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).
Thomas et al present the generational framework for health disparities research, which was instructive in examining my own research interests and projects. My current research interests fit into the generational framework at the 1st generation level. First generation research is focused on identifying and documenting disparities, as well as identifying vulnerable or disenfranchised populations. I am interested in the utilization of Palliative Care services by Pediatric Oncology patients who are racial and ethnic minorities. Additionally, I am interested in studying where Pediatric Oncology patients die (ie at home, in the hospital, or in a hospice), as this often reflects their access to Palliative Care Services. These studies could serve as valuable foundation for 3rd generation studies, which would aim to provide a potential solution to address the disparities identified. I am currently working on a pilot feasibility study of telemedicine interventions in pediatric brain tumor patients, which could potentially address some of the income and access disparities that affect access to Palliative Care services.
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.
My interests in pediatric oncology and palliative care are broad, but I am particularly interested in the ways that disparities operate and affect outcomes throughout cancer therapy—from diagnosis, to treatment, to survivorship and end of life. Access to Palliative Care and hospice services reflects many issues, including provider bias, patient and family cultural beliefs, and socioeconomic realities of the resource availabilities of families and their larger communities. An intervention which used chaplains and spiritual counselors/ providers to help families with code status discussions might help to acknowledge the cultural framework that individuals navigate within when making end-of-life decisions for their children.