Expressions of Intent for International Polar Year 2007-2008 Activities

Expression of Interest Details

PROPOSAL INFORMATION

Sexual health and sexually transmitted infections in northern frontier populations  (Sexual health in the northern frontier)

Outline
The objective of this proposal is to build the capacity to examine the individual, social and environmental factors that influence perceptions of sexual health and sexually transmitted infections (STIs) in northern frontier populations. We propose to take a modified community-based participatory research approach to investigate sexual health, focusing on Montana, Alaska, northern Canada, and Greenland. Our aims are: Aim 1: Describe the basic epidemiology of STIs, pregnancy, and pregnancy outcomes in northern frontier populations We will describe and compare the burden of reported STIs in Montana, Alaska, northern Canada and Greenland by basic demographic characteristics including age, gender and race/ethnicity. When possible, we will model the spatial and spatiotemporal distribution of chlamydial infection to evaluate the concept of core groups and areas of infection. We will incorporate community level factors to look for ecologic level associations with sexual health (STIs and pregnancy). Maps of pregnancies, births, neonatal deaths, and STIs will help us identify communities to approach for targeted capacity building. Aim 2: Build capacity for investigating sexual health issues Geographic areas identified in aim 1 as having high concentrations of STIs, high birth rates, or poor pregnancy outcomes will be considered priority areas for further investigation. Key informants will be identified within these priority areas as well as other communities and interviewed using semi-structured interviewing techniques. The goal of key informant interviews will be to gain basic insights into sexual health and STIs in the respective communities and learn ways of talking about sexual health and STIs that will be culturally sensitive and respectful. Knowledge gained from aim 1 and conversations with key informants will be used to develop a series of talks that will be presented to the different communities, after which the communities will be invited to help develop and participate in the research project. Aim 3: Investigate sexual behaviors and STI transmission dynamics Community informants and qualitative data collected in aim 2 will help us develop appropriate focus group discussion questions, and help make decisions about focus group discussions such as who should facilitate focus groups, where and when. We will conduct focus group discussions with semi-structured questions to gain insights into perceptions on sexual health, behaviors, and STI transmission dynamics. The role of environment, travel, migration, bridge contacts and nomadic lifestyle will also be explored.

What significant advance(s) in relation to the IPY themes and targets can be anticipated from this project?
We will make significant advances in the knowledge and understanding of cultural, historical and social processes that affect sexual health, STIs, and the sustainability of circumpolar human societies (theme 6). We will also address the present status of health; access to health care resources; geographic and temporal variability; social and cultural factors that may influence the sexual health and STIs; how changes in the physical environment may influence STI transmission (theme 1). The legacy of this project is to 1) design culturally appropriate interventions and long-term prevention strategies to reduce STIs and improve sexual health and reproductive outcomes and 2) develop an international circumpolar STI surveillance system.

What international collaboration is involved in this project?
Current international collaborators include: Dr. Flemming Stenz, chief medical officer in Greenland, Dr. Gert Mulvad in Greenland, and Dr. Shari Gearheard in Nunavut Canada. Key informants from Canada and Greenland will be invited to serve on an advisory board to ensure the direction of our project.

FIELD ACTIVITY DETAILS

Geographical location(s) for the proposed field activities:
The proposed field work will be conducted in communities across Montana, Alaska, Canada, and Greenland.

Approximate timeframe(s) for proposed field activities:
Arctic: 09/07-06/08      09/08-06/09      09/09-06/10
Antarctic: n/a

Significant facilities will be required for this project:

Will the project leave a legacy of infrastructure?
Yes. Our goal is to build community capacity for investigating sexual health over the entire circumpolar Arctic and lay the foundation for a sustainable international circumpolar STI surveillance system. Our research will be used to develop culturally appropriate STI intervention and long-term prevention strategies to reduce STIs and improve sexual health and reproductive outcomes.

How is it envisaged that the required logistic support will be secured?
National agency
Own support
Other sources of support

We will apply to governmental organizations and foundations to externally fund our research.

Has the project been "endorsed" at a national or international level?
Yes - We are applying to have this project be part of the Arctic Human Health Initiative.

PROJECT MANAGEMENT AND STRUCTURE

Is the project a short-term expansion (over the IPY 2007-2008 timeframe) of an existing plan, programme or initiative or is it a new autonomous proposal?
Yes

This is a new project with new investigators as PIs. It is not part of another existing or proposed project.

How will the project be organised and managed?
Our project will be self-managed with free-standing activities. A modified community based participatory research approach will be used to conduct our research. Communities will be invited to participate in the development and implementation of the research. An advisory council (project steering committee) will be established to oversee the direction of the project and comprise community members and public health practitioners. The principle investigators will manage the study, being responsible for: study design; implementation of the research plan (primarily questionnaire development; organizing, educating, and mobilizing community members; focus group facilitation); managing, analyzing and interpreting data; communicating results to local, public health and scientific communities.

What are the initial plans of the project for addressing the education, outreach and communication issues outlined in the Framework document?
Knowledge gained through this project will be communicated to the community (e.g. during talking circles and with newsletters) and used to design culturally appropriate interventions and long term prevention strategies to reduce STIs and improve sexual health. Education and outreach will be vital components of effective intervention and prevention strategies.

What are the initial plans of the project to address data management issues (as outlined in the Framework document?
We will appointment a dedicated project data manager and include funding for data management in the budget of all grant applications. Each community will own the data collected about that community and will have control over access. Principle investigators will ensure the confidentiality and security of all data collected. Following completion of the project, each community, along with the PIs and advisory council, will decide how and where the data will be archived and stored.

How is it proposed to fund the project?
We will apply to governmental organizations and foundations to externally fund our research. Internal start up funds will also be utilized.

Is there additional information you wish to provide?
Elizabeth Rink and Dionne Gesink Law are joint principle investigators on this project but we intend to have international collaborators as Co-PIs and an advisory council comprised of local community members and public health practitioners as well.

PROPOSER DETAILS

Assistant Professor of Epidemiology Dionne Gesink Law
Montana State University
Department of Microbiology
PO Box 173520, 109 Lewis Hall, Bozeman, MT
59717
USA

Tel: 406-994-5657
Mobile: no
Fax: 406-994-4926
Email:

Other project members and their affiliation