February 2013—Dr. Piroska Bisits Bullen ’12 is passionate about public health. Her goal is not simply to conduct research but to assess the research that others have already completed—and, most important, to make sure their crowdsourced solutions have a real-world impact. In short, Dr. Bisits Bullen embodies the definition of a scholar-practitioner. Her goal is to use the research she and her colleagues create to improve public health in communities around the globe.
In recognition of her innovative approach, the PhD in Public Health graduate was awarded Walden University’s 2013 Harold L. Hodgkinson Award for her dissertation, A Multiple Case Study Analysis of the Positive Deviance Approach in Community Health.
Through her dissertation, Dr. Bisits Bullen examined how positive deviance (how individuals arrive at novel solutions to local problems) is applied to a range of public health issues. Could community-sourced solutions to issues like childhood malnutrition be shared to positively impact other communities?
“Her dissertation is a remarkable example of her approach to public health,” says Dr. Michael Schwab, her dissertation committee faculty chair and the 2013 recipient of Bernard L. Turner Award. “This was a very practical dissertation, one of the most practical I’ve ever chaired,” he says.
Choosing the Focus of Her Research
To start her dissertation, Dr. Bisits Bullen examined examples of public health initiatives through hundreds of pieces of literature, finally settling on childhood malnutrition when she discovered a program in Vietnam run by Jerry and Monique Sternin of Save the Children. They found that only some families living in extreme poverty were able to raise healthy-weight children. What were they doing differently?
“Mothers in this community were collecting tiny shrimp from rice paddies and feeding them to their children along with the greens from sweet potato tops,” Dr. Bisits Bullen says. “These foods were freely available to all members of the community, but most other members of the community did not believe they were appropriate for children.”
When these mothers taught other community members how to supplement their children’s nutrition, the results were astounding, resulting in more than a 60% reduction in childhood malnutrition that was maintained several years after the program ended.
This act—teaching others how to supplement their children’s nutrition—is an example of positive deviance. The more Dr. Bisits Bullen read about positive deviance, the clearer it became that this technique—spreading others’ current successes to benefit a community’s public health—was understudied.
“The more I read about it, the more I realized that no one had done any research on the approach itself, so it was impossible to know which areas it worked for.” As a result, she says, “I decided to change my topic to address this gap in the literature.”
Although Dr. Bisits Bullen collected every publicly available document on every positive deviance program she could find, including chronic diseases, weight control, hospital-acquired infections, and maternal health, her analysis showed that positive deviance only proved effective for childhood malnutrition in a variety of settings. “I didn’t find it ineffective for other issues,” she cautions. “There simply weren’t enough rigorous evaluations in other areas to draft conclusions about its effectiveness.”
“The purpose of my research was to look past all the individual success stories and inspirational anecdotes to see if there really was something of substance behind positive deviance, something which could be counted on to deliver real, measurable results in a variety of settings,” Dr. Bisits Bullen explains.
The measurable impact for childhood malnutrition “is a very useful result for practitioners as well as donors, because they can now be more confident that this type of program is going to deliver real results that will benefit children,” she says.
Becoming a Scholar-Practitioner
As a technical management advisor for two nongovernmental organizations, the Cambodia Health Education Media Service and Cambodian HIV/AIDS Education and Care, Dr. Bisits Bullen’s goal is to have a positive and measurable impact through her research. To truly become a scholar-practitioner, she aligned her doctoral studies with her professional work.
Ultimately, her findings could positively impact all practitioners in the public health field. The results of her research were published and made available to the public in Tropical Medicine & International Health (Vol. 16, No. 11). And she urges other members of the public health community to conduct and complete research.
“These types of systematic reviews are vital for practitioners to know which programs are likely to work,” she says. “The results from systematic reviews are so important that many peer-reviewed journals now prioritize publishing them above other research. They can have an immediate positive impact.”
“I really like Walden’s focus on scholar-practitioners and the fact that most of its students are working professionals,” Dr. Bisits Bullen continues. “Although I appreciate the need for full-time academics and theoretical research, I think the world needs more practitioners who are able to do high-quality applied research while working in the field.”
About the Harold L. Hodgkinson Award
This award is bestowed annually upon a Walden graduate whose dissertation is judged as meeting the highest university standards of academic excellence. The award honors the life of dedication and the distinguished career of one of the nation’s foremost experts in demography, Dr. Harold L. Hodgkinson. It also recognizes Dr. Hodgkinson’s instrumental role in the establishment and academic development of Walden University.
Read about past recipients of the Harold L. Hodgkinson Award.