Introducing www.FEUL.org

It has been been awhile since my last post, but for good reason. We've been building www.FEUL.org, the new web face of Fundacion Enciende Una Luz. It is (mostly) complete, and you can find lots of information about our many health education activities, old and new, along with some photos and videos of our work. We'll still be updating the blog with the lastest information about the Foundation, but the website should also serve as a good resource for those who want to learn more about our organization.

Finally, some data...

Figure 1: Multiplicandos relevant questions, before and and after students participated in the program (p = 0.011).


Figure 2: Movie relevant questions, before and after students participated in the program. N for each column is approximately 15.

I've been meaning to put up some of the data we've been tracking for some time, but it always seems to get away from me. Above, you'll find the results from our first "round", which lasted three weeks, and concluded in November. The second round of seminars will be finishing today in Batey 82, and hopefully I'll be a bit more timely about getting that together.

First, a bit of scheduling background to better understand the above graphs. A typical session gets broken down like this:

Day 1: Show Tu Decides, a FEUL-produced film, hold small lecture to reinforce topics, question and answer session, and recruit young people for the remainder of the program.
Day 2: Before the small group lectures begin, administer test to assess participant knowledge on both film-oriented questions and Multiplicandos-oriented questions (Shown as "Before Program" above). Then, begin lectures, small group discussion, Q&A sessions about STDs, breastfeeding, condom use, etc.
Day 3: Continue with activities mentioned above, then review session with Q&A. Students conclude the program with a post-test that examines the same topics as before, but with different questions (Shown as "After Program" above). Finally, "graduation" from the Multiplicandos program.

As I mentioned before, there are two types of questions: those that address topics covered in the movie, and those that address topics covered in the Multiplicandos program. Ideally, we would see a jump from approximately 50% of the questions answers correctly (the questions are true/false style, making the null hypothesis 50% correct) to 100% mastery. Obviously, the improvement isn't perfect, but it is quite good. Students answered the Multiplicandos-relevant questions correctly 57% of the time before the program, and almost 90% correct after the program. Not bad at all.

The second figure shows questions addressing information in the film Tu Decides (Day 1). There is a slight (though not significant) improvement in correct responses (80% --> 90%). The bump can probably be attributed to the fact that some topics covered in the movie are also addressed in our course.

So, in response to a posted question, our tests don't exactly compare whether the film or multiplicandos style of teaching is better (since, strictly speaking, they address different topics). However, they do allow us to say whether Multiplicandos creates subject mastery at a level comparable to the film viewing session, despite the multiplicandos subject matter being considerably more difficult (it does).

A more carefully controlled experiment would test what the students know before even viewing the movie. Unfortunately, we don't know who will participate in the program before showing the film (which is used as a recruiting tool), and therefore cannot test their knowledge.

There are additional pedagogic questions that these result raise. This data doesn't tell us how effectively the information instilled in the newly-minted Multiplicadors is being disseminated to peers. Anecdotally, the Multiplicadors do indeed seem to be "multiplying the light" by sharing the information with their peer group. For example, we often find the number of people unofficially enrolling in the course grows throughout the second and third days as people tell their friends about the program.

I'm just about out of battery, but I'll try to post some recent pictures in the next few days. Happy Holidays!

A Busy Week

I have been sadly absent from the blog these past few days, as they have been busy ones for the foundation and hospital. Thankfully things have slowed down a bit and have given me time to catch up.

First, we had two days of health fairs at Hospital General Buen Samaritano. The fairs consisted of various stations to take blood pressure, glucose, body mass index, and also offer counseling on topics ranging from hypertension to neonatal care.

Second, we had a health promoter workshop at the hospital, which was attended by more than 50 local health promoters from around the La Romana region. These health promoters (pictured in the green vests) are residents of the batey communities (sugar cane villages) who work as primary care health providers. We hold conferences from time to time to troubleshoot problems in the communities, provide additional training, and distribute materials to the communities.

We also had a full week of Multiplicandos programming with a batey creatively named "16". Eleven young women from that community did spectacularly during the three days of sexual and maternal health training. Photos from their graduation ceremony are in the album below. Plans are starting to shape up for how we will continue to evaluate the program. Right now, we use a pre-test and post-test to understand whether the Multiplicandos program is having the anticipated effect. I've posted one of our tests here (en espanol) if you are interested.

The last bit of exciting news is that a major funding source (DRMP) has agreed to fund our Multiplicandos work for the next six months, which will include visits to up to 24 bateys. Congratulations to Wilkin, Pam, and the rest of the FEUL team for all of their hard work putting the application together.

Eso es todo por ahora!

A Busy Week

On blending in

Nailed it, right?

As I grow more acclimated to day-to-day life of the DR, I am more acutely aware of the smaller things that indicate my gringo status to locals.

There are, of course, the more obvious:

1. Terrible spanish

2. Blonde hair

3. Looking lost

While each of these items would raise the eyebrows of a Dominican in its own right, there are a number of more subtle indicators. These include:

1. Backpacks. Unless you are a 12 year old girl going to school, leave the mochilla at home. Briefcases are not really big here either. How, you might ask, does one cart around one's crap? Further research is underway.

2. Short pants. You might think that if you followed a line of longitude from the north pole, heading equitorially, you would encounter an increasing density of short pants. Not so in the DR. Nothing sticks out here like the pale legs of a northern tourist ensconced in bright floral swim trunks. I have been told that this is true for much of the spanish-speaking world.

3. Tennis shoes. Are you going to the gym? Perhaps to a basketball game? If not, leather shoes are de facto necessities for any near-fashionable male.

4. An inability to sing and dance well. My perspective with this one may be more questionable since the majority of my time is spent with professional musicians and dancers. However, I would venture to say that the vast majority of people here have kinetic and vocal skills that far exceed my own.

5. Walking on the sunny side of the sidewalk. Few among us enjoy vigorously sweating, and in the land of eternal summer, it is difficult to avoid. Walking in direct sunlight when shade is just a few feet away may provoke an odd stare or two.

6. Hesitantly walking through intersections. Like much of the global south, traffic rules aren't really a thing, so stride determinedly and pray that traffic stops.

7. Excessive timeliness. La Hora Dominicana. (+/-)2hrs for all plans.

Multiplicandos, PhotoVoice, and Baseball

Activities have been going well in the Dominican Republic so far. I have been living here a bit longer than a week, settling into La Romana my new apartment. My current housemate is Dr. Robina Horak, an awesome pediatrician at UCSF who is conducting a breastfeeding study in the same bateys that I visit. So far, I have tackled a youth education project and a community needs assessment.

First, the youth education project (called Multiplicandos) aims to recruit community leaders for maternal and sexual heath education. In a community without much access to outside health information, we believe that these individuals can be an excellent source of health knowledge for their peers. The program starts by showing a Fundacion Enciende una Luz film called Tu Decides which, though a series of culturally-relevant vignettes, highlights the benefits of safe-sex practices and healthy life choices. After the film, we ask for volunteers who are interested in learning more about the topics presented in the film. The volunteers return for two subsequent evenings of lectures, discussions, and small group exercises with Dr. Denny and Dra. Angela, two HGBS* physicians. In addition to coordinating the educational materials for the project, I am studying whether the the Multipliandos teaching model is more effective than our current “best practice” for community education—the health education films. We'll have the first complete set of data in two weeks.

Second, the needs assessment program uses a technique called PhotoVoice (PV). With PhotoVoice, a few community members are presented with cameras and instructed to photograph the strengths and weaknesses in their communities. We piloted this program with a few bateys in August, with positive results. The benefit of the photographs is twofold. The individuals can more specifically describe the problems that they are facing (e.g. “septic overflow is contaminating our water supply” vs. “the neighborhood is dirty”) and discussing the photos fosters a greater sense of community among the photographers. We have asked the women participating in the program to focus on maternal and infant care.

There are a few other activities going on, but I'll have to write more on those later. Besides her breastfeeding study, Dr. Horak is also conducting neonatal resuscitation trainings with local health workers, with the goal of helping babies breathe during the first, “golden minute” of life.

On a more recreational note, we went to a baseball game Saturday night to see the La Romana team, Los Toros. Baseball in in the DR (and Puerto Rico, from what people tell me) is not taken lightly. The noise can be deafening, and those not accustomed to a DR ball game are advised to bring earplugs. The entire stadium erupts whenever a player scores a run, gets a base hit, strikes out, hits a foul, tries to steal, waves to the crowd, sits down, gets a drink of water, etc.

Appropriately, baseball news stateside has been focused on the Cardinals. The Toros game Saturday, though, was amazing. The Toros were down by two points at the bottom of the ninth, with two outs and two men on base. The batter (sorry, forgot his name) hit a line drive into left field to score a double. This brought the final score to 5-4 for the Toros.

*Hospital General Buen Samaritano

24 Oct 11 Blog Post

Apologies for the delay in getting marathon photos out -- I've completed my move to the DR and internet has been a bit limited. After our 20 mile run two weeks before race day Brian and I prophetically agreed that "we will never do this to ourselves again". However, we did have a blast in Chicago, and we're starting to cautiously consider future runs.

In any case, thanks to all our supporters for their contributions. Your donations are already being put to work! More on that in future posts...

If you are still interested in donating, the PayPal link is still active (right side of page), and snail-mail donations are always possible.

Clicking on the photo below will link you to the Picasa album.

Chicago 2011

Own Chicago 2011!

Chicago 2011 is finished, and a half-dozen Steak 'n Shake meals later, we are entering recovery mode. Brian has rounds a 6am tomorrow, Lara has work, and I have some very important sleeping to do. Race pictures should follow in the next day or two. Thanks again to everyone for all of their support and contributions to Fundacion Enciende una Luz!