The NAPCare – UVA Collaboration

An example of a research-capacity building partnership between the Nepalese Association of Palliative Care and the University of Virginia.

History of the Collaboration

The NAPCare – UVA research collaboration evolved from initial partnerships that began in 2004 with the International Network for Cancer Treatment and Research. Since that time, palliative care development and capacity have significantly advanced within Nepal which laid the groundwork for the National Institutes of Health Fogarty International Center grant which helped fund this research.

Outcomes to Date

During this initial exploratory grant, our interdisciplinary, global team of investigators from Nepal and UVA:

  • Co-created, conducted, and analyzed a comprehensive survey of palliative care/oncology nurses and physicians at four diverse cancer sites that assessed: a) knowledge, beliefs, and perceived barriers to cancer pain management at the individual, intrapersonal, institutional, and country/cultural levels; b) awareness and use of the NAPCare PMG; c) smartphone use and barriers; and d) desired features and outcome metrics for a NAPCare Pain Management Guidelines (PMG) mobile health (mHealth)  app.
  • Built and iterated a beta version of the ‘NAPCare PMG mobile health app’ through extensive in-country fieldwork and remote virtual meetings and focus groups. Of note, our beta app focuses on adults with cancer. This was an intentional decision based on: 1) input from Nepal partners as to what would be most useful to healthcare providers; 2) the larger proportion of adults in Nepal with cancer compared to children; 3) the primary expertise of our clinical team and patient populations seen at our study sites; and 4) to be consistent with the scope of our exploratory work.
  • Pilot tested the NAPCare PMG mobile app with oncology healthcare providers at four diverse cancer care centers using simulated patient case scenarios developed by the Nepal team and surveyed app users to assess acceptability and gather feedback for further app development.
  • Engaged in research capacity building activities through in-person and virtual workshops and mentorship meetings that focused on: survey development, data collection, data analysis, mobile app design, and pilot testing, dissemination of findings, grant and project management, testing of beta versions of the mobile app, and the creation of our Virtual Library of open-access, web-based research resources relevant for investigators in low and middle-income countries

Future Directions

  • Secure funding support to continue to develop, disseminate and test the NAPCare PMG app.
  • Continue research capacity support between UVA – Nepal team members through virtual mentorship.