Current and Past Family Research Scholars
Research:
The proposed research study will center on the voices of pregnant and birthing people of color and their families to understand what is needed in their communities to support themselves, their families, and their communities in maintaining their health and wellness throughout the perinatal period. Through a mixed method approach, informed by Community Participatory Research and van Manen’s Interpretive Phenomenology, we will develop, implement, and evaluate a community initiative to address maternal health equity. Using a group prenatal care model that includes culturally relevant prenatal content, the program will support pregnant and birthing families from pregnancy up to one year postpartum. In addition, the group model of care will provide mental health support, health education for anticipatory guidance, and resources throughout pregnancy, childbirth, and postpartum.
Research:
In this project, I will collaborate closely with my team to identify disparities in access to home-based palliative care (HPC) among older adults. This will involve utilizing national datasets, specifically CMS datasets, as well as electronic health records (EHRs) from VNA Care. Through the implementation of this project, I foresee substantial opportunities for collaboration, intellectual exchange, engagement in public policy discussions, and participation in community outreach activities.
The accessibility of Home-based Palliative Care (HPC) for frail older adults with serious illnesses varies across the U.S. due to differences in health insurance coverage, notably within Medicare. Medicare lacks a distinct palliative care benefit, leading to uncertainty regarding HPC coverage. The CHRONIC Care Act targets improvements in care for individuals with chronic conditions, potentially affecting HPC accessibility via Medicare Advantage plans. This proposal aims to assess HPC utilization before, during, and after the CHRONIC Care Act through national data analysis and interviews with the Visiting Nurses Association (VNA) Care in MA. We anticipate disparities in HPC access among subgroups based on socioeconomic status, insurance type, geographic location, education, and cognitive barriers. Our goal is to
identify and mitigate these barriers to promote health equity for frail older adults with serious illnesses. Understanding these disparities is crucial for informing policymakers, healthcare providers, and public health professionals in crafting tailored strategies to enhance public health interventions for this vulnerable population.
Aim 1. To characterize subgroups in receiving HPC before (2018-2019), during 2020, and after the CHRONIC act period (2021-2022), using CMS claims datasets- Master Beneficiary Summary File (MSBF- demographic), Part B (outpatient- outpatient visits including HPC), Carrier Claims (NCH – non-institutional providers including HPC), and Home Health Agency. * Because there is no standard Medicare definition for HPC, outside of Hospice, our approach will initiate with the use of 'provider specialty codes' and CD diagnosis 'codes' for encounters elated to HPC.
Aim 2. To explore the barriers and facilitators affecting accessibility and utilization of HPC by conducting interviews with healthcare providers, families, and patients. [Qualitative Data]
Research:
In order to achieve a more just, sustainable and healthy society—that is, to promote human flourishing—we will need to re-envision what it means to live a “good” life. In part that means individually and collectively rethinking how different dimensions of our lives (e.g., physical and mental health, economic security, environmental sustainability, social connections and community) fit together to form the “bigger picture” of our lived experiences and how we can more intentionally integrate them to promote our own and one another’s shared flourishing. Using a mixed-methods social scientific approach, this project aims to inform, develop and test best practices and efforts that promote human flourishing through the combination of robust behavior change tools and narrative storytelling techniques. The project focuses in particular on uncovering and leveraging the connections across three core domains of human well-being: health, community, and sustainability.
Research:
Physical inactivity is responsible for the largest proportion of preventable dementia cases in the United States.Social isolation is another major risk factor for dementia. Dog ownership supports physical activity and social connectedness, but whether older adult dog owners experience better brain and cognitive aging is unknown. This project will investigate differences in cognitive function and dementia biomarkers in older adult dog owners compared to non-dog owners, as well as factors that mediate the dog ownership-brain health relationship. This research could have significant public health impact by informing novel dementia prevention interventions that support dog ownership and dog walking for older adults.
Research:
The long-term goals of my research program are to develop, test, and disseminate successful intervention programs that work at multiple levels of influence to increase youth physical activity and decrease screen media use, leading to long-term improvements in physical, social, and mental health. To accomplish these long-term goals, my research embraces the Social Ecological Model as a framework to better understand the multiple levels of influence on youth physical activity and sedentary behavior. One facet of my research program is to better understand the social and physical environmental influences on youth physical activity and sedentary behavior. At the heart of the Social-Ecological Model are an individual’s behaviors and their health outcomes. Therefore, another integral facet of my research program is to better understand how to quantify physical activity and sedentary behavior in youth. We use research-grade accelerometers (i.e., motion sensors) coupled with regression and machine-learning models to objectively quantify frequency, intensity, and timing of physical activity and inactivity but also rely on questionnaire data, when appropriate, to assess relevant contextual information.
The overall goal is to extend our recently completed Food, Activity, Screens, and Teens (FAST) Study. An NIH R03 application will support analysis and modeling of data from the FAST Study, completing core work that was interrupted by the COVID closure and taking advantage of the new opportunistic data collected after 2020; outside the scope of the original project. The aim of the R03 is to leverage our existing data to investigate the long-term impact of the pandemic closure and social distancing guidelines on social relationships, health behavior, and health outcomes for disadvantaged urban adolescents. We would also move beyond the school to incorporate neighborhood and community features related to physical activity and food access. The R03 would generate deliverables as pilot work for a planned NIH R01 competitive renewal submission. The planned NIH R01 application (Multi PD/PI: Kitts and Sirard) will build off the work from our previous R01, and the planned R03 grant. The main aim will be to design a full-scale follow up study that delivers a school-based health behavior intervention that incorporates important social network processes identified in our previous project and to deliver that intervention to a larger and broader range of schools (urban, suburban, and rural). Lastly, Dr. Sirard will contribute to a related NSF RAPID application (PI: Kitts). The RAPID grant project aims to capitalize on a unique one-time opportunity to collect follow-up data, using both survey and anthropometric measures of our original FAST Study participants (who we recruited in the 6th grade) during their senior year of high school.
Research:
The project utilizes social network analysis to represent and measure the social network properties of elite families. Specifically, using an untapped archival resource, and the techniques of network analysis, the project generates a quantitative measure of how densely connected the elite families of a given area are, and how hierarchically arranged they are. This is accomplished via the use of an array of very special archival sources known as ‘blue books’ and ‘social registers’. These documents were used historically to allow elite families to recognize and connect with one another – they were the ‘Facebook’ of the early 20th Century. Importantly, these documents provide a wealth of data: at the household level, all acknowledged family members, their clubs and society memberships and each family members’ education. What these sources provide is a way of mapping the social networks of wealthy elite families, by connecting households together via their common memberships, clubs, educational backgrounds, and even their spatial proximity to one another. Using these data allow us to measure, for a given geography and time period, how cohesive the elite families were, and how hierarchically arranged they are vis-à-vis one another.