Assessment of Barriers to Appropriate Management of Type 2 Diabetes: A Patient’s Perspective

Keno Carter-Guy, MD, Ruben Hernandez, MD

• Trinidad and Tobago (T&T) is a twin isle republic in the Caribbean and member of the Commonwealth
• Its health care system is aligned with United Kingdom model of health care
• According to WHO 2017 Diabetes is the second leading cause of death in T&T
• Few studies have been done on the island to evaluate the continued persistence of diabetes as one of the leading causes of death
• This study assessed barriers patients encounter to the appropriate management of their diabetes with respect to the social determinants of health

Translation and cultural adaptation of NIH Toolbox cognitive tests into Swahili and Dholuo languages for use in children in western Kenya

Megan M Duffey, MD; David Ayuku, PhD; George Ayodo, PhD; Emily Abuonji, BS; Mark Nyalumbe BS; Amy Kovacs Giella, BA;Julie N Hook, PhD, MBA; Tuan M Tran, MD, PhD; Megan S McHenry, MD, MS

• Cognitive development in childhood lays the foundation for a lifetime of academic achievement and economic potential1,2
• Nearly all available cognitive tests were developed in resource-rich settings and require substantial training and monitoring
• Tablet-based assessments may be a scalable option for use in low-resourced settings
• The NIH Toolbox is a set of tablet-based standardized, validated, normed cognitive tests validated in ages 3-85 years that may be useful in low-resourced settings

The aim of this study was to culturally adapt fluid cognition tests within the NIH Toolbox for use in Swahili and Dholuo languages. 

Gender Differences in Healthcare Seeking Behavior: Reviewing Surgical Outcomes at a Kenyan Referral Hospital

Anna Gillio, MD, Manisha Bhatia MD, MS, Helen W. Li, BA, Eunice Chepkimoi, Emmy Jepkurui Rutto, Connie Keung, MD, Seno Saruni, MBBS, FCS (ECSA), JoAnna Hunter-Squires, MD.

A review of outcomes among surgical patients at a national referral center in Kenya revealed gendered trends that warrant further investigation to inform public health policies and initiatives.

Primary language and pain experiences after cesarean delivery

Jennifer L. Grasch, MD, Jennymar C. Rojas, MD, Mitra Sharifi, Megan McLaughlin, Surya S. Bhamidipalli, MS, David M. Haas MD, MS

Objective: To evaluate whether experiences of pain and pain medication use after cesarean delivery differed by primary language

The Role of Community Health Workers in the Surgical Cascade: A Scoping Review

H.W. Li,  M.L. Scanlon, D.K. Litzelman

• Low- and lower-middle-income (LLMIC) countries host 48% of the world’s population but only 19% of the world’s surgeons
• There is an urgent need to expand access to quality surgical care across the surgical cascade, including screening, linkage to operative management, and post-operative follow-up care
• Role of Community Health Workers (CHWs) in surgical cascade in surgery is under-explored and mostly focused on screening
• We conducted a scoping review for literature on role of CHWs in linkage to operative management and post-operative follow up

Cultural Humility: Evaluation of a New Immigrant and Refugee Curriculum for Resident Physicians

Feenalie Patel, MD, and Christina Knight, MD

Mentors: Daniel Guiles, MD, Shaina Hecht, MD, Megan McHenry, MD

Indianapolis is home to a vibrant immigrant and refugee population. With increasing globalization, resident physicians need to be prepared to care for immigrant/refugee populations within the US. Past literature has shown that participation in domestic international health electives has a positive effect on clinical diagnostic skills, knowledge, communication, and attitude toward care for immigrant populations, as well as improvement in physician allocation of resources. However, few programs have a specific curriculum to teach all residents immigrant/refugee health at the domestic level. The aim of this curriculum is to provide instruction that helps learners develop skills critical to providing culturally effective medical care to immigrant and refugee patients domestically.

Development of a Mental Health Handbook for Parents & Caregivers in Kenya

Katherine Soe, MD, Edith Kwobah, MBChB, Florence Jaguga, MBChB

Mental illness represents a significant disease burden worldwide and a leading cause of disability. In Kenya, mental illness affects one in four people in their lifetime.1 Yet, a significant gap exists between the need, understanding of and access to mental health services in Kenya. In fact, fewer than 100 psychiatrists and even fewer child psychiatrists serve the entire country.2

The Mental Health Department at Moi Teaching and Referral Hospital cares for children and adults in and around Eldoret, Kenya, from inpatient to clinic to home visits. Their innumerable child and family encounters have identified a need for broader access to education to address this stigma and mental healthcare gap. To address this, we developed a culturally-minded Mental Health Handbook for parents and caregivers in Kenya, an educational resource describing common childhood mental illnesses. This has been translated and distributed in both English and Swahili.