Health Disparities Forum

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 2^nd generation, comment on how your work could lead in the future to 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).

My research is currently in the 1^st generation of this framework as I am describing patterns in colorectal cancer screening in safety-net population, follow-up of abnormal stool based screening tests and trying to define where disparities exist. I am currently moving into the 2^nd generation by determining how social determinants of health may be implicated in the identified disparities.  In the next research projects, I want to develop interventions based on the information gathered in the 1^st & 2^nd generations of my work that will be executed at the level of patients, providers, and health care systems to address the identified disparities.

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. What types of clinical interventions can you think of in your area of research that could similarly bridge levels of the socioecological model? 

To increase adherence to colorectal cancer screening and follow-up of abnormal stool tests, an intervention that could bridge the levels in the socioecological model would be training librarians in racially diverse neighborhoods to disseminate fecal immunochemical tests to patrons who are 50 years and older. Like the barbershop hypertension intervention, librarians could be trained to ask patrons about their colorectal cancer screening status, distribute FIT cards to those who are not up to date with screening and encourage those who’ve completed a FIT test to follow-up the results with their physicians. Such an intervention could be tied to financial incentives for the trained librarians.