Papers by Taghreed El Hajj
F1000Research, Mar 28, 2024
et al. How an international research programme can contribute to improvements in the research env... more et al. How an international research programme can contribute to improvements in the research environment: the perspective of doctoral students in sub-Saharan Africa [version 2; peer review: 3
BMC Public Health
Background Social distancing restrictions to manage the COVID-19 pandemic were put in place from ... more Background Social distancing restrictions to manage the COVID-19 pandemic were put in place from March 2020 in the United Kingdom (UK), with those classed as “highly clinically vulnerable” advised to shield entirely and remain at home. However, personal risk perception has been shown to comprise of various elements beyond those outlined in the national pandemic guidance. It is unclear whether those deemed COVID-19 vulnerable identified as high-risk to COVID-19 and thus complied with the relevant advice. The aim of this research is to explore the perception of risk in catching and spreading COVID-19, amongst individuals from individual households, and vulnerable groups in a region of the UK. Methods Two individual, semi-structured interviews were conducted, four-weeks apart, with adults living in households in the Liverpool City Region. At the follow-up interview, participants were given the option of using photo-elicitation to guide the discussion. Reflexive thematic analysis was em...
Sexually Transmitted Infections, 2015
Our aim was to assess whether routine screening for TV in females is indicated in an urban Austra... more Our aim was to assess whether routine screening for TV in females is indicated in an urban Australian setting. Methods Females attending a sexual health clinic from July 2013-February 2014 who were tested for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) were eligible to have a TV test on the same specimen. Testing was performed by transcription-mediated amplification on female genital specimens using the Aptima Trichomonas vaginalis assay (Hologic Inc., United States). Characteristics of the study population were examined. Results During the study period, 393 women were tested for CT/NG on 471 occasions. TV tests were performed 347 (73.7%) of CT/NG specimens. There were no significant differences between women who had (n = 294), and did not have (n = 99), a TV test during the study period, except that women who had recent overseas sexual contact were less likely to be tested. Of the 347 tests, two TV infections were diagnosed, a positivity rate of 0.6% (95% CI 0.07-2.1%). Both cases were Australian-born with a history of injecting drug use in the past 12 months, Neither were sex workers and one identified as Aboriginal. One presented with post-coital bleeding, and TV was identified on wet film. The other reported pelvic symptoms, but was tested on outreach and no wet film microscopy was performed. Neither had concurrent CT/NG infections detected. Conclusion We found a low positivity rate of TV among female attendees. Both TV infections were in women who had symptoms suggestive of a sexually transmitted infection. Our findings are in accord with those from previous urban Australian studies and do not support routine TV screening for asymptomatic women in metropolitan Sydney. Disclosure of interest statement Aptima Trichomonas vaginalis assay testing kits were provided free by Hologic (Australia) Pty Ltd.
BMJ Global Health, Apr 1, 2023
Research systems and cultures have been criticised for their detrimental effect on members' menta... more Research systems and cultures have been criticised for their detrimental effect on members' mental health and well-being. Many international research programmes operate through research consortia that have the resources to make a substantial contribution to improving the research environment in their member organisations. This paper collates real-life examples from several large international consortia-based research programmes about how they strengthened organisations' research capacity. The consortia primarily involved academic partners from the UK and/or sub-Saharan Africa and covered research topics including health, natural sciences, conservation agriculture and vector control. They were partly or wholly funded by UK agencies including the Wellcome, Foreign and Commonwealth Development Office, UK Research and Innovation Fund, and the Medical Research Council and they operated for 2-10 years between 2012 and 2022. Consortia's size and ability to access and share resources among their member organisations according to need meant they were uniquely placed to target actions to address weaknesses in member organisations' research capacity, to widen networks and collaborations, and to build in sustainability of capacity gains. Consortia's actions covered: (a) individuals' knowledge and skills; (b) capacity strengthening ethos; (c) organisations' visibility and prestige; and (d) inclusive and responsive management practices. Evidence about these actions formed the basis of recommendations for funders and leaders of consortium-based programmes about how they could make more effective use of consortia's resources to enhance organisations' research systems, environments and cultures. Key lessons were that training should cover management and research leadership and should be offered beyond consortium members, including to research support staff such as technicians and managers. Consortia often tackle complex problems requiring multidisciplinary inputs, but overcoming disciplinary boundaries-and making everyone feel valued and respected-takes time and skill on the part of consortium leaders. Consortia need clear guidance from funders about their commitment to strengthening research capacity. Without this, consortia leaders may continue to prioritise research outputs over creating and embedding sustainable improvements in their organisations' research systems.
BMJ Open
IntroductionCOVID-19 has tested the resilience of health systems globally and exposed existing st... more IntroductionCOVID-19 has tested the resilience of health systems globally and exposed existing strengths and weaknesses. We sought to understand health systems COVID-19 adaptations and decision making in Liberia and Merseyside, UK.MethodsWe used a people-centred approach to carry out qualitative interviews with 24 health decision-makers at national and county level in Liberia and 42 actors at county and hospital level in the UK (Merseyside). We explored health systems’ decision-making processes and capacity to adapt and continue essential service delivery in response to COVID-19 in both contexts.ResultsStudy respondents in Liberia and Merseyside had similar experiences in responding to COVID-19, despite significant differences in health systems context, and there is an opportunity for multidirectional learning between the global south and north. The need for early preparedness; strong community engagement; clear communication within the health system and health service delivery adap...
Developing a logic model for youth mental health: participatory research
Background: Early detection of common mental disorders, such as depression and anxiety, among chi... more Background: Early detection of common mental disorders, such as depression and anxiety, among children and adolescents requires the use of validated, culturally sensitive, and developmentally appropriate screening instruments. The Arab region has a high proportion of youth, yet Arabic-language screening instruments for mental disorders among this age group are virtually absent. Methods: We carried out construct and clinical validation on the recently-developed Arab Youth Mental Health (AYMH) scale as a screening tool for depression/anxiety. The scale was administered with 10-14 year old children attending a social service center in Beirut, Lebanon (N = 153). The clinical assessment was conducted by a child and adolescent clinical psychiatrist employing the DSM IV criteria. We tested the scale’s sensitivity, specificity, and internal consistency. Results: Scale scores were generally significantly associated with how participants responded to standard questions on health, mental healt...
BMJ Global Health, 2021
This practice note presents four conceptual tools intended to support the design, selection and e... more This practice note presents four conceptual tools intended to support the design, selection and evaluation of research capacity strengthening (RCS) programmes in low-income and middle-income country settings. The tools may be used by a wide range of RCS stakeholders, including funders, implementing parties and programme evaluators, to guide decision-making in lieu of largely as yet unavailable empirical evidence. The first conceptual tool guides decision-making regarding RCS intervention design, focusing specifically on the combination and integration of potential intervention activities. The second conceptual tool provides a framework for assessing the implementation challenges of potential RCS interventions in terms of: (1) the overall cost of implementing the proposed intervention in a given context; (2) the length of time required to complete full implementation of the proposed intervention in a given context and (3) the level of control the implementing partners would have over...
AAS Open Research, 2020
Background: International development partners and research councils are increasingly funding res... more Background: International development partners and research councils are increasingly funding research management and support (RMS) capacity strengthening initiatives in sub-Saharan Africa (SSA) as part of a broader investment in strengthening national and regional research systems. However, the evidence-base to inform RMS capacity strengthening initiatives is limited at present. This research note presents a synthesis of 28 RMS capacity assessments completed in 25 universities/research institutions from across 15 SSA countries between 2014 and 2018. Methods: All 28 capacity assessments were completed following a standardised methodology consisting of semi-structured interviews conducted with research and research support staff at the respective institution as well as document reviews and observation of onsite facilities. Data were extracted from the 28 reports detailing the findings of each assessment according to a framework synthesis approach. Results: In total, 13 distinct cap...
QADEROON (We Are Capable') was a year-long social-skills building intervention for Palestinia... more QADEROON (We Are Capable') was a year-long social-skills building intervention for Palestinian youth (11-14 years) living in one of Beirut's refugee camps. The status of Palestinians in Lebanon is known to be the worst of Palestinian refugees in the region due to state imposed restrictions on employment, and limited rights. QADEROON was guided by an evidence-informed logic model, and modeled on interventions previously evaluated to be effective. The intervention objective was to improve mental health through changing intermediate outcomes such as improved communication skills, improved problem solving skills, improved relationship with parents and teachers, among others. The intervention package - developed, implemented, and evaluated in partnership with a community coalition - included activities for youth, their parents, and their teachers. The youth intervention - consisting of 45 sessions - was implemented August 2008 May 2009 with approximately 150 youth. The process ev...
Lancet, 2010
Background One in five young people will have a mental health event, and low-income urban populat... more Background One in five young people will have a mental health event, and low-income urban populations and refugees are at especially high risk. A shift in emphasis of mental health research has taken place, to the importance of positive mental health and social skills. Our investigation was done in the Burj El Barajneh Palestinian refugee camp (Beirut, Lebanon), the sixth largest of 12 official camps established in Lebanon for Palestinian refugees after the establishment of Israel in 1948. Palestinian refugees in Lebanon live in dire environmental and social conditions-the camp has 14 000-18 000 residents and is 1•6 km². Conditions are thought to be the worst for Palestinian refugees in the region, because of the scarcity of employment opportunities, economic resources, and access to basic health and social services, which are exacerbated by state-imposed restrictions on employment and education opportunities. Health and social services are provided by various international, governmental, and non-governmental organisations. The UN Relief and Works Agency was set up in 1948 to provide educational and health services to Palestinian refugees. However, because of the growing number of refugees, and local and international politics, schools have become unable to accommodate the number of children in the camp. The Qaderoon (literally: we are capable) intervention to promote mental health in young people was implemented for children aged 11-14 years living in the Burj El Barajneh camp in 2008-09. The programme's aims were to enhance mental health as a primary outcome, and to improve social skills as a secondary outcome.
Injury Prevention, 2011
Research on the links between violence and social capital has produced mixed results and is mainl... more Research on the links between violence and social capital has produced mixed results and is mainly limited to Western countries. To assess the relationship of social capital to physical fights among unmarried boys aged 13-19 years living in three disadvantaged neighbourhoods in the outskirts of Beirut, controlling for variables associated with youth violence. Lebanon has a history of civil and cross-border war, which may influence the production of violence at the individual level. 674 boys were interviewed. The dependent variable was being involved in a physical fight in the last 3 months. The independent variable was social capital, classified into six categories: civic engagement and community development; locational capital; trust; reciprocity; hypothetical social support; and social network. One fifth (20%) had been in a fight in the last 3 months. Youth who were members of a group, who had been victimised, who could ask for help from a family member/friend/neighbour when they had a problem, and who liked living in their neighbourhood were more likely to be involved in a fight. This research supports the literature that indicates that physical fights are positively related to both individual and social capital variables. Social capital had a detrimental effect on physical fights. This may be related to bonding in a gang-like way. While high levels of social capital are good for other health outcomes and thus should not be reduced, interventions that channel youth energy in positive ways are needed.
Health Policy and Planning, 2011
Although logic models are now touted as an important component of health promotion planning, impl... more Although logic models are now touted as an important component of health promotion planning, implementation and evaluation, there are few published manuscripts that describe the process of logic model development, and fewer which do so with community involvement, despite the increasing emphasis on participatory research. This paper describes a process leading to the development of a logic model for a youth mental health promotion intervention using a participatory approach in a Palestinian refugee camp in Beirut, Lebanon. First, a needs assessment, including quantitative and qualitative data collection was carried out with children, parents and teachers. The second phase was identification of a priority health issue and analysis of determinants. The final phase in the construction of the logic model involved development of an intervention. The process was iterative and resulted in a more grounded depiction of the pathways of influence informed by evidence. Constructing a logic model with community input ensured that the intervention was more relevant to community needs, feasible for implementation and more likely to be sustainable.
Health Education Research, 2011
Public health interventions are complex in nature and composed of multiple components. Evaluation... more Public health interventions are complex in nature and composed of multiple components. Evaluation of process and impact is necessary to build evidence of effectiveness. Process evaluation involves monitoring extent of implementation and comparison against the program plan. This article describes the process evaluation of the 'Qaderoon' (We are Capable) intervention; a community-based mental health promotion intervention for children living in a Palestinian refugee camp of Beirut, Lebanon. The manuscript describes the context of Palestinian refugees in Lebanon, the intervention, the process evaluation plan and results. The process evaluation was guided by the literature and by a Community Youth Committee. Findings indicated that attendance was 54 and 38% for summer and fall sessions, respectively. Session objectives and activities were commonly achieved. Over 78.4% of activities were reported to be implemented fully as planned. Over 90% of the children indicated high satisfaction with the sessions. Contextual facilitators and challenges to implementing the intervention are discussed. The most challenging were maintaining attendance and the actual implementation of the process evaluation plan. Findings from process evaluation will strengthen interpretation of impact evaluation results.
Community Mental Health Journal, 2010
A variety of measures of mental health have been used with youth. The reason for choosing one sca... more A variety of measures of mental health have been used with youth. The reason for choosing one scale over another in any given situation is rarely stated, and cross-cultural validation is scarce. Psychometric testing is crucial before utilizing any measure of mental health with a certain population, due to possible cultural variations in interpreting meaning. The research reported herein describes the development and psychometric testing of the Arab Youth Mental Health Scale. The process included 5 phases: (1) reviewing existing scales leading to the identification of 14 non-clinical and relatively short mental health scales used previously with youth; (2) rating the scales by the researchers and community members leading to the identification of 3 scales with apt structure, and that were judged to be suitable, applicable, and appropriate; (3) soliciting youth input to assess comprehension of each item in the selected 3 scales and to discover context specific mental health related feelings, thoughts, and expressions; (4) seeking expert opinion to classify items remaining after phase 3 that measured common mental disorders, and to limit repetitiveness; and (5) testing for psychometric properties of the 28 items that remained after the previous 4 phases. The contribution of each phase to the process is described separately. Results of the exploratory principal component analysis resulted in one factor which explained 28% of the variance and for which 21 items loaded above an eigenvalue of 0.5. No other factor added significantly to the explanation of variance, nor had items that added theoretical or conceptual constructs. The process of soliciting feedback from youth groups, the community and professionals; and of field testing was challenging; but resulted in a contextually sensitive, culturally appropriate and reliable scale to measure mental health of youth. We recommend that researchers measuring mental health of youth critically analyze the relevance of existing scales to their context; consider using the AYMH scale if appropriate to their target population; and when needed, use a similar methodology to construct a relevant, culturally and contextually sensitive measure.
Child and Adolescent Psychiatry and Mental Health, 2011
Background Early detection of common mental disorders, such as depression and anxiety, among chil... more Background Early detection of common mental disorders, such as depression and anxiety, among children and adolescents requires the use of validated, culturally sensitive, and developmentally appropriate screening instruments. The Arab region has a high proportion of youth, yet Arabic-language screening instruments for mental disorders among this age group are virtually absent. Methods We carried out construct and clinical validation on the recently-developed Arab Youth Mental Health (AYMH) scale as a screening tool for depression/anxiety. The scale was administered with 10-14 year old children attending a social service center in Beirut, Lebanon (N = 153). The clinical assessment was conducted by a child and adolescent clinical psychiatrist employing the DSM IV criteria. We tested the scale's sensitivity, specificity, and internal consistency. Results Scale scores were generally significantly associated with how participants responded to standard questions on health, mental heal...
i ACKNOWLEDGEMENTS ii LIST OF TABLES iii CHAPTER 1: Introduction: setting the scene 1 1.
Uploads
Papers by Taghreed El Hajj