Department of Environmental and Occupational Health, School of Public Health
Collaborative Partners: Makerere University; EASEUganda
According to the United Nations Human Settlements Programme, more than half of the world’s population lives in cities, with approximately a quarter of the world’s urban population living in slums. In Africa, over half of the urban population lives in slums. People living in slum areas face multiple environmental and health challenges, including air pollution and infectious diseases. Namuwongo is the largest urban slum area in Kampala, the capital city of Uganda, and has a high incidence of tuberculosis (TB). This slum can be seen as a model study site of major global environmental and public health significance as slum populations are expected to increase worldwide in the coming decades. The purpose of this study, which was conducted in August 2017, was to collect critical pilot data to assess personal air pollution exposures in the slum area in both TB households and healthy households, and to test cough aerosol sampling systems in the slum area. Successful protocols were developed for personal air pollution exposure assessments and the cough aerosol sampling. High peak exposures of atmospheric particulate matter (PM2.5) and carbon monoxide were detected.
Poor Growth, Vitamin A Deficiency, and Microbiome in Children (2017)
Loredana Quadro, Department of Food Science, School of Environmental and Biological Sciences
Collaborative Partners: Rutgers School of Environmental and Biological Sciences; University of São Paulo; Federal University of Alagoas
More than 150 million children worldwide are undernourished and experience permanently stunted growth. Undernourished children have impaired microbiome development that may limit nutrient absorption, promote inflammatory responses, and hinder healthy growth. Vitamin A-deficiency (VAD) affects hundreds of millions of children in developing countries, where VAD and general malnutrition are often linked. Vitamin A is an essential nutrient that modulates intestinal inflammation, immunity, and cell proliferation. Given that a healthy gut is the prerequisite for proper microbiome development during childhood, it is hypothesized that children consuming a diet poor in energy and micronutrients such as vitamin A will have impaired intestinal functions that ultimately affect microbiome development, hindering normal growth. The project will determine the relationship between vitamin A status, microbiome, and growth by studying the microbiome of vitamin A sufficient and deficient children admitted for undernutrition at the Center for Nutrition Recovery and Education in Maceio, Brazil.
Real-Time Monitoring of Suicidality in Depressed Adolescents: A Smartphone-Based Ecological Momentary Assessment Study (2021)
Vincent M. B. Silenzio, Department of Urban-Global Public Health, School of Public Health
Collaborative Partners: Central South University; Xiangya School of Public Health; The Affiliated Brain Hospital of Guangzhou Medical University
To gain a highly nuanced understanding of suicide-related thoughts and behaviors among adolescents who are experiencing depression in China, this research will use smartphone-based survey apps and wearable monitoring devices to collect real-time data from study participants over a 28-day period. These data-collection methods will provide the interdisciplinary research team with a high volume of contextually specific data points and information that can influence the development of new national protocols for suicide prevention and intervention.
Sexual and Reproductive Health Knowledge, Attitudes, and Behaviors Among Urban Young Adult Women in the Philippines (2023)
Jamille Nagtalon-Ramos, School of Nursing–Camden
Collaborating with partners at: Filipino Young Leaders Program
The Philippines is experiencing an adolescent pregnancy crisis, which many consider a national emergency. In 2019, more than 10 percent of all live births in the country, an average of nearly 500 per day, were among girls aged 10 to 19 years old. Estimates indicate that 97 of these pregnancies are the result of coercive or unequal power relations between intimate partners and that half of all pregnancies in the country are unintended. Impacts of adolescent pregnancy include that only 38 percent of the mothers complete their high school education by the time they are 22 years old, which consequently leads to low-paying jobs or unemployment and, therefore, limited economic freedom. Public schools in the Philippines are not required to provide education about reproductive health and sexuality, nor is women’s access to contraceptives or post-abortion care guaranteed, due in part to opposition from pro-life groups and the Catholic church and despite the country’s passing of a reproductive health bill over a decade ago. This study aims to better understand how sexual and reproductive health care information is obtained by urban young adult women in the Philippines, and how such information and related dynamics influence these women’s attitudes, behaviors, and acquisition of health care services. The preliminary data will be utilized to develop culturally relevant and community-informed interventions to reduce disparities related to adolescent pregnancies in the Philippines.
Strengthening Vegetable Value Chains for Improved Nutrition in a Kenyan Slum (2018)
Shauna Downs, Department of Urban-Global Public Health, School of Public Health
Collaborative Partners: Rutgers School of Environmental and Biological Sciences; Mirror of Hope
Kenya is currently battling multiple burdens of malnutrition. Increasing the consumption of African indigenous vegetables (AIVs) has the potential to help address malnutrition, particularly among vulnerable populations living in urban slums. This study will provide a sample of 20 women in Kibera, a large urban slum in Nairobi, with the inputs and extension support needed to grow AIV micro-plots in two Kibera schools. Using a combination of value chain analysis and consumer surveys, we will identify the incentives and disincentives for producing and consuming AIVs; identify bottlenecks in the AIV value chains and potential solutions to improve their availability, affordability, and acceptability; and examine AIV preferences and consumption patterns among 200 Kibera consumers. The findings of this study will inform the scale-up of AIV production in Kibera, as well as the development of a package of interventions aimed at improving their availability, affordability, and acceptability.
Understanding Underdiagnosis of Dementia in the Context of Indigenous Older Adults: a Community-Engaged Study in Ecuador (2023)
Takashi Amano, Department of Social Work, School of Arts and Sciences–Newark
Collaborating with partners at: University of Vermont and Universidad San Francisco de Quito
Alzheimer’s disease and related dementias (ADRD) are debilitating conditions that impair memory, thought processes, and functioning, primarily among older adults. Timely detection of these conditions is crucial for enabling patients and caregivers to make informed decisions about treatments, support, and services. However, studies have suggested that these conditions are underdiagnosed and that ethnic minorities and people living in low-income countries are more likely to have undetected disease. Indigenous older adults are especially vulnerable to the issue of undetected ADRD, due in part to interrelated cultural, social, historic, and economic factors that influence their health. However, underdiagnosis among indigenous older adults is understudied, especially in the Global South. This community-engaged study aims to understand the underdiagnosis of ADRD in the context of indigenous older adults in Ecuador. Specific aims of this study include developing a culturally appropriate screening tool and describing the underdiagnosis of ADRD from the perspectives of older indigenous people, their families, and the community. This research will contribute to establishing an equitable system capable of effectively providing vulnerable populations with ADRD care in Latin American countries.
Using Machine Learning to Examine Quality of Care: Analyzing Nursing Notes to Investigate Racial Inequity in Brazil (2022)
Charles Senteio, Department of Library and Information Science, School of Communication and Information
Collaborative Partner: Universidade Federal do Rio de Janeiro
Racial inequalities and ethnic biases in hospital-based care delivery can influence clinical practice and, ultimately, patient outcomes. In nursing notes about patients, the use of stigmatizing words and phrases—such as addict, non-compliant, crazy, dirty, clean, drug seeker—are considered indicators of nursing providers’ beliefs and attitudes toward patients that can impact clinical decision-making and quality of care. This project will use machine learning technology and associated processes to analyze nursing notes in medical records from the federal Clementino Fraga Filho University Hospital in Rio De Janeiro, Brazil. The study’s aim is to evaluate the efficacy of these methodologies for identifying potential racial inequities in care in a standardized way. The team also will determine effective algorithms that can be applied to future interventions and clinical support systems to promote patient-centered, equitable health care across stigmatized patient populations.
Youth and Family HIV Stigma: Examining Potential Barriers to HIV Services and Stigma-Reduction Interventions (2021)
Emilia Iwu, Division of Nursing Science, School of Nursing
Collaborative Partners: Institute of Human Virology Nigeria; Association of Positive Youths in Nigeria
Through focus groups comprising adolescents and youth living with HIV (AYLHIV) and their adult caregivers in Nigeria’s River State, this research explores the impact of stigma on this population with respect to their physical and mental health and health care engagement, especially adherence to HIV treatment regimens. Additionally, the study will examine how AYLHIV and their caregivers feel about interventions to reduce stigma’s impact on their wellbeing and what they would recommend for a future intervention.