Fear of the speculum and feelings of vulnerability during the gynecologic exams are two of the biggest barriers to cervical cancer screening for women. To address these barriers, we have developed a novel, low-cost tool called the Callascope to reimagine the gynecological exam, enabling clinician and self-imaging of the cervix without the need for a speculum. The Callascope contains a 2 megapixel camera and contrast agent spray mechanism housed within a form factor designed to eliminate the need for a speculum during contrast agent administration and image capture. Preliminary bench testing for comparison of the Callascope camera to a $20,000 high-end colposcope demonstrated that the Callascope camera meets visual requirements for cervical imaging. Bench testing of the spray mechanism demonstrates that the contrast agent delivery enables satisfactory administration and cervix coverage. Clinical studies performed at Duke University Medical Center, Durham, USA and in Greater Accra Regional Hospital, Accra, Ghana assessed (1) the Callascope’s ability to visualize the cervix compared to the standard-of-care speculum exam, (2) the feasibility and willingness of women to use the Callascope for self-exams, and (3) the feasibility and willingness of clinicians and their patients to use the Callascope for clinician-based examinations. Cervix visualization was comparable between the Callascope and speculum (83% or 44/53 women vs. 100%) when performed by a clinician. Visualization was achieved in 95% (21/22) of women who used the Callascope for self-imaging. Post-exam surveys indicated that participants preferred the Callascope to a speculum-based exam. Our results indicate the Callascope is a viable option for clinician-based and self-exam speculum-free cervical imaging. Clinical study registration ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/record/ NCT00900575, Pan African Clinical Trial Registry (PACTR) https://www.pactr.org/ PACTR201905806116817.

Solutions to the most pressing global issues require creative innovators, critical thinkers, and problem-solvers. Yet rural communities globally often lack the resources to provide adequate STEM design-thinking coursework at the primary and secondary school level. Ignite is a novel approach to STEM curricula, providing a framework that addresses this disparity by using design thinking. Students are empowered to understand the sustainable development goals (SDGs) through the development of technological solutions to community or health problems; problems they may relate to or directly experience. Each Ignite curriculum follows a basic formula: (1) students learn a specific set of engineering skills, (2) students work in teams to use the human-centered design process, and (3) they develop a solution to a (SDG) using the engineering skills they learned. Ignite began with just four undergraduate students who participated in a design-thinking biomedical engineering course taught at Duke University. Through evidence-based peer-led co-learning model, 79 additional students from Guatemala and the U.S. have become trainers and have taught more than 1,500 students across 16 schools in Guatemala since 2017 with preliminary data suggesting the program has a positive impact on student perceptions of STEM in the inaugural school where Ignite was launched, Instituto Indigena Nuestra Senora del Socorro (IINSS). Preliminary data suggests that this program is both scalable and sustainable due to its peer-led, student learning model and due to a local partner, FUNDEGUA, who is managing the implementation of Ignite locally in Guatemala.

Background. Engineering design is widely recognized as a field that can generate key innovations for complex problems, such as those elucidated in the Sustainable Development Goals (SDGs). However, engineering design training is not widely accessible to the global community, particularly to people experiencing the challenges that the SDGs are striving to address. Purpose. This manuscript describes the Ignite program created by the Center for Global Women's Health Technologies (GWHT) at Duke University, which uses the human-centered design framework to apply engineering design concepts to address specific challenges associated with the SDGs. Design/Method. Undergraduate students participate in a design course (BME 290) to learn how to create and deliver a technological solution to increase access to light at night, which is a significant challenge in many communities around the globe. A subset of the undergraduate students partnered with an energy-poor community in which they implemented a curriculum based on the skills learned in BME 290. Results. Since 2014, 110 Duke students have taken BME 290, and 22 of those students traveled internationally, collectively teaching 275 students in Kenya, India, and Guatemala. Students in Kenya 2 SUMMER 2020 VOLUME 8 ISSUE 2 ADVANCES IN ENGINEERING EDUCATION Using Human-Centered Design to Connect Engineering Concepts to Sustainable Development Goals formed an engineering club and taught the curriculum to an additional 52 peers. Duke students also trained 15 other university students, both in the United States and Guatemala, who have taught the curriculum to an additional 150 students in Guatemala, which illustrates the scalability and sustainability of the curriculum across countries, communities, and cultures. Conclusions. By integrating human-centered design and the SDGs into engineering curricula and targeting communities that work with women and girls, we believe the Ignite program can impact three of the SDGs-renewable energy, quality education, and gender equality.

IntroductionUnderstanding community women's relational and financial empowerment in social entrepreneurship could be the key to scaling up community-based human papillomavirus (HPV) self-sampling programs in low- and middle-income countries. The Hope Project, social entrepreneurship in Peru, trains women (Hope Ladies) to promote HPV self-sampling among other women in their communities. This study aims to evaluate the Hope Ladies' relational and financial empowerment after participating in the program.Materials and MethodsWe evaluated the Hope Ladies' experiences of empowerment in social entrepreneurship using a parallel convergent mixed methods design. The Hope Ladies participated in semi-structured in-depth interviews (n = 20) and an eight-questions five-point Likert scale survey that evaluated their relational (n = 19)/financial (n = 17) empowerment. The interview and the survey questions were developed using three empowerment frameworks: Kabeer's conceptual framework, International Center for Research on Women's economic empowerment indicators, and the Relational Leadership Theory. Deductive content analysis was used to evaluate the interviews with pre-determined codes and categories of empowerment. Descriptive statistics were used to analyze the survey results. Qualitative and quantitative data were integrated through a cross-case comparison of emergent themes and corresponding survey responses during the results interpretation.ResultsAll Hope Ladies reported experiencing increased empowerment in social entrepreneurship. Interviews: The women reported challenges and improvement in three categories of empowerment: (1) resources (balancing between household and Hope Lady roles, recognition from the community as a resource, camaraderie with other Hope Ladies); (2) agency (increased knowledge about reproductive health, improved confidence to express themselves, and ability to speak out against male-dominant culture); and (3) achievement (increased economic assets, improved ability to make financial decisions, and widened social network and capital, and technology skills development). Survey: All (100%) agreed/totally agreed an increase in social contacts, increased unaccompanied visits to a healthcare provider (86%), improved confidence in discussing reproductive topics (100%), improved ability to make household decisions about money (57% pre-intervention vs. 92% post-intervention).ConclusionsThe Hope Ladies reported improved relational and financial empowerment through participating in community-based social entrepreneurship. Future studies are needed to elucidate the relationship between empowerment and worker retention/performance to inform the scale-up of HPV self-sampling social entrepreneurship programs.