Genital Infection Symptoms Among Syrian Refugee Women in Lebanon: A Mixed-Methods Study to Adapt, Pilot Test, and Preliminarily Evaluate an Evidence-Based Intervention

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PROJECT SUMMARY/ABSTRACT Candidate. Dr. Sasha Fahme is an Internal Medicine-trained physician-scientist who has spent the past four years conducting refugee health research in Lebanon. She has first-hand experience treating sexually transmitted infections (STIs) and conducting sexual and reproductive health (SRH) studies of Syrian refugee women. She has trained a Lebanese research team and Syrian peer educators to conduct SRH research and has established capacity for STI testing. Her preliminary data suggest that Syrian refugee women are eager to learn about SRH from peers and to engage in longitudinal SRH care, with 89% 1-year retention. She seeks to adapt and pilot-test an evidence-based intervention (EBI) to address barriers to SRH care in this population. Career Goals. Dr. Fahme's goals are: 1. To gain expertise in mixed-methods health sciences research. 2. To strengthen experience in the conduct of humanitarian health research. 3. To foster implementation science skills to develop and evaluate evidence-based interventions. 4. To develop skills in dissemination to translate research findings into practice. 5. To build leadership skills and successfully compete for R01 research grants. Career Development. Dr. Fahme will achieve her goals through workshops, virtual courses, and one-on-one mentored training from Dr. Fitzgerald (career mentorship, humanitarian health, STI epidemiology) Dr. DeJong (mixed-methods, humanitarian health), Dr. Downs (implementation science), and Dr. Abu-Raddad (STI epidemiology, dissemination). She will disseminate contextualized STI guidelines based on her findings, and present her research at international conferences. She will participate in grant-writing workshops and submit an R01 proposal of a hybrid type I cluster-randomized trial to improve Syrian refugee women's SRH in Year 5. Environment. The proposed research and training will take place at Weill Cornell Medical College (New York, USA) and at the American University of Beirut (Beirut, Lebanon), a global leader in refugee health research. Research. Syrian refugee women in Lebanon are among the world's largest and most vulnerable displaced populations, with a high burden of genital infection symptoms. The etiologies of these symptoms are not known and access to treatment is limited by numerous barriers that are most acute among rural women. Dr. Fahme will recruit 204 symptomatic, rural Syrian refugee women to participate in a longitudinal mixed-methods study. She hypothesizes that >30% will experience recurrent genital infections, and that guidelines fail to address drivers of recurrence, which she will explore through in-depth interviews. She will use these data, the ADAPT- ITT model, and the Implementation Outcomes Framework to adapt and evaluate an EBI to address genital infection symptoms in a single-group pilot feasibility study among 30 Syrian refugee women.