In the summer after her sophomore year, Honors College and College of Science graduate Cassidy Huun spent three weeks shadowing a pediatrician in a Tanzanian hospital. As she followed the daily work of the hospital’s physicians, she noticed that one of their most important tasks was testing the Tanzanian youth they saw for HIV. Considering the high prevalence of HIV in the country, she was surprised by how many people didn’t know their status and had never been tested for the life-threatening virus.
The trip was transformative. When she returned to Oregon State, she knew that her academic plans and her career ambitions had changed. “I fell in love with medicine after working in the hospitals,” she said. “I had been set on studying marine biology, but being in Tanzania was such an impactful experience. After that, I was one hundred percent sure that I wanted to go into medicine and pediatrics.”
She was also moved by the place itself. “I immediately knew I wanted to go back to Tanzania,” Huun explained. “When I returned to Oregon State, I searched for professors who were involved in HIV research.” She found Dr. Joseph Catania, a professor in the School of Social and Behavioral Health Sciences. Together they studied the instructions that come with an HIV home-testing kit and redesigned the instructions for Tanzanian patients. The home-testing kit, OraQuick, is produced by OraSure and uses an oral swab to obtain test results. OraQuick comes with a video and instruction booklet, which Huun and Catania adapted into a format that would be easy to understand for Swahili speakers.
Huun and Catania spent six months designing new instructions for OraQuick and addressing a major obstacle in delivering the test-kit instructions to Tanzanians: “Literacy is an issue,” Huun said, “so we decided to make an instructions booklet with pictures, so anyone would be able to test themselves.” That proved to be a more difficult task than either she or Catania had imagined.
For example, participants using the test can’t eat, drink, or brush their teeth for 30 minutes prior to administration. Communicating this crucial part of the process ended up being one of the most challenging steps to portray without text.
Grappling with these problems ended up being beneficial to Huun. “It will help me be a better physician,” she said, “because you don’t want to assume that your patients understand you, because they don’t always know medical jargon. It’s important to be able to explain procedures and conditions in different ways depending on who you’re talking to. The experience taught me to think outside the box.”
In the summer of 2013, supported by an Honors Experience Scholarship, Huun returned to Tanzania and analyzed how well the instruction booklet worked. The initial results were encouraging, and she returned to Oregon State to continue honing the pictured instructions.
After completing her Honors College thesis and graduating in 2014, Huun submitted the results of the test-kit instructions study to the Oregon Public Health Association and the Society of Behavioral Medicine. Catania applied for National Institute of Child and Human Development (NICHD) funding for a larger-scale application of the study in Tanzania. Her thesis and 2013 trip served as the pilot for the new, larger research study. When funding came through from NICHD, Catania served as a principle investigator on the study, and Huun became a co-investigator and project director in Tanzania.
Huun’s ambition and her work ethic are two of the qualities that impressed Catania when he first met her as an undergraduate. “What I really liked about Cassidy was her willingness to take on challenging tasks,” he said. “She was working under very tough conditions: 95-degree heat, no access to air conditioning, and two hours of commuting from where she stayed to the research site.”
Their first step in the NICHD program was to update the instructions with new pictures based on the feedback and results from the 2013 research study in Tanzania. “We added a video too, hoping that it might make it easier to understand what [patients] are supposed to do,” Huun said. Then, in late 2015 and early 2016, Huun and Dr. Margaret Dolcini with the School of Social and Behavioral Health Sciences traveled to Tanzania to evaluate the efficacy of the new self-testing kit instructions.
Her favorite part? Spending time with people in Tanzania. “It was stressful in many ways, but in the end it was worth it. I enjoyed spending time with the participant group. They were all adolescents, and the age range was somewhere around 15-19 – they were all really sweet, and it was fun to talk to them.”
Her Honors College thesis, “Adaptation of Self-Implemented HIV Test Among Adolescent Youth in Tanzania” and her participation in the subsequent NICHD study set her apart from other applicants when she applied to medical schools. “The project in Tanzania was such a great and unique experience, and it’s the thing I was asked about most when I applied to medical school.”
Huun is now studying at Oregon Health and Science University with a plan to pursue a career in pediatrics. “I like working with youth,” she says, “which I learned from this project. But I’m also going to keep an open mind and see what I learn in medical school and where that takes me.”