The Collective Vision
In the spirit of ongoing commitment to global health and the transformative power of shared knowledge, our founder Dr. Sonia Jain recently participated in the Virtual Conference of Global Health & Innovation Conference on 25-26 April 2024. This conference represents the standard of collaborative efforts in the fields of global health and social entrepreneurship, drawing together 2,000 professionals and thought leaders from over 55 countries. It serves as a remarkable platform for dialogue and the exchange of ideas that transcend geographical and cultural boundaries.

By participating in such a globally reputed event, DNA not only enriches our understanding and expands our horizon but also reaffirms our commitment to support and implement solutions that foster health equity and social empowerment. This blog post aims to share insights and experiences gathered from the conference, reflecting our vision for a world where data-driven and community-focused approaches lead the way in creating lasting impact.

Our founder, Dr. Sonia Jain, brings over two decades of public health expertise to the forefront, mirroring the conference's commitment to transcending global health challenges through actionable data. At DNA, we align closely with the vision of these global discussions, leveraging Dr. Jain's passion and our team's collective drive to influence community health outcomes positively.

This gathering has revitalized our dedication to harnessing data-driven strategies, affirming our resolution to contribute profoundly to the tapestry of global wellness. We would like to share 4 takeaways from the conference that are directly informing our ongoing and future endeavors in advancing health equity:

1. Build on what’s working well: The conference highlighted the importance of looking at models of what works, programs and strategies that have garnered sufficient evidence to effective implementation and outcomes. For example the remarkable work of Partners In Health (PIH) under Dr. Joia Mukherjee's leadership continues to be shared as a demonstrative model of transformative change in Global Health. PIH has enhanced healthcare using an integrated, innovative approach and partnership model across several developing countries over the past 15 years.  
2. Addressing critical global health issues such as violence and women’s rights: There continues to be a call to action to collectively address critical issues of violence and women’s rights around the world, using innovative, evidence-based strategies and programming across sectors.
3. Equitable Partnerships: The power dynamics and inequities often experienced by implementers and philanthropy were also highlighted. Equity involves not just allocating financial resources but also empowering local entities and practitioners with sufficient autonomy in knowledge dissemination and decision-making. Building equitable partnerships ensures sustainability and local relevance by transferring both funds and decision-making power to those who best understand their communities' needs. It may involve collaborative decision-making and information sharing opportunities.   
4. Multidisciplinary Approaches: Solving world’s biggest problems, will inevitably require leveraging the strengths of multiple disciplines, to develop and implement innovative coordinated, human-centered solutions capable of bridging the gap. We must work together! Reach out to experts globally, in practice, community, academic and most impacted resilient individuals to be part of the solution. Whether blending the insight of social sciences with biotechnology or integrating traditional practices with modern medicine, a multidisciplinary approach creates a richer, more effective tapestry of global health interventions. 

Towards A Unified Vision
Uniting for Health is a journey that demands collaboration, innovation and collective action. The insights above resonated strongly with DNA’s integrated, equitable and strength-based approach and methods, that we have practiced for decades now. We will continue to recommit and refine our approach and methods to better support local and global health programs. 

As we reflect on the insights garnered from the Global Health Conference, we at DNA Global are more committed than ever to contribute meaningfully to this global endeavor. Through our diverse array of skills and unwavering dedication, we aim to support integrated, innovative initiatives that build resilient, equitable systems of change. If you need help with program evaluation, contact [email protected] for more information, or check out our website www.datainaction.org ​

Attention-Deficit/Hyperactivity Disorder (ADHD) is a significant yet largely neglected mental health issue among girls and women that deserves greater awareness, support  and treatment options or interventions. DNA Global staff Kayla Almekhlafi, MPH and Dr. Jain recently published a scoping literature review “Unveiling Gender Disparities in ADHD: A Literature Review on Factors and Impacts of Late Diagnosis in Females (2010-2023)” as our commitment to supporting and empowering women throughout their life course, and systematically addressing gender/cultural inequity is paramount.

Female ADHD is Underdiagnosed
ADHD is often underdiagnosed in girls because their symptoms differ from boys. About 3.10% of adults have primarily inattentive ADHD, such as difficulty focusing and poor organization, while 2.95% show more hyperactive behaviors like fidgeting and excessive talking. Women tend to have more inattentive symptoms and men more hyperactive and impulsive ones, making ADHD in girls and boys easier to spot and diagnose. 

This symptom presentation contributes to misconceptions and missed opportunities for early intervention, often leaving women to cope with associated challenges, like underachievement and emotional distress. Research indicates that gender biases in medical referrals and ADHD diagnoses are systemic, resulting in fewer girls and women receiving the support they need.

This gender disparity is further exacerbated in minority populations. Cultural differences may lead to variations in what behaviors are considered atypical, contributing to lower ADHD diagnosis rates in some minorities. For instance, Black adults have a 47% lower likelihood of receiving an ADHD diagnosis compared to their White counterparts, and this discrepancy increases to 63% for Black females. Additionally, there is a treatment gap, as White children are more likely to receive ADHD treatment than Asian children, who are 64% less likely to receive treatment. These disparities underscore the necessity of addressing cultural, ethnic, and gender considerations in ADHD healthcare practices in the diverse U.S. population

Shifting the ADHD Gender Paradigm 
The current diagnostic frameworks for ADHD are broad and generally do not consider the gender-specific symptom presentation and inequities of the disorder. Recognizing the lifelong trajectory of ADHD—with lasting personal and professional impacts throughout life course, it is vital comprehensive assessments and diagnosis into pediatric wellness visits, or school based health centers. By expanding understanding and revising guidelines and use across school-based and medical care settings, we can enhance diagnostic accuracy and ensure young girls, teenagers and women across lifecourse have access to quality, culturally-appropriate care.

Practice and Research Implications: Reimagining Support and Creating Equitable Solutions
We hope the lit review is useful to provide a comprehensive summary of evidence-base re: ADHD gender inequalities, factors and implications to inform future research, evaluation and program and systems change efforts. Following are some recommendations from our research: 

• Mitigate the Gender Referral Bias from Parents: Recognize and tackle biases affecting ADHD diagnosis in girls versus boys. Educate parents and refine referral criteria to prevent the long-term impact on mental health, education, and social life.
• Training and Awareness Among Healthcare Professionals: Train primary care providers to identify ADHD in females. Update diagnostic criteria and raise awareness across medical fields. Experts advocate for an inclusive clinical approach beyond typical disruptive symptoms.
• Building Capacity of Educators and Counselors: Update teachers and counselors on ADHD's gender-specific symptoms. Improved awareness can lead to better identification of ADHD in girls, which is often masked by secondary symptoms like anxiety.
• Integrating ADHD Assessments in Prenatal and Postnatal Care: Screen for ADHD during prenatal and postnatal care to support mothers, especially those from economically disadvantaged backgrounds. Early detection is crucial for preventing postpartum mental health issues.
• Gender Specific Assessment and Evidence Based: Develop gender-specific assessment tools to improve early detection and life quality for females with ADHD. Broaden research to account for less noticeable, internalized symptoms. Better diagnosis frameworks could include a wider range of indicators like emotional dysregulation and trauma.

As evaluators, we're committed to transforming data into actionable insights. We're not just about connecting the dots; we aim to challenge the status quo and build more intelligent, empathetic systems that truly reflect the needs of those we serve. As your dedicated thought partners, we're here to help create solutions that are not only informed but also innovative and impactful. 
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if we can assist you to evaluate and address as a strategic thought partner and evaluator, reach out for a free consultation at sjain@datainaction.org. Together, we can forge a path towards a more informed and inclusive approach to ADHD and women’s mental health.

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Womens' Rights, an area of research, advocacy and action, deserves much greater investment and effort.

investing in women’s empowerment is one of the most effective ways to achieve all the Sustainable Development Goals (SDGs). Some believe it is the single most effective way. See blog written by Dr. Jain and Radhika Shah highlighting opportune time for  philanthropy and investors to innovation, collaboration across public-private sectors, and scaling collective impact for women.  

The SDGs are global goals for collective action. The urgency to eliminate some of the worst conditions of human-kind and yet access and avail of some of the most advanced technology, innovations and global momentum has never been more pressing. How do we ensure the greatest possible impact and most effectively address all SDGs, given the current global context, and wisdom amassed to date?

Women’s health and human rights remains one of the most urgent issues of our time where innovative effective models of change deserve to be supported and expanded to amass enormous collective impact – the need is paramount, and resources and services dangerously scarce. 

Half the world’s population is women, estimated at 3 billion, 70% residing in developing countries, living in conditions of utmost destitute, deprivation and disempowerment from pre-birth through life... see the original blog for details. 
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Supporting What Works
Funding scalable evidence-based innovations, policies’ enforcement, collaborative knowledge, and data sharing across diverse systems within countries are essential to achieving women’s rights. Capitalizing on multidisciplinary multi-pronged strategies, social entrepreneurship, is a powerful approach with mounting evidence of effectiveness that deserves greater support. It is a critical time for strategic collective action and investments to support, scale up, and sustain equitable social, economic and institutional change for girls and women. Feminism must be globalized.
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By Dr. Sonia Jain and Arras Amirah

Are you a nonprofit working on preventing violence and supporting youth exposed to violence? Are you measuring resilience and building protective factors? It is an innovative approach that works. See our research.

Need for Resilience Perspective to Combat Violence
October set forth a myriad of unprecedented violent events in the world and served as a poignant reminder of Violence Prevention Awareness, urging us to confront a pressing issue that disproportionately and unfairly affects millions of innocent, high-risk children and youth in the US and globally! DNA Global, with violence prevention, resilience and youth development research and evaluation expertise, is on a mission to collectively prevent violence globally by increasing awareness of, examining and addressing root causes or social determinants of violence, and building resilience and protective factors which are more powerful predictors of positive outcomes, than deficit-based public health models or punitive justice system practices. 

The Urgent Call for Action 
We are witnessing an alarming rise in all forms of violence, particularly among children. An overwhelming majority of high-risk youth have been victims of or witnessed violence. This includes physical violence, gun violence, sexual abuse, emotional abuse, child abuse, and neglect with detrimental short and long-term effects on social, behavioral and academic outcomes. Lower-income individuals and youth of color continue to be disproportionately exposed to violence, usually facing myriads of compounding risks. How do we support and empower these youth to tip the balance in favor of resilience?

Focus on Unpacking Inequities and upstream factors:
It is a complex issue, requiring implementation of multi-pronged human-centered strategies. Communities face myriad challenges in addressing this issue, from resource scarcity, magnitude of the problem, limited collective action, to ineffective implementation of evidence-based practices and policies. Though we are moving in the right direction, there is an urgency to increase  collaboration between researchers and practitioners examining inequities at the system, practice and policy levels, like unequal access to quality housing, jobs, healthcare, mental health services or opportunities amongst others. 
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Measure What Works: Resilience
Our research unveils potential solutions rooted in building resilience. Integrating  developmental assets at the family, peer, and neighborhood levels nurtures resilience, enabling individuals to thrive amidst adversity. There is compelling evidence that many youth exposed to community violence manage to adapt successfully over time. Developmental assets have been deemed salient for positive youth development, though limited longitudinal studies have examined their relevance for high-risk youth. Using the Developmental Assets framework and merging existing datasets, we tested whether supportive relationships, high expectations, and opportunities build emotional resilience, modifying risk effects over time. 
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We modeled trajectories to examine whether protective factors at wave 1 predicted emotional resilience at waves 2 and 3, using the PHDCN dataset (see paper). Over seven years, 60-85% of high-risk youth ETV classified as emotionally resilient. And above other factors, the presence of positive peers and supportive relationships with parents or other adults showed significant effects. Positive peers and family support were particularly protective for witnesses and victims of violence. This aligns with growing resilience research. Structured activities (such as sports, drama, arts) and collective efficacy influenced change in resilience differentially among those ETV.  More research, evaluation and interventions are needed that examine protective factors in the system, community, family and school levels.  

Additionally, in program evaluations, advanced statistical data analysis that controls for complex factors in youth's environments, and provides robust estimates is invaluable to identify specific strategies and designing more effective programs.  Given the magnitude of the problem and scarce resources, we need to hone in on and scale what works specifically, using advanced research and quantitative methodologies - in addition to stories and narrative. Providing advanced research and analytical skills has been a plus point of many of our evaluations. 

Finally, post-Covid, there is greater need for building mental wellness, emotional resilience and connection. Harvard Business Review recently noted in “Secrets to Building Resilience” that “Covid has created a significant transition for us all. The importance of building and maintaining your connections has never been clearer.” 

In sum, we strongly believe in the power of resilience, and measure what works.  We need to measure what matters most, given the complex nature of the problem. More Violence Prevention programs need to examine and evaluate protective factors within homes, schools, and communities that support high-risk youths in disadvantaged neighborhoods and settings. ​While becoming aware of the data and stories of resilience amidst violence around the world is a crucial first step, it is only the beginning.

Tell us what you think:
How can we use growing evidence on resilience to design and implement strengths-based strategies and programs? ​ Share your insights

If you are interested in consulting services with DNA, contact Becky Peeper, Business Development Manager ([email protected]). Thank you.