Abstract
Global Public Health is a course that allows students to learn about the complexity of communicable and non-communicable diseases, determinants of health, and delivery of health services. The Global Public Health course partnered with the Center for International Students to co-host International Education Week in November 2017. Specifically, the course held a “global successes” poster presentation event highlighting various initiatives including disease reduction, cash transfer programs, health system comparisons, and emergency preparedness. The project encouraged a dissection of the biological aspects while also focusing on the socioeconomic contexts, geo-political partners, and advocacy efforts to determine the factors that played into successful health initiatives. Quantitative and qualitative data were collected to assess project outcomes. The reach of the event was with the campus and local communities. Students reported that the project allowed them to develop an appreciation for the vastness of global health, while also identifying the importance of sustainability.
Introduction
Global health courses offer excellent opportunities for students to learn about issues outside of their local, state, and national communities. By developing projects that allow them to transcend their texts and engage with the content, they can begin to step out of their local contexts and apply their learned global knowledge. Along with learning about global health issues, students often feel disengaged to such “wicked” or massive global problems that exist. Wicked problems, including climate change, gender inequality, famine, human trafficking, and complex humanitarian issues, are defined as such because there are many stakeholders with differing opinions, and ultimately, “each attempt to create a solution changes the problem” (Kreuter, De Rosa, Howze, and Baldwin, 2004, p. 443). Focusing on a massive problem like climate change, studies have demonstrated that students are disengaged with the science regardless of their knowledge about the topic, because they lack action and self-awareness about their roles with the issue (Wilson and Henson, 1993; Cordero and Abellera, 2008; Feldmann, Nisbet, Leiserowitz, and Maibach, 2010; Wachholz, Artz, and Chene, 2014; Pfautsch and Gray, 2017). According to Reimers (2017), leaders in multiple fields including business, diplomacy, and military science were interviewed regarding their views on student readiness to address challenges with a global mindset. It was consistently reported that gaps among students exist for awareness of global issues (National Research Council, 2007; Reimers, 2017). Using case studies in the classroom has been demonstrated to assist students in identifying the “solutions for real-world scenarios . . . to raise self-awareness and improve sustainability literacy” (Pfautsch and Gray, 2017, p. 1168; see also Remington-Doucette and Musgrove, 2015).
Although global challenges exist, successes in addressing these issues are evident as maternal and child mortality have continued to decrease along with a more pronounced focus on diseases such as HIV/AIDS, tuberculosis, and malaria (Centers for Disease Control and Prevention [CDC], 2011; Jacobsen, 2014; Merson, 2014; Glassman and Temin, 2016). New medications are being developed along with lifesaving technologies and vaccinations, and via enhanced surveillance and reporting efforts, preparedness for global threats continues to be strengthened (CDC, 2011; Jacobsen, 2014). By highlighting that achievements are possible, we can assist future generations in identifying how to harness their knowledge and incorporate moral and ethical reasoning to enhance their competency in addressing issues that need sustainable solutions (Pfautsch and Gray, 2017).
Identified in the texts, Millions Saved: Proven Successes in Global Health (Levine and Kinder, 2004) and Millions Saved: New Cases of Proven Success in Global Health (Glassman and Temin, 2016), are over 35 different examples of interventions that have lasting health education and promotion effects. Using these case studies, college students can embark on an educational journey to better identify the roots of disease, disability, and death from a global perspective. In the Global Public Health course, students were challenged to find a global health endeavor that was “successful” and define, using multiple lenses, what “success” means. Students had to go beyond reading a case study and dissect the topic to gain a better understanding of factors such as the physiology of disease and the impacts of economic policies on effective health measures.
Project Description
Six student groups, ranging from two to four students per group, researched case studies including neglected tropical diseases and successes of the Deworm the World Initiative (https://www.evidenceaction.org/dewormtheworld), global vaccination perspectives in Cameroon and Southern Ethiopia, and behavior modification to eradicate guinea worm. Incorporating an interdisciplinary approach to understanding their chosen case studies, students identified underlying causes of disease (or health issues) using an agent, host, environment model to better explain how the interventions and/or successes broke the chain of causation. Specifically, students focused on disciplines including public health, health education, epidemiology, and biology. To display their case study outcomes, students developed professional 3×4 posters. In a partnership to co-host International Education Week with the Center for International Students (November 2017), students in the Global Public Health course held a poster presentation focusing on global health successes. The event was the kick-off feature, and all of campus and the local community was invited. Goals of the event were to invite discussion about pertinent global health issues that transcend national borders. To encourage attendee participation, international coffee, tea, and food items were served. All materials and supplies were purchased with funds from the Missouri Campus Compact mini-grant. For project assessment, student groups were evaluated on the guiding research questions developed for their topic, the historical and health background, elements for success (including impact, sustainability, and cost-effectiveness), the organizations involved with continued efforts, policies in place to address the issue, and finally, ways for individuals to get involved locally. To evaluate the poster event, attendees completed a short survey with 5-point Likert-scale questions from strongly agree to strongly disagree regarding the presenter knowledge, enthusiasm, professionalism, and preparation. An open-ended question was added to seek what attendees learned from attending the poster event. At the end of the course, student feedback was obtained via a short survey with a 5-point Likert-scale regarding their development of the poster content, impacts of the project on their learning, and three open-ended reflection questions. Open-ended questions were analyzed using a content-analysis procedure for patterns and themes (Altheide, 1987; Merriam, 2009), and quantitative data were analyzed using IBM SPSS 25. IRB approval was obtained in Fall 2017 before any data were collected.
Project Outcomes
Six different posters were presented. Student presenters interacted with attendees (n=~40) including members of campus administration, faculty, staff, and students from various majors. Overall, feedback from presentation attendees (n=20) was positive, with 90% strongly agreeing that presenters were prepared and knowledgeable about the material. Regarding enthusiasm and professionalism, over 95% of attendees either agreed or strongly agreed that students were excited to present and were credible regarding the content. Attendees’ comments for learning outcomes were positive and varied about what they gained from the experience. Themes from those outcomes included being unaware (n=9), identifying keys to health successes (n=8), and that successes have global outcomes (n=1). A sample of quotations for each theme is available in Table 1.
For project impacts for students in the course, 100% of students who completed an evaluation agreed or strongly agreed that focusing on global health successes was important, and over 90% agreed or strongly agreed that providing service-learning opportunities in global health was important. Overarching themes students reported focused on their surprise for the vastness of global health successes (n=5), different ways to measure success (n=4), personal gains acquired from the project (n=1), and that we are all global citizens (n=1) (Table 2).
Discussion and Suggestions for Future Practice
By engaging with the broader campus community, students participated in open discourse to identify the importance of partnership, science, sustainability, and global citizenship to address the issues. To promote the events of International Education Week, a local news station also attended the poster presentation to learn more about the topic and provide awareness. As previously stated, students may be disengaged in the classroom if lectures and assignments lack an action or self-awareness component (Wilson and Henson, 1993; Cordero and Abellera, 2008; Feldmann et al., 2010; Wachholz, Artz, and Chene, 2014; Pfautsch and Gray, 2017). This course project was an attempt to combine students’ awareness for these massive problems and research the failures and successes of the efforts to address these real-world issues. An additional component for the case study was to suggest ways in which we can advocate for these topics. Students developed ideas including identifying NGOs that are continuing to work on the issues, specifying ongoing research studies and ideas for further research, and ways in which we can expand community-based programs.
With the knowledge gained from implementing this project, instructors should build in more class time for posters to be developed and for students to reflect and to determine their questions as they navigate the research process. Students should also engage in peer review frequently throughout the semester. Peer review only occurred one time, at the mid-point of the project, and everyone would have benefitted from hearing regularly about each other’s topics, challenges, and strengths. Another interesting learning outcome would be to prepare students on how to present at a formal poster event and explain who might be in attendance. According to one student, “I was caught a little off guard when [the Vice President] and [Department Chair] showed up.”
To broaden this type of project, as Merson (2014) demonstrates, universities can engage in global health endeavors by acting as springboards for interdisciplinary collaboration of faculty and students from various institutions. Next steps for more transformative student experiences and value-added projects would be to build existing projects by partnering with different disciplines and other institutions (domestic and international). According to Ehrlich (2000), civic engagement is defined as “working to make a difference in the civic life of our common unities and developing the combination of knowledge, skills, values, and motivation to make that difference” (p. vi). As this project started in the classroom and expanded to the campus and surrounding community, this definition of civic engagement was followed, demonstrating that global successes are evident and that we should celebrate them.
About the Author
Alicia Wodika is currently an assistant professor in Health Sciences at Illinois State University. She currently teaches Program Planning and Evaluation and Introduction to Public Health. Previously, she taught Global Public Health, Research Methods for Health Sciences, Program Planning, and Environmental Health at Truman State University.
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