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Researching Community Health in Kenya

By Colbe Boles

At the beginning of my sophomore year, I began thinking about what type of research I wanted to be involved in. There are lots of research opportunities across campus and while I considered which to invest in, I realized I wanted to do a specific type of research. Rather than sign up for the first research lab I found on campus, I chose to invest my time and energy into something that I was passionate about. Because of this decision, nine months later I found myself conducting research on the relationship between trust and physicians in rural Kenya.

In addition to being in the Chancellor’s Honors Program, I am part of the College of Arts and Sciences College Scholars program, with a concentration in community health and development. College Scholars allows me to build a major that aligns with my specific interests and career plans by combining courses offered at the university into my own plan of study. My specific interest is in practicing medicine in underserved areas where people lack access to basic health care services.

As I thought about the type of research I wanted to do, I decided to do something directly related to my major and career goals. I spoke with several different professors about possibilities and eventually determined I should go to Kenya and conduct a public health study. My mentor and I decided to create a Likert-style questionnaire that would measure the attitudes of rural Kenyans toward Western medical teams. The plan was for me to create a questionnaire, get it translated to the native language, get it approved, and, finally, travel to Kenya the following June to administer it.

Accomplishing this proved to be the most difficult undertaking of my entire college career. Getting any sort of research approval is difficult, but I quickly learned that getting approved to do international research involving human subjects would be much harder than I originally thought. First, I had to apply for a research permit from the Kenyan embassy. Then I had to get approval from the University of Tennessee’s Institutional Review Board (IRB). Due to a few unfortunate circumstances, I did not receive approval on my first try and had to wait until the next time the board met for my proposal to be reviewed. The next meeting wasn’t scheduled until the day I left for Kenya, which meant I had to fly to Kenya without knowing whether I would actually be allowed to do my research. Shortly after arriving, I got the go-ahead email and started collecting data.

After getting approved, I spent about two weeks walking around the dirt roads of Tawa, Kenya, collecting survey data. Tawa is a miniscule town in the Makueni region with no running water and very little electricity. This made collecting data quite an enjoyable process. Each day, my interpreter, David, and I would go to different locations in Tawa and ask anyone we ran into if they wanted to complete our survey. Because Tawa is relatively spread out, I rode around on the back of David’s motorcycle from location to location (something that was a lot more fun than it probably should have been) and we formed a fast friendship.

Many of the people I surveyed had a lot to say about health care. I spoke to one elderly man for over an hour about reasons he would and would not go see a physician. This was the most rewarding aspect of my research—seeing how much people cared about and appreciated my interest in their access to health care.

In the end, I collected 139 surveys from the locals of Tawa. All that was left was to analyze all the data I’d collected. I used IBM SPSS Statistics, a program provided for free by UT, to organize and run analysis on my data. Using a variety of t-tests to compare the means of the questions, I determined my respondents’ preferences. In the end, I determined that although Kenyans trusted physicians who spoke their language more, they are very interested in receiving health care regardless of who the physician treating them is. Additionally, younger and more educated respondents were less trusting overall, a result that was quite surprising. It is my hope that future foreign medical groups can use these findings to better serve Kenyans.

When I returned to campus, my advisor, Dr. Baldwin, encouraged me to submit my abstract to UT’s Exhibition of Undergraduate Research and Creative Achievement (EURēCA). Once she told me it was a poster competition for undergraduate students who had conducted research and that it awarded monetary prizes, I was sold! EURēCA was a lot more fun than I originally anticipated, and it gave me a chance to practice my presentation skills within a more relaxed environment. I would encourage anybody involved in research to submit to EURēCA.

While research is important to any student, it is especially so to those in the Chancellor’s Honors Program. My entire undergraduate career has been influenced by this research. Figuring out what to do as each new challenge arose was the most formative process of my time in college. This project showed me that there is support available for those who need it—it is possible to do unusual projects that go against the norm!