Social Work and Public Health Faculty Team Up for Pilot Study in Haiti

The first time Associate Professor Patricia Kohl visited the slums of Haiti, she met two mothers and their babies. One mother was breastfeeding her infant, but never looked at the child, who was staring ahead blankly. The second mother was playing with her baby, stroking his cheek, making eye contact, and the child was similarly engaged with his mother and his surroundings.

“Despite the effects of poverty, that child has much better odds of overcoming their adverse living conditions,” Kohl said.

That difference is one basis for a project that Kohl and Lora Iannotti, also an associate professor at the Brown School, undertook to improve parenting and child development in one of the world’s poorest nations.

The project created and tested an innovative nutrition and parenting intervention to promote healthy growth and development among young children in an urban slum of Haiti. Adapted from a similar project in Uganda, the intervention is a pilot project for a larger trial. Iannotti and Kohl worked with a team from the Universite Publique du Nord au Cap Haitien led by Study Coordinator Sherlie Jean Louis Dulience.

Mothers participated in peer discussion groups facilitated by Dulience on the themes of parenting, water, sanitation and hygiene, and the importance of animal source foods in young child nutrition. Each of the 15 families participating in the pilot study were also given eggs for 12 weeks. The nutritional aspect was similar to other studies Iannotti has conducted in Haiti and Ecuador focusing on high-quality, affordable foods for resource-poor families, because those foods are important for children’s brain development.

Kohl’s expertise in parenting and child development in vulnerable families, coupled with Iannotti’s in young child nutrition and development, was an exciting combination for the veteran researchers. Kohl is the Brown School’s associate dean for social work, and Iannotti is the incoming associate dean for public health.

“It’s the best example of transdisciplinary research I’ve been involved in,” Iannotti said. “It’s got all the elements — biology, economics, policy and social development.”

Both stressed the importance of including the community in the design and development of the research. They consulted focus groups of mothers and community health workers to find out their needs and to get their insights about which solutions might be the most helpful. It was critical to hear from the community about which approaches would be the most realistic for over-stressed families to implement, given the economic hardships they faced.

“Families that are overloaded by the stresses of living in abject poverty are focused on other priorities,” Kohl said. “What loses out is their relationship to their children.”

Groups of mothers were given guidance about how to use their limited resources, like making playthings for their children from a bottle of beans, or telling them stories if they had no books to read.

“The mothers were eager to learn from us, but also from each other,” Iannotti said. “The response was very positive.”

Research assistants and staff at the Brown School, along with the study coordinator, are currently analyzing data as to child development, diet and other health outcomes, as well as the receptivity of parents. They hope to build on favorable results for funding to expand the project to many more families.

Kohl said the potential for success in Haiti can also be translated elsewhere.

“What we’re learning in Haiti is applicable to impoverished communities in the U.S.,” she said, and Iannotti agrees.

“We are inextricably linked in today’s world, where global health, environment, social and economic development transcend country borders,” Iannotti said. “Community development is community development — with contextual adaptations, of course. Our learning is so much richer with shared experiences.”