EPI222_WTR16: HW 10

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).

I think my current research project would generally be categorized as both 2^nd and 3^rd generation, in that I am interested in assessing experiences and preferences for contraception among girls in juvenile custody to inform interventions to address reproductive health disparities among these girls. I think this covers both realms because part of what we are asking about is their prior experiences (2^nd generation) with reproductive health care and also asking about their preferences for care within juvenile hall and after release (3^rd generation).

There has been limited prior data (1^st generational research) that describes the increased rates of STIs, high-risk sexual behavior and unintended pregnancy, and lower rates of routine well-child care and contraception use compared to their non-justice involved peers. Future 4^th generation work may have to address systemic racism and generational inequities leading to the disproportionate incarceration of youth of color.

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. What aspects of this program might be generalizable to other areas of health? How might this apply to your area of research?

The barbershop intervention engages in social determinants of health by acknowledging racial disparities in health and designing an intervention that is culturally appropriate, engaging community stakeholders and meeting participants where they are. I think these principles are applicable to my research, in that I hope to meet girls where they are (and elicit their past experiences and preferences, to hopefully design interventions that would be acceptable. I also am partnering with community stakeholders so that my proposed interventions will be more feasible.

Re: HW 10

by Christine Dehlendorf - Thursday, March 10, 2016, 10:55 AM

One of the important things about your particular work is that the one overlying context from a disparities perspective is the fact that girls involved in the juvenile justice system are most often from groups that experience health disparities, in addition to the fact that first generation research has found that this particular sub-population experiences even worse outcomes. I agree with your assessment that your work investigating how to meet their reproductive needs is second generation, leading clearly into plans for interventions.

The community engagement piece of the barbershop program is powerful. Further interventions designed to take advantage of similar place-based and social communication strategies in different contexts will definitely need to do work, similar to what you are doing, as well as engage with community partners, to understand the specifics of that context and ensure that these types of interventions are appropriately planned (i.e. don't take a one size fits all approach to this type of intervention).