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April 04, 2017 | Mark Barone, PhD, Medtronic Foundation Associate in PHI’s Global Health Leaders Fellowship | This post first appeared on the Global Health Leaders blog.

PHI's Global Health Leaders has placed a Dr. Mark Barone, PhD, a Medtronic Foundation Associate, in Sao Paulo to work toward stemming the growing tide of chronic disease. Mark provides on-the-ground technical insight, alignment, and representation for Medtronic Foundation’s portfolio of work in Brazil addressing chronic and acute non-communicable diseases, and contributes strategic guidance including developing guidelines to be used in assessing applicants to philanthropic grants in-country.

In this post, Mark reflects on his recent trips to PHI's central offices in Oakland California, where he met with PHI staff and other health experts. In this post, Mark reflects on his recent trips to PHI's central offices in Oakland California, where he met with PHI staff and other health experts.

Esther Tahrir, Mark Barone, and Olivia LaFond during Mark’s visit to PHI in January 2017

Visiting the Public Health Institute (PHI)’s office in Oakland is undoubtedly an enriching experience. I had the opportunity to visit twice—once in September 2016 and again in January 2017—and meet with Program Coordinators and Principal Investigators of different areas to exchange meaningful information and acquire practical advice that will be key to the success of Medtronic Foundation’s programs in Brazil. Before exploring the meeting content and introducing the interlocutors from my visits, it is important to have a general overview of the two main Medtronic Foundation programs being implemented in Brazil: HealthRise and HeartRescue. Both focus on the reduction of mortality by 25%, but while HealthRise is designed to leverage the health system and empower patients with diabetes and/or hypertension, HeartRescue aims to improve the access and assistance for individuals facing a heart-attack, sudden cardiac-arrest or stroke. In addition to the system leverage and professional training, both of the programs are directed at underserved populations.

During my first visit to PHI in September of 2016 for my Global Health Leaders fellowship onboarding, I had the opportunity to deliver a speech on diabetes in Brazil to high level PHI staff and Medtronic Foundation supervisors. Moreover, I met with administrative staff and leaders at PHI, including: CEO Dr. Mary Pittman, and Vice President of Human Resources, Valerie McCann Woodson, gaining a comprehensive understanding of PHI’s mission and structure. Other meetings throughout the week that helped me to establish a fruitful network and learn about diverse PHI programs and partner organizations, were with: Amy Max, who manages HealthData+, using the LiveStories platform in partnership with different NGOs; David Lindeman, who directs the CITRIS Health Initiative at UC Berkeley, where several digital health projects, systems and equipment are incubated; Lynn Silver, Senior Advisor for Chronic Disease and Obesity, who has a deep knowledge of public health and NCDs in Brazil; and Robert (Nap) Hosang, Public Health Professor at UC Berkley, who is also a special advisor to the Global Health Leaders program.

Mark presents to PHI staff in September 2016

In both visits to PHI, two coordinators of PHI's RiseUp, Claudia Romeu and Rufaro Kangai, shared their outstanding experience in empowering girls, women and youth through trainings and support, which has resulted in policy changes, better health outcomes, and equity. RiseUp is the umbrella for the following projects: “Let Girls Lead”, “Champions for Change” and “Youth Champions Initiative”, which have already benefited more than 115 million people in countries in the Americas, Asia and Africa. Their curriculum and methodology, aiming to enhance advocacy skills and identify leaders who demonstrate passion and commitment, is available online. In another meeting, GOJoven International’s leaders, Esther Tahrir and Susanna Moore shared the model of the successful Youth Leadership in Sexual and Reproductive Health Program they manage at PHI. In this case, the focus is on educating youth in Central America and Mexico on reproductive and sexual health. As a result, not only did GOJoven help to improve policies, programs and services where GOJoven was implemented, but the hundreds of alumni constituted newly independent legally registered NGOs in their countries with the same GoJoven mission. Thus, nowadays GOJoven Belize, GOJoven Mexico, GOJoven Honduras and GOJoven Guatemala are active organizations continuing to improve the sexual and reproductive health and rights of thousands of youth in the region.

In Brazil, where I work, I have been involved in empowerment programs over the past decade, including the Young Leaders in Diabetes Training and the National Network of Diabetes Associations and Leaders. There is a clear need to expand those efforts to other NCDs and make the programs more country-wide. For this reason, the lessons learned and shared by RiseUp and GoJoven International will inspire this expansion in Brazil, especially focusing on the patients’ roles and the needs of the underserved populations.

Andrew Broderick and Mark Barone

Among the meaningful meetings during the second visit to PHI, the one with Andrew Broderick was of special interest, due to the fact that both of our Medtronic Foundation programs in Brazil will depend on tele- and/or mobile-Health (mHealth) components. Broderick has extensive experience using mHealth with underserved patients, community health workers and primary health care professionals. He shared that prior to any attempt, it is key to find what resources are available and how they are used, plan digital education to the patients and professionals, use strategies to gain the users’ trust (they need to understand the benefits behind it), and learn from the patients how much interaction (and/or number of SMS messages) they appreciate, in order to reduce drop-outs. Interestingly, he mentioned that the individuals with diabetes in a project in San Diego loved receiving SMS health messages.

The Oakland chapter of YMCA, represented by its Regional Director of Community Health, Tiffany Hunter, was also a rewarding contact. At the YMCA, they have implemented the nationwide Diabetes Prevention Program (DPP), certified by the Center for Disease Control and Prevention (CDC). The program is one year long, with 25 sessions. All the participants have pre-diabetes or are at risk of developing diabetes, and are closely followed and oriented by a coach throughout the sessions. In order to achieve its objective, the program goals are reducing body weight by 5-7% and increasing physical activity to 150 minutes per week.

Mark visits YMCA of the East Bay in January 2017

Considering that Brazil has faced a severe increase in obesity—now affecting close to 50% of the entire population—the high number of YMCA chapters in the country and the effectiveness of the DPP model in the US presents an opportunity for improvement in this area.

I made several other relevant contacts during my latest visit to Oakland, including Dan Gillette, from the Public Private Competency Building Initiative of Global Health Leaders; Anne Kelsey Lamb, Director of Regional Asthma Management and Prevention; and Mary Anne Morgan, Director of the Chronic Disease Prevention Leadership Project. Moreover, administrative leaders at PHI such as Audrey Seger Sprain, Director of Operations; Chhaya Chaudhari, Senior Talent Acquisition Specialist; and Olivia LaFond, Global Health Leaders Administrative Coordinator, were fundamental for developing a deeper understanding of the structure and processes at PHI.

Therefore, the visits to PHI were unique learning experiences for developing health programs in various locations, thanks to the interactions with specialists from different backgrounds. As a result, I have returned to Brazil with a broadened perspective of global public health themes, programs and organizational structures.

 


Learn more about Mark's work as a Global Health Leaders Fellow here.