91福利导航

Can you describe how you started pursuing non-federal grants?聽

When I joined the Boston College School of Social Work in 2017, it was to work with an implementation science team and translate my work on developing and testing evidence-based interventions for children, youth, and families facing adversity.聽

I was looking for a place where I could enact what already had been a pathway that I had been building focused on getting all of our work out there in common usage while scaling and sustaining our evidence-based interventions. I had come to learn as a faculty member both at the Boston University School of Public Health and the Harvard T.H. Chan School of Public Health that randomized controlled trials alone were not going to get us there.聽

Prior to that realization, I had worked as a direct service mental health professional for children, youth, and families in the state of Oregon. I had also worked as an intern at the office of the UN High Commissioner for Human Rights, where I was interested in promoting better living conditions for children who faced all sorts of challenges.聽

As a result of those experiences, I鈥檇 learned about the world of the UN agencies, non-governmental organizations, and different ways to think about bridging the gap between needs on the ground in very low resource settings and what we鈥檙e learning from the science of adversity and its impact on child mental health.聽聽

I was looking for a platform where I could have more creativity and fewer institutional barriers. So, when I arrived at 91福利导航SSW, I was eager to take grants from foundations that wanted to do more translational work and I was able to circle back to opportunities that I hadn鈥檛 been able to pursue in the past.

Can you recall any pivotal moments or projects that helped you build credibility as a recipient of grants from non-federal sponsors?聽

I think my many years at Harvard writing federal grant proposals, especially for the National Institutes of Health, helped build credibility. My track record of being able to be competitive at the top echelon of rigor and being able to write and receive NIH grants helped my ability to conceptualize and write any funding proposals and really set me up for success with non-federal grant sponsors.聽

With regard to non-federal sponsors, what kinds of challenges did you face early on and how did you overcome those challenges?

I would say the sponsors came later. The partnerships are what came first. I鈥檝e always leaned into long-term participatory research with select individuals where we have shared goals and visions and it鈥檚 mutually reinforcing and rewarding.聽

I started my work in Sierra Leone in 2002 at the end of the war there. And as challenging as Sierra Leone can be, because it鈥檚 a country that really struggles with budget, with investment, with governance, I have gotten more from Sierra Leone than I've ever given it.聽

I think learning from that sort of an environment鈥攊f you can do things in Sierra Leone, you can do them just about anywhere. If you can do things in Sierra Leone, you can do them in indigenous Alaska.

What took you to Sierra Leone?

I was a school-based mental health specialist, working mainly with Medicaid-funded clients. I saw these dynamics where, when you鈥檙e working with a very poor family and the child鈥檚 having emotional behavioral problems in the school, the mother is taking time off to care for her child. But once her child starts doing better and she goes back to work, she makes more money, she loses her insurance, and all of those supports that were helping that family to flourish fall apart.聽

So I was getting frustrated with the policy elements of mental health services in the U.S. with migrant and refugee populations and I wanted to learn about human rights frameworks. I wanted to learn about promoting better environments for children.聽I had an opportunity, through my connections with indigenous populations in Alaska, to intern at the United Nations High Commissioner for Human Rights, to learn about the UN convention on the rights of the child. It just happens that that was 1995, the year that it did this large study of the impact of armed conflict on children.聽

As an intern in that office, I was going to all the UNICEF meetings with other stakeholders, including the big non-governmental organizations that were responding to the topic. During that time, I met lots of wonderful people from the major non-governmental organizations such as the International Rescue Committee, a large humanitarian organization founded after World War II at the behest of Albert Einstein, who wanted a better solution to forced migration and refugee displacement globally.聽One of the people I met at the IRC was Marie de la Soudiere, a social worker who headed the children, youth and family unit. She worked across all the IRC projects and had gotten me involved, when I was doing my doctoral work, in the Kosovar crisis in which Kosovar refugees were displaced to Albania in 1998.聽

After that UN internship, I realized public health鈥檚 focus on prevention along with translating evidence into policy and programs was more my orientation. So I then worked with IRC in the Russian Federation for the Chechen conflict in 1999. I worked with IRC in Ethiopia on refugee displacement in 2000. And then in 2002, the IRC contacted me and said, 鈥淲e have a role to play in working with the government of Sierra Leone as they're reintegrating children who were abducted into armed groups during the war. These kids are now coming home, and we would have an opportunity to think together about starting a study to look at what are the factors that contribute to better outcomes or worse outcomes over time.鈥�

So Marie de la Soudiere and I wrote a grant proposal to the Mellon-MIT Inter-University Program on Non-Governmental Organizations and Forced Migration and got the funding together, and that was one of my earliest grants to a small private philanthropy.聽

You have received grants from countless organizations. How do you ensure that your research aligns with the missions of so many different organizations, while making certain that you don鈥檛 end up with a fragmented research portfolio?

We stayed true to our values and what we want to do, but we look for funders who have an angle of it that would resonate with what they care about. I think our best example of this is the Play Collaborative in Rwanda, which is an implementation science research project to scale an evidence-based home visiting program done by non-specialists to promote early childhood development and prevent violence.聽

There are certain funders who are interested in prevention of violence. There are certain founders who are interested in early childhood development. There are certain funders who are interested in innovative work in the realms of global mental health, like using non-specialists. There are funders who are interested in implementation science and the science of scaling and sustaining evidence-based interventions. Also, because it鈥檚 a gender transformative father-engaged home visiting intervention, we had other funders who care about gender related topics.聽

I think in the end, the Play Collaborative Implementation Science Initiative, which scaled that home visiting intervention across three districts to 10,000 households, was funded by six different partners, all taking a different angle.聽

This is obviously a big project with six sponsors. How did you split that up to present a piece to each funder?

It wasn鈥檛 that linear, because that intervention had been growing out of work that started in Rwanda with an original family strengthening intervention for families affected by HIV and AIDS. Our focus on HIV and AIDS was supported by an R34 grant from the NIH, which provides support for the initial development of a clinical trial or research project. We then applied for an RO1 grant from the NIH, but we did not get it. Then we were back to the drawing board. The HIV and AIDS funding was drying up at that time, and the political will in Rwanda was shifting toward early childhood development.聽

We had a parenting intervention, so by knowing what was a priority to the government and to the donors who were coming around the work, we reached out to the World Bank. I ended up meeting a task team leader named Laura Rawlings. A TTL was like a principal investigator within the World Bank ecology. Early on, she helped us get funding to adapt the family strengthening intervention for HIV and AIDS to early childhood. And we had to remove all the HIV and AIDS specificity, bring in nutrition, stimulation, play, and hygiene. And we ended up with what鈥檚 now called Sugira Muryango, or 鈥淪trengthen the Family,鈥� a 12-module home visiting program to promote early childhood development and prevent violence. Soon after that, we got a cluster randomized trial funded by the World Bank鈥檚 Strategic Impact Evaluation Fund, and we published the results of the intervention with just 12 modules as well as a one-year follow up.

Now we have evidence, which is step one of implementation science. The thing you鈥檙e trying to scale needs to have evidence behind it. So now we had established through a very rigorous cluster randomized trial within the World Bank ecosystem that the intervention was evidence-based. And then that put us in a position to write to the Lego Foundation, the next big funder, who had a call for proposals on scaling.

Lego was very early on in its interest around scaling and sustaining evidence-based practices, and it was very interested in play. Our intervention has a focus on coaching to encourage both male and female caregivers to engage with their young child (0-3) in play, so I leaned into that when I wrote to Lego.聽

So what did I call our implementation science collaborative team approach? I called it the 鈥淧lay Collaborative.鈥� And we worked with the acronym. We found a way to channel play鈥攁t every session, there鈥檚 at least 15 minutes of play activity with both male and female caregivers. So now with Lego, I鈥檓 going to elevate that because it needs to know about the play components because that鈥檚 a top priority to them. Our intervention also prevents violence, improves hygiene, and it鈥檚 doing a lot of other things that maybe are not the priority of Lego, but nobody is going to be bothered by the fact that the intervention does more things as well.聽

Then, to get the other funders on board to have enough resources to scale to three districts in Rwanda, we said, 鈥淲ho else might be interested in other topics that are addressed by this home visiting intervention, such as girls education?鈥� Because we see effects are equal in girls and boys. And this can be a way to give girls better school readiness. Well, Echidna Giving is interested in that. Who else is interested in the effects we have on reducing intimate partner violence and violence toward children? Well, the Wellspring Philanthropic Fund is interested in violence reduction, and I know the program officer for the violence portfolio, and it鈥檚 just networking. So I would go to those other funders and say, 鈥淗ey, Lego is interested in this. We have the opportunity to do this much. If you were to join us, we could do a proper embedded trial and see if we get the same effects when we move into a new workforce.鈥�

So you have this intervention, but you can tweak and adapt and emphasize certain things differently depending on the sponsor.

Always know your audience. You can build coalitions by knowing your audience and inviting them to join, as long as they see that their topic is a part of what鈥檚 in the mix. It's a way to build a set of partners.

You have a whole bunch of grants from foreign governments, including those in Canada, the United Kingdom, and Germany. How does the process of engaging with foreign governmental sponsors compare to working with other sponsors?

I don鈥檛 think it does. Let鈥檚 take Grand Challenges Canada, which brings together Canadian government funding, and other donors aimed at聽 finding solutions for health and economic problems in low-and middle-income countries. They are very committed to Mental Health as well as child development. GCC a very formal mechanism. You apply to it formally. Just like foreign investigators are eligible for certain NIH grants, American investigators can partner with LMIC partners who are the prime in a GCC application. The challenge is the low-resource setting partner has to be up to the challenge of being the prime to manage and administer the grant. So the bigger issues are ensuring that you have a solid partnership of trust in how the grants are administered and managed so that it鈥檚 in a healthy place by the time you鈥檙e applying for them.聽

All of those years of the little grants in Rwanda and Sierra Leone meant trying out different partnerships and configurations until we found the ones that really worked. So that by the time we were applying to Grand Challenge Canada we had learned from a lot of mistakes. I鈥檝e switched partners in Rwanda several times and also in Sierra Leone several times, until we found trustworthy, mission-aligned partners who could administer grants and manage money as well as understand the importance of ethical and rigorous science.聽

That was fantastic. Thank you, Theresa, for sharing your vast experiences and wisdom with us.

You鈥檙e very welcome.