April 10, 2015 — Theresa Betancourt, ScD ’03, associate professor of child health and human rights, directs the Research Program on Children and Global Adversity, based at the Harvard T.H. Chan School of Public Health’s Department of Global Health and Population. She has spent more than a decade working in Sierra Leone studying the mental health and well-being of former child soldiers and other war-affected youth, the subject of this recent study. Betancourt is now taking a deeper look at another public health crisis that has ravaged the country — Ebola.
What is the goal of this study?
We want to understand more about people’s knowledge and perceptions and misperceptions related to Ebola, and relate this to past trauma and current mental health and social trust.
Issues around the social context of Ebola are very pressing right now in Sierra Leone, because you have thousands of affected individuals and a growing number of orphans and children affected by Ebola more broadly. We are particularly interested in learning how issues we’ve been studying for some time — such as stigma and social trust in communities — relate to knowledge, attitudes, and behaviors around Ebola prevention. We’re also looking at the mental health consequences of living in Ebola-affected communities and the interplay between past traumas and present-day stressors.
With input from our partners and stakeholders in Sierra Leone, we developed a survey that is now being administered to adults living in the western area of the capital, Freetown. Our team is using tablets equipped with the KoBo Toolbox, a data collection tool for rapid analysis and mapping created by one our co-investigators, Drs. Phuong Pham and Patrick Vinck of the Harvard Humanitarian Initiative.
Working with our other co-investigator Caroline Buckee, who specializes in modeling the spread of infectious diseases, we’ll analyze the survey results to assess how the social forces that underpin behaviors impact the spread of the virus.
Ebola transmission remains widespread in Sierra Leone. How are you addressing safety concerns during data collection?
The neat thing about this technology is that we can design the survey here in Boston and have it transmitted to our team via Wi-Fi. They download the survey into their tablets and then upload their findings.
In designing this study, we looked at different approaches to administering it in a safe way – on the phone versus face to face, non-touching community interviews. We’ve learned in Sierra Leone that it’s not typical for people to speak on the phone for half an hour, so a long phone survey isn’t something people are very used to. Our local team has advocated for doing the survey face-to-face if we can do it safely.
How will the findings be used?
The impetus for doing this research was to inform public information campaigns to prevent the spread of Ebola and also to help address the stigma and other social consequences of the disease.
We plan to share the results with policymakers and others working on the Ebola response. For example, we’ve been in discussion with our partners at Caritas, which is the development arm of the Catholic Charities, on creating simple messaging to communicate important information about Ebola. Literacy is very low in Sierra Leone, particularly among women, so this could take the form of cartoons or other nonverbal communications. This is an opportunity for transmitting what we learn back into practice.
The other exciting part of the study is that it will allow us to look at knowledge, attitudes, and behaviors over time, and to be able to see if public information campaigns are making a difference.