Health Disparities Forum

EPI 222 – Week 10 hw

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 1^st or 3nd generation, comment on how your work could lead in the future to a 3^rd or 4^th generation work.  If your work is 3^rd or 4^th generation, comment on what 1^st and 2^nd generation work was necessary as a foundation for your current work (or current interests).

As my work is focused on learning if young women conceptualize themselves as having plans to prevent STIs and what these plans are, I would say that this falls into the spectrum of 1^st (Detect) and 2^nd (Understand) generation research.  The goal of this research is to elucidate what young women are choosing to do to decrease their risks of contracting STIs, so as to identify disparities in plans and improve provider counseling.   Further 2^nd generation research is needed to investigate how and why women choose specific strategies to prevent infection, and what is important to them in choosing an infection prevention strategy.  This approach mirrors much of the contraception literature to date in terms of learning what is important to women in choosing a contraceptive method to improve provider counseling.  Further 3^rd and 4^th generation research would provide recommendations and incorporate interventions in both provider counseling and health education regarding STI prevention, which would focus on positive assets (i.e., what young women can do) to take control of their health, rather than the current practice of telling women what not to do.

1. 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 hypertension intervention provided clinical services to a specific population with historically limited healthcare access by meeting them within the community.  This is generalizable to a multitude of healthcare services that researchers and providers would like to increase access to.  I have been a part of community health fairs held at a local school, contraception outreaches to college dormitories, and puberty and health education to adolescents in an after school program for at-risk youth.  All of these were strategies to meet patients where they are in the community and to not only increase their interactions with the healthcare community, but also make them more knowledgeable in preparation for their interactions.

This may be applied to my research on STI prevention strategies by developing a curriculum on proactive measures young adults can use to prevent infection that may be incorporated outside of the clinic visit.  This could include outreach to afterschool programs, shopping malls, or supplementary to the sexual health education curriculum already taught within their schools.  This could include lectures, condom demonstrations, and role-playing of negotiating safer sex practices, in addition to resources such as STI testing and PrEP.  Similar to the barbershop intervention, the goal of the program would be to motivate young persons to pursue discussions with their providers, leading to changes in sexual risk factors or prevention strategies.