by Chris Hilburn-Trenkle, UNC School of Social Work
Read this story on the UNC School of Social Work site.
Katalia Alexander was in her second semester as a research assistant when she came across transcripts that would later provide the foundation for her first lead author publication.
It was the spring of 2024 and Alexander was reviewing interviews conducted with parents and guardians in Tanzania. The interviews were part of a National Institutes of Health-funded R01 clinical trial led by principal investigator and University of North Carolina at Chapel Hill School of Social Work Associate Professor Joy Noel Baumgartner.
The clinical trial, VITAA, is an intervention directed at improving access to primary care and reproductive health services for adolescents in low-and middle-income countries, primarily in Sub-Saharan Africa and, crucially, promoting HIV testing uptake among adolescents.
Currently in its final year of a five-year grant, the clinical trial has provided various research opportunities for students. Eleven students have worked as research assistants on the project, four students have co-authored journal manuscripts currently under review, three students have used the project as a practicum placement, and one student traveled to Tanzania to lead a training for the research team.
While reading through the transcripts, Alexander found her interest piqued by the various themes and patterns she noticed regarding parents’ perspectives for their adolescent children accessing health care.
The dual degree master’s of social work and master’s of public health student at UNC Gillings School of Global Public Health began having conversations about the data with other members of the School of Social Work research team. Not long after, Baumgartner suggested that Alexander submit an abstract for a conference presentation, or even a manuscript.
“She was super supportive about the idea of me, as just a master’s student, getting the opportunity to take leadership over this project, which was really incredible for me, at the time a first-year student,” Alexander said.
Following months of research, analysis and writing, last November Alexander submitted for review the publication, “Caregiver attitudes toward HIV testing and contraception services for adolescents in Tanzania,” which focuses on the role that parents play in helping adolescents access health care.
“Katalia has been an incredible gift to our VITAA team,” Baumgartner said. “Her diligent and detailed effort on this NIH-funded clinical trial has benefited our team in numerous ways. Her qualitative analyses are supporting multiple journal manuscripts and her ability to bring high standards to the various tasks of complex research management has been deeply appreciated. Most importantly, Katalia is generous with her time and skills — working closely with our Tanzanian colleagues and other UNC students for mutual learning.”
Research process
Alexander worked full-time on the project over the summer with Baumgartner and members of her team. She read through relevant qualitative data from interviews with parents and reviewed literature to find specific data that had been previously published on the subject of adolescent access to health care services in Tanzania and the role parents play in helping them access care. From there, she identified the gaps that her project could potentially fill.
Using a theory of planned behavior — linking behaviors to beliefs — to underscore the analysis, Alexander combed through transcripts to describe parental attitudes for adolescents accessing services. She identified the tension and interplay between the role of parents and adolescents who were behaving more independently as they aged, and conducted analysis of these trends.
Alexander consulted not only Baumgartner and other members of the research team to help shape her paper but also received the perspectives of individuals with Muhimbili University of Health and Allied Sciences in Tanzania who handled data collection on the ground. She collaborated with a research supervisor, David Gitagno, at Muhimbili University to go over her analysis, gaining insights about parents in Tanzania through his personal perspective and research expertise.
“I was able to take his input and the input from the whole team and use that when writing the draft,” Alexander said.
The results of Alexander’s study included the importance for parents of ensuring that adolescents received access to health care while accompanied by a trusted adult. Despite the stigma surrounding HIV, she also found that most parents were supportive of ensuring their adolescent was tested for HIV.
“That was really encouraging to see,” Alexander said. “There’s been so much anti-stigma and HIV education work in places like Tanzania over the last couple of decades. To see that positive outlook toward HIV testing was promising.”
Alexander plans to continue pursuing projects involving health care access, specifically involving adolescents. She’s begun working with other manuscripts related to the VITAA clinical trial, armed with a fresh perspective as the lead author of a peer-reviewed publication.
“I’ve gained so many qualitative research skills through the experience of conducting this analysis and writing this manuscript that I’m confident I’ll be able to continue to use some of those skills to do more research and work,” Alexander said.