USAID & PEPFAR

MATRIX was a collaboration with leadership at the Magee Women’s Research Institute at the University of Pittsburgh, and approximately 18 partners from the global north and south, including biomedical product developers. The overall mission of MATRIX is to facilitate development of a range of new HIV and pregnancy prevention products that – in addition to being safe and effective – are also acceptable, affordable, scalable and deliverable, thus meeting the needs of women globally who are at risk of HIV infection and unplanned pregnancy.

● Led engagements with end-users in Kenya, South Africa, and Zimbabwe during pre-clinical and Phase 1 stages of product development for a range of devices – vaginal ring, film, and dissolving inserts; long-acting injectables; long-acting dissolvable implants in hydrogel and pellet format. 

● Used design-based, participatory qualitative methods with primary (sexually active women of reproductive age) and secondary (clinicians, pharmacists, male partners of women) end users to elicit feedback on target product profile and packaging preferences as related to acceptability and broader lifestyle fit. Focus on usability, intuitiveness, and desirability.

● Generated actionable feedback for product developers on user acceptability and access preferences, probability of technical use success, ease of introduction and framing for uptake.

Bill & Melinda Gates Medical Research Institute (Gates MRI)

Development of long-acting injectable (LAI) formulations of tuberculosis (TB) drugs could transform global TB management. We assessed the acceptability of and preferences for three potential LAI TB treatment scenarios and seven product-specific attributes among TB patients and survivors, TB clinicians, and other key program stakeholders in the Philippines.

• Designed and led implementation and analysis of interviews with key informants from public health organizations, government, and clinical practice to inform the parameters and options included on a subsequent discrete choice experiment survey designed to inform target regimen profiles.

UNICEF & GPEI

2022 – Designed and led rapid qualitative research to provide the UNICEF Polio Programme behavior change team and Global Polio Eradication Initiative (GPEI) with insights on how COVID-19 restrictions and perceptions of the newly developed COVID-19 vaccines influenced perceptions of OPV and vaccination campaigns, in order to inform recommendations for communications and social mobilization strategies.

• Collected feedback from caregivers of young children, frontline workers, clinicians, and community leaders at two sites each in Ethiopia and Cameroon. These sites were purposively selected to represent countries with active cVDPV2 outbreaks that had recent OPV campaigns delivered concurrent with COVID-19 vaccine roll-outs.

2020 - nOPV2 is a novel polio vaccine in development that contains a genetically-modified attenuated virus, designed to be more stable to reduce risk of vaccine-derived poliovirus. At the time, the new vaccine was being considered for distribution under a World Health Organization Emergency Use Listing. The mOPV2 one-drop dose-sparing strategy was a potential response to the shortage of mOPV2 vaccine stock that proposed to administer 1 drop of mOPV2 instead of the standard 2 drops to children in outbreak settings.

• Designed and led rapid qualitative research to provide the UNICEF Polio Programme behavior change team and GPEI with insights on how two changes to oral polio vaccination – the introduction of nOPV2 and a one-drop dose-sparing strategy for administration of mOPV2 – would be received by key stakeholders, to inform decisions about content and mode of messaging in support of a smooth vaccine strategy transition.

• Collected feedback from caregivers of young children, frontline workers, clinicians, and community leaders in Democratic Republic of Congo and Kenya (and analyzed data previously collected by UNICEF in Nigeria) to suggest barriers and facilitators to roll-out of these two approaches.

Medicines for Malaria Venture (MMV)

Tafenoquine pediatric is to be provided in blister packs of 3 tablets and patients will be given the correct number of tablets in line with their weight. This was a major change from the current practice of providing antimalarials in weight‐specific blister packs. The challenge was to ensure that health care providers and care givers (e.g. parents) fully understand the dosing instructions. To address this challenge, two different approaches using user‐friendly pictograms and messages were developed to illustrate the weight bands and dosing instructions. A user‐friendly leaflet for providers and patients was also developed with visual aids with information about the dosing schedule and correct use of treatment to serve as a reminder for the caregiver in case they do not fully recall the verbal instructions from the health worker. 

• Medicines for Malaria Venture (MMV) and GSK provided a suite of pediatric TQ packaging information and patient instructions for testing. Our team worked with a  graphic designer to develop the associated decision-making algorithm for testing.

• Designed the research and supervised the teams that carried out comprehension and acceptability testing of several versions of packaging instructions for this new formulation of pediatric malaria treatment using in-depth interviews and focus groups with caregivers of young children and clinicians in multiple regions of India and Brazil.