1. After reading the article by Thomas et al., comment on where your research, or your research interests, fit into the generational framework for health disparities research. If your work is 1st or 2nd generation, comment on how your work could lead in the future to 3rd or 4th generation work. If your work is 3rd or 4th generation, comment on what 1st and 2nd generation work was necessary as a foundation for your current work (or current interests).
An area of research that interests me is the examination of disparities pertaining to the ordering and interpreting of radiologic imaging. My research project is on fetal MRI, so a potential question could be whether there are racial disparities in the ordering of fetal MRI--does a pregnant woman's race/ethnicity impact whether she gets referred for a fetal MRI (and control for factors such as geographic distance from a facility that does fetal MRI)? This would constitute 1st generation research, because it asks the question "does a disparity exist?" If I performed a study on this topic and found that there was a racial disparity, then the next steps would involve developing studies that seek to gain insight into why such a disparity exists, what interventions have been or can be developed to mitigate if not eliminate the disparity, and to include the affected community members in that research process. An example intervention might be developing a standardized algorithm that includes the specific indications for referring pregnant women for fetal MRI. A 3rd and/or 4th generation study could examine whether such an intervention reduces or eliminates the racial disparity in the ordering of fetal MRI.
2. The barbershop hypertension intervention, while essentially a clinical services intervention operating at either the fence or safety-net level as described by Jones, has some engagement with the social determinants of health. Interventions like that described in the Gottleib article are designed to mitigate the impact of social determinants. How could you apply one of these two types of interventions to your area of research? Propose one or two interventions that engage with social determinants on some level.
The research question I posed in part 1 is more in the realm of health disparities due to provider bias, so any interventions would need to be focused on modifying provider behavior and/or reducing providers' subconscious biases. In addition to that area of research, I would also be interested in exploring other interventions similar to the barbershop hypertension study that addresses chronic disease at the fence or safety-net level. For instance, I have read about K-12 public schools that installed washing and dryer machines in order to improve school attendance, as some children do not have consistent access to clean clothes and stay home as a result. Seeing that the school can be a important conduit for connecting with parents and families, particularly in low-income neighborhoods, I would be interested in studying an intervention that involved providing blood pressure and/or blood glucose monitoring and referral for parents at their children's schools. Many parents pick up their children from school, so that could be a convenient point to engage with busy parents, hopefully reducing the barrier to receiving basic health screenings.