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Gamble A1,2, Mohammed Amin Ahmed A3,4, Hartman J5
1Wchan Orgnization for Victims of Human Rights Violations, Kurdistan Region, Iraq, 2Side by Side Global, Kurdistan Region, Iraq, 3Wchan Orgnization for Victims of Human Rights Violations, Kurdistan, Iraq, 4Sulaimani Polytechnic University, Technical College of Health, Kurdistan Region, Iraq, 5Northwestern University, Feinberg School of Medicine, Department of Physical Therapy and Human Movement Sciences, Chicago, United States
Background: According to The World Bank, two billion people live in countries that are considered fragile and conflict-affected states (FCAS). Many challenges exist in conducting research in this context. The Kurdistan region of Iraq (Kurdistan) is a recognized FCAS and has limited skilled researchers, contributing to a gap in research conducted to support the needs of vulnerable populations. In an effort to address this gap, Wchan Organization for Victims of Human Rights Violations (Wchan), a non-governmental organization (NGO) founded in Kurdistan, entered into a partnership with Northwestern University, USA, (NU).
Purpose: This case report describes an initiative between researchers from a research-intensive university in the United States and a Kurdish founded and led NGO to plan and implement a randomized wait-list controlled study to achieve two objectives:
1) measure the impact of an interdisciplinary treatment approach aimed at improving the health of survivors of torture in a prison in Kurdistan, and
2) build the research capacity of Kurdish physiotherapists and other healthcare providers.
Methods: To build capacity in an underserved context and execute a research study with a vulnerable population, the following steps occurred:
1. Development meetings between Wchan, NU, and the prison directorate to establish feasible and culturally-sensitive capacity building and research procedures.
2. Collaborative development of formal research proposal.
3. Attainment of approval from NU's Institutional Review Board (IRB), the prison directorate, and Kurdistan's ethical committee.
4. Capacity building trainings with Wchan´s clinical team.
5. Execution of the research study while simultaneously facilitating capacity building opportunities.
6. Data analysis of the study's outcome measures is currently being performed.
7. A dissemination plan, including formal publications and presentations via locally accessible platforms, is in development.
Results: The research leadership team consisted of one faculty member from NU and two staff from Wchan including a United-States trained doctoral physiotherapist and a Kurdish physician that serves as director of Wchan. The Wchan clinical team included 2 physiotherapists, 5 psychotherapists, and 2 support members. The research leadership team facilitated 20 hours of in-person capacity building trainings in research ethics, informed consent, and principles and procedures of data collection and data management. During the implementation of the study, the clinical team participated in 15 hours of team discussions and the physiotherapists benefited from 30 hours of direct clinical supervision during data collection. In addition to the provision of the clinical services and data collection, Wchan's clinical team contributed to the study's procedures and will be supported to interpret and disseminate findings via co-authorship on manuscripts and presentations.
Conclusion(s): The successful completion of an IRB-approved study by a Kurdish clinical team providing services to survivors of torture in a prison in Kurdistan reflects the success of the capacity building model described in this case report.
Implications: This case report describes a model that promotes research in underserved and FCAS contexts through a culturally sensitive partnership between a western academic institution and an organization that works with vulnerable populations. This model can be used to expand professionals' clinical research skills, improve outcomes, and disseminate findings to a broader audience.
Keywords: Research, Capacity building, Survivors of torture
Funding acknowledgements: The UN Voluntary Fund for Victims of Torture
Purpose: This case report describes an initiative between researchers from a research-intensive university in the United States and a Kurdish founded and led NGO to plan and implement a randomized wait-list controlled study to achieve two objectives:
1) measure the impact of an interdisciplinary treatment approach aimed at improving the health of survivors of torture in a prison in Kurdistan, and
2) build the research capacity of Kurdish physiotherapists and other healthcare providers.
Methods: To build capacity in an underserved context and execute a research study with a vulnerable population, the following steps occurred:
1. Development meetings between Wchan, NU, and the prison directorate to establish feasible and culturally-sensitive capacity building and research procedures.
2. Collaborative development of formal research proposal.
3. Attainment of approval from NU's Institutional Review Board (IRB), the prison directorate, and Kurdistan's ethical committee.
4. Capacity building trainings with Wchan´s clinical team.
5. Execution of the research study while simultaneously facilitating capacity building opportunities.
6. Data analysis of the study's outcome measures is currently being performed.
7. A dissemination plan, including formal publications and presentations via locally accessible platforms, is in development.
Results: The research leadership team consisted of one faculty member from NU and two staff from Wchan including a United-States trained doctoral physiotherapist and a Kurdish physician that serves as director of Wchan. The Wchan clinical team included 2 physiotherapists, 5 psychotherapists, and 2 support members. The research leadership team facilitated 20 hours of in-person capacity building trainings in research ethics, informed consent, and principles and procedures of data collection and data management. During the implementation of the study, the clinical team participated in 15 hours of team discussions and the physiotherapists benefited from 30 hours of direct clinical supervision during data collection. In addition to the provision of the clinical services and data collection, Wchan's clinical team contributed to the study's procedures and will be supported to interpret and disseminate findings via co-authorship on manuscripts and presentations.
Conclusion(s): The successful completion of an IRB-approved study by a Kurdish clinical team providing services to survivors of torture in a prison in Kurdistan reflects the success of the capacity building model described in this case report.
Implications: This case report describes a model that promotes research in underserved and FCAS contexts through a culturally sensitive partnership between a western academic institution and an organization that works with vulnerable populations. This model can be used to expand professionals' clinical research skills, improve outcomes, and disseminate findings to a broader audience.
Keywords: Research, Capacity building, Survivors of torture
Funding acknowledgements: The UN Voluntary Fund for Victims of Torture
Topic: Disability & rehabilitation; Research methodology & knowledge translation
Ethics approval required: Yes
Institution: Northwestern University
Ethics committee: Northwestern University Institutional Review Board
Ethics number: STU00206726
All authors, affiliations and abstracts have been published as submitted.
