Faculty Member

Paula K.A. Braitstein BA, MA, MSc, PhD

Email Address(es)
paula.braitstein@utoronto.ca, pbraitstein@gmail.com
Office Phone
+254 728 825 620
Office Address
Mailing: 155 College Street, 5th floor, Toronto, Ontario M5T 3M7 Canada
Website(s)
Orphaned and Separated Children's Assessments Related to their (OSCAR's) Health and Well-Being Study, Academic Model Providing Access to Healthcare, Planetary Health
Division(s)/Office
Epidemiology Division
Office of Global Public Health Education & Training
Position
Associate Professor
SGS Status
Full Member
Appointment Status
Contract

Research Interests

Dr. Braitstein is an epidemiologist and environmentalist, living and working in the western highlands of Kenya. Originally from Montreal, Paula’s roots are in the community-based HIV/AIDS movement in Canada as an HIV treatment educator and activist. She received her MA in Liberal Studies from Simon Fraser University (Vancouver), and her MSc and PhD in epidemiology from the University of British Columbia (Vancouver). In Kenya since 2007, Paula’s major research, education and service priorities have been oriented around major health and social issues in East Africa including HIV prevention and treatment, high HIV risk children youth such as those who have been orphaned (from HIV and other causes), separated, abandoned, and street-connected children and youth. Witness to the massive social, economic and environmental challenges and changes taking place in East Africa, Paula has begun leveraging her successes in population health to direct her research and attention to what is likely to become the single biggest threat to the health and well-being of future human generations: planetary health. Paula is the holder of a prestigious research Chair of Applied Public Health from the Canadian Institutes of Health Research, and is Associate Professor in the Dalla Lana School of Public Health. Paula has published widely in the peer-reviewed literature on diverse topics. Her research foci today are concentrated on the HIV prevention-care continuum, specifically HIV implementation research in sub-Saharan Africa, and vulnerable and marginalized children and adolescents, including orphans, street-involved children and youth. She is the Principal Investigator of a ten year observational cohort study funded by the National Institutes of Health funded examining the effect of care environment and care characteristics on orphaned children, called the “Orphaned and Separated Children’s Assessments Related to their (OSCAR’s) Health and Well-Being Study”.

Affiliations:
Dr. Braitstein is Associate Professor in the Dalla Lana School of Public Health at the University of Toronto (Canada), Visiting Professor at Moi University School of Medicine (Kenya), and Adjunct Professor in the Fairbanks School of Public Health at Indiana University (USA). In addition to doing her own research, she is Co-Field Director of Research for the Academic Model Providing Access to Healthcare (AMPATH) Consortium.

Education & Training History

Undergraduate:

1988 John Abbott College, Ste. Anne de Bellevue, Canada: DEC (Social Sciences)

1991 McGill University, Montreal, Canada: BA (Anthropology)

Graduate:

1998 Simon Fraser University, Vancouver, Canada: MA (Graduate Liberal Studies)

2001 University of British Columbia, Vancouver, Canada: MSc (Health Care and Epidemiology)

2005 University of British Columbia, Vancouver, Canada : PhD (Health Care and Epidemiology)

2000-05 Research Associate, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada

Post-Doctoral:

2006 University of Bern, Bern, Switzerland (Canadian Institutes of Health Research): The Antiretroviral Therapy in Lower Income Countries (ART-LINC) Collaboration

Affiliations

Current Affiliations:

  • Canadian Institutes of Health Research (CIHR) Chair of Applied Public Health, Canada
  • Associate Professor, University of Toronto, Dalla Lana School of Public Health, Division of Epidemiology, Toronto, Canada
  • Visiting Professor, Moi University, College of Health Sciences, School of Medicine, Department of Medicine, Eldoret, Kenya
  • Adjunct Associate Professor, University of Toronto, Faculty of Medicine, Department of Obstetrics and Gynecology
  • Adjunct Associate Professor, Indiana University, Fairbanks School of Public Health, Division of Epidemiology, Indianapolis, USA
  • Affiliate Investigator, Regenstrief Institute Inc., Indianapolis, USA
  • Co-Field Director of Research, Academic Model Providing Access to Healthcare (AMPATH) Consortium, Kenya
  • Full member, School of Graduate Studies, University of Toronto
  • Full member, Institute of Medical Sciences, University of Toronto

Other Current Affiliations (Selected)

  • 2017-2021    Member, National Institutes of Health Fogarty Foundation, Adolescent HIV Prevention and Treatment Implementation Science Alliance
  • 2018-2020     Member, University of Toronto President’s International Council – Africa

Primary Teaching Responsibilities

  • Lead Instructor,  Planetary Health – Course number CHL7001H F3 – Fall 2018
  • https://planetaryhealth.wixsite.com/learnplanetaryhealth
  • Course Goal: This 12-week, half-credit course will provide students with a big picture perspective of planetary health, research, policy and practice issues related to them, and the implications and opportunities related to planetary health for public and population health globally. The course will be offered simultaneously in real-time to students in Toronto (through DLSPH) and in Eldoret, Kenya (through Moi University, College of Health Sciences, School of Public Health).
  • A key theme throughout the course is consideration of health and social inequities and inequalities and the differential impacts of climate and other environmental changes on populations in light of these issues.
  • Course Format: There will be 12 classes of 3 hours each. Each class will break for 15 minutes in the middle. We will use a combination of lectures, videos, reading, reflection, discussion, and small group work. Students are expected to spend approximately one day per week including class time related to the class. The first 2 hours of each class in Toronto will overlap with the second half of the class in Eldoret via videoconferencing. This time will be used for guest and core lectures, student presentations, and will enable cross-fertilization and cross-cultural discussion and perspectives, and the opportunity for collaborative class assignments. Individual site time (first hour for Moi class, last hour for UT class) will be used for discussion about assigned readings (with structured questions for guidance). A course website will host a course blog to encourage and facilitate discussions between classes.

– Mentoring MPH students, PhD and post-doctoral fellows and other students in their field practicums and research in Kenya.

– Teaching short courses in Kenya on epidemiologic methods, grant and manuscript writing, and literature searching and synthesis.

Professional Summary & Appointments

Areas of Expertise:

  • Observational Epidemiology
  • Global Health
  • HIV/AIDS
  • Population Health
  • High risk children and youth
  • Homelessness
  • Access to Care
  • Social Vulnerability
  • Resilient Adaptation
  • Social Determinants of Health
  • Planetary Health

RECENT Honours & Awards

2015 Winner (of 65 proposals), Public Anthropology Book Series, University of California Press. “Street Smart: Stories of Struggle, Survival and Resilience Among Street Children in Kenya”. (book in progress)

2017  Winner, Canadian Institutes of Health Research, Institute of Population and Public Health “Trailblazer Award” for Mid-Career Scientists. University of Toronto.

Current Research Projects

Current as Principal Investigator

“Evaluating a population-level program to control the HIV epidemic in a high-burden resource-constrained region.” Principal Investigator: P. Braitstein. Funding Source: Canadian Institutes of Health Research – Institute of Population and Public Health Chair of Applied Public Health. Grant number: CPP-137911. Dates: 10/1/14-09/30/19. Description: This 5-year career award supports the salary of the PI and research funds to evaluate a comprehensive program to find, link, treat and retain all HIV-infected individuals within catchments of the Academic Model Providing Access to Healthcare (AMPATH). Total funding: $925,000 CAD. Funding for current year: $185,000.

“Orphaned & Separated Children’s Assessment Related to their Health & Well-Being”. Principal Investigator: P. Braitstein (phase II with J. Sidle).  Funding Source: NIH-NICHD. Grant number: R01 HD060478-07. Dates: 9/15/09-7/31/20. Description: This project is evaluating the care environments of orphaned and separated children and their impact on the children’s health and well-being. Total funding: $6,000,000 USD. Funding for current year: $447,707 USD plus indirects.

“Identifying, adapting and piloting interventions to engage street-connected children and youth in the HIV prevention continuum in Kenya”. Funding Source: Canadian Institutes of Health Research – Institute of Infection and Immunity. Grant number: FRN 145367. Dates: 01/04/2016 – 30/08/2018. Description: This is an Implementation Science grant (Component 1) designed to identify, adapt and pilot a number of interventions aimed at engaging street youth in HIV prevention in Eldoret, Kenya. Total funding: $150,000 CAD. Annual funding: $75,000 CAD

“Getting engaged: Rates, predictors and outcomes of HIV-positive children and adolescents identified or diagnosed through home-based HIV testing failing to link to HIV care in rural western Kenya”. Funding source: National Institutes of Health – NIAID, Supplement to East Africa IeDEA Grant. Supplement to Dr. Kara Wools-Kaloustian’s NIH grant #5U01AI069911-1. Dates: 2017/10-2018/9. Description: This grant uses a combination of advanced statistical techniques and double-sampling methods to estimate the rates of engagement in HIV care and treatment among children and adolescents infected with HIV in a population-based study. Title: Total Funding: $287,000 USD. Annual funding: $143,500 USD.

“Recognition and response: Using applied public health research to understand and address a population health emergency in street-connected children and youth in Kenya”. Principal Investigator: P. Braitstein. Funding Source: Canadian Institutes of Health Research – Institute of Population and Public Health Trailblazer Award for Mid-Career Population/Public Health Researchers. Grant number: TBL-154669. Dates: 09/01/17-08/30/19. Description: This award is in recognition of my research with street-connected children and youth in Kenya and globally. Total funding: $12,500 CAD.

“Adapting and scaling-up “Peer Navigators” to targeted populations of street-involved youth in Canada and Kenya to increase linkage to HIV prevention, testing, and treatment.” Principal Investigator: Braitstein. Funding Source: Canadian Institutes of Health Research – Institute of Infection and Immunity. HIV Implementation Research Component II. Grant number: CTW-155343. Description: This study will adapt and scale-up Peer Navigators to populations of street-involved and homeless youth in Toronto, Montreal, London Ontario, and two cities in Kenya. Total Funding: $2,000,000 CAD. Annual funding: $400,000 CAD. Dates 2018/1-2022/12.

“Technology-mediated learning for planetary health sustainability.” Principal Investigator: P. Braitstein. Funding source: University of Toronto Provost’s Instructional Technology Innovation Fund (ITIF). Non-cash award equivalent of $20,000 for access to an educational technology or instructional design specialist for up to 150 hours per year per project). Description: To develop a multi-media, bi-national, graduate-level course to provide Masters and PhD students from public health disciplines with the knowledge and skills necessary to meaningfully respond to the public and population health priorities of planetary health, including climate and environmental changes and sustainable human development. Dates: 2018-2019.

As co-investigator: 

“East Africa Regional International Epidemiologic Databases to Evaluate AIDS (IeDEA) Consortium”. Principal Investigator: K. Wools, C. Yiannoutsos. Funding Source: NIH-NIAID. Grant number: U01 A1069911. Dates: 3/1/04-7/31/22. Description: Consortium to link database across the East African Region in order to address questions related to HIV care. Funding for current year: $1,517,647 USD.  Role: Co-Investigator (I contribute to study design, research questions, data collection, interpretation, manuscript development and publication).


RECENT PUBLICATIONS

  1. Lee H, Hogan JW, Genberg BL, Wu XK, Musick B, Mwangi A, Braitstein P. “A State-Space Framework for patient-level modeling of engagement and retention in HIV care using longitudinal cohort data”. Stats Med 2018 Jan 30;37(2):302-319. doi: 10.1002/sim.7502. Epub 2017 Nov 22. PMID: 29164648
  2. Kiplagat J, Mwangi A, Keter A, BraitsteinP, Sang E, Negin J, Chasela C. “Retention in care among older adults living with HIV in western Kenya: A retrospective observational cohort study”. PLoS One. 2018 Mar 28;13(3):e0194047. doi: 10.1371/journal.pone.0194047. eCollection 2018. PMID: 29590150
  3. Genberg BL, Lee H, Hogan JW, Some F, Wachira J, Wu ZK, Braitstein P. “Point of diagnosis and patient retention in HIV care in western Kenya” Point of diagnosis and patient retention in HIV care in western Kenya. J Acquir Immune Defic Syndr. 2018 Apr 10. doi: 10.1097/QAI.0000000000001703. [Epub ahead of print] PMID: 29649078
  4. Embleton L, Ayuku D, Makori D, Kamanda A, Braitstein P. Mortality among street connected children and youth in western Kenya: a retrospective case series. BMC Health and Human Rights. 2018 May 15;18(1):19. doi: 10.1186/s12914-018-0160-8. PMID: 29764412
  5. Olney J, Eaton J, Braitstein P, McRobie E, Hogan JW, Hallett T. “Optimal timing of home-based counseling and testing rounds in western Kenya”. Journal of the International AIDS Society. 2018 Jun;21(6):e25142. doi: 10.1002/jia2.25142. PMID: 29883052
  6. Giles M, Achhra A, Abraham A, Haas A, Gill J, Lee Man P, Luque M, McGowan C, Cornell M, Braitstein P, de Rekeneire N, Becquet R, Wools-Kaloustian K, Law M. “Sex based differences in antiretroviral therapy initiation, switching and treatment interruptions: global overview from the International Epidemiologic Databases to Evaluate AIDS (IeDEA)” in press Journal of the International AIDS Society
  7. Wachira J, Genberg B, Kafu C, Braitstein P, Laws MB, Wilson IB. “Experiences and expectations of patients living with HIV on their engagement with care in western Kenya”. in press Patient Preference and Adherence