Dorian Ho, Health Policy and Management BSPH, 2025
This summer, I had the privilege of interning with SESH Global, a UNC-affiliated global health research collaborative based on Guangzhou, China (Figure 1). I joined the team of the PIONEER project, a randomized controlled trial evaluating pay-it-forward and community engagement on gonorrhea and chlamydia test uptake among men who have sex with men (MSM) in six Chinese cities. Pay-it-forward is a novel approach of providing free STD tests for MSM and encouraging donations to support other MSM. This intervention includes a financial nudge (free testing) and a social nudge (handwritten postcards from other local participants, Figure 2). I was drawn to this research because of its emphasis on social innovation, robust community input, and patient empowerment in health delivery.
Figure 1. Dorian Ho, UNC undergraduate, at SESH Global office in Guangzhou.
Figure 2. Examples of postcards with words of support written by MSM participants.
With the trial in its pilot stages, I joined the fieldwork team in conducting site feasibility checks, piloting the intervention across seven trial sites, and monitoring recruitment to ensure intervention fidelity (Figure 3). Over two months, I saw how implementation varied across public hospitals and community-based organizations in Jiangmen, Zhuhai, Huizhou, and Foshan. Busy hospital workflows, older patient populations, differences in regional languages (ex. Cantonese in Foshan, Hakka in Huizhou), and varying provider knowledge and enthusiasm for the intervention presented implementation challenges. In working with the fieldwork team to develop site-specific solutions that maintained fidelity and accounted for contextual factors, I learned how intervention efficacy cannot be assessed independently of intervention context.
Figure 3. Pilot-testing community-engaged stickers and fans to enhance STD test uptake.
Outside of fieldwork, I worked on writing a qualitative manuscript using thematic analysis to consider a mechanism for pay-it-forward. I brushed up these skills by participating in a write-o-thon, an inaugural two-day event organized by SESH Global to support academic writing. I also contributed to screening and data extraction for a rapid evidence synthesis of adolescent HIV interventions for a collaborative UNICEF/WHO/UNAIDS Blueprint project. These projects broadened my understanding of the current interventions used in STD prevention and the potential for pay-it-forward and other participatory approaches to address needs.
I thank my colleagues at SESH Global and Dr. Gifty Marley for the opportunity to expand my worldview and skill set as a global health researcher this summer and look forward to continued collaboration.