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 1rst 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 1rst and 2nd generation work was necessary as a foundation for your current work (or current interests).
As a novice researcher with no clinical background, my research is based on secondary analyses of existing data. I am currently working on a project that will analyze the clinical and demographic factors associated with complimentary and alternative medicine (CAM) use among women suffering from symptomatic uterine fibroids. In my opinion, this falls under first generation research, focusing on the detection of disparities. Although I am quantifying the prevalent use of CAM, I am actively thinking of what I can do to contextualize the actual causes/reasons of symptom burden that leads to the use of CAM use. Because I am using existing data, secondary research is necessary to uncover causal relationships that underlie health disparities, specifically around the determinants in health status and unequal access to medical/surgical interventions for the treatment of fibroids. Aside from quantitative analysis, I think qualitative work would help fill the gap that exists in this field, through focus groups and community engagement to center research in the perspective of women from minority ethnic and racial groups. With knowledge of individual-level contributors and environemental factors (i.e. familial, social, cultural, economic, historical, political, and media influences), the concordant use of behavior and cognitive theory could help tailor culturally versed interventions for providers working with women in these groups. After reading this article, I realize that research does not necessarily fit a linear framework specifically among the 3rd and 4th generations of research. Ideally we should be adopting PHCR and CRT early into our proposed interventions or during the discussion portion of observational work.
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.
Similar to the intervention described by Jones, I participated in a study that examined the impact of race concordance and incentives on the take-up of preventive health services by black men. The study partnered with local barbershops as a technique to facilitate recruitment of our target population. When barbershop clients agreed to participate in the study, they received a generic flyer advertising preventive health care services (for blood pressure, diabetes, and cholesterol) at a local clinic, and received a free haircut, and an incentive payment after visiting the clinic.
For my research specifically, I would want to look into the barriers and enablers around preventative/routine gynecologic among Latinx women. Although this is not an intervention itself, I would partner with business that cater to this population, like hair and nail salons, to survey women on this matter. This could then set the foundation for a relavent, culturally versed, educative intervention around the importance of routine care, in a setting that these women are comfortable in and easily accessible.