Choose a faculty advisor whose area of interest and research covers the topic that you want to pursue.  Professors are not always available in a particular quarter so you may want to have more than one professor in mind that you would like to work with.

Students may work with a Global Health-affiliated faculty member or seek pre-approval to work with a non-affiliated UC San Diego Faculty member.

• The faculty sponsor/instructor must have a UCSD faculty title. If the mentor is not from UCSD s/he has to be from an appropriately accredited institution.
• Lecturers are not eligible to serve as faculty advisors. (e.g. Dr. El Wardani, Dr. Villarino, Dr. Olivas - Hernandez, Dr. Schonberg)

When meeting with potential faculty instructors, it is important to discuss the nature of the project, frequency of contact, prerequisite knowledge needed, and the means of evaluation with the faculty instructor prior to enrollment in this course.

Can I work with a faculty member, not on this list?

• If there is a mentor who is not part of our affiliated faculty that a student would like to work with please submit the following information to ma-globalhealth@ucsd.edu to get approval:
  
  • Proposal: Professor title, info, contact, website, the reason you would like to work with the professor, and what you plan on working on for your experience.
  • Students seeking academic credit for an off-campus internship/research experience should consult with the Academic Internship Program for options.

Prior to the quarter you plan to enroll, meet with the faculty member you plan to work with to discuss the terms of your independent research and come to an agreement on the work that will be completed. 

You will need the following information to submit your request:

• the nature of the project
• frequency of contact - It is expected that students will arrange to meet with the faculty advisor a minimum of three times during the quarter to discuss progress.
• prerequisite knowledge needed
• Means of evaluation (10-page paper required or equivalent assignment in addition to research poster)

Submit your application -  Application link

Once approved by the Program Director - Complete the Easy Special Studies Request form. 

A message will be sent to your UC San Diego email once you have been approved to enroll. 

This is an independent research course so students will need to develop a schedule to devote around 10-12 hours per week towards their research (the standard for a 4-unit course). Your faculty advisor serves as a mentor but this is a self-sought-after course and you will be responsible for seeking out the majority of materials and resources. 

Your faculty advisor will help you finalize your paper topic, give you feedback on the paper/poster over the quarter, and guide you on appropriate readings and resources. They provide feedback on the draft and consultation through the writing process. Students will meet with their faculty advisor a minimum of 3 times per quarter.

At the end of the quarter, you will submit a 10-page Research Paper or Project to your faculty advisor.

Your faculty advisor will then assign you a grade at the end of the quarter (you may want to send them a reminder during week 10 or finals week).

You do not need to submit a copy of your final paper to the Global Health Program office. 

During Spring Quarter - students will submit their abstract (late April) and complete a research poster for Horizons (early May)

Research Poster:

Abstract and poster session resources can be found here.

• Abstracts are submitted in April.
• Posters are due one week prior to Horizons (research does not need to be complete)
• Poster presentations at Horizons will take place in May.

You may work with a faculty advisor who already has research going on that you can contribute to or analyze data for or you can write a literature review on an approved topic, working with a knowledgeable faculty advisor.

Since this is a one quarter course, students don't typically have time to submit an IRB and complete original research.

Writing Resources:

• Developing a research poster
• Creating a scholarly poster in powerpoint (template included)
• Writing an abstract

The librarian is an excellent resource for finding materials.

The Writing Hub supports all writers on campus – every writer, any project – and promotes writing as a tool for learning.

They offer:

• One-on-one writing tutoring by appointment, 6 days/week
• Supportive, in-depth conversations about writing, the writing process, and writing skills
• Help with every stage in the writing process
• Walk-in tutoring (Monday-Thursday 5pm-7pm, and same-day appointments by availability)
• Questions? Contact the Writing Hub (writinghub@ucsd.edu)

2024 Abstracts

• Amanda Khoury - “The Hidden Impact of Cystic Fibrosis in the Middle Eastern Population”

• Hannah Abraham - “A Literature Review on the Implications of Social Risk Factors of Neonatal Abstinence Syndrome”

• James Terzian - “Breast Cancer Awareness in Armenian-American Communities”

• Jennifer Quiroz - “A Systematic Literature Review Exploring the Integral Role of Promotoras de Salud as Puentes de Salud y Cultura within Latinx Communities in the United States”

• Johoney Ronco - “Barriers to Care and Undiagnosed Eye Diseases Among Underserved Communities: UCSD EyeMobile Study”

• Joshua Holguin - “Cultivating Health and Community: The Role of Community Gardening in Addressing Nutritional Disparities at the Health Frontiers in Tijuana Clinic”

• Jovana Durovic - “Assessing the Effects of the COVID-19 Pandemic on Adolescent Mental Health Globally”

• Karina Salcedo - “Intersecting Vulnerabilities: A Literature Review on Homelessness, Substance Abuse and WaSH”

• Maria Sophia Abueg - “Analyzing the Impact of Migration Policies on Migrant Mental Health at the US-Mexico Border, A Mixed Methods Approach”

• Michael Alcazar - “The current scope on pterygium and the social determinants that are studied”

• Noa Aoyagi - “Reclaiming and Redefining Maternal Healthcare: A Journey Through the Role of Granny Midwives and Modern Midwifery”

• Zoe Slipper - “Establishing Care: Analyzing transborder networks of care for asylum-seekers in Southern California-Tijuana Border regions”

2023 Abstracts

• Daniel Hayek - “Distraction osteogenesis: An exploration of the intersection of extreme auxological elective surgery and medical tourism in pursuit of increased linear skeletal dimensions”

• Melissa Bittencourt Jaeger - “Factors Associated with HIV Testing among Young Adult Probationers in Southern California”

• Isaac Lara - “Exploring the Peer Support Spectrum: A Systematic Review of Peer Support Models Used at Higher Education Institutions”

• Zachary Manalo - “Characterizing The Socio-Cultural Barriers to Abortion in The Border Regions of Mexico: A Literature Review”

• Vaishnavi Melkote - “The Prevalence of Depression Among Older Adults in Tijuana”

• Andres Angel Rivera - “A Retrospective Analysis of the BMI of Patients at the HFIT Clinic in Tijuana, Mexico”

• Edward Andrew Schneider - “Cleft Lip and Palate in Vietnam: Disparities, Surgical Care, and Future Recommendations”

• Nina Suh-Toma - “Trapped in a WASH cycle": Unsheltered individuals’ access to water, sanitation, and hygiene (WASH) and its impact on mental health and stigma”

• Kacey Tran - “Sociocultural and Economic Drivers of Self-Medication: How Self-Prescription of Antibiotics Leads to Antimicrobial Resistance in Vietnam and India Using the One Health Approach”

2022 Abstracts

• Khadiga Fouad - "Association Between Acculturation/Acculturative Stress and Healthcare Seeking Behaviors of Iraqi Refugees" 

• Emily Hardy - “Barriers and facilitators to substance use treatment engagement for the heroin-based drug Whoonga: Qualitative evidence from South Africa” 

• Darren Harms - “Making the Invisible Visible: Skin Cancer Obfuscation in South Africa”

• Nicolette Le - "Vaccine Development in the Age of Fake News: A Qualitative Content Analysis of Misinformation on the Pediatric COVID-19 Vaccine by Verified Minority Twitter Users"

• Gabriela Stone - "Examining the Determinants of COVID-19 Childhood Vaccination Decisions: The Role of Protective Behaviors Adherence and Burnout"

2021 Abstracts

• Rebecca Noelle Donham - "For and by Communities: An Assessment of Feasibility for a Novel International Healthcare Program in Rural Ghana and Nigeria"  

• Alicia Gaidry Sykes - “Pediatric Trauma in the California-Mexico Border Region: Injury Disparities by Area Deprivation Index”

• Nhi Nguyen "Osteoarthritis in Asia: A Literature Review"

• Francisca Rivera - "Structural Gender-Based Violence and Unresolved Trauma: Power Structures and Social Dynamics that Influence the Migration of Women Fleeing the Northern Triangle Countries of Central America"

• Rachel Kai-Xin Yim - "What Medical Schools Don't Teach You"

2020 Abstracts

• Cortni Bardier - “Detecting Electronic Cigarette User Disparity Behaviors: An Infovelliance Study on Twitter”

• Tiana Mcmann - “Healthcare Worker Preparedness Among Clinicians Treating the Forced Migrant Population”

2024 Abstracts

The Hidden Impact of Cystic Fibrosis in the Middle Eastern Population

Amanda Khoury

Background: Cystic fibrosis (CF) is a progressive, autosomal recessive, genetic disorder that is associated with multiorgan dysfunction and shortened life expectancy.  Initially, CF was predominantly recorded within Caucasians of Northern and Western European ancestry; however recent studies have revealed more CF cases in regions around the world that were initially presumed to be rare, including the Middle East. There has been a massive jump in the life expectancy of patients diagnosed with CF in the US with a median age of survival of approximately 53.1 years in 2021, while in the Middle East, median life expectancy is only 10-20 years. Improvements in longevity observed in CF are not equal by race or ethnicity even within the US with CF patients from racial/ethnic minority backgrounds experiencing greater disease burden and worse outcomes. However, this has not been studied in CF patients in the US of Middle Eastern descent. 

Aim: This research aims to provide a comprehensive description of CF patients in the US of Middle Eastern descent with a focus on demographic characteristics, genetic profiles, clinical features, treatment patterns, and health outcomes. 

Methods: The CF registry in the US is a national database maintained by the CF Foundation that collects and stores medical and demographic information on individuals with CF. Unfortunately, Middle Eastern ethnicity is categorized under “Other” in the database. Therefore, to allow for the compilation of data on Arab American CF patients, surveys will be distributed to major CF centers across the US. 

Results: We anticipate that the demographic and clinical characteristics of Arab American CF patients will be like those of other minority groups in the US with CF. We expect to find a later age of diagnosis, varying genetic profiles, lower likelihood of treatment with modulator therapies, and worse health outcomes compared to non-minority populations. 

Conclusion: In conclusion, this study fills a crucial gap in research by providing a detailed description of CF patients of Middle Eastern descent living in the US. It will also contribute to the growing body of evidence showing that CF is not solely a Caucasian disease and help narrow the healthcare outcome disparity gap among minority groups of patients with CF. These findings can be expanded upon to enhance diagnosis and improve health outcomes for Arab American CF patients as well as to inform strategies for managing CF in the Middle East.  

A Literature Review on the Implications of Social Risk Factors of Neonatal Abstinence Syndrome 

Hannah Abraham

Neonatal Abstinence Syndrome (NAS) is a condition that impacts neonates of mothers who use(d) opioids, benzodiazepines, barbiturates, or antidepressants, during their pregnancy. As opioid use and misuse have risen, so have rates of NAS. Rates of NAS were 5 times higher in 2012 than they were in 2000. Infants diagnosed with NAS are adversely affected during and shortly after birth, and they require extra medical care. The purpose of this study is to analyze Neonatal Abstinence Syndrome diagnosis frequency patterns using the socioecological model, which utilizes interactions between individual, community, social, political, and environmental factors. This analysis focuses on demographic differences and social factors like ethnicity, gender, socioeconomic status, and geographical area that impact the development and incidence of NAS. Most studies report that male infants are initially more associated with severe withdrawal symptoms of NAS, although gender-specific cumulative effects of NAS are unclear. Although Black and Hispanic individuals are more likely to be of lower socioeconomic status, white infants of lower socioeconomic status are more likely to be diagnosed with NAS. Notably, maternal food insecurity among women who used opioids was found to be associated with more severe manifestations of NAS; they were 3-4 times more likely to give birth to infants who needed pharmacological treatment for NAS. Urban and metropolitan populations had lower rates of NAS in comparison to rural populations; Rural areas were also significantly farther from opioid abuse treatment centers, resulting in gaining access to treatment less likely. The results of the literature review highlight that the effects of demographic and social variables can inform comprehensive interventions and policies aimed at reducing health disparities and promoting health equity among NAS at-risk populations.

Breast Cancer Awareness in Armenian-American Communities

James Terzian

This research study holds significant importance as it aims to delve into the awareness of breast cancer risk factors, prevention, and treatment in various socioeconomic statuses across Armenian American communities. The existence of health disparities in breast cancer care and treatment is closely linked to gaps in breast cancer awareness and education. By focusing on Los Angeles Armenian-American communities, this study strives to not only gauge breast cancer awareness but also identify areas where awareness and education can be enhanced, thereby directly benefiting the community.

Methods: The Institutional Research Board approved the awareness study so that researchers could carry out the survey-based study in Los Angeles. Researchers maintain CITI certifications for working with human subjects for ethical research. The breast cancer awareness Qualtrics survey consists of 47 questions, which are either free-response, multiple choice or true/false formats. Initial questions are about socioeconomic status and the social determinants of health. The Breast Cancer Awareness portion tests patients’ understanding of breast cancer by asking true/false questions regarding breast cancer awareness, risk factors, and breast self-examination. Patients also fill out an informed consent form prior to taking the survey. A translator created an Armenian version of the survey and consent form to ensure that participants who do not read or write in English can participate in the study. The study design is cross-sectional, focusing on recruiting participants in a particular time frame in Spring 2024 with the goal of 200 participants. Eligible participants are members of the Armenian-American community living in the Los Angeles region who are at least 18 years of age. Local churches, community centers, schools, and businesses will receive the survey. The research study flyer lists an introduction to the research and uses 2 QR codes for each language where patients can participate in the study on their mobile devices. The survey questionnaire is estimated to take participants 30 minutes to complete. There are no incentives for patients to participate in the study. Data collected will be analyzed using statistical models, Qualtrics, and other analytical software to look for response correlations and trends.

Results: The research study still needs to finish collecting participant responses for the questionnaire. Survey data will undergo statistical analysis as the research team closes the participation window.

Discussion/Conclusion: The research study is valuable in gaining insight into learning about breast cancer awareness in a multi-language approach. The research team can use a translator to investigate patients regardless of language barriers. Working with Armenian-American community centers is unique because it allows them to go out to the community and recruit participants in their respective communities. Survey data can gauge awareness of breast cancer and point out areas that pose issues about gaps in healthcare education. The research can guide future policies on breast cancer awareness and education. In the future, the research findings may help people make informed decisions about their health.

A Systematic Literature Review Exploring the Integral Role of Promotoras de Salud as Puentes de Salud y Cultura within Latinx Communities in the United States

Jennifer Quiroz

In this literature review, I explore the integral role of Promotoras de Salud as puentes de salud y cultura within Latinx communities in the United States. Promotoras serve as puentes both within and outside their communities as they navigate resources and connections to meet the needs of their community. I conducted a partial systematic review of scholarly articles, utilizing keywords such as "puentes de salud," "promotoras de salud," "community health workers," "social capital," and "Latinx health”. Twelve articles and a recommended book make up the base of my analysis. From this literature, I identified the following prominent themes and subsequently explored them in this paper: puentes de la comunidad, puentes entre la comunidad, puentes cultivan social capital, la misma lucha, and desafíos de los puentes, as well as an emergent theme of puentes cultivan social capital. The dual role of promotoras as puentes entre y de la comunidad sheds light on their effectiveness in leveraging trust and social connections to disseminate information and enhance community resilience. In addition to external stressors, promotoras face the compounded struggle of navigating through the same challenges that contribute to the unmet needs faced by their communities. There are limitations to the effectiveness of los puentes hechos por promotoras as these bridges alone are not enough to overcome systemic healthcare disparities faced by members of their communities. This literature review highlights the need for future research that delves into the perspectives of promotoras, shedding light on their experiences building connections within and beyond their immediate communities to strengthen community health and reduce health disparities.

Barriers to Care and Undiagnosed Eye Diseases Among Underserved Communities: UCSD EyeMobile Study

Johoney Ronco

Background: Undiagnosed eye diseases and barriers to eye care persist as significant public health concerns among adults in underserved communities. Some of the greatest healthcare disparity was found in a study among Hispanics who often sought care depending on the severity of their symptom (Chheda et. al., 2019). This reactive approach to seeking care is often exacerbated by economic barriers that include a lack of health insurance, decreased work flexibility to receive care, and lack of transportation among adults (Goins et. al., 2005). 

Aims: Conduct a landscape analysis by reviewing existing literature on mobile eye clinics and social determinants of health in relation to eye conditions. Design a framework for data collection for the new UCSD EyeMobile for adults. Analyze the distribution of eye diseases and barriers to eye care among underserved adults in San Diego County undergoing screenings at the EyeMobile. This research project aims to investigate the distribution of eye diseases and the most common barriers to eye care among adults from underserved communities in San Diego undergoing screenings with the UCSD EyeMobile for adults. 

Methods: A literature review has been conducted which revealed that racial and ethnic minority groups are among those facing a higher risk of ocular diseases in adults aged 40 and older in the United States (Elam et. al., 2023). Being uninsured or underinsured–among other factors leads to patients utilizing eye care services less frequently (Lee et al., 2009). Moreover, the lack of work flexibility to address eye care, low health literacy, avoidance of out-of-pocket costs, and having a reactive approach to eye care further compound the burden of visual impairment within this population, resulting in their underutilization of eye care services (Chheda et. al., 2019). 

Following the literature review, data on the patients attending the Eyemobile will be collected and analyzed to further investigate the distribution of eye diseases in various communities in San Diego. Validated survey instruments will be utilized which will consist of questionnaires from the AIREADI platform and Social Determinants of Health (SDoH) from the PhenX Toolkit. 

Results: A landscape analysis revealed financial constraints, insurance status, and a diagnosis of diabetes as potentially important SDoH among those seeking vision care. 

Future expected results include a descriptive analysis of the patient population using the eye Mobile and the most common barriers to care in this population. Determination of any association of SDoH and access to eye care within this population

Conclusion: Investigating the socioeconomic factors that contribute to the disparities in seeking eye care services among various communities through the EyeMobile clinic is extremely vital for future interventions. 

Cultivating Health and Community: The Role of Community Gardening in Addressing Nutritional Disparities at the Health Frontiers in Tijuana Clinic

Joshua Holguin

The Health Frontiers in Tijuana (HFiT) clinic, founded in 2011 under the leadership of Dr. Victoria Ojeda and Dr. Jose Luis Burgos, serves marginalized communities in Tijuana's Zona Norte through a binational effort between the University of California - San Diego (UCSD) and Tijuana's Autonomous University of Baja California School of Medicine (UABC). Catering to a diverse array of individuals, including migrants from Central America, the clinic operates within Desayunador Salesiano, "Padre Chava," offering healthcare services to underserved populations. The methodology in this review involved synthesizing evidence on the interplay between nutrition, health, migration, and gardening, emphasizing policy, practice, and future research implications. Globally, malnutrition, encompassing both under and over-nutrition, is a significant concern, especially in low- and middle-income countries, contributing to health disparities. Obesity, a global concern, impacts millions, with Mexico facing among the highest rates. Dietary choices play a crucial role in metabolic syndrome development, with studies linking higher fruit and vegetable intake to reduced risk. The correlation between migration and dietary habits emerges as a critical consideration, especially among the migrant population served at the HFiT clinic. Urban gardening initiatives, such as those observed in La Mesa Verde in San Jose, California, and community gardens in Flint, Michigan, offer promising solutions to address food insecurity and improve dietary habits. These interventions, characterized by increased access to fresh produce, cost savings, and community engagement, hold particular relevance for the diverse patient population of the HFiT clinic. By establishing a community garden, the clinic can enhance food security, reduce nutritional disparities, and promote overall well-being among its patients, while fostering social cohesion and healthy dietary practices through education workshops and community involvement initiatives. However, further exploration is needed to determine the feasibility of establishing a community garden in collaboration with Desayunador Salesiano and securing funding to support this endeavor.

Assessing the Effects of the COVID-19 Pandemic on Adolescent Mental Health Globally

Jovana Durovic

Aims: Adolescence is a formative stage of development and is crucial for establishing social and emotional habits that lead to good mental health in the future. Due to adolescents being in such a vulnerable stage of development, they may be more susceptible to having long-term mental health consequences from stressors caused by the COVID-19 pandemic. The uncertainty, huge death tolls, worries for loved ones, continuous school shutdowns, and lockdowns brought on by the COVID-19 pandemic have affected the mental health of adolescents worldwide. Additionally, pandemic-related disruptions to learning have led to limited peer interactions and isolation. Adolescents are in a vulnerable time where socialization is highly necessary for their maturation, development, and health. This study aims to (a) assess the overall mental health impacts that the COVID-19 pandemic had on adolescents and (b) analyze risk and protective factors that contributed to changes in mental health in adolescents. 

Methods: Through a literature review, this study characterizes adolescent mental health outcomes globally due to the pandemic. Additionally, it identifies risk and protective factors affecting adolescent mental health during the peak of COVID-19 pandemic responses. This study utilizes three case studies to represent patterns of change in the mental health of adolescents while considering both risk and protective factors. 

Results: Evidence shows that post-COVID-19 government restrictions, children of all ages have higher rates of depression, anxiety, and post-traumatic symptoms, as is expected in the aftermath of any disaster. Some groups of adolescents are more vulnerable to worse mental health outcomes than others. Adolescents react to stress differently depending on their age, gender, socioeconomic status, media exposure, and previous mental health diagnosis. 

Conclusion: Globally, there has been an overwhelmingly negative effect on adolescents’ mental health due to the COVID-19 pandemic and governmental responses. In future pandemic responses, the mental health of adolescents should be considered when implementing any widespread health regulations.

Intersecting Vulnerabilities: A Literature Review on Homelessness, Substance Abuse and WaSH 

Karina Salcedo

Millions of people across the world lack access to safe water, sanitation, and hygiene (WaSH). This is especially true for vulnerable populations such as people who inject drugs (PWID), many of whom also identify with unhoused populations as both face multiple burdens that further exacerbate their access to basic needs and WaSH resources. The absence of adequate WaSH resources places these vulnerable populations at increased risk of developing multiple complications which include physical, mental, and emotional health effects that further reduce these populations' ability to thrive. There is limited existing research that focuses on PWID and unhoused individuals as a central population of focus, much less on how WaSH insecurity gives rise to multiple barriers that directly impact the health and well-being of these populations. This literature review, therefore, aims to shed light on a public health issue that is of growing concern by reviewing existing research and addressing the current gaps in knowledge and limitations among intersectional factors between PWID, unhoused populations, and access to WaSH resources and infrastructures. The question this literature review explores and aims to encompass is the following; what are the outcomes of vulnerable populations such as PWID and unhoused individuals experiencing WaSH insecurity? In what ways do these outcomes affect their overall health and well-being? Based on existing literature, research agrees that intersectionality exists among substance use, unsheltered individuals, and WaSH. They are all intertwined due to several structural factors that create an ongoing cycle of WaSH inaccessibility which include stigma and discrimination. Therefore, structural interventions must be implemented to alleviate the struggles and health issues of vulnerable populations experiencing WaSH insecurity.

Analyzing the Impact of Migration Policies on Migrant Mental Health at the US-Mexico Border, A Mixed Methods Approach

Maria Sophia Abueg

This mixed method study reviewed migration policies during the 2019-2023 period in Mexico and the United States and evaluated how policies shape the mental health experiences of migrants. A systematic literature review was utilized to understand the intersection between government policies and migrant mental health. This review was completed by using PubMed and Web of Science databases. Only qualitative articles that focused on migrant mental health experiences were included and a combined total of 102 peer-reviewed research articles appeared on searches. After 3 screenings of titles, abstracts, and the entirety of the article, 19 articles were included in the review. With this and using the structural violence framework, migrants' mental health is drastically and negatively affected by policies made by the US and Mexico, as they create hostile, vulnerable environments that put migrants' mental and physical health in danger. Further studies focused on migrant experiences and voices are needed to fully understand how violent structural forces such as government policies can shape the overall health of vulnerable populations.

The current scope on pterygium and the social determinants that are studied

Michael Alcazar

Aim: This study aims to identify the current understandings and misconceptions that are left in the disparities of pterygium among communities around the world. Pterygium is an ocular disease that can impact anyone who is highly exposed to the risk factors. If there are trends that have still not been identified, these will be reported as not every study completed in the past will be able to find common associations. This literature review will also serve as an educational program to help those who may not be familiar with pterygium and the distinctive ways it impacts people. 

Methods: A literature review was conducted by searching existing studies that were done in the past 10 years on any population that has been impacted by pterygium. Databases such as PubMed and CINAHL were used to find the relevant articles. The literature review search used the keywords pterygium, disparities, equator, and ethnic. A total of 34 articles were selected for review, with 27 meeting the requirements of the study.

Results: After reviewing the current available literature, health literacy and basic access to health insurance is what leads most patients to leave their pterygium untreated. Prevalence rates and statistics were used to form theories about how pterygium can affect a community’s ability to address ocular disease. Patient data that was used in the study were mostly applied to a local level and not to an international context. This is due to the different locations of the studies, which ended up being a major determinant of a person’s chances of developing pterygium, alongside behavioral and lifestyle choices.

Conclusion: While many studies were conducted among different populations, the risk factors and data suggested different conclusions that cannot all be in agreement. Drastic differences in protective factors also raised concerns among the various studies as they did not settle on a significant conclusion. To address this issue, more studies are recommended to be conducted in different areas around the world as more data will allow for trends to be more visible.

Reclaiming and Redefining Maternal Healthcare: A Journey Through the Role of Granny Midwives and Modern Midwifery 

Noa Aoyagi

Background: Maternal mortality is a major global health concern: 80% of maternal deaths are preventable, particularly among marginalized communities. Despite significant healthcare advancements, the U.S. continues to grapple with high maternal mortality rates, disproportionately affecting the Black population. 

Purpose: This literature review examines the historical evolution of maternal healthcare services in the U.S., from the Colonial Era to the present, with a focus on the significant role of Black traditional midwives or “granny midwives”. Additionally, it explores how midwifery care can help mitigate racial disparities in maternal health outcomes, supported by an informal conversation with a midwife from a non-profit birth center in Los Angeles. 

Methods: The data collection process includes systematic literature searches through academic databases such as PubMed and Google Scholar. Search terms included “Black Traditional/ Granny Midwives,” “U.S. Maternal Health Disparities,” and other related topics. No limitations were imposed on publication dates, while exclusion criteria included studies unrelated to the study’s objectives. An informal conversation from midwives was recorded, transcribed, and analyzed over Zoom. 

Results: Common themes were found in the literature, where granny midwives played an important role in serving both White and Black communities, particularly in underserved rural areas. However, their contributions were marginalized and undermined by medicalization, regulatory efforts, and institutional biases. These challenges transcend history, as modern midwifery continues to face delegitimization by medical professionals and segments of the population, despite growing recognition of its benefits. 

Conclusion: This literature review highlights the importance of acknowledging and honoring the legacy of granny midwives and the continued necessity for midwifery care. Through understanding the benefits of midwifery for maternal health care, and the historical significance and the systematic challenges faced by midwives, policymakers and health professionals can work together with midwives in promoting structurally congruent and equitable maternal healthcare services. 

Establishing Care: Analyzing transborder networks of care for asylum-seekers in Southern California-Tijuana Border regions

Zoe Slipper

In a liminal, legally and politically disconnected space as the U.S.-Mexico border, ‘asylum seekers’ cannot effectively ‘seek’ care and security after arrival to the United States without the use of immigration services and resources in bordering U.S. states. I argue that psychosocial well-being for asylum-seekers who migrate across the U.S.-Mexico border cannot be attained without the use of organized, grassroots coalitions and support networks. My project aims to understand how to improve transborder networks of psychosocial health care for displaced persons on their journeys through the U.S.-Mexico border by critically examining common issues faced by transborder network services in Southern California, mainly examining the largest transnational metropolitan space in the US-Mexico Border and busiest port of entry, San Diego, California. By collecting my data from the U.S.-Mexico Border Alliance meeting notes from convening U.S.-Mexico Border Alliance meetings held between April 2021 to March 2024, I will compare how immigration services in Southern California identify problems and work to form solutions. By creating an exhaustive list of key themes and takeaways from meeting participants, I compare each network’s priorities in place to assist the influx of migrants. I analyze transborder networks of care through the lens of a feminist critical social theory; for my project's design and methods, I engage a descriptive ethnography and a content analysis to organize the meeting document data. While there is an ebb and flow to “care” as a system inextricably linked to political, social, and economic structures, I examine the synchronic and diachronic nature of care as it pertains to transborder networks of migrant care. I analyze the flux of migrants and the issues addressed across the Tijuana-Southern California border region as a quantitative marker of need. I hope that my data collection will pinpoint recurring immigration issues in San Diego; furthermore, allow productive organization of key players and policies necessary for actionable improvements in asylum-seeker psychosocial health and well-being.

2023 Abstracts

Distraction osteogenesis: An exploration of the intersection of extreme auxological elective surgery and medical tourism in pursuit of increased linear skeletal dimensions

Daniel Hayek

Recent technological advances have resulted in a new form of extreme elective surgery named cosmetic limb lengthening (CLL). These procedures are carried out at specialized clinics in several countries and have built out a substantial online following to expand their clientele through social media outreach and advertisement. CLL involves complex invasive surgery with various risks, prolonged recovery with rehabilitation, substantial post-operative complications, and is extremely expensive with little to no insurance coverage available. Media marketing coupled with online forum activity has fed a narrative of this surgery being an option for those with the proper economic means who qualify for surgery. However, to qualify as a candidate there are significant mental health concerns being largely ignored. Such a radical procedure that requires high levels of not only financial and time investment, but also pain tolerance, is indicative of symptoms of body dysmorphia. Unfortunately, many of the most prominent clinics take a lackadaisical approach to screening clientele for this chronic condition and have taken to naming those in search of surgically altering their adult height as merely suffering from height dysphoria. This study involved a literature review of the available academic information on these procedures and their consequences. In addition, systematic searches into various popular online social platforms were conducted to analyze themes of social interaction. This procedure has a documented history of complications and its growing popularity is placing patients in need of mental treatment at greater risk of peril and permanent harm. The results of this study point towards the increasing popularity of the procedure amongst young men while simultaneously indicating that awareness of the extreme risks and associated mental health issues remains low. While this procedure remains legal and available to those of adequate financial means who pass for surgical qualification, its invasive nature and high risks should raise larger societal questions about the negotiation of bodily agency and the permissibility of permanent extreme elective surgery. Further research at the academic level is warranted to explore the disturbing links between the mental health of young men and the growing prevalence of this procedure. 

Factors Associated with HIV Testing among Young Adult Probationers in Southern California

Melissa Bittencourt Jaeger

The transition period from incarceration to community reentry is a critical time when individuals face numerous challenges, including housing instability and disrupted sexual networks, increasing their risk for HIV and other STIs (Wise et al., 2019). Coping with these challenges can lead to engaging in risky behaviors, such as multiple sexual relationships, intravenous drug use, and transactional sex for drugs or money (Gordon et al., 2018). Despite being at increased risk, many individuals on probation and parole do not receive HIV testing, and some refuse testing due to concerns about stigma and discrimination (Gordon et al., 2013; Lichtenstein & Barber, 2016). However, limited research has explored the specific factors that influence HIV testing among young adult probationers enrolled in health-focused reentry programs. 

The study aims to identify demographic and personal factors associated with HIV testing among young adult probationers in the UCSD RE-LINK program and explore barriers and facilitators to testing. 

The study used data from the UCSD RE-LINK program's health-focused reentry coaching pilot program. The survey included questions on demographics, personal factors, and HIV testing history. Descriptive statistics and odds ratios were used to analyze the data. 

The study analyzed data from 151 young adult probationers between the ages of 18 and 26 who participated in the six-month health-focused reentry program in South San Diego County. The majority of participants identified as male (79.5%), with 53% identifying as Latinx/Hispanic and 24.5% as African American/Black. Food insecurity (34%) and housing insecurity (42%) were also reported by participants. 

The study found that 28% of participants reported never having received an HIV test. Odds ratio analysis revealed that females were almost 7 times more likely to have been tested for HIV compared to males (OR=6.98; IC 95%: 1.58-30.76). Young adults between the ages of 21-23 and 24-26 had almost 3 times (OR=2.90; IC 95%: 1.22-6.92) and over 6 times (OR=6.28; IC 95%: 2.35-16.77) the odds of being tested for HIV, respectively, than young adults between the ages of 18-20. Individuals who had experienced a traumatic event had over 4 times the odds of having been tested for HIV (OR=4.03; IC 95%: 1.55-10.46). In contrast, participants who had selected "Other type of ID" had lower odds (OR=0.21; IC 95%: 0.06-0.79) of having been tested for HIV. 

The findings emphasize the need for targeted interventions to improve HIV testing rates, particularly among young adult probationers. Public health programs and policymakers can focus on implementing targeted interventions that address the identified demographic and personal factors associated with HIV testing, such as gender, age, and history of trauma. Efforts should also be made to increase access to identification documents, which may enhance testing rates. 

Exploring the Peer Support Spectrum: A Systematic Review of Peer Support Models used at Higher Education Institutions

Isaac Lara

Within the last decade, the prevalence of mental illness has significantly increased, with the World Health Organization reporting that 1 in 8 people live with a mental disorder, globally. Despite the increasing prevalence of mental illness and the need for mental healthcare treatment, the mental health workforce lacks the capacity to meet the present need for care. The Peer Support model offers an innovative approach to rapidly expanding the mental healthcare workforce by integrating those with lived experience with mental illness into the economy of care for mental health patients. Peer support has been implemented to varying degrees across colleges and universities. The present study will assess the uses and limitations of common models of peer support utilized in higher education settings. 

Characterizing The Socio-Cultural Barriers to Abortion in The Border Regions of Mexico: A Literature Review

Zachary Manalo

In this Non-systematic Literature review, we aim to analyze the social, legislative, and medical barriers that make abortion such a dire health issue. We will describe the current methods of abortions available to patients in Mexican border communities, and how the current Mexican legislature may influence accessibility. Furthermore, we intend to make preliminary connections with the United States and describe the increasingly retrieve legislature surrounding such procedures. Finally, we provide insight into the future of abortion in Mexico and what the United States can learn from having legalized abortion despite the backlash based on the philosophical ideologies of religious institutions.

The health system in Mexico is fragmented and complex leading to great diversity in abortion outcomes. Nevertheless, the recent decriminalization of abortion within the first trimester is predicted to increase the rate of abortions in Mexico slightly. In addition, the current legislation within the United States has gone in the opposite direction making abortion more inaccessible. In a new paradigm in abortion within America, the United States can learn a great deal about how abortion clinics are manufactured despite the many moral and ideological contradictions.

More research must be done to investigate the health framework of the entire country. Abortion since its specific legalization in the 1990s had paved the path possible into the current political sphere of abortion. There must be more work done in the regulation of these surveys, and the evaluation of medical professionals after such programs. 

The Prevalence of Depression Among Older Adults in Tijuana

Vaishnavi Melkote

This systematic review aimed to identify the risk factors for depression among the older adult population in Tijuana and identify the structural barriers that prevent the population from receiving accessible mental healthcare. 

A search was conducted on Google Scholar and PubMed with the keywords including “depression”, “older adults”, “Tijuana”, “Red Light District”, “determinants”, “Zona Norte”, “Mexico”, “mental health”, and “barriers to care”. Nine peer-reviewed papers and articles published between 2000-2023 were considered. Older adults were defined as 60 years of age and above. Literature that did not identify risk factors or discuss barriers to depression care in Tijuana concerning the older adult population was excluded. 

Older adult depression risk factors identified in the search include being female, having no intimate partner, having low or no levels of education, lacking decision-making power in household finances, having disabilities, experiencing psychosocial stress, insomnia, a decline in physical functioning, and having no support. High-risk environmental stressors that many of Tijuana’s migrants and asylum seekers experience include violence, poverty, and natural disasters. High rates of sex work, homelessness, socioeconomic deprivation, and substance usage in Tijuana’s Zona Norte are also risk factors. A lack of mental healthcare workers and/or trained professionals, poor distribution of resources nationwide, cost, and transportation are significant barriers to care in Mexico. 

Research on the prevalence of depression among the older adult population in Tijuana is limited. Current literature mostly identifies risk factors for depression among structurally vulnerable populations by considering a wider age range of 18 years and above. Additionally, there is a lack of data regarding the barriers to depression care pertinent to the older adult population in Tijuana. Existing literature regarding structural barriers is generalized to Mexico and therefore does not consider the variables unique to Tijuana such as its location close to the US-Mexico border." 

A Retrospective Analysis of the BMI of Patients at the HFIT Clinic in Tijuana, Mexico

Andres Angel Rivera

Obesity is a global issue that disproportionately affects individuals experiencing poverty within high-income countries. BMI (Body Mass Index), is the standard measure for indicating a healthy weight or an unhealthy weight, such as underweight, overweight, or obesity. Most patients at the HFIT (Health Frontiers in Tijuana) clinic consist of underserved populations, including migrants, deportees, homeless, sex workers, and other groups who experience poverty. The aims of this study are to analyze the BMI data of the patients at the HFIT clinic in order to determine if they are at higher risk for obesity compared to other populations. The methods for this retrospective analysis study consisted of analyzing BMI, sex, and age data collected from a random sample of patients whose height and weight were measured during medical evaluations at the HFIT clinic within the past year. Height and weight data was converted to BMI using the equation, kg/m². The average age of male patients in the study was 40.5 years old with an average BMI of 25.22. The mean female age was 44.1 years with an average BMI of 26.42. The age-adjusted obesity prevalence was 42.9 percent for patients aged 20-39 years and 12.5 percent for patients aged 40 or older. Within the United States, the mean BMI is about 26.5, which is classified as overweight. According to the CDC, the age-adjusted obesity prevalence amongst US adults is 39.8 percent for ages 20-39 and 44.3 percent for ages 40 to 59 years. In comparing the BMI data of the HFIT clinic to the US national average, there was a 5 percent increase in obesity prevalence amongst HFIT patients aged 20-39 years, but for ages 40 and above, there was a significant decrease in obesity prevalence. 

Cleft Lip and Palate in Vietnam: Disparities, Surgical Care, and Future Recommendations

Edward Andrew Schneider

Cleft lip and palate - which can occur in isolation or co-occur - are among the more common birth defects and can have significant implications for a child’s health if left untreated or treated improperly.  Surgical treatment for cleft lip and palate is complex and resource-intensive, leading to disparities in access to care for this condition in many underserved contexts worldwide, including in Vietnam.  This project seeks to understand existing disparities in cleft lip and palate care in Vietnam and past efforts to address the issue and concludes with recommendations for future efforts to address current disparities.  A literature review through the academic article database PubMed was utilized to explore the issue at hand — articles were refined through a search to include results from within the last fifteen years.  The extant literature indicates that a combination of genetic, environmental, and social factors drives a high rate of cleft lip and palate in Vietnam and that significant disparities in access to care for this condition currently exist in this region.  Short-term, often charity and volunteer-based, medical missions have been utilized in the past in an attempt to provide surgical care for cleft lip and palate in Vietnam.  This approach lacks the level of follow-up care that is needed to obtain optimal results for cleft lip and palate surgery.  The literature from Vietnam, as well as literature on cleft lip and palate care in general, indicate that measures such as capacity-building efforts and the direction of funding towards this issue represent the best steps towards achieving equitable access and optimal outcomes for cleft lip and palate surgical care in Vietnam. 

Trapped in a WASH cycle": Unsheltered individuals’ access to water, sanitation, and hygiene (WASH) and its impact on mental health and stigma 

Nina Suh-Toma

How does unsheltered individuals’ access to water, sanitation, and hygiene (WASH) affect their mental health and their experience with stigma?

Unsheltered individuals experience unique barriers to accessing clean water, adequate hygiene, and sanitation. Existing literature indicates WASH inequities experienced by people experiencing homelessness in the United States (Ballard et al., 2022). In addition, people experiencing homelessness have higher rates of poor mental health and substance use compared to the general population (Adams et al., 2022). However, there are gaps in research around the intersections between WASH access, drug use, mental health, and stigma experienced by unsheltered individuals (Leibler et al., 2017). Drug use may further complicate or exacerbate a lack of WASH access and poor mental health. To address this research question, a literature review using key search words and phrases such as “homeless,” “unhoused,” “water, sanitation, and hygiene,” “mental health,” and “stigma” was conducted through various article databases. 

The results support that unsheltered populations lack access to basic water and sanitation at significantly higher rates than those in the general urban U.S. population. The adverse impact of inhibited WASH access on the mental and emotional health of unhoused people indicates a cycle in which limited WASH access/behaviors worsens health outcomes and worsened health outcomes further limits adequate WASH access (Adams et al., 2022). Stigma experienced by unhoused individuals related to or as a result of poor WASH access can be explained by various theories linked to social norms and biases that often ignore structural issues faced by unsheltered populations. 

As the rates of homelessness continue to rise in the U.S. and the threat of infectious diseases such as COVID-19 is ever present (Capone et al., 2020), the issue of WASH access among unsheltered individuals is an urgent public health and human rights issue. The results of this study can shape policy and interventions at the local and national levels that recognize the health of people experiencing homelessness in a more comprehensive way. Gaining a better understanding of the mental health effects and stigma from lack of adequate WASH challenges simplified, prejudiced, and incomplete notions of homelessness, can pave the way for more equitable and sustainable solutions to this growing crisis. 

Sociocultural and Economic Drivers of Self-Medication: How Self-Prescription of Antibiotics Leads to Antimicrobial Resistance in Vietnam and India Using the One Health Approach 

Kacey Tran

Antibiotic resistance, or antimicrobial resistance (AMR), represents a rising concern in global health that threatens one’s ability to treat and prevent common infectious diseases. Resulting from antibiotic overuse or misuse, the practice of self-medication (SM) and self-prescribing of antibiotics fuels the emergence of drug-resistant bacterial infections and further harms population health, especially in low and middle-income countries (LMICs). The aim of this literature review is to assess the prevalence of self-medicating with antibiotics in two LMICs, Vietnam and India. For this review, using the One Health Model will highlight a transdisciplinary approach to optimizing the health of all affected by AMR, including individuals, animals, and the environment. Examining both qualitative and quantitative studies, various authors discuss patterns of SM behaviors and implementation of pharmaceutical regulations in both countries; however, there must be a further examination of the drivers behind these practices. Although much of the current literature provides suggestions for regulation reforms, both Vietnam and India still face a high prevalence of AMR because of social and economic drivers in four ways: structural and communal perceptions of antibiotics as a strong, effective, and convenient alternative to visiting their providers, improper use and disposal of antibiotics, barriers to accessing appropriate healthcare, and pharmacists facing demand-side pressure from consumers. Between individual interest, economic influence, and the lack of regulation enforcement, community-based interventions are essential to reduce antibiotic use at the community and individual levels, rather than relying solely on governmental oversight. Having socially engaged public health interventions, such as campaigns and educational materials, simultaneously engages with community values and structural beliefs and disseminates information about antibiotics and their risks. AMR is a global threat that must be addressed urgently and it will take more than regulatory oversight to control it in LMICs, such as Vietnam and India.

2022 Abstracts

"Association Between Acculturation/Acculturative Stress and Healthcare Seeking Behaviors of Iraqi Refugees" 

Khadiga Fouad

The current refugee crisis is the most pressing global challenge, threatening the safety, well-being, and quality of life of 80 million forcibly displaced individuals. Refugees’ experiences of pre- and post-migration trauma, post-migratory stressors, the additional burden of resettling in a new country, and a history of mental illness make the acculturation process of refugees unimaginably difficult and taxing, both mentally and physically. There is a lack of research exploring acculturative stress as a barrier to seeking healthcare. Participants in this study consisted of 213 Iraqi refugee women resettled in San Diego, California. The Social, Attitudinal, Familial, and Environmental Acculturative Stress (SAFE) scale was used to assess acculturative stress in the sample. Healthcare access, history of mental illness, and demographic information were also collected. Statistical analyses included analysis of variances (ANOVAs), Tukey post-hoc pairwise testing, t-test procedures, and chi-square tests of independence to determine the association between acculturative stress and healthcare access. A Directed Acyclic Graph (DAG) was constructed to represent the focal relationship and confounding variables. Quantitative analysis indicated higher levels of acculturative stress were associated with lower levels of education, increased financial strain, history of mental illness, and seeking mental health care. Predictors of acculturative stress, specifically increased financial strain and history of mental health, were also significantly associated with putting off, postponing, or not seeking medical care. Furthermore, those with higher levels of education were more likely to be dissatisfied with the U.S. healthcare system and prefer receiving treatment from healthcare providers of the same race or ethnicity. The results of this study highlight the barriers to accessing healthcare services refugees face upon resettlement. An understanding of these barriers will help with targeted interventions to ensure the health and well-being of refugees. Future research should examine qualitative reasons why refugees postpone care.

“Barriers and facilitators to substance use treatment engagement for the heroin-based drug Whoonga: Qualitative evidence from South Africa” 

Emily Hardy

Whoonga is a smoked, heroin-based street drug in South Africa. Also known as nyaope, its use poses a significant health and public safety problem for South African communities. Prior studies have shown that opioid-related treatment admissions have increased, but nothing is known about barriers and facilitators to treatment access. In 2015, semi-structured interviews were conducted with 30 men who smoked heroin while undergoing residential substance use treatment. In 2017, an additional 10 men and women with smoked heroin use were recruited from the social networks of participants in residential substance use treatment. Participants were interviewed about their experience with the drug and in accessing substance use treatment. Interview data were coded using qualitative content analysis. Barriers to treatment were stigma, addiction, and availability. Methadone was a facilitator of treatment maintenance. A supportive family helped to overcome barriers of stigma and availability, but many participants had experienced times in their lives when they were alienated from their families. Participant experiences did not appear to differ based on race/ethnicity. There were a variety of social, structural, and biological forces that served as barriers and facilitators to substance use treatment. Further research evaluating methadone maintenance outcomes and treatment availability is needed. Familial and social relationships were highlighted as motivators for substance use treatment maintenance. Interventions addressing the social and biological forces of addiction will be needed to promote substance use treatment engagement.

“Making the Invisible Visible: Skin Cancer Obfuscation in South Africa”

Darren Harms

Skin cancers, among the most common cancers worldwide, have rapidly increased over the last fifty years, contributing to the overall global burden of disease. In the Republic of South Africa, skin cancer rates have skyrocketed, but little to no interventions have been put in place to promote the detection of this relatively neglected disease category. Currently, there is no global consensus on how to institute the screening of skin cancers, which is further complicated by the lack of awareness on diagnosing skin cancer among darker-skinned populations. Differences in skin pigmentation affect how patients inflicted with malignancies, such as Kaposi’s sarcoma, Merkel cell carcinoma, and melanoma are diagnosed. The resources for skin cancer surveillance on a global level rely on three main mechanisms: the Global Initiative for Cancer Registry. Development, the Skin Cancer Foundation, and AIM at Melanoma. While these initiatives work to educate the public on the importance of skin cancer prevention, these organizations lack the necessary tools to expand healthcare resources in skin cancer surveillance. This thesis examines how skin cancer has been rendered invisible in South Africa at three different levels: the impact of skin cancer on the body, within national public health infrastructures, and global policies put in place for the surveillance and monitoring of this disease. Broadening options for the prevention and treatment of skin cancer among more diverse populations than those currently reflected in dermatology textbooks need to be implemented for further education and screening purposes.

"Vaccine Development in the Age of Fake News: A Qualitative Content Analysis of Misinformation on the Pediatric COVID-19 Vaccine by Verified Minority Twitter Users"

Nicolette Le

False, unvetted, and misleading information about COVID-19 is regarded as a major threat to public health and vaccine confidence. Prior studies have identified Twitter as a major channel of COVID-19 misinformation. Little research has been done on the sentiments of minority communities on Twitter. Tweets were collected from the Twitter API using keywords related to the COVID-19 pediatric vaccine. From this, the 200 most retweeted tweets were subjected to manual content classification to identify tweets with explicit vaccine misinformation that are authored by Twitter-verified minority users. Direct replies to these tweets were also collected for qualitative content classification. A total of 863,007 tweets were collected. Four misinformation-labeled tweets were authored by Twitter-verified minority users within the Top 200. The themes identified were “vaccine development conspiracy,” “vaccine is experimental,” and “vaccine is a control tactic”. 156 relevant replies were examined. 72% agreed with the misinformation presented. Common among replies were concerns for child safety, calls for resistance, and further discussions of conspiracy theories. The results of this study provide insight into online sentiments surrounding the COVID-19 pediatric vaccine and, specifically, organic user reactions to explicit vaccine misinformation by Twitter-verified minority users. Further research is needed to understand how dissemination of misinformation occurs within marginalized communities and by members of marginalized communities.

"Examining the Determinants of COVID-19 Childhood Vaccination Decisions: the Role of Protective Behaviors Adherence and Burnout"

Gabriela Stone

This mixed-methods study investigates associations between the COVID-19 pandemic, emotional health, and physical health to understand what factors mediate the relationship between burnout and adherence to protective behaviors. Qualitative analysis utilized 15 semi-structured focus group discussions of school staff (n= 22) and parents (n= 20) conducted between December 2020 and March 2021 in English and Spanish within San Diego County. The quantitative analysis utilized a cross-sectional survey administered in 2 waves (February and March 2022) of parents’ pandemic experiences (n= 541) conducted in English (n= 382) and Spanish (n= 159). The study population was participants from school sites partnered with Safer at School Early Alert (SASEA) and located in zip codes of high social vulnerability according to the California Healthy Places Index. Qualitative analysis revealed themes such as mental distress, fear regarding learning loss, concern for the physical and emotional well-being of children, misinformation and miscommunication, economic uncertainty, and perceptions of structural barriers as important for protective decision-making. Two models were created for the main outcomes of interest in the quantitative data, vaccination of children and parent mental health. Variables significantly associated with vaccination uptake of children included perceived risks, vaccination status of parents, flu vaccination willingness, child age, masking behaviors, and family income. Variables significantly associated with parental burnout included the child’s mental health, housing instability, identification of misinformation, child masking behaviors, and income. Facilitators and barriers for vaccination uptake of children were also analyzed and disaggregated among each survey wave, and by language (English and Spanish). This study confirms key mediating variables in vaccination uptake of children and parental burnout associations with protective behaviors, highlighting the importance of adjusting promotion strategies accordingly to boost vaccination uptake and bolster mental health responses.

2021 Abstracts

"For and by Communities: An Assessment of Feasibility for a Novel International Healthcare Program in Rural Ghana and Nigeria"  

Rebecca Noelle Donham

Residues of Global Health’s origins in tropical and colonial medicine remain central in the framework of international medical outreach—trips in which students and practitioners arrive in other countries to impose health aid. In hopes of redirecting such aid in a manner that also builds community autonomy, twenty-six partnering communities across rural Ghana and Nigeria developed a novel healthcare system proposal that impresses community voice as imperative while collaboratively working with international volunteers. This thesis seeks to exemplify this framework of community-driven efforts by working at the request of these communities to investigate the legal frameworks and technological precedents salient to the implementation of their program proposal. A grey literature review of legal documents from Ghana, Nigeria, and the United States, as well as a review of international codes and technologies, finds that the proposed program is both feasible and supported by the current infrastructures related to all healthcare governments. While further steps are required to initiate the proposed program, the example it leaves is one towards a community-driven framework. 

“Pediatric Trauma in the California-Mexico Border Region: Injury Disparities by Area Deprivation Index”

Alicia Gaidry Sykes

"Osteoarthritis in Asia: A Literature Review"  

Nhi Nguyen

Osteoarthritis (OA), an age-related disease of the joint characterized by progressive cartilage degradation and chronic pain, is a leading contributor to disability. The prevalence of OA is increasing worldwide with global population aging. The rise in OA prevalence is especially concerning for many Southeast and East Asian countries with unprecedentedly rapid population aging. This literature review aims to explore the OA prevalence and risk factors, the OA lived experience, and the OA situation in Vietnam and Japan in the Southeast and East Asian regions.  Knee and hand OA are highly prevalent in Southeast and East Asia and are associated with diverse biological, behavioral, and social factors such as age, sex, body mass index, occupation and educational level, and sociocultural activities. The OA lived experience is highly variable and characterized by limited knowledge of OA and OA management; pain and disability impact physical, sociocultural, and psychological health; and self-management of OA.  Finally, a closer look at the OA situation in Vietnam and Japan revealed more challenges for OA management in Vietnam, and most challenges lie in the Vietnamese healthcare system. Learning from Japan, we recommend that Vietnam consider implementing a long-term care insurance system to support OA patients with disability, in addition to promoting public awareness of OA and OA prevention/ management. 

"Structural Gender-Based Violence and Unresolved Trauma: Power Structures and Social Dynamics that Influence the Migration of Women Fleeing the Northern Triangle Countries of Central America" 

Francisca Rivera

Guatemala, El Salvador, and Honduras share a volatile history of fostering structural systems that sustain extreme violence against women, sanctioning the normalization of gender-based violence. Given the precarious environmental conditions of women fleeing the Northern Triangle regions, contextualization of their lived experiences, as they navigate the duality of caretaker and survivor during the migration decision-making process, is of the utmost importance in ensuring mental health wellness. Therefore, understanding trauma exposures during the migration journey, pre-, during, and post-flight periods, also known as the triple trauma paradigm, is necessitated. Through an in-depth literature review and synthesis of existing qualitative data, this thesis provides a conceptual framework to further understanding of how structural violence towards women increases their exposure to trauma throughout their lives, subsequently, increasing the probability of intergenerational trauma. Although the available literature documents migrant experiences, current research lacks an emphasis on migrant women’s experiences of structural gender-based violence, unresolved compounded trauma, and how those experiences influence their mental health outcomes. The appropriate contextualization of migrant women’s mental health encumbrances has both immediate and long-term implications on the establishment of appropriate intervention strategies explicitly tailored to the diverse mental health care needs of migrant women. As the number of women migrating to the U.S.-Mexico border region increases, it becomes increasingly critical to highlight the rising global mental health challenges they experience, which have societal and public health implications for migrant women’s life trajectories, and influence their ability to endure the challenges of transnational migration and resettlement in the U.S.  

"What Medical Schools Don't Teach You"

Rachel Kai-Xin Yim

In response to the murder of George Floyd, confrontation with the violence of racism in all its forms sparked protest and conversation across the country. As a student hoping to go to medical school, I watched how this discussion traveled or did not travel, into medicine. As a future medical professional, I hoped that my professional development would include building capacity to combat the racial injustice that frequently undermines medical care. As critical race studies scholars’ have powerfully documented, mere exposure to these lessons is insufficient to create medical professionals who can transform these into their everyday clinical practices.

My project draws on the work of Linda Tuhiwau Smith, David L Brown & Rajesh Tandon, and Eve Tuck on decolonial and antiracist qualitative methodologies to highlight the urgent need to transform existing medical school curricula towards more socially and racially just frameworks. Through a literature review, medical school analysis, lecture analysis, survey, and semi-structured ethnographic interviews on students who are already engaged in equity, diversity, and inclusion work in the medical school, my findings call upon the Medical School’s leadership to take further decisive actions against structural racism and anti-Black violence that plagues underrepresented communities. 

This project reveals how focusing on race in the formal medical school curriculum is inadequate because so much of medical school is informally taught outside of the curriculum. These aspects of the hidden curriculum are not being addressed by proposed curricular changes through programs such as PRIME. Even when the medical curriculum does address race, it does so in ways that reinforce racist ideas (race as a biological determinant of health). The lack of understanding of how racism is embedded in existing institutional structures, the history of medicine, and medical racism, are not at all addressed. Further, the microaggressions experienced by students of color both inside and outside the classroom require deeper cultural transformation. This project also calls for the need for antiracist and social justice work to be truly collective, to be the responsibility of each and every medical professional, rather than the burden of a few. Rather than a “choice” or “option,” all students and staff must learn how to integrate knowledge of racism and colonialism in their training. Currently, the structure--which emphasizes individual volunteers to take on this work--causes certain students who take on this work and who encounter difficulties and resistances to blame themselves, while white students (or students not in the PRIME program) are able to overlook structural violence and other health determinants.

2020 Abstracts

“Detecting Electronic Cigarette User Disparity Behaviors: An Infovelliance Study on Twitter”

Cortni Bardier

The study aimed to observe racial and ethnic disparities among electronic cigarette use by detecting and characterizing user-generated conversations about electronic cigarettes on social media platforms. The investigative approach was through a literature review, analyses of NHANES data, and data collection of geocoded tweets from Twitter. A total of 5,718 tweets were collected. Using BTM output to identify relevant clusters about electronic cigarettes, 348 tweets were identified to include conversations about user behavior. These tweets were grouped into three categories and matched with a map to see where conversations were located for a racial-ethnic component. The results of the study provide insights into organic conversations regarding user behavior of electronic cigarettes. Future studies should focus on other themes and topics associated with electronic cigarettes on social platforms to inform health communication and global public health.

“Healthcare Worker Preparedness Among Clinicians Treating the Forced Migrant Population”

Tiana Mcmann

In the midst of the forced displacement crises, the proliferation of resources and healthcare services is the cardinal focus to address the acute needs of those displaced. While much data is provided regarding the volume of refugees and asylees and the necessity for medical services, far less information exists discussing healthcare workers and their preparedness in dealing with the acute needs of those they are treating. Of those that have, many challenges are identified in all aspects of a healthcare provider’s experience of treating displaced individuals. While healthcare workers are vital to aid in the critical needs of refugees and asylees, this can be more effectively accomplished when they are equipped to handle the unique health needs they encounter. The current study explores healthcare providers' preparedness in treating refugee and asylum seeker populations within San Diego County and how the level of preparedness affects the treatment delivered.