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).
Behavioral
and developmental concerns are common in children and adolescents, making early
intervention key to prevent those concerns from becoming larger issues in the future.
Primary care pediatricians are often the first clinicians to interact with
these children, therefore my current research focuses on gathering data
regarding how primary care pediatricians address mental health issues among
children and adolescents. More specifically, the studies I am working on assess
the effectiveness of both appropriate mental health screening and
appropriate/timely referral to mental health services for children who are at
risk of or show behavioral/developmental concerns. The goal is for my research
to be translated into QI interventions that enhance mental health services
among children and adolescents in primary care and to eventually prevent the
escalation of mental illness. I would like to think my research fits into the 3rd
or 4th generations given that the objective is to lower risk by
providing better access to resources, enhancing services, and early
intervention, in addition to identifying and tackling barriers to mental health
care access. That being said, the 1st generation would include
efficacy and effectiveness research on psychological treatments to treat those
who have developed moderate to severe psychological disorders. 2nd
generation would involve efficacy and effectiveness research on mild
psychological disorders to prevent deterioration.
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).
I could definitely apply a similar intervention in my area of research. For example, when it comes to mental health screening, there are many neighborhoods in the Bay Area where there is no conveniently located clinic that assesses for child mental health. Those neighborhoods could be predominantly of ethnic minority or low SES. Therefore one way to apply this intervention is to provide teachers at their children’s schools with resources to be able to systematically screen all children and provide the results to their parents. That way, parents are constantly exposed to mental health screening and may feel encouraged to seek help when needed. A second intervention that may help engage the community in addressing mental health could be in community centers or churches/religious centers in the area. Having an open dialogue, educating individuals, and disseminating information on resources to obtain help could become the fence at the top of the cliff that would lower risks of developing severe psychological illness upon early intervention.