Internship Report Kei Alegria 2010 December

Internship Report Pan‐American Health Organization Intern: Kei L. Alegria‐Flores Supervisor: Ms. Eleana Villanueva

Period: September 1, 2010‐December 15, 2010 Communications Internship Supervisor Signature: ______________________

EXECUTIVE SUMMARY The Health Research Promotion and Development is part of the Pan‐American Health Organization (PAHO) Headquarters in Washington DC. My internship with this team lasted for 3 stimulating and exciting months. One of the first assignments as their intern was to revise, modify and update their vision, mission and objectives for website posting in collaboration with members of the team 1 . With the updated Vision, Mission and Objectives, I was able to embark on the main assignment, which was developing and executing a communication strategy for the team. The development of the communication strategy included producing a survey that was sent to identified audience groups. The tool was used to collect data regarding the various means of communication the team uses to disseminate information to these audiences. A summary report was used to synthesize the findings and guide changes to the means of communication. Ms. Eleana Villanueva supervised the Communications Internship at the Health Research Promotion and Development team at PAHO and Dr. Norka Ruiz Bravo also contributed with some advising until the end of October. Dr. Luis Gabriel Cuervo Amore, the leader of the team, was also briefed weekly about the progress of the strategy and provided his inputs throughout the process.

As part of the communication strategy, I also executed a few other assignments as needed. I participated in the making of the Health Policy Documents CD that was distributed to Ministers of Health from the Americas at the 50th Directing Council that took place September 27 – October 1. In order to contribute to the team’s website, I was trained on how to use Joomla, the program used to manage PAHO’s website. Once trained, I updated and created websites within the Health Research Promotion and Development pages as needed. Two Newsletters were developed and disseminated through the PAHO HQ Bulletin and other list servers. To continue with the Research Interest Group’s on going activities, I coordinated 2 events using 1

Vision: A world of healthy people through the promotion and facilitation of scientific, evidence‐informed and equitable policy‐making and practices. Mission: We catalyze sustainable improvements that rest on policies and practices informed by research evidence for the Americas. Objectives: To work with member states to strengthen their national health research systems, critical components of their health systems and their public health systems. To coordinate the research governance within PAHO in support of technical cooperation.

Elluminate to increase our range of audiences. Finally, I have consolidated the contact information for Research focal points, KMC focal points, Dr. Cuervo’s focal points, and the Cochrane Workshops to facilitate access and promote communication between the Health Research Promotion and Development team and people of the Americas.

With support from Ms. Villanueva and Dr. Cuervo I have successfully presented this Internship as my Practicum, which is a required step to obtain my Master’s degree in Global Public Health from the George Washington University. Another very exciting aspect of my PAHO experience was the numerous opportunities to attend events and activities of capacity building, conferences, press releases, meetings and interviews. Some of these events have led to connections with experts outside of the Health Research Promotion and Development team that will also help with my future career goals.

INTERNSHIP ACTIVITIES Communications Strategy: The goal of the strategy was to increase the dissemination of information regarding high quality scientific and evidence‐informed policy‐making and practices, and their effects on the health of people within PAHO’s member countries 2 . I was able to get the strategy started in collaboration with Ms. Villanueva and Ms. Ruiz. The summary of the survey is available in Annex 5. It is the next Intern’s responsibility to continue on with this initiative. The next step in the strategy plan is to develop a plan of action for each product produced by the Health Research Promotion and Development team (Annex 1).

Health Policy Documents CD: The production of this CD was a request by Ms. Villanueva for its distribution to members of the Ministries of Health in the Americas who were visiting PAHO during November for the 50th Directing Council which took place September 27 – October 1, 2010. The CD is composed of a series of documents that are relevant to the 2

Objectives: To improve our communication and feedback processes by identifying, reaching out to, and assessing our target populations. To identify our communication vehicles. To establish a framework for the development of a plan of action for each product the unit develops.

Activities: Identify and create list of audiences, create survey, collect data, analyze data, identify means of communication, create communications advisory committee, develop framework for the plan of action for each product within the Health Research Promotion and Development team.

initiative for strengthening national health research systems (CD available at the Health Research Promotion and Development unit).

Joomla Training: Training was provided in 3 different parts. First a quick overview presented by former staff member Kristina MacKenzie, the formally by KMC members Cristina Mitchell and America Valdes, and simultaneously while referring back to a Joomla manual for the basic steps.

Website Updates: While many pages were updated during my time at PAHO, the most visited pages were “Homepage‐Inicio”, “What’s New”, “Training Opportunities”, “Research Interest Group”, “Funding Opportunities”, and “EVIPNet Americas”. Updates included anything from adding news lines with corresponding links to the homepage to restructuring the entire page for “EVIPNet Americas” and “Funding Opportunities”. The work was completed in English as well as Spanish.

Creation of Web Pages: I created a total of 3 new pages while at PAHO, “Health Agenda for the Americas 2008‐2017 Prize”, “Cochrane Iberoamericana Workshops”, and “SUPPORT Tools for Evidence‐Informed Policy‐Making (STP): Accessible in four languages”. The websites were completed in English as well in Spanish (Annex 2).

Newsletters: These newsletters highlight activities and events supported and executed by the team’s members. Once public, the information was disseminated to PAHO HQ staff as well as PAHO staff all over the Americas, and the team members also sent them out to other interested parties. Some feedback was received via email and was very positive (Annex 3).

Research Interest Group Events: One of the on going responsibilities of all interns passing though this unit is coordinating RIG events. My two events were “What Researchers Owe Research Participants‐ A Conversation on Ethics by Dr. Carla Saenz” and “Stem Cell Research

by Dr. John Tisdale”. Both events were broadcasted via Elluminate and are posted in the PAHORIG website.

Contact Information Database: Originally this list was meant to aid in the collection of data through a survey and as part of the communications strategy activities. However, once the team heard about this list of contacts that was being created, they requested that it be shared

upon completion. The list, in Excel format, includes names and contact information for all focal points related to Health Research Promotion and Development team activities and all researchers who participated in the Cochrane Iberoamericana Workshops series and is available in the G: Drive in the file named “Eleana Villanueva”.

ASSESSMENT OF THE INTERNSHIP What Differed from my Expectations: The Internship was posted as a Communications Internship, and that is exactly what I did. Not only with the development and execution of the strategy, but with other activities which aimed to provide our audiences with high‐quality information from our team to strengthen their national health research systems. However, what differed from my expectations was the lack of an action plan at the beginning of the internship. Although there was plenty of work to do, the direction and scope of my tasks were not clear. There was also undertainty about whether or not I would be trained to use Joomla.

After a couple of weeks my tasks became more clear and I was trained to execute them.

Updating the vision, mission and objectives for the team, and developing the communications strategy were also very helpful in overcoming this initial hiccup.

New Skills Learned: As metnioned above, I was trained to use Joomla to access, edit and add websites within the Health Research Promotion and Development pages. This is one of the many trainings and skills I gained while being an intern at PAHO. Through my interaction with the experts in my team, I also learned more about health research and its influence in policy making to save lives and improve people’s quality of life in the Americas. The RIG events allowed me to experiment with the software Elluminate for the first time and learn very important facts about health research ethics and stem cell research. During my participation in meetings and conferences I was exposed to experts and witnessed and participated in many high level discussions in the field. Most importantly, and my most valued skill from this experience, for the first time I was exposed to Spanish terminology in the field of my interest. It was intimidating at first, but as I became more comfortable with my interactions with the

experts from my team, I was very happy to broaden my Spanish vocabulary adding technical and sophisticated terms that I will use for the rest of my career.

Difficulties Encountered: I encountered some confusion about the roles of some staff members. This particularly affected my work as I was directed to seek guidance from the person whose function is to be the liason between HSS and KMC. This person is assigned to support the Health Research Promotion and Development team, among others. Although her expected supportive role is known to all, some of the communication channels are partially broken. The team’s expectations do not match the actual support they receive from this liason person. Since the messages received from my advisor often did not match those of the liason person, eventually I stopped seeking guidance from the KMC person except for minor technical diffculties with Joomla to avoid confusion. Another point that stands out in my mind is the quality of the products posted on the web pages. Most of the content with quality problems were produced by past interns as part of their tasks. I feel that some products are useful to the intended audiences while others are only meant to be part of the Intern’s portfolio, but not as part of the website. This was especially clear as I found grammatical errors and missing references in some documents. These accumulation of misplaced content could potentially affect the reputation of the team’s website.

Connection with Past Work Experience: Working at PAHO was a very different experience from any other work setting before. Its contribution to public health is mainly managerial in nature and requires many hours spent in front of the computer. Although I am not used to working from a cubicle, I would still describe the work environment as very happy and supportive. Every person of the team is inceredibly passionate and energetic about their work and have amazing amounts of knowledge in their field. I have worked in very high‐paced clinical settings before where I was not allowed to make mistakes, but never with a team so well educated and with such degree of expertise.

Connection with Academic Focus, Practicum: As the development of the communication strategy was discussed and became one of my assigned tasks at PAHO, I connected this with a required step for my graduation from the George Washington University School of Public

Health. The Practicum is meant to be a public health service hands‐on experience that teaches me what to expect in my field as I graduate with a Masters degree. Since the commitment required from school is only 120hrs, I was able to focus my Practicum only on the communications strategy in my last month at PAHO. My Practicum successfully ended on November 30th and I had nothing but wonderful things to say in the evaluation.

CONCLUSION My intership as part of PAHO’s Health Research Promotion and Development team was a very positive, stimulating and challenging learning experience. Through my involvement with various activities such as creating the team’s Newsletters, developing the communication strategy, coordinating RIG events and participating in meetings and conferences alongside co‐workers, I was able to contribute to the promotion of health research while supporting the team. I have made some strong relationships with PAHO staff and fortunately will continue to learn from them through my continuing engagement in a couple of research projects.

With a clear set of vision, mission and objectives and the structure of a communication strategy, I leave the team hoping that my time and hard work are useful to all. I am very grateful for all the support, advice, lessons, love and laughter while at PAHO, and my ability to apply some of this time as my Practicum. I will surely mention the Health Research Promotion and Development team as a significant contributor to my Masters degree upon graduation.

RECOMMENDATIONS As a team, I have no recommendations other than to ask that you continue to show strong leadership through your passion and dedication to your mission. You are a great team of experts who are also great at collaborating, communicating, and supporting each other.

Communications: The broader understanding of the means of communication, strengths and weaknesses have become clear through the survey. The next step is to take each of the team’s products and manage them separately to increase access and quality.

Joomla Training: All Interns must be trained on Joomla as soon as they start their internships. It is impossible to complete assignments as a Communications Intern without having this training.

Before changing anything, it is also very important for interns to understand that JoomFish is used to find the translations of the original website. The original websites are sometimes in English and other times in Spanish. Before making changes, make a copy of the original on a word document in case a mistake is made. For any questions or doubts about Joomla, go to America Valdes for help.

Newsletter: Instead of publishing these when it seems convenient and possible, I do not see any reason why there should not be a systematic process and a timeline for production. While it can be time consuming, from personal experience, these should be available on a monthly basis and on the same date every month.

Research Interest Group Events: All should be broadcasted via Elluminate. Events should be publicized twice, once a week prior to the event, and the second time the day before the event as a reminder. Team members should be notified and invited in addition to the announcements on HQ Bulletin because sometimes these emails do not reach them. Promotion should be posted under “Training Opportunities” and “PAHORIG” websites and on the Newsletters whenever possible. Once the event has passed, the Elluminate link to the recording, Youtube link (from Dr. Cuervo), and the original PowerPoint presentation must be all posted under the “PAHORIG” website as soon as they are available. Emails thanking participants and including these links should also be sent out the day after the event.

Contact Information Database: This must be checked for updates every month, as many of these focal points change on a regular basis. The original form should be kept in the G: drive and an updated version should be emailed out to all members of the team on a monthly basis to avoid problems in their communication with other countries.

HSS/KMC Liaison: I would suggest addressing the communication barriers with the HSS/KMC liaison person. By sharing expectations, concerns and misunderstandings this professional relationship may improve and benefit the development of the communication strategy.

Future Interns: Start a physical document, as well as its electronic version, of all the activities and events you take part in at PAHO from the very first day. It will help greatly at the end when you need to summarize everything. Get training for Elluminate, SurveyMonkey, Joomla and PAHO Intranet as soon as you arrive. Get very familiar with Joomla features and the Health Research Promotion and Development website before making any changes.

ANNEXES AND SUPPLEMENTARY MATERIAL Annex 1.

Communication Strategy

Goal

To increase the dissemination of information regarding high quality scientific and evidence‐ informed policy‐making and practices, and their effects on the health of people within PAHO’s member countries.

Objectives

to improve our communication and feedback processes by identifying, reaching out to, and assessing our target populations

To identify our communication vehicles.

To establish a framework for the development of a plan of action for each product the unit develops.

Activity 1

Objective: To identify, reach out, and assess our target populations in order to improve our communication and feedback process

1. Identify Audience and create lists a. Internal - PAHO Regional Offices Staff - PAHO HQ Staff - Focal Points - LGC counterparts - WHO Staff b. External - Ministries of Health - Researchers/Academia - Partners - Potential partners - Universities - NGOs

2. Create Survey http://www.surveymonkey.com/s/DRWBRXD

3. Disseminate survey and collect data Produce report of findings

4. Asses and Analyze (Summary Report)

Activity 2

Objective: To identify our communication vehicles

1. Tools/Channels and their Roles

‐ Website: site for content and links with other in‐house and outside sites

‐ Newsletter: alert audience of our past, upcoming, and most important news and events.

‐ Journals

‐ Booklets

‐ CD: compilation of important documents

‐ Case studies: show examples of good use of health research for policy‐making

‐ Factsheets

‐ Media Press (interviews, news, press releases)

Activity 3

Objective: To establish a framework for the development of a plan of action for each product the unit develops.

1. Create a Communications Advisory Committee a. Meetings bi‐weekly b. For guidance and feedback

2. Break down activities into products to facilitate process a. Who We Are b. EVIPNet Americas c. Strengthening Health Research Systems d. Clinical Trials Registration e. PAHO Ethics Review Committee f. Guidelines for Development of Guidelines g. Training Opportunities h. Funding Opportunities i. What’s New

3. Audit Communication Vehicles a. Use feedback from users b. Make adjustments:

c. Ensure information is available in friendly formats by diverse media

4. Build and Consistently Use Key Messages a. these should be developed around PAHO’s mission b. Identify 3‐5 things we want people to know about our department (SOCO) c. Incorporate these key messages into all communication pieces, as fits

6. Gauge Communications Effectiveness a. Test and gather feedback to continuously improve b. Identify trends to help improve communication efforts

Annex 2.

“Health Agenda for the Americas 2008‐2017 Prize” http://new.paho.org/hq/index.php?option=com_content&task=view&id=4402&Itemid=931&la ng=en “Cochrane Iberoamericana Workshops” http://new.paho.org/hq/index.php?option=com_content&task=view&id=4443&Itemid=931&la ng=en “SUPPORT Tools for Evidence‐Informed Policy‐Making (STP): Accessible in four languages” http://new.paho.org/hq/index.php?option=com_content&task=view&id=4468&Itemid=931&la ng=en

Annex 3.

Annex 5.

Survey Report: Communications Strategy Total responses: 73

Question 1: Which category best fits your primary occupation? Please check all that apply.

Others: Government –MOH Research unit inside a third level university hospital PAHO Consultant PAHO Staff Country Office PAHO Consultant at KMC (no staff)

Summary: The people we were able to reach to fill out our survey are mostly internal staff from PAHO HQ (29.2%), PAHO Staff (13.9%), WHO (4.2%) and Focal Points (6.9%). The second

largest group who filled out surveys was in the Academia/Research category with 31.9% of all surveys.

Question 2: Please rate our means of communication on a scale from 1 to 5. If you have never used it, please mark it as 6=N/A.

Suggestions for means of communication you would like us to add that are not listed above (ie. Social media, journals, etc).

I want to start investigating. Suggest something for me.

Social media Boletins Social networks Friend’s email Journals Triumph – very useful Website more friendly Website ease of navigation could be improved

Journals Some access need subscription payment and limits some search Social media, website with all information and materials Social networking Summary: Except for the website, all means of communication had N/A as the most frequent response for usefulness. Means of communication rated more negatively in their usefulness are the CD, Booklets, and the most useful are the Website and List Server Equity.

For answer 5=want more of this, 10.3% marked Website, and 6% marked List Server Research.

Question 3: How often do you receive/obtain information from us?

Summary: Over a third (36.5%) of respondents receive/obtain information from us a few times a year, followed by once a month (20.3%) and daily (18.9%). 6.8% reported never receiving/obtaining information from us.

Question 4: How often do you visit our website?

Summary: In regards to our Website, over one third (36.5%) responded as visiting it a few times a year. 23% said they never visit the website, and 16.2% visit it once a week.

Question 5: What other information/data/resources would you like to receive from us that we do not yet provide?

1. Information about courses of investigation of biostatistics * 2. Information about postgraduate programs in clinical epidemiology 3. I would need to have time to explore the resources you already provide in order to answer this question, sorry 4. About the possibilities for money for financing projects $ 5. Special issues for prevalent diseases could be very useful # 6. No comment. Information received is satisfactory 7. Elluminate marketing sessions explaining in Spanish products and services offered by HRPD * 8. Mental health # 9. Specific information about seminars, courses, or training opportunities * 10. Becas, up to date in research $ 11. Health public

12. World wide epidemiologic statistics and data somehow has change, and make it a little more difficult to find, for example for cancer #. And also a list for openings for research grants. $ 13. Indicadores de salud, medicina basada en evidencias, opinions de expertos #.

14. Informacion prioritaria que se genera en los paises 15. Mas información en espanol o portugues (lista de equidad) 16. Información sobre trabajos de investigación en salud 17. Stadistic software and aplication that can make more easily the training for health volunteers in the rural area who capability in the knowledge is very low * 18. Creo que ha sido adecuado el envio de informacion, usando diferentes medios 19. Access to database for further análisis and dissemination 20. Recent scientific releases from Cochrane Collaboration (systematic reviews) 21. Seguridad alimentaria y nutricional #, cursos en linea *, agendas regionales

Summary: The 3 top themes for other information/data/resources requested are funding, training (especially virtual and elluminate options), and disease‐specific data.

Question 6: Please provide us with any additional comments and/or suggestions.

1. Sorry, but I’m very “new” at RCIB 2. Definitively one big problem for me is to keep updated with the continuous flooding of informations and data; on the other hand at my institution there is still too much bureaucracy and too much waste of time.

3. Information. About the possibilities for money for financing projects $ 4. Your permanent work is excellent 5. Nothing more to add 6. I would like to participate in some research about mental health # 7. More free training * 8. Thanks for your support for research in my country 9. Promote the development of south research webs through your page or make it easier to find a partner 10. For me this kind of webinars are fully useful, since professors are very professional and also see comments from other researchers * 11. Mayor comunicacion via Elluminate para acciones conjuntas * 12. Por favor sigan con los cursos virtuales son muy buenos para aprender * 13. Keep living the training if it’s possible in the native language * 14. Muy buen trabajo 15. Maybe the website should be more organized by topics, for example: webinar, scholarships, internships, etc 16. I think it will be very useful that you create a facebook, twitter, and other social network accounts for you to enhance communication @ 17. Thank you 18. Great job continue like that

Summary: The major themes for additional comments/suggestions are continuing and doing more training (especially virtual and elluminate options) and funding for research.

Additional Findings I:

When isolating for people who answered “Academia/Research” to Question 1: Total: 23/73 Question 2:

26.3% answered Press Releases were 3=less useful 42.1% answered Website was 1=very useful 30% answered Health Research Newsletter was 2=somewhat useful 36.8% answered List Server Equity was 6=N/A, 21.1% answered 1=very useful 28.6% answered List Server Research was 6=N/A, 23.8% answered 1=very useful 45% answered CD was 6=N/A, 25% answered 3=less useful 47.6% answered Booklets were 6=N/A, 14.3% answered 1=very useful, 14.3% answered 3=less useful 31.6% answered Factsheets/Info sheets were 6=N/A, 26.3% answered 1=very useful

Suggestions included social networks, journals, and concern that some access need subscription payments that limit search

Question 3:

34.8% receive/obtain information from us a few times a year, 26.1% once a month, 17.4% once a week.

Question 4:

39.1% visit our website a few times a year, 21.7% once a month, 17.4% never.

Question 5:

The main requests for other information/data/resources were:

• Information about courses of investigation of biostatistics • About the possibilities for money for financing projects • Elluminate marketing sessions explaining in Spanish products and services offered by HRPD • Specific information about seminars, courses, or training opportunities • Becas, up to date in research • Health public

• • • • •

Indicadores de salud, medicina basada en evidencias, opinions de expertos.

Informacion prioritaria que se genera en los paises Stadistic software and aplication that can make more easily the training for health volunteers in the rural area who capability in the knowledge is very low Recent scientific releases from Cochrane Collaboration (systematic reviews) Seguridad alimentaria y nutricional, cursos en linea, agendas regionales

Question 6: Additional comments/suggestions included:

• Definitively one big problem for me is to keep updated with the continuous flooding of informations and data; on the other hand at my institution there is still too much bureaucracy and too much waste of time.

• Information. About the possibilities for money for financing projects • Thanks for your support for research in my country • For me this kind of webinars are fully useful, since professors are very professional and also see comments from other researchers • Mayor comunicacion via Elluminate para acciones conjuntas • Keep living the training if it’s possible in the native language

Additional Findings II:

When isolating for people who are PAHO or WHO staff (internal) in Question 1: Total: 37/73 Results cannot group all PAHO and WHO data as one for analysis purposes, but a printed version of their individual results excluding all other groups is available. I will bring this to the meeting tomorrow.

Interesting points:

• Only 5 KMC/Research focal points answered the survey.

• Research/KMC focal points rated most means of communication positively and no one selected 6=N/A or 5=want more of this for any of them. The website was the most popular among this group followed by the List Servers.

• PAHO Staff HQ were less likely to rate the means of communication positively for all items.

• The Health Research Newsletter was the least used (exception with KMC/Research focal points) means of communication.

• The Website was the most used means of communication.

• About a third of PAHO staff never visit our website.

• Only 2 suggestions/requests typed in spaces provided about increasing number of training opportunities via elluminate.