Table 1.

Global Health Capstones, Competencies, and Examples

CUGH Competency	How Capstones Can Address this Domain	Capstone Example
Global Burden of Disease	Completing literature reviews based on capstone research questions can increase understanding of morbidity and mortality in the population/region of interest and inform about current efforts to address those issues	Systematic review on glaucoma in Africa that included prevalence data, available treatment options, barriers to care, inequalities in access to treatment services, and recommendations for improving care
Globalization of Health and Healthcare	Focusing on how globalization affects health, health systems, and health care delivery by describing different systems of care and their impact on outcomes and expenditures; learning how global trends in health care practice, multinational agreements, and multinational organizations contribute to the quality and availability of health care	Retrospective chart review at a hospital in Kenya to identify patterns of HIV testing services, which were expanded after the Kenya Ministry of Health developed the Kenya AIDS Strategic Framework to scale up HIV testing and counseling services based on recommendations from the World Health Organization; the review identified testing barriers and potential testing biases to make recommendations for expanding testing services
Social and Environmental Determinants of Health	Understanding the social, economic, and environmental factors that impact morbidity, mortality, and access to quality health care services as well as how culture impacts perceptions of health and disease	Retrospective chart review to understand how the West African Ebola epidemic impacted HIV care for soldiers in Sierra Leone; found that the outbreak negatively impacted HIV care for several reasons, including an overburdened health care system and travel restrictions implemented to prevent the spread of Ebola
Capacity Strengthening	Focusing on sharing skills, knowledge, or resources in a manner that will strengthen the programs, infrastructure, or health care workforce available in an area or for a population, particularly when working with local partners and taking an asset-based approach	Key informant interviews with healthcare providers at a teaching hospital in Ghana to understand the hospital’s capacity and needs; informed recommendations for increasing capacity to better serve the hospital’s patient population
Collaboration, Partnering, and Communication	Developing equitable relationships with local partners and key stakeholders to complete projects, working with diverse partners and key stakeholders, and building trust with community partners	Design and delivery of an emergency medicine educational program in collaboration with a hospital in Mongolia; potential for the program to serve as a model for similar training at hospitals throughout the country
Ethics	Completing human subjects research training to gain an understanding of research ethics; applying ethical principles to global health work including managing diverse economic, political, and cultural contexts as well as working with vulnerable populations or in low-resource settings	Evaluation of a global health partnership between a US-based institution and local organization that focused on cervical cancer screening in Senegal; the evaluation outlined strengths and challenges of partnership and made recommendations for creating and maintaining an equitable relationship between partners
Professional Practice	Learning to adapt skill sets, particularly in low-resource settings; developing professionalism through collaborating with a diverse set of partners to implement projects; describing barriers to health and health care in low-resource settings	Needs assessment in Peruvian Amazonian communities in collaboration with local governmental and non-governmental institutions to understand met and unmet health care needs in these remote, rural settings
Health Equity and Social Justice	Using a framework that addresses health inequalities across socially, demographically, or geographically defined populations and engaging marginalized populations in project development and implementation	Survey administered to understand barriers to contraceptive use among adolescents in Nicaragua that found social factors (e.g., fear, lack of communication) played a larger role in non-use compared to physical barriers (e.g., cost)
Program Management	Working through the process of planning, implementing, and/or evaluating global health programs	Survey administered to assess knowledge, preference, and use of HIV prevention methods in high disease prevalence communities in Cape Town, South Africa; involved in managing all phases of the project including drafting a grant proposal and presenting findings
Sociocultural and Political Awareness	Planning a project that considers cultural context and the current local, national, and international landscapes and how those factors impact health	Key informant interviews with health care providers in Ghana to analyze the benefits and challenges of the recently developed National Ambulance Service, how government interventions impacted the health sector, and how factors associated with the patient population (e.g., poverty) impacted care
Strategic Analysis	Using systems thinking to understand the diverse and interrelated factors that impact morbidity, mortality, and access to care and how to consider those complex factors when developing global health programs	Mixed methods community assessment using a community-based participatory research framework with newly settled refugees in Chicago to understand barriers to healthcare access, concerns about accessing care, and how this can be used to improve access