Trusted, Equitable, Open Access Humanitarian Health Education
Summary
In 2022, Ariadne Labs, in partnership with UNHCR, YouTube, International Medical Corps and other partners, commits to produce 45 videos on medical and public health topics that are relevant to conflict situations, mass casualty medical situations and environments supporting refugees and displaced people. Ariadne Labs is affiliated with Mass General Brigham hospital, a leading global hospital, and has already created several videos for residents of the Ukraine to quickly learn how to tie bandages, stop bleeding and use tourniquets, in the Ukrainian language. With its partners, Ariadne Labs and other health care providers will create new 45 new videos that will be distributed via the global networks of its partners, such as UNHCR and International Medical Corps, and narrated in local language, to maximize effectiveness. Through the power of social media and our partnership with YouTube, we believe that millions can access the information they need to address certain medical needs under difficult circumstances
Approach
Ariadne Labs’ objective is to strengthen safe, effective, and timely care by developing novel, trusted, open access educational videos aimed at empowering the public and public safety professionals in conflict and refugee settings. Ariadne Labs will utilize their Innovation Platform’s approach of human-centered design to leverage and convene their best educators, medical/public health experts, community trust agents, and digital media leaders to identify key topic areas that can reduce preventable causes of morbidity and mortality.
Ariadne Labs will use an iterative process to develop scripts that meet the local cultural context, and ultimately shoot and produce short videos. The ubiquitous nature of access to platforms like YouTube and others allows for the information to be readily accessible and allows for the visualization of complex clinical and public health topics to be broken down into more easily visualized and digestible formats. These forms of information sharing, though not well studied, have been accelerated during the Covid 19 pandemic as healthcare professionals attempted to reach the public.
Most significantly Ariadne Labs will engage their implementation, improvement science, human centered design and analytical expertise to create a monitoring and evaluation plan to gauge efficacy and impact of the videos. Ariadne Labs will 1) draw from successful evaluation techniques that others have used for online public health education videos and 2) explore novel measurement and evaluation tools where needed to fill measurement gaps.
Action Plan
Ariadne Labs proposes a three-year commitment to produce 45 videos (15 for each of three countries / regions) on medical and public health topics and to develop and execute a measurement and evaluation plan. Ariadne Labs will begin with a commitment at the CGI meeting in September 2022. Commitments will include subject matter expertise, in-kind services, and financial support.
Ariadne Labs will use the principles of the Ariadne Labs Arc to move partners to action with human-centered design, testing , and spread of solutions. The WHO Surgical Safety Checklist is an example of our framework in action.
By the middle of Year 1, Ariadne Labs will have convened subject matter experts, collaborators, and stakeholders to determine population, region, language, and topics. Secondly, we will define a measurement and evaluation plan focused on impact.
By the end of Year 1, we will:
complete 15 videos for country / region 1, including background research (e.g. population, health topics, trusted messengers) ; script development and storyboarding; filming; and post-production.
create a dissemination plan and data collection tools and analysis plan.
By the end of Year 2, we will:
execute the dissemination plan and measurement and evaluation plan in country / region 1.
complete the videos and execute the dissemination plan and measurement and evaluation plan in country / region 2.
By the end of Year 3, we will:
continue execution of the dissemination plan and measurement and evaluation plan in country / region 1 and 2.
complete the videos and execute the dissemination plan and measurement and evaluation plan in country / region 3.
develop and submit manuscripts and conference abstracts summarizing the project’s work, lessons learned, and proposed next steps.
Background
War has profound adverse effects on health. Twenty-five percent of people worldwide live in regions directly affected by armed conflict. Approximately 50,000 direct and 1,000,000 indirect deaths of civilians and combatants annually are attributed to conflicts (https://ucdp.uu.se) , including communicable and noncommunicable disease; maternal, neonatal, and nutritional disease; and acute injury (Jawad, M, et al. “Estimating indirect mortality impacts of armed conflict in civilian populations: panel regression analyses of 193 countries, 1990–2017.” BMC medicine 18.1 (2020) : 1-11.
Traditional constructs of humanitarian care, like wartime relief and postwar reconstruction, have great impact but are usually limited to the communities to which humanitarian professionals deploy and require significant logistical, financial, and personnel resources.
Opportunities exist beyond these traditional avenues to empower the public and save lives through equitable, open access education. For example, over 50 years of campaigns have empowered the public to perform cardiopulmonary resuscitation (CPR) : 55 – 65% of out-of-hospital cardiac arrests receive layperson-initiated CPR (Dainty, KN et al. Understanding the Importance of the Lay Responder Experience in OHCA. Circulation 145.17 (2022) .
Furthermore, in 2010, an estimated 5.1 million trauma deaths occurred worldwide, including 730,000 children (Berwick, D et al “A national trauma care system: integrating military and civilian trauma systems to achieve zero preventable deaths after injury.” (2016) . Between 20 – 27.5% of US trauma deaths are preventable, suggesting significant preventable deaths globally. (Spinella, PC et al. “Zero preventable deaths after traumatic injury: an achievable goal.” Journal of Trauma and Acute Care Surgery 82.6S (2017) : S2-S8.) To reduce trauma deaths, the Stop the Bleed campaign has trained over 2.1 million people in 134 countries to recognize life-threatening bleeding and rapidly intervene.
More can be done to use equitable, open access education to empower the public and save lives in conflict and refugee settings.
Progress Update
Brigham and Women’s Hospital and Ariadne Labs have completed 37 total videos in Ukrainian on emergency care that have over 7,000,000 views.
How can nutrition support your family’s mental health during wartime 2.1 Million Views https://www.youtube.com/watch v=P9NFLZKoLkw&list=PLjXJ52z-MHwc8I15-d7IDf6MkI1Q6umfN&index=2
How you should respond to children in distress duringh wartime /1.5 Million Views https://www.youtube.com/watch v=pRcwcY1aRg8&list=PLjXJ52z-MHwc8I15-d7IDf6MkI1Q6umfN&index=3
Videos were shot in Ukraine with Ukrainian actors and a Ukrainian psychiatrist who completed a fellowship with us at Harvard.
Partnership Opportunities
Ariadne Labs hopes to engage partners that can assist with:
Content validation
Amplification Strategies
Measurement and Evaluation
These would include experts from various fields (medicine, public health, education, humanitarian care, cultural sensitivity, digital media) and sectors (private, academic, and public sector (e.g. telecommunications/internet service providers) ) .
Potential partners Ariadne Labs has begun conversations with include UNHCR, USAID, and Project Hope.,Ariadne Labs would offer subject matter expertise in facilitation, medicine, public health and education and amplification through social media and media affairs channels.