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).
Because my research acts to disseminate an intervention aimed at increasing education about contraceptive methods among adolescents, I would posit that it fits into the 3rd generation framework for health disparities research. A 1st generation work that laid the foundation for my group’s current work includes research that identified adolescents to have a more narrow fund of knowledge with regard to contraceptive options when compared to older adolescents (Craig et.al, 2014). An excellent example of a 2nd generation work that was necessary as a foundation for my current work includes a study by our group that examined adolescent barriers to IUD use. In this study, adolescents reported that contraceptive information received from friends and family members is more well-received/ trustworthy when compared to information received from clinicians. This same study also showed that lack of social communication and education about contraceptive methods, particularly IUDs, acts as a barrier to their use (Brown et al, 2013). These successful 1st and 2nd generation research endeavors have been pivotal in guiding our current research questions.
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 Walton 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. (Note: Next week we will discuss policy-level interventions designed to directly impact social determinants).
Suggestive of the impact of peer-to-peer communication on adolescent contraceptive use, previous studies have shown that contraceptive use increases with increasing classmate use (Ali et al, 2011). Combing peer-to-peer communication with accurate and relevant contraceptive information is an example of an intervention, and one that my research team is currently carrying out, that engages with social determinants of health, particularly on the level of education. This intervention has the ability to act as a primary prevention (the fence at the top of the cliff) by positively influencing adolescent knowledge about their contraceptive options and reproductive health as a whole. A second intervention that engages with education could be group contraceptive counseling visits. Though there are some aspects of group medical visits that are still being debated (some of which are highlighted in this article https://catalyst.nejm.org/case-shared-medical-appointments/), I think that if delivered under the right circumstances they have the potential to engage community members with each other and with the medical community in a way that could potentially act as a tool to mitigate some contraceptive educational barriers.