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EP28 Implementation Science Lab with Chisom Obiezu-Umeh & Milena Dalton
Deborah Onakomaiya: Hey guys, and welcome to another episode of I AM GPH. On the show today, we have two alumni of GPH, Milena Dalton, who graduated with an MPH in Global Health in 2017. Milena currently works as a program coordinator in the Department of Population Health at NYU Langone. She is passionate about reproductive, maternal and child health and improving the lives of women and children through community-driven approaches. She is also part of the Implementation Science Lab that was started by Dr. Gbenga Ogedegbe, and she's here on the show today to talk about her work. Also on the show today is Chisom Obieuz-Umeh who graduated with an MPH in Epidemiology this year of 2018. She is also a member of the Implementation Science Lab, and her research interests are specific to analyzing and interpreting the double burden of HIV and CVD, using large scale research data with a focus on sub-Saharan African populations. All right guys, thank you so much for coming on our show today. It's awesome to have both of you here.
Milena Dalton: Thank you.
Chisom Obieuz-Umeh: Thank you for having us.
Deborah Onakomaiya: Yeah, thank you. So Milena, you are a global health program coordinator at the Department of Population Health at NYU Langone. Can you tell us a little bit about that work?
Milena Dalton: Sure. So I mainly work across noncommunicable disease programs in sub-Saharan Africa. My focus is on hypertension and cervical and breast cancer. My day-to-day really includes anything from scoping reviews to developing grant proposals, writing briefs, organizing webinars and implementation science, assisting with the community health officer training in Ghana. And one of the big events that I have run since starting this job was the 6th Annual Symposium on Global Cancer Research, which was a satellite of the CUGH Conference. And we had speakers from many different low middle income countries come in for that event. So that was great.
Deborah Onakomaiya: Wow. That's amazing, amazing work. And for our listeners, a lot of them are prospective students. Both of you are alumni of NYU, how were you able to land this gig? Were there any useful NYU resources you used, job strategies, people, professors, stuff like that?
Milena Dalton: Yes, so I was quite fortunate to have already been working as a consultant for about six months when I graduated; first with the UN Commission of Lifesaving Commodities for Women and Children and -
Deborah Onakomaiya: That's a mouthful.
Milena Dalton: It is. And then with Alive and Thrive, which is an infant and young child feeding nonprofit based out of DC. So whilst I was consulting, I was looking out for a full time role, and certainly speaking to professors, and looking at websites such as Devex and Idealist were really useful in looking for global health roles. I found this one just through ... I knew I wanted to focus on programs for global health and so that's how I found my current role. I will say that what I did find really useful in the job search process, was meeting with different people from different organizations for coffee. I started in my second year just to find out about what the organization they worked for were doing, how they got that role, what skills they needed. So that was really useful in terms of trying to work out where I would be able to get a job once I graduated.
Deborah Onakomaiya: Wow, that's nice. And you Chisom, just graduated, congratulations. So what's next for you?
Chisom Obieuz-Umeh: I'm currently working on building my resume. I'm hoping to apply to a PHD programs, applied statistics. And in the meantime, this gap year, I'm going to work on getting more research paper out there and co-author several proposals and publications, and also I'm taking classes on Coursera just to build my statistical skills, and I'm also at the same time I'm talking to professors, just to seek collaborations from professors here. For example, Melody Goodman and -
Deborah Onakomaiya: Whoop whoop, shout out, Professor Goodman.
Chisom Obieuz-Umeh: So yeah, that's what I'm currently working on.
Deborah Onakomaiya: Oh wow, that's amazing. And what does your research focus on? In this gap year, what type of research are you going to be doing?
Chisom Obieuz-Umeh: So my research is based on hypertension in HIV patients. There's a rise in the double burden of non-communicable and communicable diseases in sub-Saharan Africa. Not just in Africa actually, all over the world. And so we're trying to figure out how we can use existing HIV clinics and resources to integrate hypertension management and care in low resource settings in Nigeria, Ghana, and Tanzania. So that's pretty much what I'll be working on this year.
Deborah Onakomaiya: Well, wow, that sounds like a huge project. That's amazing. You guys are both alumni of GPH, so looking back at your experiences or different ... experiences that you had at NYU, what would you say was the most valuable class and or experience that you had, or you got out of your time at NYU?
Milena Dalton: I would say for me it was the two classes that allowed me to travel and work in different countries. So, in the summer after first year I traveled to Ghana with Wagner, for the food security course, and we spent three weeks traveling across the country and meeting with different NGOs as well as academics and some private organizations, and then also conducting research on a specific commodity. So I was looking at rice, so we would go to the big markets and interview rice sellers and also consumers to find out why people preferred the imported rice rather than the local rice, which is more nutritious. So that was an incredibly valuable experience to be able to go and do that as part of a course. And then the other one would be my capstone with the World Food Program in Madagascar. To be able to work with the World Food Program staff and then travel into the field and conduct research was incredible.
Deborah Onakomaiya: Wow, that's amazing. How about for you Chisom?
Chisom Obieuz-Umeh: I would say mostly my statistical based classes. For example, intermediate epidemiology and epidemiology methods and design, high level epi classes were my favorite actually. I learned new skills that are definitely transferable now at my current position, and I learned how to use new statistical software from, for example, the SAS programming course was really good and -
Deborah Onakomaiya: Shout out to Dr. Goldman.
Chisom Obieuz-Umeh: Goldman, yes. And also I had the opportunity to do a study abroad class over the J-term in Tanzania. It was an implementation science course, and it was basically looking at how they used evidence based interventions to improve health outcomes in low middle income country, and we got the opportunity to see firsthand some of the intervention work they were doing in Tanzania, to improve hypertension management and control in a low resource settings, in rural areas.
Deborah Onakomaiya: Can you tell us a little bit about what those interventions look like?
Chisom Obieuz-Umeh: So I know they had problems with linking patients to care, so they used m-health interventions, they used mobile phone text messages to text patients who were screened and at high risk for hypertension, to give them lifestyle counseling tips, and also to connect them with the closest hypertension specialist or cardiologist to better manage their condition. So that's basically what it was all about.
Deborah Onakomaiya: What advice would you guys have for students, especially who are interested in an MPH? So you talked about your capstone experience. You talked about all the statistical classes that you took. What mindset should students be coming in to the program, what type of things should they be leveraging?
Milena Dalton: My main advice would be to take as many practical classes as you can, so that you really come out of the MPH with practical skills that will get you a job. So, like statistics, program analysis and evaluation. Capstone is definitely a very useful experience. The World Food Program and UNICEF courses that Dr. Chris Dickey runs. And then I would also say, couple that with internships. So make sure that you're doing internships across the two years, and that is both to gain skills but also to learn about what type of role you might want to go into after you finished.
Chisom Obieuz-Umeh: So building from what Milena said, I agree with taking more applied courses in general. Also, talking to professors. A lot of professors are doing big things. They have multiple grants and they're always looking for help. They're always looking for people, for students to train and students to mentor. So for example, before I came to NYU I did my research on the professors who are currently teaching at College of Global Public Health. I looked at their research focus and I scheduled meetings with them, and for some of them, for the position I have now, I just spoke to the professor, I went to his office hours, I just gave him an idea of what he wanted to do, and I mentioned that I'm interested in his research focus and that was how I was able to get the position. So just by using ... speaking to professors and ... also I would say be open and be flexible. For example, I came into the College of Global Health with a global health concentration. But along the line, I figured that I liked more statistical courses and the more I took classes, the more I spoke to professors, I found what I really truly wanted to do. So I would say just be open, be flexible because you just never know, things change along the way.
Deborah Onakomaiya: Wow. So guys, be flexible, also take awesome classes. Wow. And both of you are currently part of the Implementation Science Lab at NYU GPH and also housed at St. Louis University, can you tell us Chisom a little bit about what the lab is, what you guys do and stuff like that?
Chisom Obieuz-Umeh: So I'll start by talking a little bit about implementation science. So, the way I understand implementation sciences, people conduct clinical effectiveness research. For example, you want to know if certain drug works or a certain behavior intervention. Maybe you wanted to see if a nutrition plan works for a certain population at risk, and after you do that you also want to ... you do it with a small group of people to prove that it's evidence based. And then now you want to translate the research into practice or policy, and that's where implementation comes into place. It bridges that gap between research and practice. So we study method, we study ways to translate that evidence based intervention to real world settings. And the only way you can do it is to make sure the intervention is ... it's specific to that context. For example, you would go into a country and you figure out, maybe the intervention was ... it was conducted here in the United States, but you wanted to take that back to a country in Africa, and you wanted to know if it will work in a different setting. So as implementation scientists, we go in and we conduct surveys about barriers and facilitators to see, to figure out if this is even feasible, if it's practic ... if it could be translated in this unique settings. So we study method really, and take those evidence based interventions to real world settings and see if it's feasible, I guess.
Deborah Onakomaiya: So what do you guys do in the labs? So the way you explained it is that you guys are in between research and practice. You guys are right in between that. So what type of things do you guys do? Are you guys writing papers? Are you guys going into the field? What does that day to day look like?
Chisom Obieuz-Umeh: I would say we do a little bit of everything. First of all we write proposals and we conduct literature reviews. We do situational analysis. If for example, there's an opportunity for implementing an intervention in a different setting, we write publications, we also travel. For example, I got an opportunity to travel to Ghana, Nigeria and Tanzania. And what we basically did there, we organized key stakeholder meetings just to discuss the possibilities of the intervention to be carried out in that setting. Also we wanted to get a feel of the barriers, the facilitators, things that would enable us to be able to implement that intervention. And basically I do a little bit of survey design specific to the country of interest, and we do a little bit of it, we're a group of experts.
Deborah Onakomaiya: Tanzania, Ghana, Nigeria. Wow, that's amazing. How about for you? Have you been able to go into the field with ... along the lines of your work with implementation science?
Milena Dalton: Yeah. So we actually just got back from Ghana where we were in Accra, Kumasi and Kintampo. We're implementing a hypertension control program where we're training nurses to coach community health workers on how to screen, counsel and refer for hypertension patients. So one of the key components of this is really integrating it into the lowest level of the health system and working with the Ministry of Health at all levels to ensure that it's context specific and sustainable, so that once the study is over, they'll be able to maintain and even translate this into policy.
Deborah Onakomaiya: Why is this type of work, especially the work you guys do at the lab, why is it so important? Why does it have to be context specific? Why do you guys have to go into the field? Why is all this work important, from your point of view?
Milena Dalton: From my point of view, I think that all health programs should be context specific. I think that that's really the only way that you will have the maximum impact and that they will be sustainable. So I think the lab is really unique in that it brings a team of interdisciplinary members together to work on identifying context specific solutions, building capacity in different areas and then making sure that the whole time you're really working with the main people in the main organizations in that country, so that it's really what they want, not what you're putting onto them.
Deborah Onakomaiya: How about for you? Why is this work important?
Chisom Obieuz-Umeh: Say Milena said it all, but it's very important because, like I said, there's this rising double burden of disease, between non-communicable and communicable diseases. And the work we do, it has to be context specific for it to be sustainable.
Milena Dalton: If there's any students that are interested, the lab is led at the School of Medicine by Dr Ogedegbe. We are in the section for global health and on the website, there are contact details should any students be interested in learning more about it and how they can apply. It's on the Department of Population Health website.
Deborah Onakomaiya: All right guys, so if you want to be part of this awesome lab, definitely try and visit that website. What was the most rewarding part of your NYU MPH experience?
Milena Dalton: I think going back to what Chishom was saying before, building relationships with different professors and working with different professors. I was fortunate enough to work with Professor Pomeranz and Professor Dickey and having that whilst studying was extremely valuable.
Deborah Onakomaiya: And could you speak a little bit more to your time with these two professors? What did that work look like?
Milena Dalton: So with Professor Pomeranz, I was her teacher's assistant for the health policy class for the undergraduate, for one academic year. And then with professor Dickey I worked with him to design the UNICEF behavior change course online, and then also went to Ghana with him to help run the course over there.
Deborah Onakomaiya: That's really, really amazing. How about for you? What was the most rewarding part?
Chisom Obieuz-Umeh: I would say, well I have two main experiences. One would be working under Dr Ogedegbe, working as a research assistant. I was able to translate all the knowledge that I learned from the classroom to the real world setting. And I learned so much on site, when we traveled to Tanzania, Nigeria and Ghana. And it's one thing if you learn something in the classroom, but it's another if you actually see the knowledge that you're learning in class, and the work in action, thank you. So I would say another experience that I really find valuable is I got the opportunity to be a course assistant for Dr. Melody Goodman's biostatistics intro course. And I was able to learn ... I was able to teach a class in stata to the SDG students as I taught biostatistics to the student, I got the opportunity to also solidify my skills.
Deborah Onakomaiya: Why are both of you so passionate about the work you do? Where does all this motivation come from?
Milena Dalton: So I had a background in international development once I finished my undergraduate degree, and I knew that I wanted to work globally so I moved to Vietnam, and it was in Vietnam that I started working in health. And it was really at that point that I realized, for me, health is the most important, because if you don't have health then it's difficult to get an education, it's difficult to work, and really, it's the starting point. So that's why I decided to focus on health and that's why I've continued to work in that area since then.
Chisom Obieuz-Umeh: Being born and raised in Nigeria, healthcare is one of the biggest issues, and while as an undergrad I did an internship in Lagos, Nigeria at a children's hospital. And we found that a lot of mothers ... there were a lot of preventable diseases, that could have been prevented if they took the right precautions, and it could go as safety or just doing the right thing, eating the right food, just taking care of yourselves and ...
Milena Dalton: Yeah, I think prevention is really a key part of why we love public health so much because really, if we can stop diseases, we can stop noncommunicable diseases, then that's what we should be aiming for. Not the treatment.
Deborah Onakomaiya: Prevention is key. How would you advise students to get into this type of work that both of you do? So you're more focused on research, you're more focused on programmatic side and funding. How would you advise students to get into this line of work?
Chisom Obieuz-Umeh: I would say, like I said earlier, talk to professors and look at ... do your research on what they're already doing and their research focus, and if it interests you, just meet up for coffee, meetup during their office hours and ask to work with them or ask to ... for mentorship. And that's the biggest advice I have for students who are trying to get into the field, and just keep on reading. That's another thing I would say, read for pleasure or just read publications. Just see what does ... what has already been done. And yeah, that's my biggest thing.
Milena Dalton: Yeah. I would say along the same lines, be proactive and seek opportunities. So whether that be working with professors or internships, networking is really important. And also making sure that you really come out of the degree, not just with the course based skills, but also some really applied skills. I think that that is particularly valuable in getting a job.
Deborah Onakomaiya: Guys, hope you were taking notes then. Awesome. So, our final question for today is, and I want you guys to really think about this, looking 10 years or 20 years into the future, what impact do you want to have in the world?
Milena Dalton: I think for me, I hope to have contributed to designing and running programs in coordination with ministries of health in lower middle income countries that really are sustainable, and have been able to inform policy so that it's really reaching the population health level.
Chisom Obieuz-Umeh: I would say my biggest thing is building statistical research capacity, and just something as little as teaching simple data analysis and management to low resource settings and ... for example, well specifically, sub-Saharan Africa, and also contribute to building effective evidence based solutions that are region specific.
Deborah Onakomaiya: Thank you guys so much for coming on our show today. It was so amazing to have both of you on. Thank you very much for having us.
Chisom Obieuz-Umeh: Thank you for having us. Thanks.