International collaboration is a subject that's near and dear to my heart on many levels. One is just a very practical level. Right now I'm involved with a collaboration in Honduras with the Familias Fuertes Program or the Strengthening Families Program, which we're trying to adapt for Alabama immigrants, and we're working with nursing colleagues at the University of Honduras, the Universidad Nacional Autonoma in Tegucigalpa.

And they are actually the co-investigators assuming primary responsibility for data collection, implementation of the intervention, and so forth. But the initial development of the design and ideas was truly a collaborative effort.

We're working with very busy nursing faculty who are overworked and trying to help them find time to do all of the detailed data collection and analysis and figure out how, in the United States as a partner, how can I facilitate that?

Another big challenge is ethics committee or Institutional Review Board approval for projects. In this case, because I will be pretty integrally involved throughout the process and helping with data analysis, our university requires such projects to have not only IRB approval in the collaborating country, in this case Honduras, but from our IRB, and that whole process took us almost six months.

And the whole process of negotiating what the consent document even has to look like. In the United States, we have certain regulations that may or not, may not apply in other countries, such as HIPAA, the Health Insurance Portability and Accountability Act, which was designed mainly to protect privacy and confidentiality of patient information, identifying information. It wasn't designed to be used in research, but some IRBs are insisting that we have separate consents just for that.