Rachel Vreeman
Datos Biográficos
| ID | 354978 |
|---|---|
| NOMBRE | Rachel Vreeman |
| NOMBRES | Rachel |
| APELLIDO | Vreeman |
| FIRMA | VREEMAN R |
| AFILIACIONES | Indiana University School of Medicine |
| ORCID | 0000-0001-5460-8204 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 35 |
| TOTAL DE CITAS | 21 |
| TOTAL COMO AUTOR | 35 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2007 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 3 |
Living the work
Costs and cost-effectiveness of community health worker programs on reproductive, maternal, newborn and child health in low- and middle-income countries (2015–2024)
Community Health Workers (CHWs) are vital in delivering primary health care in low- and middle-income countries (LMICs). To inform their broader rollout, this study updates a 2015 review, critically examining the costs, cost-effectiveness and affordability of reproductive, maternal, newborn and child health (RMNCH) CHW programs in LMICs. A scoping review was conducted using ten databases and grey literature, covering studies published between Aug…
Under the Influence
Alcohol and substance use in youth living with HIV (YLHIV) can influence health and treatment outcomes. We assessed substance use and associations with antiretroviral therapy (ART) adherence among YLHIV. The Adolescent and Young Adult Network of IeDEA enrolled YLHIV (15–24 years old) receiving ART (2021–2024) from 6 global regions. We assessed biopsychosocial experiences with validated tools; adherence with self-reported missed medication doses a…
Challenges Faced by Perinatally-Infected Kenyan Adolescents and Youth Living with HIV During the Covid-19 Pandemic
Factors associated with caregiver compliance to an HIV disclosure intervention and its effect on HIV and mental health outcomes among children living with HIV
Background: The HADITHI study is a cluster-randomized trial of children living with HIV and their caregivers in Kenya that aimed to increase rates of caregiver disclosure of their child's HIV status, encourage earlier status disclosure, and improve pediatric mental health and HIV outcomes. This analysis identified characteristics predicting caregiver non-responsiveness and compared outcomes among children based on disclosure status. Methods: A pe…
A Global Health Reciprocal Innovation grant programme
Unilateral approaches to global health innovations can be transformed into cocreative, uniquely collaborative relationships between low-income and middle-income countries (LMICs) and high-income countries (HIC), constituted as ‘reciprocal innovation’ (RI). Since 2018, the Indiana Clinical and Translational Sciences Institute (CTSI) and Indiana University (IU) Center for Global Health Equity have led a grants programme sculpted from the core eleme…
Multi-media teacher training and HIV-related stigma among primary and secondary school teachers in Western Kenya
HIV stigma is associated with delayed HIV disclosure and worse clinical outcomes for adolescents living with HIV (ALWH). Teachers critically influence school environments, but are understudied in terms of HIV stigma. We implemented a school-level, cluster-randomized trial to assess the impact of a one-day multi-media training on the knowledge, attitudes and beliefs (K/A/B) of school teachers in western Kenya. Teachers' K/A/B were evaluated at bas…
Longitudinal impacts of the Covid-19 pandemic on adolescents living with HIV in New York City
Adolescents living with HIV (ALWH) are particularly susceptible to disruptions in care, which may lead to poor HIV-related health outcomes. Here, we report the results of a longitudinal phone-based study investigating impacts of the COVID-19 pandemic on ALWH in New York City. Participants (N = 10, mean age 21.2 years, 50% female) demonstrated substantial COVID-19 knowledge and identified Instagram as their primary source of COVID-19 information. …
Ethical Considerations for Engaging Children and Adolescents Living with HIV in Research in African Countries
Research engaging children and adolescents living with HIV (CALWH) is critical for youth-friendly services and HIV care, and researchers need to ensure that such engagement is ethical. We conducted a systematic review to identify key ethical considerations for the engagement of CALWH in research. The review focused on primary research articles conducted in African countries that examined ethical issues in CALWH engaged in research. Ten studies me…
Ethical Considerations for Engaging Youth Living with HIV in Research
Introduction: Engaging youth living with HIV (YLWH) in research is critical to improving HIV-related outcomes, but their involvement raises unaddressed bioethical questions. Methods: This study used qualitative inquiry with Kenyan YLWH, caregivers, and subject matter experts (SMEs) to evaluate ethical considerations and strategies for research involving YLWH. Results: Interviews were conducted with 99 participants: 40 YLWH (median age 17.5, 50% f…
A systematic review of interventions to reduce HIV-related stigma among primary and secondary school teachers
Reciprocal innovation
Global health researchers often discount mutual learning and benefit to address shared health challenges across high and low- and middle-income settings. Drawing from a 30-year partnership called AMPATH that started between Indiana University in the US and Moi University in Kenya, we describe an innovative approach and program for mutual learning and benefit coined 'reciprocal innovation.' Reciprocal innovation harnesses a bidirectional, co-const…
I have never talked to anyone to free my mind” – challenges surrounding status disclosure to adolescents contribute to their disengagement from HIV care
Complex challenges surrounding HIV status disclosure to adolescents contribute to care disengagement. There is need to enhance training and resources for HCW, and to empower caregivers to support children and adolescents before, during, and after HIV status disclosure. This should include counseling caregivers on how to provide children with developmentally-appropriate and accurate information about their health from an early age, and to support …
Social Stigma Related to Covid-19 Disease Described by Primary and Secondary School Teachers and Adolescents Living With HIV in Western Kenya
Introduction: Understanding community members' knowledge, attitudes, and beliefs about the novel SARS-CoV-2 virus and the prevalence of associated stigma are critical steps for increasing accurate public health knowledge, encouraging uptake of preventative or mitigating health behaviors, and ultimately bringing the COVID-19 pandemic under control. Methods: We conducted a one-time, phone-based assessment to assess the presence of perceived COVID-1…
Perspectives of education sector stakeholders on a teacher training module to reduce HIV/Aids stigma in Western Kenya
Data from interviews with education sector stakeholders demonstrate that our process for developing a culturally appropriate multi-media intervention to reduce HIV stigma in the schools was feasible
Preventive Health Service Coverage Among Infants and Children at Six Maternal-Child Health Clinics in Western Kenya
A Pilot Study of a Mobile Intervention to Support Mental Health and Adherence Among Adolescents Living with HIV in Western Kenya
Mobile technologies represent potentially novel and scalable intervention delivery platforms for adolescents living with HIV (ALWH) in low- and middle-income countries. We conducted a prospective, mixed methods pilot study to evaluate the acceptability and feasibility of the WhatsApp ® platform to deliver individual counseling services and facilitate peer support for ALWH in western Kenya. Thirty ALWH (17 female, mean age 15.4) on ART, engaged in…
“A problem shared is half solved” – a qualitative assessment of barriers and facilitators to adolescent retention in HIV care in western Kenya
Adolescents living with HIV (ALHIV, ages 10-19) are retained in care at low rates, resulting in poor clinical outcomes. We investigated barriers and facilitators to retention experienced by perinatally infected ALHIV in western Kenya. This qualitative study purposefully sampled hospitalized ALHIV (engaged and not currently engaged in care), ALHIV engaged in outpatient care, and caregivers of ALHIV. In total, 116 ALHIV and caregivers participated …
Interventions for developmental delays in children born to HIV-infected mothers
Tablet-based disclosure counselling for HIV-infected children, adolescents, and their caregivers
Tablet computers containing resources for disclosure are an acceptable and potentially effective resource to help providers support families with disclosure. Further work is needed to train the clinical providers in using the resources in a developmentally appropriate manner, and to develop new resources on adolescent-specific and HIV-related topics
Mental health challenges among adolescents living with HIV
Introduction : Mental health is a critical and neglected global health challenge for adolescents infected with HIV. The prevalence of mental and behavioural health issues among HIV‐infected adolescents may not be well understood or addressed as the world scales up HIV prevention and treatment for adolescents. The objective of this narrative review is to assess the current literature related to mental health challenges faced by adolescents living …
Patient-Reported Barriers to Adherence to Antiretroviral Therapy
Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya
Knowledge of one's own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of …
Comprehensive Evaluation of Caregiver-Reported Antiretroviral Therapy Adherence for HIV-Infected Children
Models of care for orphaned and separated children and upholding children’s rights
BACKGROUND: Sub-Saharan Africa is home to approximately 55 million orphaned children. The growing orphan crisis has overwhelmed many communities and has weakened the ability of extended families to meet traditional care-taking expectations. Other models of care and support have emerged in sub-Saharan Africa to address the growing orphan crisis, yet there is a lack of information on these models available in the literature. We applied a human righ…
Child abuse and neglect among orphaned children and youth living in extended families in sub-Saharan Africa
Researchers and aid organizations have reported that orphans in sub-Saharan Africa (SSA) are particularly vulnerable to abuse and neglect. This article is a review of qualitative studies that address experiences of maltreatment among orphaned children and youth living in extended families in SSA. It aims to inform policy and programming by providing a better understanding of the types of maltreatment encountered and the perceived risk factors. A …
Factors Sustaining Pediatric Adherence to Antiretroviral Therapy in Western Kenya
Antiretroviral therapy (ART) requires nearly perfect adherence to be effective. Although 90% of HIV-infected children live in Africa, there are limited data on pediatric adherence from this multicultural continent.We conducted a qualitative study to identify key factors contributing to pediatric ART adherence. Ten focus group discussions (N = 85) and 35 individual interviews were conducted with parents and guardians of HIV-infected children recei…
Factors underlying taking a child to HIV care
OBJECTIVE: With the aim of reducing pediatric loss to follow-up (LTFU) from HIV clinical care programs in sub-Saharan Africa, we sought to understand the personal and socio-cultural factors associated with the behavior of caregivers taking HIV-infected and -exposed children for care in western Kenya. METHODS: Between May and August, 2010, in-depth interviews were conducted with 26 purposively sampled caregivers caring for HIV-infected (7), HIV-ex…
Pediatric Assent for a Study of Antiretroviral Therapy Dosing for Children in Western Kenya
MULTINATIONAL COLLABORATORS IN health research face particular ethical challenges when conducting studies involving vulnerable populations such as children. We use an example from our first attempt to implement pediatric assent in the context of a longstanding research and clinical partnership between Kenyan and American medical schools to highlight the ethical and procedural issues related to pediatric assent that must be considered for multinat…
Community Perspectives on Research Consent Involving Vulnerable Children in Western Kenya
Involving vulnerable pediatric populations in international research requires culturally appropriate ethical protections. We sought to use mabaraza, traditional East African community assemblies, to understand how a community in western Kenya viewed participation of children in health research and informed consent and assent processes. Results from 108 participants revealed generally positive attitudes towards involving vulnerable children in res…
A Systematic Review of School-Based Interventions to Prevent Bullying
OBJECTIVE: To conduct a systematic review of rigorously evaluated school-based interventions to decrease bullying. DATA SOURCES: MEDLINE, PsycINFO, EMBASE, Educational Resources Information Center, Cochrane Collaboration, the Physical Education Index, and Sociology: A SAGE Full-Text Collection were searched for the terms bullying and bully. STUDY SELECTION: We found 2090 article citations and reviewed the references of relevant articles. Two revi…
Impact of the Kenya post-election crisis on clinic attendance and medication adherence for HIV-infected children in western Kenya
During a period of humanitarian crisis, the vulnerable, HIV-infected pediatric population had disruptions in clinical care and in medication adherence, putting children at risk for viral resistance and increased morbidity. However, unique program strengths may have minimized these disruptions
Pediatric Assent for a Study of Antiretroviral Therapy Dosing for Children in Western Kenya
MULTINATIONAL COLLABORATORS IN health research face particular ethical challenges when conducting studies involving vulnerable populations such as children. We use an example from our first attempt to implement pediatric assent in the context of a longstanding research and clinical partnership between Kenyan and American medical schools to highlight the ethical and procedural issues related to pediatric assent that must be considered for multinat…
Factors Sustaining Pediatric Adherence to Antiretroviral Therapy in Western Kenya
Antiretroviral therapy (ART) requires nearly perfect adherence to be effective. Although 90% of HIV-infected children live in Africa, there are limited data on pediatric adherence from this multicultural continent.We conducted a qualitative study to identify key factors contributing to pediatric ART adherence. Ten focus group discussions (N = 85) and 35 individual interviews were conducted with parents and guardians of HIV-infected children recei…
The Vulnerabilities of Orphaned Children Participating in Research
Orphans are a subpopulation with a unique set of additional vulnerabilities. Increasing focus on children's rights, pediatric global health, and pediatric research makes it imperative to recognize and address unique vulnerabilities of orphaned children. This paper describes the unique vulnerabilities of the orphaned pediatric population and offers a structured set of factors that require consideration when including orphans in biomedical research…
Community Perspectives on Research Consent Involving Vulnerable Children in Western Kenya
Involving vulnerable pediatric populations in international research requires culturally appropriate ethical protections. We sought to use mabaraza, traditional East African community assemblies, to understand how a community in western Kenya viewed participation of children in health research and informed consent and assent processes. Results from 108 participants revealed generally positive attitudes towards involving vulnerable children in res…
Factors underlying taking a child to HIV care
OBJECTIVE: With the aim of reducing pediatric loss to follow-up (LTFU) from HIV clinical care programs in sub-Saharan Africa, we sought to understand the personal and socio-cultural factors associated with the behavior of caregivers taking HIV-infected and -exposed children for care in western Kenya. METHODS: Between May and August, 2010, in-depth interviews were conducted with 26 purposively sampled caregivers caring for HIV-infected (7), HIV-ex…
Harnessing the power of the grassroots to conduct public health research in sub-Saharan Africa
CBPR methods have the ability to enable and strengthen epidemiological and public health research in sub-Saharan Africa within the social, political, economic and cultural contexts of the diverse communities on the continent. This project demonstrates that adaptation of these methods is crucial to the successful implementation of a community-based project involving a highly vulnerable population
Child abuse and neglect among orphaned children and youth living in extended families in sub-Saharan Africa
Researchers and aid organizations have reported that orphans in sub-Saharan Africa (SSA) are particularly vulnerable to abuse and neglect. This article is a review of qualitative studies that address experiences of maltreatment among orphaned children and youth living in extended families in SSA. It aims to inform policy and programming by providing a better understanding of the types of maltreatment encountered and the perceived risk factors. A …
Models of care for orphaned and separated children and upholding children’s rights
BACKGROUND: Sub-Saharan Africa is home to approximately 55 million orphaned children. The growing orphan crisis has overwhelmed many communities and has weakened the ability of extended families to meet traditional care-taking expectations. Other models of care and support have emerged in sub-Saharan Africa to address the growing orphan crisis, yet there is a lack of information on these models available in the literature. We applied a human righ…
The government of Kenya cash transfer for orphaned and vulnerable children
BACKGROUND: The 'Cash Transfer to Orphans and Vulnerable Children' (CT-OVC) in Kenya is a government-supported program intended to provide regular and predictable cash transfers (CT) to poor households taking care of OVC. CT programs can be an effective means of alleviating poverty and facilitating the attainment of an adequate standard of living for people's health and well-being and other international human rights. The objective of this analys…
Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya
Knowledge of one's own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of …
Comprehensive Evaluation of Caregiver-Reported Antiretroviral Therapy Adherence for HIV-Infected Children
Patient-Reported Barriers to Adherence to Antiretroviral Therapy
Mental health challenges among adolescents living with HIV
Introduction : Mental health is a critical and neglected global health challenge for adolescents infected with HIV. The prevalence of mental and behavioural health issues among HIV‐infected adolescents may not be well understood or addressed as the world scales up HIV prevention and treatment for adolescents. The objective of this narrative review is to assess the current literature related to mental health challenges faced by adolescents living …
Tablet-based disclosure counselling for HIV-infected children, adolescents, and their caregivers
Tablet computers containing resources for disclosure are an acceptable and potentially effective resource to help providers support families with disclosure. Further work is needed to train the clinical providers in using the resources in a developmentally appropriate manner, and to develop new resources on adolescent-specific and HIV-related topics
Interventions for developmental delays in children born to HIV-infected mothers
“A problem shared is half solved” – a qualitative assessment of barriers and facilitators to adolescent retention in HIV care in western Kenya
Adolescents living with HIV (ALHIV, ages 10-19) are retained in care at low rates, resulting in poor clinical outcomes. We investigated barriers and facilitators to retention experienced by perinatally infected ALHIV in western Kenya. This qualitative study purposefully sampled hospitalized ALHIV (engaged and not currently engaged in care), ALHIV engaged in outpatient care, and caregivers of ALHIV. In total, 116 ALHIV and caregivers participated …
Social Stigma Related to Covid-19 Disease Described by Primary and Secondary School Teachers and Adolescents Living With HIV in Western Kenya
Introduction: Understanding community members' knowledge, attitudes, and beliefs about the novel SARS-CoV-2 virus and the prevalence of associated stigma are critical steps for increasing accurate public health knowledge, encouraging uptake of preventative or mitigating health behaviors, and ultimately bringing the COVID-19 pandemic under control. Methods: We conducted a one-time, phone-based assessment to assess the presence of perceived COVID-1…
Perspectives of education sector stakeholders on a teacher training module to reduce HIV/Aids stigma in Western Kenya
Data from interviews with education sector stakeholders demonstrate that our process for developing a culturally appropriate multi-media intervention to reduce HIV stigma in the schools was feasible
Preventive Health Service Coverage Among Infants and Children at Six Maternal-Child Health Clinics in Western Kenya
A Pilot Study of a Mobile Intervention to Support Mental Health and Adherence Among Adolescents Living with HIV in Western Kenya
Mobile technologies represent potentially novel and scalable intervention delivery platforms for adolescents living with HIV (ALWH) in low- and middle-income countries. We conducted a prospective, mixed methods pilot study to evaluate the acceptability and feasibility of the WhatsApp ® platform to deliver individual counseling services and facilitate peer support for ALWH in western Kenya. Thirty ALWH (17 female, mean age 15.4) on ART, engaged in…
A systematic review of interventions to reduce HIV-related stigma among primary and secondary school teachers
Reciprocal innovation
Global health researchers often discount mutual learning and benefit to address shared health challenges across high and low- and middle-income settings. Drawing from a 30-year partnership called AMPATH that started between Indiana University in the US and Moi University in Kenya, we describe an innovative approach and program for mutual learning and benefit coined 'reciprocal innovation.' Reciprocal innovation harnesses a bidirectional, co-const…
I have never talked to anyone to free my mind” – challenges surrounding status disclosure to adolescents contribute to their disengagement from HIV care
Complex challenges surrounding HIV status disclosure to adolescents contribute to care disengagement. There is need to enhance training and resources for HCW, and to empower caregivers to support children and adolescents before, during, and after HIV status disclosure. This should include counseling caregivers on how to provide children with developmentally-appropriate and accurate information about their health from an early age, and to support …
Medicine (27 obras) · HIV/AIDS Research and Interventions (19 obras) · Psychiatry (16 obras) · Psychology (16 obras) · Adolescent Sexual and Reproductive Health (15 obras) · Family medicine (15 obras) · Nursing (14 obras) · Public health (13 obras) · Environmental health (9 obras) · Political science (9 obras)