There are multiple research initiatives involved in the Community Health in Limpopo (CHIL) projects. New for 2017, is a community health research study of alcohol-related sexual risks, and the risk of alcohol-exposed pregnancy in Limpopo. Students learn how to interview people about sensitive topics such as sexual behaviors, intimate partner violence, alcohol use, sexual assault, HIV, unintended pregnancy, and to modify approaches to fit local cultures. Individual interviews, focus groups, and discussion groups with stakeholders including: student leaders, faculty, village leaders, and traditional healers will inform the development of a culturally-competent survey instrument that can be translated and used for larger scale administration in village and urban settings in Limpopo.
A second study, seeks to understand palliative care interventions used by professional nurses and Community Health Workers (CHWs) in the rural areas. This study will also involve individual and focus group interviews and collection of digital narratives that tell the story of good palliative care provided at the end of life.
A third project involves continuing the prospective cohort study of people living with HIV to determine how the usage of Western vs. traditional medications influences biomarkers of health outcomes.
The Community Health in Limpopo research initiatves are community health-focused projects conducted in Limpopo by various faculty-student teams over the past 5 years. These teams collaborate with staff at the Ministry of Health and the University of Venda, both in Thohoyandou, Limpopo. Faculty from the University of Venda and the University of Virginia initiated CHIL by mentoring medical, nursing, and undergraduate students in training community health workers in village clinics about diabetes and hypertension management. This work continued with nursing students, developing and providing training in a curriculum addressing diabetes and hypertension.
This project evolved to include a Motivational Interviewing (MI) project in 2014 by training community health workers (CHWs) and nurses in MI skills at the request of the health district. In 2015, a team of medical and undergraduate students (from UVA) and nursing students (from the University of Venda) conducted a 5-week research project to determine what level of MI skills CHWs could attain with training and field-based coaching. They taught MI skills to CHWs in the community clinics in Thohoyandou and Tiyani. After the training, they observed CHWs as they delivered home-based care in villages. The student teams (American and South African student pairs for each CHW) observed and coded MI skills during these visits. Data showed that CHWs improved MI skills over time with coaching in the field.
In 2016, faculty and medical students from UVA, along with nursing students from the University of Venda jointly taught professional nurses and nursing students to use MI in patient care. They trained standardized patients and conducted a pre-post training study of nurses’ MI skills; these data are being analyzed now to determine the level of skill attained by nurses after training. Currently, the nursing faculty at the University of Venda is planning a new course on MI for the nursing curriculum.