PROJECTS
Local
District Of Columbia Department of Health - GW Public Health - Academic Partnership
Sponsor: District of Columbia Department of Health
Years of Project: 2006 - Present
Principal Investigator: Alan Greenberg, MD, MPH
Participating Faculty: Amanda Castel, MD, MPH, Heather Hoffman, PhD, Irene Kuo, PhD, MPH Manya Magnus, PhD, MPH, Dante Verme, PhD, MS and Health Young, PhD, MPH, CHES
Description: In March 2006, the DC Department of Health HIV/AIDS Administration (DOH HAA) and the GW SPHHS Department of Epidemiology and Biostatistics developed the "Public Health - Academic Partnership" to work together to improve HIV/AIDS surveillance activities in the District of Columbia. These surveillance efforts have helped to provide a comprehensive picture of the HIV/AIDS epidemic in DC. To date, the Partnership has been highly successful, collaborating extensively on projects including:
- A comprehensive technical evaluation of HIV/AIDS surveillance in DC;
- The successful transition to named HIV reporting in DC;
- The release in October 2007 of the DC HIV/AIDS Surveillance report, which included the first AIDS case data since 2002 and the first HIV data ever in DC and a follow-up annual report in 2008;
- The successful conduct of the CDC-funded National HIV Behavioral Surveillance System composed of alternating cycles of surveys in three high-risk populations, including heterosexuals, men who have sex with men and injection drug users;
- A monitoring and evaluation project of the DC DOH's HIV testing campaign with data from over 38,500 clients HIV tested in DC entered and analyzed; and
- The provision of technical support and analysis for the DC DOH's hepatitis case registry.
HIV/AIDS Surveillance
Sponsor: District of Columbia Department of Health
Years of Project: 2006 - Present
Project Principal Investigator: Amanda Castel, MD, MPH
Participating Faculty: Alan Greenberg, MD, MPH, Dante Verme, PhD, MS, and Heather Young, PhD, MPH
Description: Through the DC DOH-GW Partnership, launched in the spring of 2006, a doctoral-level epidemiologist has been embedded at HIV/AIDS Administration as the "Chief HIV/AIDS Epidemiologist." The DOH and GW have worked together to restructure the Surveillance Bureau; hire new and talented technical staff; investigate and enter into the database thousands of previously un-entered cases; clean and de-duplicate the AIDS surveillance database; and initiate named HIV case reporting for the first time in DC. These efforts resulted in the production of a comprehensive HIV/AIDS surveillance report that was released in November 2007 - which contained the first AIDS surveillance data in DC in five years and the first HIV surveillance data in DC ever. An update of this report was released in 2009 and demonstrated HIV/AIDS prevalence rates surpassing those in many sub-Saharan African countries. Additionally, technical work has been done on incidence surveillance data collected by the Bureau and ensuring that it meets CDC guidelines.
National HIV Behavioral Surveillance Project
Sponsor: District of Columbia Department of Health
Years of Project: 2006 - Present
Project Principal Investigator: Manya Magnus, PhD, MPH
Participating Faculty: Irene Kuo, PhD, MPH (Project Director), Alan Greenberg, MD, MPH
Key Staff: James Peterson, EdD, MHA, Anthony Rawls, Kath Shelley, MPH, Luz Montanez, Gregory Phillips, MPH
Description: In 2002, CDC developed the National HIV Behavioral Surveillance (NHBS) System to help health departments monitor selected behaviors and assess the use of prevention programs in groups at highest risk for HIV infection. The study is conducted in 20-25 metropolitan areas across the country, including Washington, DC. NHBS is a serial, cross-sectional survey focusing on the three main populations at risk for HIV: men who have sex with men (MSM), injection drug users (IDU), and heterosexuals at high risk for HIV infection (HET). Conducting NHBS in Washington, DC enhances our understanding of HIV risk and testing behaviors in community-based populations, and the extent to which current HIV-prevention programs are reaching targeted communities. Findings from this study help direct HIV-prevention activities to reduce HIV transmission in the District.
Through the DC DOH-GW Partnership, and in collaboration with DC DOH/HAA, GW works on conducting NHBS in Washington, DC. Locally known as WORD UP (Washington Outreach Research Drive to Understand Prevention), strong community support, including an active Community Advisory Board (CAB), has enabled NHBS to succeed in DC. In 2006-7, 750 high risk heterosexuals were enrolled in collaboration with Family Medical and Counseling Services, with an HIV rate of 5.2%. In 2008, 500 MSM were recruited in venues such as bars, nightclubs, and gymnasiums, with an HIV rate of 13.8%. The NHBS cycle in injection drug users is being conducted in 2009.
Community Service Assessment
Sponsor: District of Columbia Department of Health
Years of Project: 2006 - Present
Project Principal Investigator: James Peterson, EdD, MHA
Participating Faculty: Amanda Castel, MD, MPH
Key Staff: Michelle Folkers
Description: Through the DC DOH-GW Partnership, The District of Columbia HIV/AIDS Administration (HAA) asked GWU Department of Epidemiology and Biostatistics to assist with a mandated Community Services Assessment, an integral part of the upcoming 2010 HIV Prevention Plan. The Community Services Assessment (CSA) consists of three parts: a needs assessment, a resource inventory and a gap analysis. The needs assessment describes HIV prevention needs of identified high-risk populations while the resource inventory provides information about existing HIV prevention organizations, programs and interventions. The gap analysis compares the two previous components to identify the met and unmet needs of the targeted populations. Target populations for this project are non-injection substance users, transgender individuals, men who have sex with men (MSM) and high risk heterosexuals.
Viral Hepatitis Surveillance
Sponsor: District of Columbia Department of Health
Years of Project: 2008 - Present
Project Principal Investigator: Irene Kuo, PhD, MPH
Participating Faculty: Alan Greenberg, MD, MPH, Amanda Castel, MD, MPH and Heather Hoffman, PhD
Description: Through the DC DOH-GW Partnership, technical assistance is being provided to the DC DOH to help improve hepatitis surveillance, integrate it with routine HIV/AIDS surveillance, and to assess epidemiologic trends in hepatitis A, B and C and hepatitis/HIV co-infections in DC. More than 30,000 cases of viral hepatitis have been reported from 2001-2007 in the District of Columbia. This information will help guide public funds for targeted and appropriate prevention efforts to curb the incidence and prevalence of viral hepatitis in the District.
Routine Testing Campaign - Monitoring & Evaluation
Sponsor: District of Columbia Department of Health
Years of Project: 2006 - 2008
Project Principal Investigators: Amanda Castel, MD, MPH, and Manya Magnus, PhD, MPH
Participating Faculty: Alan Greenberg, MD, MPH
Description: Through the DC DOH-GW Partnership, retrospective monitoring and evaluation was done of the DC DOH's 2006 Routine HIV Testing Campaign, "Come Together DC-Get Screened for HIV," which encouraged free HIV testing of DC residents ages 14-84 years old through social marketing materials and distribution of free HIV rapid test kits. Washington, DC, was the first US city implementing and supporting widespread routine screening in an effort to increase the number of HIV+ persons who know their status and can be offered treatment. The purpose of this evaluation was to use qualitative and quantitative methods to characterize community and provider perception of the campaign as well as to better understand client- and provider-level correlates of testing and methods to improve testing within the city's population.
DC Partnership for HIV/AIDS Progress
Sponsor: National Institutes of Health
Years of Project: 2008 - Present
Principal Investigator: Alan Greenberg, MD, MPH
Key Staff: Stephanie Panichello, MBA, and Jennifer Skillicorn, MPH
Description: In 2008, the District of Columbia and the National Institutes of Health initiated a new partnership to enhance the DC DOH response to the HIV/AIDS epidemic, with GW serving as the Secretariat. The Partnership is drawing upon a diverse portfolio of universities, health care providers, community-based organizations, and stakeholder groups for design and implementation of specific projects and activities.
The Partnership has developed four initial projects:
- HIV Prevention Trials Network - two new prevention studies (HPTN 061 and 064) to reduce HIV transmission in high risk men who have sex with high risk men and women.
- HIV Sub-Specialty Care - enhanced HIV subspecialty services are being developed at three community medical clinics in DC.
- DC Cohort Study - collection and analysis of data from large medical providers in DC to improve the quality of HIV care in DC.
- Test and Treat - test the effectiveness of increased HIV testing, linkage to care and ARV adherence interventions to reduce HIV transmission in DC.
HIV Prevention Trials Network Clinical Research Site
Sponsor: National Institutes of Health
Years of Project: 2009 - Present
Site Lead: Irene Kuo, PhD, MPH, and Manya Magnus, PhD, MPH
Participating Faculty: Shelita Merchant, PhD,MPH, and Alan Greenberg, MD, MPH (Clinical Research Site Director)
Key Staff: Avery Barber, Melissa Douglas, RN, Vienna Mbagaya, MPH, James Peterson, EdD, MHA, Ashley Price, Anthony Rawls, Kath Shelley, MS, Christopher Chauncey Watson, and Amber Young
Description: GW competed successfully to establish The HIV Prevention Trials Network (HPTN) Clinical Research Site (CRS) site in Washington, DC. The first study, HPTN 061, will determine the feasibility and acceptability of an HIV behavioral intervention among black MSM and help prepare for a future community-level study to test the efficacy of the intervention in reducing HIV incidence in this population. The second study, HPTN 064, will estimate the rate of new HIV cases among women at high risk, and assess risk behaviors and how to develop programs to help reduce these risks. Both of these studies initiated enrollment in the summer of 2009, and will be completed in the next 1-2 years.
DC Cohort
Sponsor: National Institutes of Health
Years of Project: 2009 - Present
Principal Investigator: Alan Greenberg, MD, MPH
Participating Faculty: Amanda Castel, MD, MPH, (Project Director) and Heather Young, PhD, MPH
Key Staff: Currently recruiting
Description: GW and the Cerner Corporation completed a feasibility assessment for establishing a "DC Cohort." The DC Cohort would be a real-time database of all consenting HIV-infected persons in care at the major clinics in DC. The creation of this city-wide cohort would enable clinicians and public health officials to assess the effectiveness of treatment over time, the proportion of HIV-infected adults who are receiving appropriate care, and to improve the clinical outcomes of HIV-infected persons in DC.
U.S.
Evaluation of SPNS and Care Act Programs
Sponsor: HRSA
Years of Project: September 2003 - August 2004
Co-investigator: Manya Magnus, PhD, MPH
Description: The purpose of this project was to develop a mixed method curriculum specific to evaluators in the field working in the domain of HIV service delivery. The full curriculum was presented in a three-part Institute at the Ryan White All Grantees Meeting in Washington, DC, as well as presented in monograph format to RWCA grantees.
The Lab Tracker Medical Information Systems SPNS Project
Sponsor: HSRA HIV/AIDS Bureau; Special Projects of National Significance
Years of Project: October 2002 - December 2006
Evaluator/Co-Investigator: Manya Magnus, PhD, MPH
Description: The purpose of this study was to administer and analyze provider and patient satisfaction surveys at eight of the HIV clinics throughout the state, and to conduct epidemiologic studies, in order to evaluate the impact of Lab Tracker Information Technology Medical System on care delivery and outcomes. There are three components to this study: Evaluation of provider use of and satisfaction with LT; evaluation of patient satisfaction with LT (including patient educational materials and behavior change among providers); and epidemiologic studies to evaluate the impact of LT on patient care, the identification of patients at risk for negative HIV-related outcomes, and the identification of new trends in HIV-related disease and treatment.
Global
Elizabeth Glaser Pediatric Aids Foundation - GW Partnership for Pediatric AIDS and Public Health
Sponsor: Elizabeth Glaser Pediatric AIDS Foundation
Years of Project: 2007 - Present
Principal Investigator: Alan Greenberg, MD, MPH, and Laura Guay, MD
Participating Faculty: Amanda Castel, MD, MPH, Heather Hoffman, PhD, Jeanne Jordan, PhD, Irene Kuo, PhD, MPH and Manya Magnus, PhD, MPH
Key Staff: Michelle Gill, MPH
Description: In 2007, the Elizabeth Glaser Pediatric AIDS Foundation
(EGPAF) and the George Washington University, through the School of
Public Health and Health Services' Department of Epidemiology and
Biostatistics, created the Partnership for Pediatric AIDS and Public
Health. The objectives of the Partnership include the provision of
technical expertise from GW to support the Foundation's global
pediatric HIV/AIDS activities and the creation of innovative educational
opportunities for GW students. The Partnership Director, Dr. Alan
Greenberg, Professor and Chair of the GW Department of Epidemiology and
Biostatistics, provides technical leadership for the Partnership and
serves on the Foundation's Senior Leadership Team. In the past three
years, support from GW faculty members, research staff and graduate
students has been provided in the areas of program evaluation,
biostatistics, laboratory diagnostics, monitoring and evaluation (M&E),
operational research and global policy. A notable Partnership
accomplishment was the successful recruitment of Dr. Laura Guay to serve
both as the Vice President of Research at EGPAF and a Research Professor
at GW. Recent examples of collaborative projects include hosting a large
global expert consultation on operations research for PMTCT and
pediatric care and treatment supported by UNICEF and WHO and conducting
a comprehensive assessment of the Foundation's M&E systems. GW
graduate students have supported a number of EGPAF projects in the areas
of M&E, research, and quality improvement.
Evaluation of EGPAF Antiretroviral Treatment Programs in Three African Countries
Sponsor: Elizabeth Glaser Pediatric AIDS Foundation
Years of Project: 2008 - 2009
Project Principal Investigator: Amanda Castel, MD, MPH
Additional Faculty: Irene Kuo, PhD, MPH
Key Staff: Michelle Gill, MPH, and Jennifer Skillicorn, MPH
Project HEART is one of the key programs of the Elizabeth Glaser's Pediatric AIDS Foundation (EGPAF) and was launched in 2004 to provide care and treatment to families, with a particular focus on children. The program supports nearly 200 sites in five countries: Zambia, Cote d'Ivoire, South Africa, Tanzania and Mozambique. Through the Partnership, GW faculty and staff, along with a team of external consultants and senior staff at EGPAF developed and executed an assessment of Project HEART in three countries, Zambia, Cote d'Ivoire and Tanzania. The goal of the assessment was to gauge the overall success of the program and to determine areas for improvement, utilizing both quantitative and qualitative measures. The final report presented these findings and made recommendations to promote the sustainability of the program over a five-year period.
Monitoring and Evaluation Activities
Sponsor: Elizabeth Glaser Pediatric AIDS Foundation
Years of Project: 2008 - 2009
Project Principal Investigator: Manya Magnus, PhD, MPH
Key Staff: Michelle Gill, MPH
Description: An assessment has been undertaken of EGPAF's monitoring and evaluation systems for its implementation programs in 17 countries, primarily in Africa. The assessment focused on identifying the successes and challenges of the current monitoring and evaluation systems, including components that are working well and areas that could be strengthened. The assessment provides information necessary for further adaptation of the monitoring and evaluation systems in the future.
Rapid Point of Care Diagnostics
Sponsor: Elizabeth Glaser Pediatric AIDS Foundation
Years of Project: 2009-
Project Principal Investigator: Jeanne Jordan, PhD
Description: Through the partnership with EGPAF, Dr. Jordan's laboratory is currently evaluating a nucleic acid amplification test for its ability to detect HIV RNA in whole blood samples and dried blood spot specimens. The results are being compared to HIV RNA viral load results from the same blood draw. The goal of the project is to identify a molecular test that would be suitable for point of care testing to screen newborns at the time of delivery when their mother is known to be HIV-positive, and from young infants, before 18 months of age, while they are being seen in clinic. Unlike HIV serology testing, which cannot be used for infant diagnosis of HIV before the infant is 18-24 months of age, molecular-based testing would allow healthcare workers to detect infections sooner and initiate treatment earlier in infants to improve outcomes.
Biostatistical Support
Sponsor: Elizabeth Glaser's Pediatric AIDS Foundation
Years of Project: 2009-
Project Principal Investigator: Heather J. Hoffman, PhD
Description: GW provides biostatistical support for a series of Operational Research studies with EGPAF, including "Maternity Interventions Are Key Components to Expanding PMTCT Access in Swaziland", an Infant and Young Child Feeding Public Health Evaluation Protocol in Rwanda, and an Infant Feeding PHE Protocol in Cote d'Ivoire.
Technical Assistance for Operational Research Studies in Mozambique
Sponsor: Elizabeth Glaser Pediatric AIDS Foundation
Years of Project: 2008-2009
Project Principal Investigator: Laura Guay, MD
Additional Faculty: Manya Magnus, PhD, MPH
Key Staff: Michelle Gill, MPH
Description: GW provided assistance in the protocol development for a formative study on "Evaluating Factors that Influence Pediatric Enrollment into HIV/AIDS Care and Treatment Programs in Two Provinces in Mozambique." The purpose of the study was to characterize barriers and promote factors of identification and enrollment of HIV-positive children into care and treatment programs in Mozambique, as rates of enrollment of children into HIV care and treatment programs is low compared to adult rates, both in Mozambique as well as elsewhere in Africa. Study methods included an inventory of available healthcare resources in conjunction with an evaluation of community leaders, parents/caregivers, pregnant women, and healthcare providers who use and deliver healthcare services.
Technical Assistance to a WHO-funded Rapid Syphilis Testing Project
Sponsor: Elizabeth Glaser Pediatric AIDS Foundation
Years of Project: 2008-present
Project Principal Investigator: Manya Magnus, PhD, MPH
Key Staff: Kath Shelley, MS
Description: The Elizabeth Glaser Pediatric AIDS Foundation is a partner in the World Health Organization STD Diagnostics Initiative (SDI). The SDI is a program within the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases whose mission is to promote the development, evaluation and application of affordable, rapid, simple point-of-care sexually transmitted infection diagnostics appropriate for primary health care settings in developing countries. The overall goal of the Rapid Syphilis Test Pilot research project is to reduce disease burden associated with syphilis in pregnancy. The project has two primary objectives: 1) to determine the feasibility of increasing access to antenatal syphilis screening using a Same-Day Testing And Treatment (STAT) strategy and 2) to determine the cost effectiveness of introducing quality-assured rapid syphilis testing into existing services for PMTCT and other antenatal care facilities in selected districts of Uganda and Zambia.
GWU - APHL International Institute for Public Health Laboratory Training
Sponsor: Association of Public Health Laboratories
Years of Project: 2006 - Present
Project Director: Jeanne Jordan, PhD
Principal Investigator: Alan Greenberg, MD, MPH
Description: In 2006, GW and the Association of Public Health Laboratories (APHL) together created the International Institute for Public Health Laboratory Management. The overall goal of the Institute is to provide training in the management and oversight of public health laboratories, initially for Laboratory Directors and Ministry of Health personnel from PEPFAR target countries, and subsequently for staff from other developing world countries and potentially from domestic laboratories as well. Three Institute seminars have been held at GW for two-week periods in October 2007, 2008 and 2009. Over sixty National Laboratory Directors and senior laboratory personnel from Africa, Asia and South America have participated in these seminars. The faculty of these seminar has included US State Laboratory Directors from throughout the US and GW faculty from the Schools of Public Health and Medicine.
UNICEF Operational Research Secretariat
Sponsor: UNICEF
Years of Project: 2009
Principal Investigators: Alan Greenberg, MD, MPH, and Laura Guay, MD
Key Staff: Michelle Gill, MPH
Description: Supported by UNICEF and WHO, GW in collaboration with EGPAF was selected as the Secretariat for a new initiative to define high priority Operational Research questions that need to be rapidly addressed to support the global scale up of prevention of mother-to-child HIV transmission and pediatric HIV care, support and treatment. As the Secretariat, GW/EGPAF conducted an extensive literature review in the summer of 2009 of nearly 300 manuscripts and more than 100 abstracts to create a database of the published, ongoing, and planned Operational Research literature in four priority areas. In September 2009, an expert consultation was held on the GW campus with more than 70 global experts in pediatric HIV/AIDS attending from international organizations, government, universities, research institutions, and non-governmental organizations to identify gaps in knowledge and the highest priority operational research questions. As Secretariat, GW/EGPAF continues to work with UNICEF and WHO to disseminate the results of this meeting and to work towards ensuring that these high priority operational research questions are addressed in a timely fashion.
World Health Organization
Developing a Regulatory Framework for Task Shifting
Sponsor: World Health Organization
Years of Project: 2007 - 2008
Principal Investigators: Alan Greenberg, MD, MPH and John Palen, PhD, MPH
Co-Investigators: Seble Frehywot, MD, MHSA, Anne Markus, PhD, JD, Amanda Castel, MD, MPH, and Irene Kuo, PhD, MPH
Description: GW faculty from the Departments of Epidemiology and Biostatistics and Health Policy collaborated with the WHO, the US Office of the Global AIDS Coordinator, and numerous collaborating governments and partners to develop a regulatory framework (ie laws and policies) that would support task shifting as a response to the health care worker shortage crisis in the developing world. Task shifting is the redistribution of roles and responsibilities from more highly trained to less highly trained cadres of health care workers, to facilitate the provision of care, treatment and prevention services. Extensive research and site visits to four African countries (Malawi, Ethiopia, Uganda and Namibia) resulted in the successful development of the regulatory framework, which was a critical component of Global Guidelines for Task Shifting released by WHO in January 2007.
Developing a Regulatory Framework for Global Health Initiatives and Health Systems Strengthening
Sponsor: World Health Organization
Years of Project: 2008 - 2009
Principal Investigators: Alan Greenberg, MD, MPH, Seble Frehywot, MD, MHSA, and Anne Markus, PhD, JD
Description: GW faculty from the Departments of Epidemiology and Biostatistics and Health Policy conducted an analysis of policy implementation at the donor and host country level to provide recommendations to help facilitate synergies between major global health initiatives and health systems. The essential focus of this project was to review existing regulations (laws and policies) that guide the financing and implementation of the global health initiatives at both the donor and host country levels, determine how at present they either facilitate or inhibit the synergy between global health initiatives and health systems, and to develop recommendations on the regulatory issues that would need to be addressed to maximize this synergy.
