Alumnae/i Theses and Current Positions

Hicks, Lauren. 2023. Living at the Intersection of Illness, Healing, and Discrimination: Care for Black Women with Physical and Mental Health Conditions.

In this thesis, I will argue that the identity of Black women with mental and physical health conditions affects how others perceive and treat them in clinical, social, and occupational spaces, which in turn influences the paths these women take to seek healing. Black women choose to identify to various degrees with social categories such as disease and race. The identities that an individual accepts affect how they are perceived, and this perception of who they are, which may or may not match with their internal beliefs, affects how they are treated. This extends to clinical spaces, where treatment of a patient is reflected by the doctor-patient relationship. It also extends to social and career-based settings, where women experience acceptance or rejection due to the way others see them. This perception-based treatment and the identity that these women claim factor into the importance of certain healing methods in their lives.

Streib, Catherine. 2023. The Precarious Wellbeing of Resettlement Providers.

Refugee Resettlement Agencies in the United States make headlines because of the people they help, but what about the immigrant support providers doing the work? In Boston and Worcester, Massachusetts there are organizations that open their doors to newly arrived people needing assistance. The purpose of this case study was to explore the experience of working as a resettlement provider for immigrants in Massachusetts between 2016 and 2021. I argue that Donald Trump’s policy decisions were a form of structural violence against and experienced by the resettlement organizations contracted to the federal government to assist refugees.

Preliminary literature reviews showed research on refugees was saturated. A few articles discussed psychological impacts on providers in a clinical setting or presented quantitative analyses of immigration statistics. My research is a novel ethnographic case study of resettlement organizations. This study was conducted over three years during the COVID-19 pandemic. I examined the effect of changes to the body-politic, the social-body, and the body-self levels of experience. By using a holistic model of health, I connect these experiences to the physical, social, and psychological dimensions of wellbeing.

Throughout the fourth chapter, I argue that Trump’s pernicious executive policy decisions were intentional acts of violence against resettlement organizations across the United States. The anti-immigrant rhetoric in the media and policies, combined with increased xenophobia withdrew vital physical and social resources for providers. This created a shift in the hegemonic forces in the United States that impacted organizations and refugees alike.

Chapter Five argues that Massachusetts resettlement organizations were impacted through implicit effects at the state and community levels. As the pressure of their work increased and their community relationship became more complicated, their precarity was compounded by COVID-19. This is illustrated through the starvation of the social-body and subsequent re-feeding they experienced. Finally, Chapter Six argues that individual resettlement providers experienced a state of precarious wellbeing. They had to develop creative coping mechanisms to work through the precarity after being flooded with new arrivals. The providers embodied this precarity on a personal level, though not passively. They pushed back against the Trump Administration’s violence through interagency legal action, solid community partnerships, and individual coping mechanisms.

Clark, Halle. 2022. Medical School Curriculum and Patient-Centered Care.

Patient-care skills in medicine have become more important over time to promote the health and well-being of patients. It has become critical to research how medical schools can best teach students patient-care skills. This is a mixed-method study on the experiences of first and second-year Boston University School of Medicine students and faculty about the relationship between their medical school curriculum and patient-centered care skills including communication, empathy, and the cultural context of care. Patient-centered care and its accompanying skills (empathy, communication, and cultural context of care) are supported and developed at the Boston University school of Medicine. These skills are promoted through curricular adaptation influenced by changing concerns within biomedicine. As well as Doctoring 1 and 2 courses, their patient-actor events, and the development of students’ professional physician identity. Methods will include participant observation and review of curriculum and program documents. This study also includes surveying first and second-year students and in-depth interviews with students and faculty. The conclusion of this study is the importance of evaluating medical school curriculum as it relates to patient-centered care skills, and particularly how those skills are utilized in the clinical world.

Grossmith, Samantha. 2022. Trauma and the Art of Healing: Examining Pathways of Coping and Healing for Women Experiencing Poverty and Homelessness.

This study sought to examine pathways of coping and healing for women experiencing homelessness and poverty in the Boston area. Data was collected through participant observations of shelter dynamics, semi-structured interviews with shelter clients (referred to as “guests”), card-sorting activities in which participants were asked to rank self-generated cards for support groups, coping mechanisms, and internal selves across a range of situations, and a free association task, which involved having participants submit whatever self-generated cards of the above groups they associated with the terms “health,” “safety,” “shame,” and “pride,” respectively. Results were subsequently organized into three analytical chapters representative of the three levels of physiological response to threat. The first level of analysis looks at social engagement in the form of receiving and giving care. The second level examines expressions of rage and how these contribute into cycles of isolation, violence, and suffering. The third level further explores these dynamics within the realm of grief and erasure. The final chapter of this thesis then discusses the implications of these areas, as well as some suggestions for how to improve or potentially intervene in the perpetuation of these cycles, with a focus on how to emphasize healing while decreasing the need for coping.

Ranger, Marah. 2022. Faith-Based Resettlement Agencies: The Intersections of Faith and Well-Being.

Many of the local resettlement organizations in the United States are faith-based organizations (FBOs). This research explores the role of faith in these organizations and its effect on the well-being of the volunteers and the community they serve. I conducted fieldwork and interviews with staff, volunteers, and clients at FBOs that serve refugees and asylum seekers in the Boston and Greater Boston area. Although these organizations are based in faith, I discovered a complex variety of practices, expressions and understandings of faith that shaped complex interactions, experiences of the organization, and understandings of well-being. I have found that there are a variety of experiences and motivations that shape faith that affect various components of these organizations, such as public presentation, interactions with clients and decision making, and can affect individual experiences of resettlement and well-being.

Schafroth, Jamie. 2022. Contested Suffering: Navigating Care and Making Meaning from Gendered Violence.

Unequal, gendered power relations drive gendered violence, disproportionately affecting vulnerable populations. A paucity of research compares knowledge produced by people who experience gendered violence to their technocratic representations. An analysis of fieldwork data collected virtually through a community-based advocacy program and semi-structured interviews (n=23), shows that survivors and service providers utilize and contest gendered discourses, like constructions of victimhood and survivorship, and policies ostensibly designed to facilitate care in conjoined and distinct ways. I also demonstrate how care systems structure the lives and subjectivities of people who travel through them, producing forms of contested and moralized citizenship. However, people actively resist these forces by creating their own care systems outside the context of managed care. Adopting harm reduction strategies (e.g., affirming people as the primary agents of their care), addressing structural factors underlying gendered violence, and increasing inter-agency communication will create inclusivity and streamline care pathways.

Subedi, Sangeeta. 2022. Reimagining Kinship: Explorations of QTPOC Family and Reproductive Health.

The model of the biological nuclear family is deeply embedded in the American cultural imaginary. The privileging of this model – through healthcare systems, legal systems, and the media – contributes to the erasure of diverse family forms that exist among marginalized communities. In this study, I focus specifically on the experiences of family among queer and trans people of color (QTPOC), who have been actively excluded from normative reproductive processes at the intersections of race, gender, and sexuality. I ask the following questions: 1. How do QTPOC think about family and make decisions about whether or not to have children? How do QTPOC describe their experiences with reproductive health services, specifically those pertaining to fertility and family planning? What barriers do QTPOC describe facing in their family formation processes? Through an analysis of 11 semi-structured interviews, participant observation, and media analysis, I find that QTPOC contest raced and classed expectations for family, imagining a form of kinship that blends biological, extended, and chosen families. However, they also face pressure to adhere to normative models of family and encounter micro- and macro-level barriers to actualizing their ideal family forms. I therefore call for reproductive healthcare systems, as well as legal systems, to reconceptualize family and support QTPOC kinship outside the bounds of cisheteronormative nuclear family.

Hyman, Jason. 2021. Immigration as a Structural Determinant of Health: Embodying Clinical Competence for Treating Im/migrant Patients.

The aim of this thesis is to argue what it means to embody clinical competence for treating im/migrant patients. Im/migrants are a distinct yet heterogeneous patient population. They come to the U.S. for a variety of reasons, with a great diversity of backgrounds, upbringings, experiences, and ways of life. Considering the structural violence and push and pull factors directly connected to reasons for im/migration and experiences of distress upon settlement in the U.S., the central framework of this thesis is im/migration as a structural determinant of health. The operations of social structures, through policy, law enforcement, and discriminatory belief systems, make im/migrants structurally vulnerable. When healthcare providers treat im/migrant patients from a structurally informed approach to care, the context of these patients’ needs become more apparent and likelihood of positive health outcomes increases. Central to this structural approach, as I explain, is understanding how to best communicate with, gain the trust of, and provide effective social interventions for im/migrant patients relative to the operations of violent social structures. Im/migrant status truly is a determinant of health in its own right, and accordingly, care for im/migrant patients is also a specialized clinical realm with specific skills and competencies. As I argue, healthcare providers can only attain—embody—the competence for treating im/migrants through an awareness of how social structures affect these patients’ lives and modifies the delivery of care.

Mallick, Kamini. 2021. Bonded in Crises: Youth Activism in the Face of COVID-19, Racial Injustice, and Climate Change.

This is a year-long ethnographic study of high-school student activists in the New England area that examines youth perceptions of climate change and climate change activism. Our society often devalues the opinions and experiences of young people because of the intersecting marginalized identities they inhabit, including age, race, and gender. Thus, discussions on how climate activism affects youth tend to lack the perspective of the young people themselves. Through a combination of participant-observation and semi-structured interviews, I sought to answer the following research questions: 1) How do young activists in the New England area understand climate change? 2) How does participating in a youth-centered climate justice organization impact their overall sense of well-being? About half-way through the planning of this research study, the coronavirus pandemic swept the world, which added another layer to this research study: 3) How does the COVID-19 pandemic impact youth perceptions and experiences of climate change activism? In this thesis, I argue that young people in this climate organization, through their shared experiences of cultivating social capital, expanding critical consciousness, and adaptive redefining of social relationships, develop a strong and sustained sense of community that motivates them to continue their activism. In a society that undervalues young people, these youth actively reclaim agency and use this to challenge the structures that continue to perpetuate environmental injustice. This in turn provides these young people with a heightened sense of well-being in the face of multiple existential threats that threaten their current and future existence, namely racial injustice, the COVID-19 pandemic, and the potential destruction of their planet.

Publications:

Lee, Rebekka M., James G. Daly, Kamini Mallick, Shoba Ramanadhan, Cristina Huebner Torres, Cassidy R. Hayes, Alyssa Manuel, and Karen M. Emmons. 2023. Implementation of evidence-based primary cancer prevention interventions in MA community health centers: an explanatory sequential mixed methods study. Research Square DOI: https://doi.org/10.21203/rs.3.rs-2588180/v1.

McCarthy, Catherine. 2021. Enculturating Empathy: The Ethical Representation of Institutional Review Boards.

As part of a preliminary literature review of research concerning the relationship between medical anthropology and bioethics committees, it became clear that Institutional Review Boards, a foundational component of research, had never been evaluated as a population with a characterizable identity. Some examples of contextual critiques and policy analysis with the goal of procedural efficiency were accessible (Gunsalus 2006; Fitzgerald 2009; Lederman 2006; Ozdemir 2009; Sontag 2012), but qualitative data on the local knowledge of IRBs as a population do not exist. A synthesis of theoretical orientations and methodological planning have been integrated to inform these novel research questions to learn more about the ethical decision-making process of an Institutional Review Board within a research university and hospital. Bioethical reasoning grounded in Western morals creates enough opportunity for cognitive dissonance because of the potential misapplication of ethics, but when decision-making authority is deemed objectively scientific, it can cause a power dynamic by being taken as self-evident. Considering these biomedical frameworks, research with human subjects is grounded in morality, making IRBs a relevant site of praxis for philosophical and scientific research. The overall purpose of this project is to identify the ethical values that define Institutional Review Boards as a population, evaluate the moral implications of biomedical governmentality in clinical research, and define common phenomenological understandings of moral praxis within positions of relative power.

Ritger, Carly. 2021. Embrace the Good, Refuse the Bad: Haitian American Children’s Selective Engagement with the United States.

This qualitative research study investigates the perceptions of children, parents, and staff members at a Boston multi-service nonprofit for Haitian immigrants. It is an exploration of how children cultivate their identity, and how a center for immigrants functions in the current sociopolitical climate. There is an evidentiary lacuna of qualitative explorations on children of immigrants’ perceptions and health. The COVID-19 pandemic makes this issue even more temporally relevant, as new data suggests structural factors make marginalized groups, such as people of color and immigrants, more vulnerable to infection and death. This study will contribute to the body of work on children of immigrants’ health by 1) analyzing the unique child perspective, as opposed to focusing entirely on adults or using quantitative child measures, 2) employing qualitative data to create more robust depictions of lived experiences, 3) and situating data in the particular Haiti/U.S. historical, political relationship. This study’s methodology includes ethnographic participant observation during regular visits to a nonprofit organization for immigrants (Fanmi Nou) over the course of several months, semi-structured video interviews with children, parents, and staff members of this organization, and content analysis of documents produced by Fanmi Nou. Through different waves of migration to the United States, children of Haitian immigrants have lived bicultural lives. In the last four years, however, biculturalism and transnationality have come under growing assault. As a reactionary response to overt hostility, parents, staff members at Fanmi Nou, and children themselves, actively promote a Haitian identity in children. Living under an administration characterized by its hostility to immigrants, Haitian American children pick and choose which aspects of American life to welcome and which to reject. Through a multi-service nonprofit organization, these children and their families selectively engage with the U.S. political, educational, and social systems. I argue that these children and this organization strategically support the healthy development of self under these new restrictions.

Publications:

McNeal, Demetria M., Rebecca Hanratty, Shea E. Hogan, Megan Morris, Amy G. Huebschmann, Steven Lockhart, Carly Ritger, and Pamela Peterson. 2022. Abstract 260: Provider Perspectives On Peripheral Artery Disease: Uncovering Practice Patterns That May Contribute To Health Disparities. Abstract Poster Sessions. Circulation: Cardiovascular Quality and Outcomes, 15:A260.

Simpson, Matthew J., Carly Ritger, Jason A. Hoppe, Wesley C. Holland, Megan A. Morris, Bidisha Nath, Edward R. Melnick, and Caroline Tietbohl. 2023. Implementation strategies to address the determinants of adoption, implementation, and maintenance of a clinical decision support tool for emergency department buprenorphine initiation: a qualitative study.” Implementation Science Communications 4(1): 41-53.

Asif, Soubhana. 2020. Meanings of Eldership in the Urban Native American Community in the Greater Boston Area.

This qualitative research study explores the meanings of Eldership and eldering in a local urban Native American community in the Greater Boston Area. Studies regarding older Native Americans often use “older adult” and “elder” synonymously. By relegating aging to simply a “chronological pace,” researchers assume that Native communities view time and the transition into elderhood as an independent physiological experience, when alternative understandings may exist. Urban Native Americans may not have ties to the land they live on, are separated from the culture and traditions of their tribal members on reservations, and are consumed by the dominating modality of their colonizer. However, an urban Native community continues to exist in the Greater Boston Area in Massachusetts. This in part is due to the persistent efforts of elders within the community over time who elder-in-place: they maintain networks and pass down knowledge to younger generations within a co-constructed shared space. However, when an elder passes or moves away, there is a “gap” in the community’s network. The challenges Indigenous peoples face further inhibit transitions into Eldership or the practice of eldering. Indigenous organizations such as Native American LifeLines (NAL) and North American Indian Center of Boston (NAICOB) provide services, although limited, to try and help overcome such problems, including transport services, health care outreach, employment training and opportunities, and cultural workshops. By working together and with non-Native organizations, such groups can fortify the Indigenous structure in the Greater Boston area. NAICOB in particular, with its fifty-year-long history and community-driven structure, acts as a place-in-eldering: a ‘living’ Indigenous being which enacts Eldership at an organizational level. However, NAICOB is a place-in-eldering insofar as community members elder-in-place. Many issues promote a negative feedback loop which deters individuals from consistently participating at NAICOB. This lack of engagement in turn makes it difficult for the organization to show how they support the community when applying for grants. It is through an active symbiotic relationship between place and person which allows individuals to transition into Eldership in Boston. In this way, it is possible for the next generation of elders to fill the current “gap” in the community and promote engagement. From analyzing these relationships and interactions, we can see that these Eldership attempts to continue the vision of a “good life”—social and emotional wellbeing for not only themselves, but the entire community as well.

Publications:

Asif SM, Asif S[oubhana]. 2019. Doctors with borders: The White Helmets and radical political medicine. In: Weber AS, Verjee MA, editors. Proceedings of the 1st International Conference on Medical Humanities in the Middle East [Internet]; 2018 Nov 17-18: Doha, Qatar: Innovations in Global Health Professions Education; 2019 March. p. 27-29. (Innovations in Global Health Professions Education; vol. 2019, spec. no.: 1). https://dx.doi.org/10.20421/ ighpe2019.01.09.

Mangla, Mahima, Saljooq Asif, Soubhana Asif, Michael Terzella, D.O., and Sheldon Yao, D.O. 2021. “Assessing Usage and Perceptions of Osteopathic Manipulative Treatment (OMT) and Self-identity Among Osteopathic Physicians.” Featured NYITCOM Research at OMED21, Osteopathic Medical Education Conference (OMED), New York Institute of Technology College of Osteopathic Medicine (NYITCOM). October 22-24.

Haq, Kanwal L. 2020. Mental & Muslim: The Impact of Stigmas on Communities.

Since September 11, 2001 there has been much commotion regarding the Muslim- American community. Constituting one percent of the U.S population, Muslim- Americans represent a multitude of ethnicities, socioeconomic classes, beliefs, preferences, and behaviors, occupying a multitude of worldviews–those arising from their various religious and cultural heritages and those innate to their American roots. Muslim-Americans’ unique hyphenated-identities, imbued with historical and political significance in the post-9/11 era, makes them vital to understanding the current landscape of minority mental health. While existing literature examines Muslim-Americans perceptions of mental health, focused exploration of Muslim-Americans lived experiences with mental health has been limited. This study investigates Muslim- Americans perceptions of mental health using standard ethnographic methods: in-depth and open-ended interviews, and immersion as participant observer in the research population at a local Islamic center and through community events. The findings suggest that: 1) Muslim-Americans’ interstitial identity, compounded by socio-political and religious-cultural frameworks, shapes their perceptions of and attitudes towards mental health and 2) mainstream American narratives of mental health care and support do not adequately accommodate varying approaches to personhood and well-being.

Publications:

O’Connor, Mary I., Kanwal L. Haq. 2022. Taking Care of You: The empowered woman’s guide to better health. Mayo Clinic Press.

Presumey-Leblanc, Garssandra. 2020. Rewriting the Present: Post-Traumatic Slave Syndrome as a Foundation for Social Determinants of Health.

Social determinants of health (SDOH) are often used to discuss health inequities and systemic barriers experienced by minority populations. In the United States, the intersection of SDOH leaves these populations vulnerable to negative health outcomes. Missing from the SDOH discourse are the underlying historical causes for these disparities. Medical-Legal Partnerships (MLPs) have undertaken the role of educating the health and human services (HHS) workforce on interdisciplinary collaboration, cultural competence, and the skills to recognize experiences of negative SDOH. However, current research does not explore the foundational impact of historical trauma, more specifically Post Traumatic Slave Syndrome (PTSS), on experiences of negative SDOH. This ethnography primarily uses the personal accounts of black female HHS workforce members and participant observation from within a MLP to examine how historical trauma acts as a foundation for understanding the complex interactions of SDOH. The SDOH discourse does not challenge the medical and legal institutions that contribute to how minority populations experience negative SDOH. As currently structured, MLPs unintentionally reproduce a pedagogical narrative that erases the lived experiences of SDOH by only focusing on individual factors and not systems. Black female HHS workforce members agree that historical context is missing (e.g. PTSS) from the SDOH discourse and contemporary experiences of racism and discrimination. Historical context would change how HHS workforce members advocate for their patients as well as engage in system-challenging praxis within the medical and legal institutions. This suggests the need to examine how American institutions exclude particular histories and reinforces a white supremacist and patriarchal narrative.

Publications:

Presumey-Leblanc, Garssandra, and Megan Sandel. 2022. “Perpetuating commodification of suffering: how social determinants of health framing prolongs historical racial inequities.” Women’s Health Reports 3(1): 281-285.

Hameed, Afshan B., Alison Haddock, Diana S. Wolfe, Karen Florio, Nora Drummond, Christie Allen, Isabel Taylor, Susan Kendig, Garssandra Presumey-Leblanc, and Emily Greenwood. 2023. “Alliance for Innovation on Maternal Health: Consensus Bundle on Cardiac Conditions in Obstetric Care.” Obstetrics and gynecology 141(2): 253-263.

Presumey-Leblanc, Garssandra, and Megan Sandel. 2023. “The legacy of slavery and the socialization of Black female health and human services workforce members in addressing social determinants of health.” Journal of racial and ethnic health disparities: January 23: 1-11. https://doi.org/10.1007/s40615-023-01510-y.

Sitter, Kailyn. 2020. Hunting for Zebras: The Enculturation and Socialization of Genetic Counselors.

Genetic counselors (GCs) serve as health professionals who bridge the gap between patients and genetic medicine. Understanding the processes of genetic counselor enculturation and socialization gives a better picture of how these unique clinicians navigate the spaces between biomedical explanatory models and patient illness narratives, especially pertaining to how biomedicine has influenced how GCs experience the world and shape their professional and personal identities. In this two year-long study, I observed GCs, their students, faculty, patient presenters, and other guests of a genetic counselor training program (“GC Program”) to better understand the ways biomedical discourse is internalized and perpetuated through generations of students. Through semi-structured interviews, a free-listing exercise, and the analysis of applicant essays, I focus on how ritualized process leads to the experience of biomedically influenced periods of enculturation and socialization for GC students, applicants, and professionals who have graduated. I discuss how technology and materializing devices allow for the construction and interpretation of genetic identities closely tied to a counseling profession, which can either magnify the personal identities of its members or alienate those who feel as though they do not belong. The identities of genetic professionals force patients into ideal medical imaginaries; however genetic counselors set themselves apart from overlying biomedical structures as clinicians who defy norms to better take care of their patients. Last, I provide suggestions on how the field of genetic counseling can expand its interpretations of genetic citizenship and responsibility to broaden its reach and deepen its rich history of compassionate advocacy for its patients and members.

Ward, Audrey E. 2020. Beyond the Biomedical: Choosing Health and Patterns of Resort among Latin American Immigrant Women.

This thesis explores the health-related decisions Latin American immigrant women make in MetroWest Massachusetts. Within public health and biomedical literature, women from Spanish-speaking communities are often measured by their adherence to biomedical guidelines. Several programs have been designed to increase compliance with recommended cancer screenings like Pap smears and mammograms in an effort to reduce health inequities between Latina populations and their white counterparts in the United States (Peek and Han 2009). Community Health Organizations often prioritize biomedical models of care, as Community Health Workers are typically trained in public health and biomedicine. Yet little research has been done on women’s conception of their own health. Using the theoretical concept of patterns of resort, this research examines what women prioritize for their own health needs, why, and what local resources women use to meet these needs. Women have a broad understanding of their own health, and use varying resources to meet the needs of physical, emotional, mental, social and spiritual health needs. By understanding these specific health needs, researchers and those invested in immigrant communities may create more effective programs with women’s health in mind.

Bailey, Hannah M. 2019. In/Visible: An Ethnographic Case Study of the Pursuit of a Good Life in Boston’s Little Saigon.

Little existing research examines how Vietnamese American individuals conceptualize wellness in relation to the community in which they live. Fewer studies examine the ways in which communities of Vietnamese expatriates form networks of support, based around community resources. Even fewer, if any, focus on these qualities within the context of Boston’s own Little Saigon – Fields Corner.

This ethnography analyzes discussions with and observations of individuals living in a predominantly Vietnamese neighborhood in Boston who are a part of a support group for families of children with special needs. Through this analysis, two key themes emerge. First, through the learning of information and sharing of knowledge, this Network’s connections have impacts far beyond the four walls of their bi-weekly meeting space. Second, wellness for the parents in this group is directly tied to existing as a part of a community support network which allows them to successfully navigate three distinct institutions of care for their children – the medical and special education systems, as well as the expression of Vietnamese culture that exists in this neighborhood.

I argue that in discussions with members of this support group, it is necessary to focus on channels alternative to biomedical mental health services when confronting the pursuit of a life worth living. This network acts as a site of social change through parental advocacy for their children’s flourishing within various institutions. Parents then act as vectors of consciousness to raise awareness for specific action. Within this context, parents are enabled to fight for their definition of a life worth living and their personal wellbeing.

Publications:

Christopher J. Miller, Christopher J., Bo Kim, Samantha L. Connolly, Elizabeth G. Spitzer, Madisen Brown, Hannah M. Bailey, Kendra Weaver, Jennifer L. Sullivan. 2023. Sustainability of the Collaborative Chronic Care Model in Outpatient Mental Health Teams Three Years Post-Implementation: A Qualitative Analysis. Administration and Policy in Mental Health and Mental Health Services Research 50:151–159 https://doi.org/10.1007/s10488-022-01231-0

Brown, Madisen E. 2019. Violent Encounters: Mediatization, Socio-Medical Legitimation, TBI, and CTE: Lived Experiences of NFL Players, Military Veterans, and Their Caretakers.

Clinical Researchers recently identified NFL players and US military veterans as high-risk populations for sustaining repetitive Traumatic Brain Injury (TBI) and developing the neurodegenerative disease Chronic Traumatic Encephalopathy (CTE). American culture celebrates military veterans as national heroes, and NFL players as popular athletes and social icons. Both subcultures are constructed around hyper-masculine ideals embedded in tenants of violence and aggression, suffer repeated TBIs due to this nature, and are ultimately at high-risk for developing CTE. The TBI/CTE phenomenon also affects family members who assume care-taking responsibilities for these first two populations as their loved one’s symptoms persist. The purpose of this research is to understand the TBI/CTE experiences of NFL players, military veterans, and their caretakers, and how all three populations intersect with mediatization and the social and medical legitimation of TBI/CTE in America. Using narratives from all three populations, I explore how power dynamics within the NFL and US military have intersected with modern media outlets and functioned to socio-medically legitimize a sick role for those who suffer from persistent symptoms of TBI and CTE.

Publications:

Christopher J. Miller, Christopher J., Bo Kim, Samantha L. Connolly, Elizabeth G. Spitzer, Madisen Brown, Hannah M. Bailey, Kendra Weaver, Jennifer L. Sullivan. 2023. Sustainability of the Collaborative Chronic Care Model in Outpatient Mental Health Teams Three Years Post-Implementation: A Qualitative Analysis. Administration and Policy in Mental Health and Mental Health Services Research 50:151–159 https://doi.org/10.1007/s10488-022-01231-0

Chuersanga, Geeranan. 2019. Traditional Thai Medicine in Eastern Massachusetts.

The growing Thai community in Eastern Massachusetts has an unofficial ethnic enclave that surrounds the neighborhood of Allston/Brighton. Studies of Thai communities in the United States indicate that Thai-Americans have limited access to quality health care in the United States due to factors that contribute to health disparities such as language barriers and cultural beliefs. As a result, Thai people have different approaches to how they treat illnesses through traditional Thai medicine (TTM), Western medicine (also called biomedicine), or a mixture of both medical systems. This study examines healthways Thai/Thai Americans in Eastern Massachusetts draw on in response to different illnesses. In-depth stories of how this community engages in illness prevention and responses to the experiences of illness illuminated by Thai people’s approaches to different medical systems helps us understand how they present their values when seeking medical care. I argue that responses to various illness episodes experienced by members of the Thai community in Eastern Massachusetts influence perceived health and health-seeking behaviors. Factors that contribute to Thai-American health practices include: religion, sociocultural elements (cultural identity, generational differences, cross-cultural differences, structural violence), and Thai constructs of illness and well-being.

Farthing, Rachel J. 2018. Structural Violence, Food Insecurity, and Chronic Disease in the Lives of Mattapan’s Black Women.

This is a qualitative study that seeks to understand the intersections of food insecurity and chronic diseases in the lives of women living in Mattapan. This research takes place in Mattapan, a neighborhood in Boston. Mattapan is a very diverse and unique community which is home to a majority of people of color. Mattapan is often criticized and viewed as an undesirable place to live for those who live outside of its borders. These negative stereotypes and the presence of structural violence have generated a built site of scarcity within the Mattapan community. This makes it incredibly difficult for Black women in Mattapan to be healthy because their environment actively prevents them from doing so.

It is important to give women special consideration when looking at food insecurity because more increasingly they are becoming the sole and primary caregivers in their homes. They are responsible for the production and preparation of food within their families. Therefore, it is necessary and important to focus on this particular population and obstacles they endure navigating those obstacles.

This research focuses on how past and present lived experiences of women of color in Mattapan inform how these women identify, understand, define, and interpret structural factors that contribute to food insecurity, and chronic diseases. Having access to fresh and affordable food is one of the most basic necessities of life. Yet, many communities of color across the country lack this basic access. Twenty percent of all African American household’s experience food insecurity compared 12.5 percent of the nation as a whole. In addition, African-American women are almost twice as likely to be overweight and obese compared to non-Hispanic White women.

With such grave proportions of African-Americans suffering from chronic diseases it is important to consider the ways in which obesity systematically occurs. Structural violence and the presence of structural barriers inhibit Black women from eating healthy. In predominately Black and immigrant communities like Mattapan the environment is a major barrier that women must navigate every day in order to achieve healthiness.

Gerlin, Gerpha. 2019. Autoethnographic Reflections on Subjectivity and Chronic Mental Illness.

This project emerges from engaging and studying the lives, including mine, of the many who go—and stay—crazy. Here, I explore the kinds of existences that those impaired by severe and persistent mental illness(es), what I refer to henceforth as “chronic mental illness”— have had (or been able) to forge and leverage, as well as some of the resources and structures they have developed/manipulated in order to do so.

This thesis explores one way in which chronically mentally ill people exact agency over their own embattled personhood. The term “personhood” draws from existential traditions in philosophy and theology (Strawson 1959; Taylor 1989, 127-142; Rosfort 2018), though I understand and use it here as it is relevant to phenomenological psychopathology. By “personhood”, I mean the normative traits of a society wherein individuals are recognized by seemingly “common” traits of humanity. While there is not, as philosopher Robert Spaemann contends, “a [single] characteristic that can be called ‘being a person’” (Spaemann 1996, 14), to understand human beings (being) is to also grapple with the ethical demands of intentionality, autonomy, experience, and subjectivity.

By “subjectivity”, I refer to the innumerable and descriptive components that comprise individual, relational, and intersubjective experience(s). These components, and how they are known and described, emerges from a self-awareness in maneuvering the world and, consequently, developing a particular lifeworld. My interests in personhood and subjectivity emerge from the assumption that “the fragility of human identity is rooted in the various ways in which our biology challenges our experience of being an autonomous self” (Ricoeur 1966; Ricoeur 1970, 472; Rosfort 2018, 5). Part of what complicates personal identity is the impossibility of grounding personhood in either biological otherness or an intrinsic, pre-reflective selfhood. Being a person is “the task of becoming […] concrete […] through the constant encounter with the otherness that is an inescapable part of one’s identity” (Rosfort 2018, 6). Seeing a person, Ricoeur believes, requires the perpetual examination of experiential tensions among identity traits that go beyond biological reductionism and constancy. Illness narratives are useful tools for understanding the extent to which disability incites a fundamental interrogation of the self, as well as a reckoning of practices of self-recognition and phenomenological metamorphosis.

This multi-field site investigation engages self-identifying psychiatrically disabled people via participant-observation at three peer support networks within the greater Boston area. Data, by way of stories recounted and collected, is framed by my own lived experience participating in similar structures, both in-person and online. Stories from both occasions, including interview data and media analysis, are relayed as means of triangulation. This project relies on sociologist Noman Denzin’s concept of “cumulative epiphanies” (Denzin 1989), or, moments wherein ill authors/speakers recognize the extent to which their personhood was honed through the medium of the illness itself (Frank 1993, 46).

In large part, this project explores ways that people experiencing disabling effects of mental illness learn to take care of themselves. It pays particular attention to how the personal views of people with such illnesses shape the construction and layout of varied peer support networks. Although it considers general psychiatric practice involving prescribing clinicians (e.g., physician or nurse practitioner) and non-prescribing clinicians (e.g., talk therapists), the central objective is to consider the emergence of mutual support, or “self-help” models, as a mode of constructing a new sense of self/advocating for unmet needs within traditional medical practice.

More broadly, this project maps the reflexive transformation(s) of person into patient and the varied methods of healing and treatment that the chronically mentally ill utilize in such contexts. It considers the emergence of PSNs as a counter/cultural borderland (Kleinman 1980; Garcia 2016) between the social “psy”ences (Matza 2013; Raikhel & Bemme 2016) and psychiatry. As a theoretical fusion of history of psychiatry, sociology of mental health, and phenomenology, I trouble the parameters within which PSNs and their participants help craft, shape, and directing a particular kind of experience of mental illness, suffering1, and/or convalescence.

Publications:

Gerlin, Gerpha. 2021. “‘There’s Got to be More to Life than Feeling Like This’: Navigating Mental Illness Recovery Alone, Together, and in-Between”. Anthropology and Mental Health Interest Group (AMHIG) Graduate Student Paper Prize Graduate Student Paper Prize Award.  https://amhig.medanthro.net/amhig-graduate

Koenders, Sedona. 2019. Veteran Experiences of Living with Chronic Pain in the Context of VA Care and an Opioid ‘Epidemic’.

While chronic pain is an increasingly prevalent condition in the United States, it is twice as common among the military veteran population. As many Vietnam War era veterans are aging and experiencing comorbid medical conditions, their chronic pain is becoming increasingly complex. Policies enacted in response to the ‘opioid epidemic’ have in some ways made treatment of pain safer, but have also left remaining questions regarding how to properly provide care. There are three fields of complexity that interact within this topic: patients with a clear need for care and pain management, providers committed to helping patients, and structural barriers that unintentionally interfere with the provision of care.

The lived experience of chronic pain and receiving care through the VA healthcare system combined with a common military culture exemplifies a lifeworld centered on pain—which I call a ‘painworld.’ This painworld is seen in the illness narratives of older, white, male veterans with chronic pain. Examining the way a single VA site provides pain care shows the providers are dedicated to treating veteran patients and offer a large number of treatment options. While the need for pain management services is clear from both the patient and provider perspectives, translating the lived experience of these veterans and their medical needs into a hierarchical bureaucratic structure is difficult. Furthermore, the bureaucratic nature of a large federal organization creates gaps in the healthcare system. This leads to the creation of informal systems through systems-correcting praxis to fill the gaps and attempt to prevent siloing and slippage throughout. Together, these fields of complexity are organized into three chapters, building the argument that the convergence of veteran painworlds, pain care, and bureaucracy can contribute to miscommunication, leading to unintended slippage through the system and inadequate care, despite good intentions of staff. Furthermore, the VA system and structure of providing pain care both influences and is part of the painworld, as are the interactions that occur between veteran patients and staff.

Publications:

Koenders, Sedona L., Linda L. Barnes, Lance D. Laird, Bayla Ostrach, and Gemmae M. Fix. 2020. “Applied Training in a Medical Anthropology Master’s Program.” Practicing anthropology 42(1): 43-47.

Koenders, Sedona L. 2022. “Painworld: A Phenomenological View of Veteran Experiences of Living with Chronic Pain.” In Meanings of Pain: Volume 3: Vulnerable or Special Groups of People. Cham: Springer International Publishing, pp. 87-105.

McNally, Kellan I. 2019. Hardily Working: Stories of Labor in a State Mental Hospital.

Nineteenth-century state mental hospitals across New England and the United States are linked today with images of confinement, forced treatment, torture, abandonment, and family separation. This project does not directly challenge those associations. An ethnographic study in medical anthropology, this study is based on three years of fieldwork observations and qualitative interviews with neighbors, townspeople, former employees, and visitors to the open campus of a decommissioned state mental hospital in Massachusetts. Excavated from that hospital’s annual reports dating back to 1896 and gathered from local memories and storytelling, this projects considers the central place that work once held in the lives of psychiatric patients at Medfield State Hospital and the place that idleness holds for patients living within today’s institution of community care. Participants’ memories track the shifting perceptions and meanings of mental illness that resulted once “industrial therapy” programs were ended in state mental hospitals. This inquiry describes the ways that the loss of work changed psychiatric patients’ experiences of suffering, promoting the use of new chemical treatments, accelerating deinstitutionalization, and catalyzing new patterns nationally of service utilization and psychiatric disability. From participants’ memories and the author’s reflections on clinical practice as an independently licensed social worker (LICSW) in Massachusetts, this analysis uncovers the social functions of staying sick within contexts of unequal opportunity and joblessness. This study reveals the complicated and punishing work of surviving and helping people survive across de-industrialized landscapes as mental health practitioners assist the disenfranchised by recasting social suffering into psychiatric illness with treatment-induced embodiments that simultaneously help to manage poverty and perpetuate risk within disabilized citizens.

Publications:

McNally, Kellan. 2023. “Able-bodied Characters and the Appeal of Medicaid Work Requirements in Arkansas.” Journal of Policy Practice and Research, pp. 1-16.

Patrick, Samantha. 2019. Child Trauma: Surviving Structural Violence in America.

The definitions of trauma and trauma behavior are expansive and have continued to grow in the past century. While biomedicine continues to expand the Diagnostic and Statistical Manual for cultural competency and subjective experience, the concept of trauma is still limited to certain behavior and events determined by hegemonic views. This becomes detrimental to families and children exposed to everyday instances of structural violence. Looking at major child care sectors— the education system, biomedical care, and the family unit—to understand the influen­ces of biopower and the consequences of structural violence, data collected from the greater Boston area reveals the consequences of structural violence on both child behavior and the manifestation of trauma. This thesis reexamines the social construct of trauma and trauma behavior, and uses its own term, structural trauma, to account for the social frameworks that create a legitimacy deficit for the trauma-related behaviors children embody. Examination of these three main child care sectors and the barriers that contribute to, or try to deconstruct, structural trauma reveals that these institutions have organized themselves into a pastoral apparatus that can prove to be more harmful than helpful for addressing child trauma and family well-being. Through structural trauma, researchers and society can gain further insight on how policies and practices create additional, unintentional vulnerabilities in underserved populations, consequently inhibiting healing and understanding amongst families and institutions.

Riley, Jessica T. 2019. Meanings of Wellbriety and Wellness among Urban Native Peoples in Boston.

The definitions of trauma and trauma behavior are expansive and have continued to grow in the past century. While biomedicine continues to expand the Diagnostic and Statistical Manual for cultural competency and subjective experience, the concept of trauma is still limited to certain behavior and events determined by hegemonic views. This becomes detrimental to families and children exposed to everyday instances of structural violence. Looking at major child care sectors— the education system, biomedical care, and the family unit—to understand the influences of biopower and the consequences of structural violence, data collected from the greater Boston area reveals the consequences of structural violence on both child behavior and the manifestation of trauma. This thesis reexamines the social construct of trauma and trauma behavior, and uses its own term, structural trauma, to account for the social frameworks that create a legitimacy deficit for the trauma-related behaviors children embody. Examination of these three main child care sectors and the barriers that contribute to, or try to deconstruct, structural trauma reveals that these institutions have organized themselves into a pastoral apparatus that can prove to be more harmful than helpful for addressing child trauma and family well-being. Through structural trauma, researchers and society can gain further insight on how policies and practices create additional, unintentional vulnerabilities in underserved populations, consequently inhibiting healing and understanding amongst families and institutions.

Publications:

Brady, Christopher B., Ian Robey, Thor D. Stein, Bertrand R. Huber, Jessica Riley, Nazifa Abdul Rauf, Keith R. Spencer et al. The Department of Veterans Affairs Gulf War Veterans’ Illnesses Biorepository: Supporting Research on Gulf War Veterans’ Illnesses. Brain Sciences 11(10): 1349.

Still, Michael E. 2019. Rising Tides: An Ethnographic Case Study of Resident-Activists in an Environmental Justice Community.

Environmental justice communities in the US are located at a nexus of social justice, political and corporate interest, and public health. This paper explores how resident-activists, primarily those who identify as Latinx and female, simultaneously inhabit roles of resident and activist. In doing so, they create a space of equitable knowledge exchange, and support community members in realizing their own agency. Additionally, their efforts include, but are not limited to, collaboration with researchers in a way that promotes emancipatory education and culture-centered research models. The author spent over a year as a staff member of an urban EJ organization in Massachusetts, participating in and observing community meetings, fundraising efforts, municipal and state level environmental impact hearings, and organized protests. These community activists wrestle with the tension of simultaneously depending on and disrupting systems that have historically burdened their community.

Publications:

Mesfin, Nathan, Jolie Wormwood, Renda Soylemez Wiener, Michael Still, Chris S. Xu, Jennifer Palmer, and Amy M. Linsky. 2013. Impact of the COVID-19 Pandemic on Providing Recommendations During Goals-of-Care Conversations: A Multisite Survey. Journal of Palliative Medicine 26(7): 951–959.

Jolly, Dee (Divya). 2018. Navigating the Borderlands: Intersectional Healthcare Experiences of Queer and Trans People of Color

This mixed methods research study examines the experiences of multiply marginalized individuals in healthcare, and the ways in which structural systems produce and reinforce cultural norms and values, which simultaneously reproduce those same systems. Through a combination of semi-structured interviews, participant observation, and qualitative and quantitative survey data, I provide evidence that norms and values that emerge on the interpersonal, intrapersonal, and institutional levels drive perceptions of care among Queer and Trans People of Color (QTPOC). A critical discussion of the politics of identity, microaggressions, and perceived empathy demonstrates that structural and cultural violence shape perceptions of care for this community. I then explore how violence creates social marginalization and impacts the health of both the individual and the QTPOC community.

Publications:

Chan KJ, Jolly D[ivya], Liang JJ, Weinand JD, Safer JD. Estrogen Levels Do Not Rise with Testosterone Treatment for Transgender Men. Endocrine Practice. 2018 Mar 21; 24(4): 329-33.

Liang JJ, Jolly D[ivya], Chan KJ, Safer JD. 2018. Testosterone Levels Achieved by Medically Treated Transgender Women in a United States Endocrinology Clinic Cohort. Endocrine Practice 24(2): 135-142.

St. Dennis, Victoria. 2018. Mis-Matching Structures of Breastfeeding Support

This ethnographic research study explores the interaction between peer, partner, and provider support and breastfeeding outcomes. And to argue that there exists a mismatch between breastfeeding ideals and realities. Breastfeeding has been proposed as the first choice in infant feeding practices beginning from birth until a minimum of six months, without the inclusion of other nutrient products. While breastfeeding remains the medical standard, rates across the United States have not reached the Healthy People 2020 goals. The purpose of this study was to address the outcome of shared breastfeeding knowledge, in relation to the interaction between chronic individual stress, access to supportive resources, and the immediate stress involved with breastfeeding. Relying on Modified Grounded Theory (mGT), participant observation, surveys and interviews, the original aim of this study was to provide information about the role of social support, stressors and breastfeeding. There ultimately exists a mismatch between the ideals of breastfeeding and application of breastfeeding resources in the United States. For breastfeeding to be successful there needed to be a culture of support from peers, providers, and partners (or family members). This overlap of care results in breastfeeding mothers feeling more capable in handling their individual experiences of stress, as well as stress directly related to their infant.

Seamon (Will), Kevin. 2018. Connecting with the Healthconnector: Experiences of Massachusetts Latinx Patients with Subsidized Healthcare

While rates of uninsured have dropped in the United States, The Latinx population continues to suffer from the highest proportion of the uninsured (KFF 2016). Obstacles persist for Latinos/Latinas, even though health coverage appears to be at its peak. The purpose of this paper is to investigate the experiences of Latinx in the Greater Boston Area, who are eligible under the Affordable Care Act and/or state-subsidized health care. The focus of this investigation is the subsidized health plan enrollment process and health care experiences of those who are eligible and interested in enrolling. This includes obstacles to signing up for health plans offered on the state health care exchange, Latinx perceptions of and their experiences with the ACA and the HealthConnector, and how subsidized health care influences their perceptions surrounding access to care. To capture a more accurate image of the Latinx experiences with state-subsidized healthcare, this paper also explores the 2017 political climate, the proposal of Trumpcare, and the effects of the proposed healthcare reform on a vulnerable population.

Waller, Katherine (Kat). 2018. Taking a Closer Look: Negative Reporting and Positive Experiences with Healthcare for East African Refugees in Boston.

This thesis explores the experiences of the health care system for East African refugees in Boston. I argue that refugee experiences lie on a spectrum ranging from inadequate to exceptional, and that by exploring what makes care both a negative and positive experience for refugees it may be possible to better serve the community. I conceptualize these experiences using the metaphor of a rope bridge: at the beginning, refugees are stuck in a formal structure that limits their movements and agency; throughout the middle, they are forced into a liminal space in which both their identity and experiences are made ambiguous; on the far end of the bridge; they have mitigated the deleterious effects of structural violence and liminality through practices involving selective acculturation, resilience, and self-verification. My participants reported being dissatisfied with the bureaucratic barriers to health care they encountered and with the power imbalances they felt when interacting with clinicians. They also spoke about the encounters they had with clinicians that made them feel listened to, cared for, and empowered. Much of the distinction between good and bad care relied on whether the patient felt like they were respected by their doctor, and whether they felt like they had a say in their own care and treatment. Due to the limited nature of this endeavor, further research is recommended on: 1) the role of memory in recovery; 2) liminality as it applies to the resettlement experience; 3) maintaining and bolstering the assets that allow refugees to mitigate the effects of structural violence; and 4) in what ways the health care system is working for refugees, and how those can be expanded upon.

Cabral, Naciely. 2017. Structures of Risk: Lived Experiences of Multi-Syndemic Clustering in the Greater Boston Area.

People who experience structural violence are an increased risk for health conditions including HIV and Hepatitis C. Particularly they are at greater risk for experiencing known syndemic interactions between these two chronic infectious diseases. The risks are mediated bio-socially through the ways that structural inequality increases social and biological vulnerability to illness and suffering. Structural inequalities, or experiences of structural violence shape environments of risk; environments of risks increase social and biological vulnerability to the structures of risk promoting syndemic interactions between biological, behavioral, and psychological conditions.

The lived experiences of people diagnosed with a combination of HIV, HCV, and mental health conditions (MHC) (e.g., mood disorders and depression) are, however, thus far understudied. Many aspects and consequences of structural violence and social suffering; poverty, homelessness, substance use, lack of access to healthcare, and structural risks for HIV, HCV, MHC and interactions between the three. Through this mixed-methods, primarily qualitative, ethnographic fieldwork with individuals in the Boston area living with HIV, HCV, or both HIV and HCV, or suffering from MHC I ethnographically explore people’s perceptions of their vulnerability to these syndemic interactions. I also investigate their experiences of being at-risk for these conditions.

Through this process, I seek to illuminate individuals’ understandings of the impact structures of risk (i.e., substance use, food insecurity and unstable housing) have on lived experiences with HIV/HCV, HIV/MHC, and HCV/MHC syndemics. The perceptions of the lived realities of disease-behavioral-psychological interactions and health consequences are analyzed in the context of substance use. Substance use’s biological and social dimensions have a role in promoting syndemic interactions for each of the syndemics experienced within this population.

Therefore, substance use is a syndemogenic factor because of its role as a mediator for environments of risks, and as a structural risk factor in all three of these syndemics. These interactions, and consequential health outcomes, in sufferers’ own words, enrich the landscape of syndemics research, producing a clearer picture regarding the structures of risks affecting this vulnerable group in the greater Boston area.

Publications:

Reid, Chinyere N., Kimberly Fryer, Naciely Cabral, and Jennifer Marshall. 2021. “Health care system barriers and facilitators to early prenatal care among diverse women in Florida.” Birth 48(3): 416-427.

Caban-Martinez, Alberto J., Claudia Parvanta, Naciely Cabral, Cynthia K. Ball, Adrienne Eastlake, Jeffrey L. Levin, Kevin Moore et al. “Barriers to SARS-CoV-2 Testing among US Employers in the COVID-19 Pandemic: A Qualitative Analysis Conducted January through April 2021.” International Journal of Environmental Research and Public Health 19, no. 18 (2022): 11805.

Parvanta, Claudia, Alberto J. Caban-Martinez, Naciely Cabral, Cynthia K. Ball, Kevin G. Moore, Adrienne Eastlake, Jeffrey L. Levin, Dalia E. Nessim, Matthew S. Thiese, and Paul A. Schulte. 2022. “In Search of a Value Proposition for COVID-19 Testing in the Work Environment: A Social Marketing Analysis.” International Journal of Environmental Research and Public Health 19(19):  12496.

Fryer, Kimberly, Chinyere N. Reid, Naciely Cabral, Jennifer Marshall, and Usha Menon. 2023. “Exploring Patients’ Needs and Desires for Quality Prenatal Care in Florida, United States.” International Journal of Maternal and Child Health and AIDS 12(1).

Kelleher, Charlotte. 2017. When the Hearing World Will Not Listen: Deaf Community Care in Hearing-Dominated Healthcare.

The Deaf Community has faced a great deal of historical oppression from hearing people that still resonates throughout the Community today. Recent literature has acknowledged the disconnect between the Deaf and hearing worlds, particularly in healthcare and education settings. Likewise, there have been many advocacy and service projects and programs to try to improve these situations. However, much of the existing literature and projects have failed to include input from Deaf Community members. As such, hearing perspectives dominate the lives of Deaf individuals. This study examines how the dominant biomedical perspective of deafness affects Deaf individuals’ ability to receive adequate healthcare.

Using standard ethnographic methods, including in-depth, open-ended interviews, and immersion in the research population through ongoing participant observation at a Deaf agency and Deaf Community events, this study highlights the perspectives of Deaf Community members themselves. The findings confirm previous studies’ assertions that the dominant biomedical perspective toward deafness negatively affects Deaf people overall, particularly because of communication obstacles and a lack of understanding about Deaf Culture, specifically in the realm of access to biomedical care. This has never been more worrisome for Deaf people in America than in the current unstable political climate that now threatens access to subsidized healthcare, disability services, and legally protected accommodations.

Morillo, Meghan. 2017. Refugee and Asylum-Seeker Health Seeking in the Greater Boston Area

In this research project, I examine the role that three organizations play in the greater Boston area. I sought to understand how these organizations were offering care to this population, and, in a broader sense, what it means to care for asylum-seekers and refugees. To answer this question, I developed a qualitative study that consisted of semistructured interview and participant observation at three different sites from August 2015 through February 2017. I argue that the agencies where I did my research demonstrated that healthcare does not equal medical care. These agencies offered an integrative approach to overall care for those refugees and asylum-seekers utilizing their services. This care reflected the pre-defined needs and desires of refugees and asylum-seekers while also remaining fluid and adapting to individual cases.

Nicklas, Jeffrey. 2017. Through the Lens of Exploitation: Landscapes of Care of Identified Trafficked People

In this qualitative research project, I examine the development of landscapes of care for, and by, identified trafficked people and its implications for rebuilding a sense of place and identity. Through in-depth interviews and ethnographic data, I argue that discourse, place and identity interact to form complex landscapes within both providers and clients/patients that emerge as distinct experiences of care or non-care experiences.

Each analytical chapter examines a particular production of care: a merging of psycho-legal care, the interactions of formalized informal caring relationships, and the burden of external identification in the configuration of self-identity among identified trafficked people. Building on anthropological theories of care (Giordano 2014; Mulla 2014; Stevenson 2014; Mattingly 2010), these chapters build the argument that, in contrast to humanitarian human trafficking and trauma discourse that focuses on a specific kind of trafficking experience; the complex assemblage of trafficking experience and subsequent care should be considered within what I term “structural trafficking.”

Becoming identified as trafficked is beneficial for receiving specific rights and services. However, this identity can also be detrimental for rebuilding a sense of self and place, because it assumes a fixed experience that translates to fixed care packages. I examine multiple landscapes of care to better understand potentials for care by expanding identity and coordinating existing and novel systems of care.

Publications:

Shimada, Stephanie L., Mark S Zocchi, Timothy P Hogan, Stefan G Kertes, Armando J Rotondi, Jorie M Butler, Sara J Knight, Kathryn DeLaughter, Felicia Kleinberg, Jeff Nicklas, Kim M Nazi, Thomas K Houston. 2020. “Impact of patient-clinical team secure messaging on communication patterns and patient experience: randomized encouragement design trial.” Journal of medical Internet research 22(11): e22307.

Stewart, Maureen T., Timothy P. Hogan, Jeff Nicklas, Stephanie A. Robinson, Carolyn M. Purington, Christopher J. Miller, Varsha G. Vimalananda et al. 2020. “The promise of patient portals for individuals living with chronic illness: qualitative study identifying pathways of patient engagement.” Journal of medical Internet research 22(7): e17744.

Emard, Nicholas. 2016. Biomedical Moralities: A Syndemic Approach to Stigma, Community, and Identity in HIV-Positive Boston

Stigma is multi-faceted and intersects with other damaging forms of social suffering. The evolving nature of HIV stigma is particularly evident in HIV communities, where community members adopt hegemonic views of biomedicine and incorporate them into their shared social space. I argue that such structural discrimination is a product of embracing “biomedical moralities,” where older community members adopt biomedically defined medical management as the standard of conduct. Such standards of living become so pervasive that HIV stigma nearly functions as a form of structural violence producing negative stereotypes of members who do not demonstrate “correct” ways of living with HIV.

These “biomedical moralities” lie at the nexus of community formation, contingent identities, and perceived stigma that members of HIV communities enact and embody. In this work I propose a newly identified stigma-linked syndemic which is thought to contribute to HIV spread, pose challenges for HIV medication adherence, and promote known syndemic interactions between HIV and other STIs. Through ethnographic research I present HIV communities’ experiences with stigma and how that can worsen overall health effects. I suggest that such research highlights needed improvements in anti-stigma campaigns and calls for an expansion of existing stigma-related HIV syndemics research.

Publications:

Emard, Nicholas. 2017. Biomedical Moralities: HIV Community Stigma and Risks for HIV/STI Syndemics. In Shir Lerman, Bayla Ostrach, and Merrill Singer, eds. Foundations of Biosocial Health: Stigma and Illness Interactions. Lanham, MD: Lexington Books, pp. 157-184.

Trevino KM, Raghunathan N, Latte-Naor S, Polubriaginof FCG, Jensen C, Atkinson TM, Emard N, Seluzicki CM, Ostroff JS, Mao JJ. 2020. Rapid deployment of virtual mind-body interventions during the COVID-19 outbreak: feasibility, acceptability, and implications for future care. Support Care Cancer 29(2):543-546. doi: 10.1007/s00520-020-05740-2. Epub 2020 Sep 9. PubMed PMID: 32902712; PubMed Central PMCID: PMC7479401.

Emard N, Lynch KA, Liou KT, Atkinson T, Green AK, Daly B, Trevino K, Mao JJ. 2021, Virtual Mind-Body Programming for Patients With Cancer During the COVID-19 Pandemic: Qualitative Study. JMIR Cancer 7(2):e27384. doi: 10.2196/27384. PubMed PMID: 33882018; PubMed Central PMCID: PMC8189285.

Liou KT, Chen C, Emard N, Lynch KA, Hou YN, Mao JJ. 2021. Herbal Topical Analgesic for Pain Management: Perspectives from Cancer Patients. Pain Med 22(6):1435-1440. doi: 10.1093/pm/pnab072. PubMed PMID: 33620470; PubMed Central PMCID: PMC8185551.

Lynch KA, Emard N, Liou KT, Popkin K, Borten M, Nwodim O, Atkinson TM, Mao JJ. 2021. Patient Perspectives on Active vs. Passive Music Therapy for Cancer in the Inpatient Setting: A Qualitative Analysis. J Pain Symptom Manage 62(1):58-65. doi: 10.1016/j.jpainsymman.2020.11.014. Epub 2020 Nov 19. PubMed PMID: 33221385; PubMed Central PMCID: PMC8131401.

Mao, Jun JJ, Kin Wai Hung, Nicholas Emard, Fernanda CG Polubriaginof, Kathleen Lynch, Thomas Michael Atkinson, Kelly Marie Trevino, and Claus Jensen. 2021. “Implementing virtual mind-body programming to support cancer patients during COVID-19.” In Shir Lerman, Bayla Ostrach, and Merrill Singer, eds. Foundations of Biosocial Health: Stigma and Illness Interactions. Lanham: Lexington Books, Pp. 1585-1585.

Houston, Ashley R., Kathleen Lynch, Bayla Ostrach, Yoshua Seidner Isaacs, Carolina Nve Diaz San Francisco, Jae Moo Lee, Nicholas Emard, and Dylan Atchley Proctor. 2022. “United States immigration detention amplifies disease interaction risk: A model for a transnational ICE-TB-DM2 syndemic.” Global Public Health 17(7): 1152-1171.

Romero, Sally AD, Nicholas Emard, Raymond E. Baser, Katherine Panageas, Jodi MacLeod, Desiree Walker, Margaret Barton-Burke et al. 2022. “Acupuncture versus massage for pain in patients living with advanced cancer: a protocol for the IMPACT randomised clinical trial.” BMJ open 12(9): e058281.

Houston, Ashley. 2016. (In)Visible Embodiment: Somali Perspectives of Diabetes and Mental Health in Diaspora

Somalis represent the largest consecutively displaced and resettled group in the United States yet, little is known about their experiences with and perceptions of illness in diaspora. In this research project, I examine how Somalis’ understandings of the body and embodiment shape perceptions of diabetes and mental health. In addition, I ask how are the effects of migration and diaspora embodied among Somalis in Boston? To answer these research questions, I developed a qualitative study among Somali Muslims in Boston. I utilized information from semi-structured interviews (n=6), informal interviews (n=4), and participant observation at a local mosque from March 2015 to March 2016. I argue that for Somalis, diaspora is embodied through: bodily practices based on fluid and complex body ideals and values, food ritual and practices of consumption, and chronic physical health and mental health issues resulting in culturally relevant somatic explanatory models.

Publications:

Ostrach, Bayla, Ashley Houston, and Merrill Singer. 2015. “Syndemics and Legislative Outreach.” Anthropology News (July 3). http://www.anthropology news.org/index.php/2015/06/01/syndemics and legislative outreach/.

Joseph, Natalie, Paula Gardiner, Karla Damus, Kirsten Resnick, Ashley Houston, Hira Shrestha, and Lance Laird. 2017. “Integrating Human Papilloma Virus (HPV) Vaccination Promotion and Cervical Cancer Screening in a Diverse Inner City Primary Care Settings.” Journal of Pediatric and Adolescent Gynecology 30(2): 323.

Houston, Ashley R., Alisa Lincoln, Sarah Gillespie, Tibrine Da Fonseca, Osob Issa, Heidi Ellis, and Carmel Salhi. 2021. “You have to pay to live: Somali young adult experiences with the US health care system.” Qualitative Health Research 31(10): 1875-1889.

Houston, Ashley R., Kathleen Lynch, Bayla Ostrach, Yoshua Seidner Isaacs, Carolina Nve Diaz San Francisco, Jae Moo Lee, Nicholas Emard, and Dylan Atchley Proctor. 2022. “United States immigration detention amplifies disease interaction risk: A model for a transnational ICE-TB-DM2 syndemic.” Global Public Health 17(7): 1152-1171.

Houston, Ashley R., Kathleen Lynch, Bayla Ostrach, Yoshua Seidner Isaacs, Carolina Nve Diaz San Francisco, Jae Moo Lee, Nicholas Emard, and Dylan Atchley Proctor. 2022. “United States immigration detention amplifies disease interaction risk: A model for a transnational ICE-TB-DM2 syndemic.” Global Public Health 17(7): 1152-1171.

Houston, Ashley R., Tibrine Da Fonseca, Tiffany D. Joseph, and Alisa K. Lincoln. 2022. “Challenging federal exclusion: Immigrant safety, health, and healthcare access in sanctuary cities.” Health & Place 75: 102822 (1-9).

Snyder-Young, Dani, Ashley Houston, Ana Bess Moyer Bell, Andy Short, and Alisa Lincoln. 2022. “Recovery capital and collaborative theatre making: how actors in recovery from substance addiction value their participation in addiction prevention plays.” Research in Drama Education: The Journal of Applied Theatre and Performance 27(1): 121-136.

Houston, Ashley R., Dani Snyder-Young, Meghann Perry, Maren Flessen, and Alisa K. Lincoln. 2023. “‘Let Others Love You Back to Health’: The Role of Performance-based Support Groups for People in Recovery.” Community Mental Health Journal 1-12.

Lynch, Kathleen. 2016. “The Land Tells Our Story”: Urban Native Place-Making and Implications for Wellness

In this mixed-methods community-based participatory research project I examine the ways in which sense of place (or lack thereof) is developed for Native Americans living in the urban Boston area, and the implications this has for physical health and social wellbeing. Through in-depth interviews, ethnographic data, and community photo-voice, I argue that a triad of Place, Stress, and Identity configure and act upon the bodies of urban Natives in complex ways, creating a paradoxical sense of place in the city. Each analytical chapter examines particular interactions of this triad: place as a physical and socially-experienced phenomenon, the interactions of place and stress, the process of “place-making”, and social stress surrounding “urban Native” identity.

Developing a framework of “place/body multiple” (Eyles and Williams 2007, Scheper-Hughes and Lock 1987; see background chapter), these chapters build toward the argument that, in contrast to “sense of place” literature that focuses on reservations (see Background Chapter), urban “sense of place” operates within what I term a “landscape of distress.” Forming an urban “sense of place” is beneficial to overall well-being because it leads to support networks and creates a proxy for “home”, building on current literature on social support and anthropological literature on Indigenous place-making. However, it is also detrimental to health because it creates an identity that is inherently separate from tribe and traditional land, creating both social and physiological distress.

Publications:

Applebaum, Allison J., K. E. Roberts, K. Lynch, R. Gebert, M. Loschiavo, M. Behrens, L. E. Walsh, L. C. Polacek, E. L. Diamond, and W. S. Breitbart. 2022. “A qualitative exploration of the feasibility and acceptability of meaning-centered psychotherapy for cancer caregivers.” Palliative & Supportive Care 20(5)): 623-629.

Applebaum, Allison J., Laura C. Polacek, Leah Walsh, Anne S. Reiner, Kathleen Lynch, Stephanie Benvengo, Justin Buthorn et al. 2020. “The unique burden of rare cancer caregiving: caregivers of patients with Erdheim–Chester disease.” Leukemia & lymphoma 61(6): 1406-1417.

Applebaum, Allison J., Raymond E. Baser, Kailey E. Roberts, Kathleen Lynch, Rebecca Gebert, William S. Breitbart, and Eli L. Diamond. “Meaning-Centered Psychotherapy for Cancer Caregivers: A pilot trial among caregivers of patients with glioblastoma multiforme.” Translational Behavioral Medicine 12, no. 8 (2022): 841-852.

Atkinson, Thomas M., Kevin T. Liou, Michael A. Borten, Qing S. Li, Karen Popkin, Andrew Webb, Janice DeRito, Kathleen A. Lynch, and Jun J. Mao. 2020. “Association between music therapy techniques and patient-reported moderate to severe fatigue in hospitalized adults with cancer.” JCO Oncology Practice 16(12): e1553-e1557.

Atkinson, Thomas M., Lynch, Kathleen A., Vera, J., Olivares, N.M., Webb, A., Diamond, L.C., González, J., Lubetkin, E.I., Bucher, G., Rosa-Cunha, I. and Berry-Lawhorn, J.M., 2022. Linguistic validation of the Spanish version of the Anal Cancer High-Grade squamous intraepithelial lesions outcomes Research Health-Related Symptom Index (A-HRSI): AMC-A04. Journal of patient-reported outcomes, 6(1), p.108.

Austria, Mia D., Kathleen Lynch, Tiffany Le, Chasity Burrows Walters, Thomas M. Atkinson, Andrew J. Vickers, and Sigrid V. Carlsson. 2021. “Sexual and gender minority persons’ perception of the Female Sexual Function Index.” The Journal of Sexual Medicine 18:12): 2020-2027.

Austria, Mia, Colin Kimberlin, Tiffany Le, Kathleen A. Lynch, Behfar Ehdaie, Thomas M. Atkinson, Andrew J. Vickers, and Sigrid V. Carlsson. “Patient Perceptions of a Decision Support Tool for Men with Localized Prostate Cancer.” MDM Policy & Practice 8, no. 1 (2023): 23814683231156427.

Desai, Anjali V., Rajiv Agarwal, Andrew S. Epstein, Gilad J. Kuperman, Chelsea L. Michael, Haley Mittelstaedt, MaryAnn Connor, Camila Bernal, Kathleen A. Lynch, Jamie S. Ostroff, Brittany Katz, Kelsey L. Corrigan, Dana Kramer, Mary Elizabeth Davis, and Judith E. Nelson. 2021. “Needs and perspectives of cancer center stakeholders for access to patient values in the electronic health record.” JCO Oncology Practice 17(10): e1524-e1536.

Emard N, Lynch KA, Liou KT, Atkinson T, Green AK, Daly B, Trevino K, Mao JJ. 2021, Virtual Mind-Body Programming for Patients With Cancer During the COVID-19 Pandemic: Qualitative Study. JMIR Cancer 7(2):e27384. doi: 10.2196/27384. PubMed PMID: 33882018; PubMed Central PMCID: PMC8189285.

Epstein, Andrew S., Jada G. Hamilton, Elyse Shuk, Danielle R. Romano, Kathleen Lynch, Erva Khan, Margaux Genoff, Chelsea Michael, and Christine Iacobuzio-Donahue. 2019. “Stakeholders’ perceptions and information needs regarding research medical donation.” Journal of pain and symptom management 58(50): 792-804.

George, Login S., Laura C. Polacek, Kathleen Lynch, Holly G. Prigerson, Ghassan K. Abou‐Alfa, Thomas M. Atkinson, Andrew S. Epstein, and William Breitbart. “Reconciling the prospect of disease progression with goals and expectations: Development and validation of a measurement model in advanced cancer.” Psycho‐Oncology 31, no. 6 (2022): 902-910.

Hamilton, Jada G., Smita C. Banerjee, Sigrid V. Carlsson, Jacqueline Vera, Kathleen A. Lynch, Lili Sar-Graycar, Chloé M. Martin, Patricia A. Parker, and Jennifer L. Hay. 2021. “Clinician perspectives on communication and implementation challenges in precision oncology.” Personalized Medicine 18(6): 559-572.

Houston, Ashley R., Kathleen Lynch, Bayla Ostrach, Yoshua Seidner Isaacs, Carolina Nve Diaz San Francisco, Jae Moo Lee, Nicholas Emard, and Dylan Atchley Proctor. 2022. “United States immigration detention amplifies disease interaction risk: A model for a transnational ICE-TB-DM2 syndemic.” Global Public Health 17(7): 1152-1171.

Jenkelowitz, Juliet, Margaux Genoff Garzon, Kathleen Lynch, Elyse Shuk, Eva Feindler, Heather Landau, and Allison Applebaum. 2021. “Exploring the caregiver’s experience in an innovative homebound hematopoietic stem cell transplantation program.” Palliative & supportive care 19(4)): 397-404.

Landau, Heather J.…Kathleen Lynch, et al._2018_Homebound autologous hematopoietic cell transplantation for plasma cell disorders in an urban setting is safe for patients and preferred by patients and caregivers.” Blood 132: 2258.

Lapen, Kaitlyn, Christopher Sabol, Amy L. Tin, Kathleen Lynch, Alyse Kassa, Xiaolin Mabli, John Ford et al. 2021. “Development and pilot implementation of a remote monitoring system for acute toxicity using electronic patient-reported outcomes for patients undergoing radiation therapy for breast cancer.” International Journal of Radiation Oncology* Biology* Physics 111(4): 979-991.

Leng, Jennifer, Florence Lui, Bharat Narang, Leslie Puebla, Javier González, Kathleen Lynch, and Francesca Gany. 2022. “Developing a culturally responsive lifestyle intervention for overweight/obese US Mexicans.” Journal of Community Health, 1-11.

Liou, Kevin T., Chen C, Emard Nicholas, Lynch, Kathleen A., Hou YN, Mao JJ. 2021. Herbal Topical Analgesic for Pain Management: Perspectives from Cancer Patients. Pain Med 22(6):1435-1440. doi: 10.1093/pm/pnab072. PubMed PMID: 33620470; PubMed Central PMCID: PMC8185551.

Liou, Kevin T., Kathleen A. Lynch, Ogechi Nwodim, Karen Popkin, Jane S. Greene, Thomas M. Atkinson, Joke Bradt, and Jun J. Mao. 2022.”Comparison of depressive symptom outcomes in hospitalized adult cancer patients receiving music therapy or massage therapy.” Journal of pain and symptom management 63, no. 2 (2022): e155-e159.

Lynch Kathleen A., Emard N, Liou KT, Popkin K, Borten M, Nwodim O, Atkinson TM, Mao JJ. 2021. Patient Perspectives on Active vs. Passive Music Therapy for Cancer in the Inpatient Setting: A Qualitative Analysis. J Pain Symptom Manage 62(1):58-65. doi: 10.1016/j.jpainsymman.2020.11.014. Epub 2020 Nov 19. PubMed PMID: 33221385; PubMed Central PMCID: PMC8131401.

Lynch, Kathleen A., Adeleye D. Omisore, Olusola Famurewa, Olalekan Olasehinde, Oluwole Odujoko, Jacqueline Vera, T. Peter Kingham et al. 2021. “Designing Participatory Needs Assessments to Support Global Health Interventions in Time-Limited Settings: A Case Study From Nigeria.” International journal of qualitative methods 20: 16094069211002421.

Lynch, Kathleen A., Adeleye D. Omisore, Thomas M. Atkinson, Olusola C. Famurewa, Jacqueline A. Vera, T. Peter Kingham, Olusegun I. Alatise et al. 2020. “Multistakeholder Needs Assessment to Inform the Development of an mHealth-Based Ultrasound-Guided Breast Biopsy Training Program in Nigeria.” JCO global oncology 6: 1813-1823.

Lynch, Kathleen A., Alexis Merdjanoff, Donna Wilson, Lauren Chiarello, Jennifer Hay, and Jun J. Mao. ““Moving forward”: older adult motivations for group-based physical activity after cancer treatment.” International Journal of Behavioral Medicine (2022): 1-13.

Lynch, Kathleen A., Angela Green, Leonard Saltz, Andrew S. Epstein, Danielle R. Romano, Jacqueline Vera, and Judith E. Nelson. 2022. “The hardest weeks of my life: a qualitative study of experiences, practice changes, and emotional burden of New York City oncology physicians during the COVID-19 surge in 2020.” JCO Oncology Practice 18(5): e669-e676.

Lynch, Kathleen A., Camila Bernal, Danielle R. Romano, Paul Shin, Judith E. Nelson, Molly Okpako, Kelley Anderson et al. 2022. “Navigating a newly diagnosed cancer through clinician-facilitated discussions of health-related patient values: a qualitative analysis.” BMC Palliative Care 21(1): 29.

Lynch, Kathleen A., Thomas M. Atkinson, Adeleye D. Omisore, Olusola Famurewa, Olalekan Olasehinde, Oluwole Odujoko, Olusegun I. Alatise et al. “Developing a Technology Acceptability and Usage Survey (TAUS) for mHealth Intervention Planning and Evaluation in Nigeria: Pilot Study.” JMIR Formative Research 6, no. 4 (2022): e34035.

Mao, Jun JJ, Kin Wai Hung, Nicholas Emard, Fernanda CG Polubriaginof, Kathleen Lynch, Thomas Michael Atkinson, Kelly Marie Trevino, and Claus Jensen. 2021. “Implementing virtual mind-body programming to support cancer patients during COVID-19.” In Shir Lerman, Bayla Ostrach, and Merrill Singer, eds. Foundations of Biosocial Health: Stigma and Illness Interactions. Lanham: Lexington Books, Pp. 1585-1585.

Mazzella‐Ebstein, Ann M., Cynthia Paradiso, Kathleen Lynch, Judith E. Arnetz, and Margaret Barton‐Burke. “Data‐driven clinical improvement: Oncology nurse leaders’ perceptions and experiences of organisational data reports.” Journal of Nursing Management (2022).

Mitchell, Hannah-Rose, Allison J. Applebaum, Kathleen A. Lynch, Anne S. Reiner, Thomas M. Atkinson, Justin J. Buthorn, Allison S. Sigler et al. 2022. “Challenges and positive impact of rare cancer caregiving: A mixed-methods study of caregivers of patients with Erdheim-Chester disease and other histiocytic neoplasms.” Eclinicalmedicine 54: 101670.

Ostroff, Jamie S.,… Kathleen Lynch, et al. 2022. “Study protocol of a multiphase optimization strategy trial (MOST) for delivery of smoking cessation treatment in lung cancer screening settings.” Trials 23(1): 664.

Patel, Snehal G., Thomas M. Atkinson, R. Michael Tuttle, Andrea L. Pusic, Jatin P. Shah, Ashok R. Shaha, Kathleen Lynch et al. “ThyroidEx: Development and Preliminary Validation of a Thyroid Surgery Expectations Measure.” Otolaryngology–Head and Neck Surgery 165, no. 2 (2021): 267-274.

Rosa, William E., Kathleen A. Lynch, Rachel A. Hadler, Cassidy Mahoney, and Patricia A. Parker. ““Doing palliative care with my hands tied behind my back”: telepalliative care delivery for oncology inpatients during a COVID-19 surge.” Translational Behavioral Medicine 12, no. 7 (2022): 816-824.

Rosa, William E., Kathleen A. Lynch, Rachel A. Hadler, Cassidy Mahoney, and Patricia A. Parker. 2023. ““It Took Away and Stripped a Part of Myself”: Clinician Distress and Recommendations for Future Telepalliative Care Delivery in the Cancer Context.” American Journal of Hospice and Palliative Medicine 40(2): 235-243.

Salz, T.; Ostroff, J. S.; Nightingale, C. L.; Atkinson, T. M.; Davidson, E. C.; Jinna, S. R.; Kriplani, A.; Lesser, G. J.; Lynch, K. A.; Mayer, D. K.; Oeffinger, K. C.; Patil, S.; Salner, A. L.; Weaver, K. E.. “The Head and Neck Survivorship Tool (HN-STAR) Trial (WF-1805CD): A protocol for a cluster-randomized, hybrid effectiveness-implementation, pragmatic trial to improve the follow-up care of head and neck cancer survivors.” Contemporary clinical trials 107 (2021): 106448.

Sarro, Emily Long, Kelly Haviland, Kimberly Chow, Sonia Sequeira, Mary Eliza McEachen, Kerry King, Lauren Aho, Nessa Coyle, Hao Zhang, Kathleen A. Lynch, Louis Voigt, and Mary S. McCabe. 2022. “PASTRY: A nursing-developed quality improvement initiative to combat moral distress.” Nursing Ethics 29(4): 1066-1077.

Underwood, Jody, Susan McCloskey, Ann Raldow, Amar Kishan, Chad Zalkin, Daniel Navarro, Lisa Scott Holt, Andrew Webb, Kathleen A. Lynch, and Thomas M. Atkinson. “Developing a Mobile Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events Administration System to Capture Postradiation Toxicity in Oncology: Usability and Feasibility Study.” JMIR formative research 6, no. 4 (2022): e27775.

Washington, Charles, Stephanie Benvengo, and Kathleen Lynch. 2020. “Addressing Service Recovery Practice With Radiation Oncology Frontline Managers: A Project Brief.” Journal of Patient Experience 7(6): 915-919.

Zhang, Helen, Elaine E. Cha, Kathleen Lynch, Oren Cahlon, Daniel R. Gomez, Narek Shaverdian, and Erin F. Gillespie. 2020. “Radiation oncologist perceptions of telemedicine from consultation to treatment planning: a mixed-methods study.” International Journal of Radiation Oncology* Biology* Physics 108(2): 421-429.

Zhang, Y. Helen, Elaine Cha, Kathleen Lynch, Renee Gennarelli, Jeffrey Brower, Michael V. Sherer, Daniel W. Golden, Susan Chimonas, Deborah Korenstein, and Erin F. Gillespie. “Attitudes and access to resources and strategies to improve quality of radiotherapy among US radiation oncologists: A mixed methods study.” Journal of Medical Imaging and Radiation Oncology 66, no. 7 (2022): 993-1002.

Major [Nvé] Diaz San Francisco, Carolina. 2016. Migration, Transnationalism, Illness and Healing:  Toward the Consolidation of the Self among the Congolese Diaspora in Boston and Lynn, Massachusetts

This thesis explores the perceptions of illness and healing among the Congolese diaspora in Boston and Lynn, MA, and within the contexts of migration and transnationalism. With this thesis, I argue that the Congolese who participated in this study perceive illness as social suffering, and healing as the consolidation of the self. Participants express their perceptions of illness and healing according to their identities, or the orientations of the self. Perceptions of illness were expressed as illness narratives framed under the theories of structural violence, and from the perspectives of the Congolese as displaced and migrant people. Congolese extend their perceptions of illness also to other non-Congolese communities they have come to belong to through transnational and global social formations. Congolese demonstrate that healing means the consolidation of their self, or identities, as Catholic Congolese in diaspora, advocates for refugees, African-Americans, Blacks, and “the Priest” in Lynn. Congolese emphasize that building and maintaining their newly acquired identities form part of their strategies to establish themselves in the USA, and bring healing to themselves and others. This exploration is limited, and thus, further research is recommended on: 1) other Congolese community groups; 2) the local and global Congolese diasporic activism for conflict resolution directed to the DRC; 3) practical proposals for collaborative research in order to resolve the socio-cultural and economic barriers that Congolese have in clinical settings.

Publications:

Nvé Díaz San Francisco, Carolina. 2018. Skins, Identities, and Their Tragedies: The Learning and Healing of a Hispano-Guinean Woman in the Diaspora. In Msia Kibona Clark, Loy Azalia, Phiwokuhle Mnyandu, eds. 2018. Pan African Spaces: Essays on Black Transnationalism. Lexington Books, pp. 53-60.

Nvé Díaz San Francisco, Carolina. 2019. An Ethnographic Experience: Freedom, Fiction, and Medicine Women in Afrofuturist Contexts. Irish Journal of Anthropology 22(1): 138-146.

Nvé Díaz San Francisco, Carolina. 2019. Mis madres son estrellas. Revista Cronopio (September 29). (See also: Briseida Cidoncha. 2019. La escritora hispanoguineana Carolina Nvé Díaz San Francisco presenta su nueva novela “Mis madres son estrellas”. Toda Literatura [May 29]).

Nvé Díaz San Francisco, Carolina. 2020. The Dictatorship of Biomedicine in Equatorial Guinea. Ufahamu: A Journal of African Studies 42(1): 23-42.

Nvé Díaz San Francisco, Carolina. 2020. The Head of state or the body of the nation, plays with biomedicine as He pleases, As if Healing was a toy. Ufahamu: A Journal of African Studies.

Nvé Díaz San Francisco, Carolina. 2022. “Care During Pandemic Times: Digital Ethnography with Mental Health Professionals i n Equatorial Guinea.” Anthropology and Humanism 329-345.

Houston AR, Lynch K, Ostrach B, Isaacs YS, Nvé Díaz San Francisco C, Lee JM, Emard N, Proctor DA. United States immigration detention amplifies disease interaction risk: A model for a transnational ICE-TB-DM2 syndemic. Glob Public Health. 2022 Jul;17(7):1152-1171. doi: 10.1080/17441692.2021.1919737. Epub 2021 May 4. Review. PubMed PMID: 33945403.

Nvé Díaz San Francisco, Carolina. 2023. “Cultures of Dialogue and Pro-democracy in Equatorial Guinea and Diaspora.” Journal of Dialogue Studies 11: 63-85.

Nvé Díaz San Francisco, Carolina. 2023. Attitudes of diverse older adults towards the COVID-19 vaccine: A qualitative study of vaccine uptake among racial/ethnic minorities (in press).

Mellett, Erin. 2016. Cochlear Implants and CODAs: The Impact of a Technology on a Community

There has been a great amount of debate between the medical community and the Deaf community regarding cochlear implants. Indeed, some factions of the Deaf community have reacted with hostility to the development of the technology and have protested its implementation. Existing literature examines Deaf individuals’ perceptions of cochlear implants, however there has been a significant lack of academic attention paid to the hearing children of deaf adults (codas). As children of deaf parents, codas grow up simultaneously inhabiting two worlds: the Deaf world of their parents and the hearing world of their peers. It is codas’ unique position and loyalties between the Deaf world and the hearing world that make them important to the cochlear implant debate. This study investigates codas’ perceptions of cochlear implantation using standard ethnographic methods, including in-depth, open-ended interviewing with codas, and immersion in the research population through ongoing participant-observation at a deaf school. The findings suggest that (1) codas’ interstitial identity impacts their perceptions of and attitudes towards cochlear implantation and (2) cochlear implants have contributed to a refinement of Coda identity in relation to the Deaf community.

Proctor, Dylan A. 2016. Growing Narrative, Conviviality, and Security: Community and Gardening in the North Shore of Massachusetts.

Growing Narrative, Conviviality, and Security: Community and Gardening in the North Shore of Massachusetts is an ethnography of the Highlands neighborhood of Lynn, Massachusetts. In this thesis I argue that the efforts of this community to combat the ills of their neighborhood seen through the lens of a community garden rely on three key factors. The first is their reliance and sharing of a narrative that reminds fellow community members of the difficult points in their past, but with the message that there is always a possibility of a brighter future. The second aspect is the reliance on the shared moments of celebration that the neighborhood actively supports and engages, which instill the bonds of community in an otherwise disparate, and multicultural setting. Finally, the narrative and celebration of community would not be sustainable if the community did not also provide the structure for security upon which the neighborhood can continue to improve their communal and social wellbeing. The lessons learned from this community are useful to understand how a multiracial, multicultural urban site can turn around their violent past in order to create a livable space.

Publications:

Houston, Ashley R., Kathleen Lynch, Bayla Ostrach, Yoshua Seidner Isaacs, Carolina Nve Diaz San Francisco, Jae Moo Lee, Nicholas Emard, and Dylan Atchley Proctor. 2022. “United States immigration detention amplifies disease interaction risk: A model for a transnational ICE-TB-DM2 syndemic.” Global Public Health 17(7): 1152-1171.

Resnick, Kirsten. 2016. Bridging Birth: The Birth Sisters as an Adaptation to Hospital Birth.

This study was designed to explore the mediated experience of supported birth in a hospital setting by examining the role of the Birth Sisters, with a focus on how the individual Birth Sisters perceived the impact of their role. The goal of my research is to understand the ways in which having a Birth Sister assist women in emerging from birth empowered and achieving better psychosocial and medical outcomes. I hope to contribute to the growing research on the role of doula support by providing a focused examination of the lived experiences of the women providing this support as part of a hospital setting. As such, this study examines the ways in which Birth Sisters act as a mitigating force to bridge the biocultural, cultural and structural aspects that emerge in a U.S. hospital birth.

Publications:

Dresner, Danielle, Kirsten Resnick, Paula Gardiner, Katherine Gergen Barnett, and Lance Laird. 2014. “Qualitative evaluation of an integrative medicine group visits program for patients with chronic pain and associated comorbidities.” The Journal of Alternative and Complementary Medicine 20(5): A55-A56.

Dresner, Danielle, Katherine Gergen Barnett, Kirsten Resnick, Lance D. Laird, and Paula Gardiner. 2016. “Listening to their words: A qualitative analysis of integrative medicine group visits in an urban underserved medical setting.” Pain Medicine 17(6): 1183-1191.

Joseph, Natalie, Paula Gardiner, Karla Damus, Kirsten Resnick, Ashley Houston, Hira Shrestha, and Lance Laird. 2017. “Integrating Human Papilloma Virus (HPV) Vaccination Promotion and Cervical Cancer Screening in a Diverse Inner City Primary Care Settings.” Journal of Pediatric and Adolescent Gynecology 30(2): 323.

Roseen, Eric J., Oscar Cornelio-Flores, Chelsey Lemaster, Maria Hernandez, Calvin Fong, Kirsten Resnick, Jon Wardle, Suzanne Hanser, and Robert Saper. 2017. “Inpatient massage therapy versus music therapy versus usual care: A mixed-methods feasibility randomized controlled trial.” Global advances in health and medicine 6: 2164957X17735816.

O’Rourke-Suchoff, Danielle, Lauren Sobel, Erica Holland, Kirsten Resnick, Rebecca Perkins, and Shannon L. Bell. 2018. “A Qualitative Study of Pregnancy and Childbirth Experience for Women with a History of Sexual Trauma [37B].” Obstetrics & Gynecology 131: 29S.

Simmons, Molly, Bo Kim, Justeen Hyde, Tiffany Lemon, Kirsten Resnick, and D. Keith McInnes. 2018. “Veteran Sex Offender Access to Housing and Services after Release from Incarceration: Obstacles and Best Practices.” VA National Center on Homelessness Among Veterans. May: 1-5.

Onyango, Monica Adhiambo, Kirsten Resnick, Alexandra Davis, and Rupal Ramesh Shah. 2019. Gender-Based Violence Among Adolescent Girls and Young Women: A Neglected Consequence of the West African Ebola Outbreak. Schwartz, David A., Julienne Ngoundoung Anoko, Sharon A. Abramowitz, eds. Pregnant in the Time of Ebola: Women and Their Children in the 2013-2015 West African Epidemic. Cham, Switzerland: Springer Nature, pp. 121-132.

Sobel, Lauren, Danielle O’Rourke-Suchoff, Erica Holland, Kimberly Remis, Kirsten Resnick, Rebecca Perkins, and Shannon Bell. 2018. “Pregnancy and childbirth after sexual trauma: patient perspectives and care preferences.” Obstetrics & Gynecology 132(6): 1461-1468.

Rinne, Seppo T., Kirsten Resnick, Renda Soylemez Wiener, Steven R. Simon, and A. Rani Elwy. 2019. “VA provider perspectives on coordinating COPD care across health systems.” Journal of General Internal Medicine 34: 37-42.

Rosenthal, Staci. 2016. Birthing into Death: Stories of Jewish Pregnancy from the Holocaust

This thesis investigates the stories of Jewish women and men living in Europe during the Holocaust who made decisions related to pregnancy, abortion, birth, and ‘parenting’ in ghettos, concentration camps, and in hiding. By reviewing existing, publicly accessible survivor testimonies, and by interviewing still-living survivors, I analyze the various ways Jewish women and men used available but limited forms of reproductive assistance to preserve their own lives and to secure the safety of their unborn or born children. Jewish women and their doctors or other ad-hoc medical providers weighed the risks of possible illness or diseases resulting from clandestine care against the seemingly greater or graver risk of Nazi exposure. By highlighting stories from Holocaust survivors who speak about experiences receiving or providing reproductive “health care” during the Holocaust, this study emphasizes what survivors say about seeking or providing abortions under conditions they might not have otherwise accepted, pursued, or suggested. Women who became pregnant during the Holocaust embody the unspeakable dilemma of “birthing into death,” as reproduction often meant murder for Jewish mothers. Pregnant Jewish women and their partners, the medical providers who attended to them, and their witnesses during the Holocaust all have unique perspectives on their own in-themoment responses to pregnancy under extreme conditions. Their testimonies speak to how the decisions they made involved Jewish cultural notions of childrearing in Europe during the time of the Holocaust, and to the complex shaping of traumatic memory.

For Related Papers

Treadwell (Loomer), Stephanie. 2016. A Paradox of Support: The Department of Children and Families and Their Construction of the “Good Mother”

Pregnant women with substance use issues are a doubly at-risk group in desperate need of support. Using open-ended interviews, participant-observation, and media analysis, I examine the support provided by the Department of Children and Families (DCF) in Massachusetts for pregnant women who seek treatment at Project Empowerment. Project Empowerment provides prenatal care, maintenance therapy, and other services to expectant mothers who struggle with substance use issues. Drawing upon Foucault’s (1975) notion of surveillance, I explore how pregnant women with substance use issues are surveilled by agencies, and how these surveillance agencies structure their care and policies through their definitions of what it means to be a “good mother.” I argue that through the Department of Children and Families definition of the “good mother,” DCF produces an unintended paradox of support for pregnant women with substance use issues in Massachusetts.

Publications:

Lu, Christine, Stephanie Treadwell, Rachel Ceccarelli, Kathleen Mazor, and Ann Wu. 2017.  “Payer Decision-Making for Pharmacogenetic Tests: Preliminary Results.” Journal of Patient-Centered Research and Reviews 4(3): 170-171.

Bracho-Perez, Bianca. 2015. Cellf-Care: The Role of Smartphones In Decision-Making And The Formation of Health and Self

Smartphone technology has transformed the process by which women understand themselves, manage their care decisions and access health information, while also creating a space for more integrated and individualized understandings of wellness. Using exploratory, semi-structured interviews (n = 27) and observation of phone use, this study examines how minority women in Boston engage with smartphones through healthrelated mobile applications and web searches. Drawing upon postphenomenology, I examine the way smartphones have become both a regulatory force and motivational tool in the formation of self. I argue that the integration of smartphones into user identity positions them as the primary entryway for health decision-making (Garro, 1986, 1998), patient-clinician interactions.

Petrov, Svyatoslav. 2015. “Such Cases Are Awakenings!” Transforming Clinical Relationships Through Critical Incidents In Refugee Care

A positive physician-patient relationship is crucial for high quality and effective health care. Yet, cultural and language differences between providers and patients often challenge the establishment of effective physician-patient relationships. These challenges are especially evident in provider-refugee-patient interactions in which patients have experienced loss, torture, and trauma. Understanding of what constitutes a positive doctor-patient relationship is fundamental to diagnosis and treatment and is crucial for the delivery of quality care for diverse patient populations, including refugees. This qualitative, phenomenological case-study focuses on physician-reported experiences caring for refugees in order to identify what experiential factors contribute to effective therapeutic relationships.

Publications:

Petrov, Slavvy (Svyatoslav). 2015. Living on the Edge: The Role of Critical Incidents on the Development of Secondary Resilience in Physicians. International Journal of Emergency Mental Health and Human Resilience 17(4): 714-716.

Christian, Robert J. 2014. “You Know a Girl When You See One”: Experiences of Surgeons Who Perform Gender Affirmation/Reassignment Surgery

Most recent research on gender affirmation/reassignment surgery focuses on discrimination and health disparities faced by the transgender community, and on perspectives and identity constructions of patients transitioning from one gender presentation to another. However, few studies address perspectives and experiences of the surgeons performing these operations. This exploratory study examines narratives of some of these surgeons in order to understand how they entered this particular practice, and how they perceive and classify these procedures. This study also aims to show the affect these procedures have on these surgeons and their discipline, and how these surgeons navigate the complex relationships between patients, healthcare providers, and surgeons, in the context of social values and popular media perspectives in the United States.

Poster Presentation: “You Know a Girl When You See One”: Experiences of Surgeons Who Perform Gender Affirmation/Reassignment Surgery (GAS)

Featured in: Toni Cardarella. 2014. KU Medical Center gives back during the holidays. KU Medical Center News Dec. 22.

Publications:

Christian, Robert J. and Mandy VanSandt. 2021. Using Dynamic Virtual Microscopy to Train Pathology Residents During the Pandemic: Perspectives on Pathology Education in the Age of COVID-19. Academic Pathology 8: 1-8.

Garza, Rebecca D. 2014. Delivering Diversity: Meanings of Cultural Competence Among Labor and Delivery Nurses in an Urban Hospital

Nursing theory has contributed significantly to discussions of so-called culturally competent biomedical healthcare delivery. This study explores how Labor and Delivery nurses at a large, urban teaching hospital negotiate the care of a hyperdiverse patient population and construct working understandings of competence. Archival research, semi-structured interviews and participant observation demonstrate that cultural competence is not a distinct concept, but rather functions as an ambiguous symbol used to discuss a variety of challenges with advocating for patients and delivering care in communities faced with issues of racism, immigration, low socioeconomic status, and multiple comorbidities.

Melstrom, Eva R. 2014. “Who Minus Who”: Suicide in Boston’s Ethiopian Community

This thesis examines suicide in Boston’s Ethiopian Community. The act of suicide and individual cases are explored through participant narratives. Narratives from family members and acquaintances of those who died by suicide are examined. I rely on in-depth (N=8) and follow-up interviews (N=7). Drawing heavily on culturally constructed notions of self, this thesis explores what it has meant for persons of the Ethiopian community to lose fellow members to suicide. Intersections of emotions, constructions of choice and agency, and idealized notions of self emerge as central themes. The body, in life and death, is situated as a vehicle for communicating dis-eased social relationships and unrealistic cultural expectations. Participants position their perceptions of the deceased in relation to popular preconceived notions of life in the United States and stresses encountered during and after the immigration process. Memory of Ethiopia, the United States, immigration, and the suicide are significant for understanding the rigidity of culturally authoritative truths.

This thesis emphasizes the progressive and beneficial methodology of an anthropological investigation into suicide. Understanding the reasons and acquiring specific knowledge about Ethiopian suicide in the United States can contribute to current conversations regarding immigrant suicide. Ultimately, this study aims to contribute to comprehensive prevention measures, which support every individual.

Publications

Melstrom, Eva R. 2019. Seeking Change: Ethiopian Migrant Domestic Workers’ Predicament. UCLA Center for the Study of Women.

Melstrom, Eva Rose. 2021. The Gate of Weeping: Ethiopian Women Returning from Domestic Work in the Arab States of the Persian Gulf. UCLA. ProQuest ID: Melstrom_ucla_0031D_20201. Merritt ID: ark:/13030/m58q2db9. Retrieved from https://escholarship.org/uc/item/6ft3w73c.

Turner, Katie-Elyse. 2014. In Practice: Narrative Care & Decision-Making among Pediatric and Adolescent Health Providers

This thesis explores the experiences of several pediatric health care providers in the Boston area. It identifies and examines the stories told by providers to discuss their profession, their decision-making processes, and the methods that they use to “know” themselves and their patients through the lens of current topics of interest in pediatrics, including the Human Papillomavirus (HPV) vaccines. Pediatricians, pediatric nurse practitioners, adolescent health providers, and pediatric focused gynecologists were recruited from several private, community-based, and academic medical center practices in the Boston area. This study used several qualitative data collection methods, focusing primarily on the use of semi-structured interviews while including participant and non-participant observations in two distinct clinical settings.

Welch (Borges), Michelle. 2014. Sexual Orientation and Identity in Diabetes Health Care: the Experience of Type 2 Diabetes among Lesbian, Queer, and Women-Loving Women

This Master’s Thesis reports on the experiences of Type 2Diabetes of Lesbian, Queer, and Women-Loving Women. The thesis examines the impact of sexual orientation on experiences with diabetes, and how this chronic disease affects the way a woman views herself, her health, and her body image. Each participant presented her narrative and world views in regards to her diabetes health care and management, stress and trauma, and management of relationships. Through narrative analysis, I have revealed differing mechanisms of coping and explanatory models; the many women of this study selectively chose to be more open about her sexual orientation than her diabetes status.

Doran, Heather M. White. 2014. “What Am I Supposed To Eat?”: Nutritional Messaging in an Inner-City Integrative Medicine Clinic

Public health has developed education campaigns based on nutritional messaging to alleviate illnesses related to food consumption.  This thesis examines cultural factors affecting the accessibility of such messaging, such as economic status, ethnicity, role in the family, access to transportation and markets, and familiarity with the topics of messaging. I explore how these variables affect learning and applying new nutrition knowledge in an individual’s daily life. The methods used were semi-structured interviews (n=11) and participant observations conducted in an Integrative Medicine clinic at an urban hospital.

Xin, Tong. 2014. Covering Health: Healthworlds of First-Generation Chinese Immigrants in Boston Chinatown

This study examines the healthworlds of first-generation Chinese immigrants in Boston’s Chinatown.  Through participant observation and interviews conducted within a local church and a local park community, three key issues emerged: how the space of Chinatown influences people’s post-immigration healthworld, the dynamics of community health supports and health challenges, and the daily health lives of these immigrant individuals within their respective families. Likewise, complex understandings of health coverage emerge that include not only health insurance, but also social forms of insurance. Community integration becomes not only a cultural tradition, but also how health resources and health support are linked and provided. This social form of insurance makes it possible for community members to reach out cultural and religious health resources and support in the context of everyday life.

Sullivan, Eileen C. 2013. From Washing to Whitening: The Cosmetic Practices and Beauty Politics of Vietnamese-American Women in Boston

This thesis examines perceptions of normative beauty ideals among Vietnamese-American women and the impact of these ideals on beauty seeking behaviors. I explore women’s lived experience of beauty via practices pursued and products consumed, and frame beauty work as a disciplinary practice, as well as an investment in embodied species of capital. I query how ideals of appearance relate to being Vietnamese within American culture and the critical role of appearance in affirming identity. The methods used were in-depth interviews (n=5), an open-ended response Internet survey (n=19), and a content analysis of a transnational Pond’s advertisement to which both Internet participants and in-depth interview participants contributed.

Kelly, Masami Tabata. 2013. Becoming a Kidney Transplant Citizen: Kidney Transplantation, Race and Biological Citizenship

I conducted a four-month ethnographic fieldwork study to document the stories of thirteen post-kidney-transplant minority patients and three nephrologists at Boston Medical Center. My research explores how patients’ interactions with health professionals, medical regimens, dialysis treatments, and adaptation to living with transplanted kidneys constantly shape their identities and perceptual worlds. Patients’ narratives highlighted the emotional struggles they encountered along the path of End-Stage Renal Disease, which unfolded as distinct experiences influenced by their varied backgrounds. The majority of my patient-participants lived on the verge of poverty, and in some cases, their insurance status caused delays in their being registered on the transplant waiting list, making them endure a long wait. Some patients were afraid of wearing short sleeves because they thought the scars on their arms from dialysis treatment would lead others to think they were gangsters. Instantiations of various theories emerged from the saturated data and narrative analysis, from Bourdieu’s concept of habitus with regard to the process of how patients alter their consciousness through interactions with medicine to Foucault’s ideas of power relations and technologies of the self that address the issues of agency and power that influence the formation of patients’ identities. The intersection of these theoretical frameworks led me to develop the critical medical anthropological-oriented concept of biological citizenship. This paper examines 1) the ways in which “race” interacts with the theoretical concept of biological citizenship and 2) the ways in which socioeconomic status and race tailor a kidney transplant patient’s illness experience, and related discourse.

Publications

Amass, Timothy, Lauren Jodi Van Scoy, May Hua, …Masami Tabata-Kelly…2022. “Stress-related disorders of family members of patients admitted to the intensive care unit with COVID-19.” JAMA internal medicine 182(6): 624-633.

Hu, Frances Y., Masami Tabata-Kelly, Fabian M. Johnston, Anne M. Walling, Charlotta Lindvall, Rachelle E. Bernacki, Andrea L. Pusic, and Zara Cooper. 2022. “Surgeon-reported Factors Influencing Adoption of Quality Standards for Goal-concordant Care in Patients with Advanced Cancer: A Qualitative Study.” Annals of Surgery 10-1097.

Tabata-Kelly, Masami, Mengyuan Ruan, Tanujit Dey, Christina Sheu, Emma E. Kerr, Haytham MA Kaafarani, Ali Salim, Bellal Joseph, and Zara Cooper. 2022. “The Association Between Preparedness for Caregiving and Caregiver Burden among Informal Caregivers of Older Injured Adults.” Journal of the American College of Surgeons 235(5): S97.

Silver, Kristina Fenn. 2012. Developing A Dialogue Between Refugee Patients and Their Healthcare Providers About Traditional Medicine Usage: Why Context Matters

Traditional medicine use is common and diverse among patients in the United States. Many do not tell healthcare providers about their traditional medicine use or remedies nor do healthcare providers typically have the time to ask. This creates a barrier to the care received because the patient and healthcare provider do not communicate fully about treatment options. The goal of this study was to increase communication about traditional and integrative medicine by putting together a survey following the analysis of these ethnographic interviews.

Working within the Boston Center for Refugee Health and Human Rights at Boston Medical Center, I interviewed refugee and asylum seeking patients and their healthcare providers about traditional medicine use. This included a demographic survey and qualitative, open ended interviews. I formally interviewed 27 refugee and asylum seeking patients and spoke with several healthcare providers throughout the study. The majority of interviewees were female (n=22) and from Africa (n=19), reflecting the demographic of patients throughout the clinic. Eighteen patients we interviewed reported using herbal remedies at some point in their lives, more than half (n=13) in the United States. Participants were much more open to discussing herbal medicine and religious healing than other types (e.g. ancestor worship).

Through this survey, I hope to increase health care practitioner’s awareness of these issues and help them effectively navigate this conversation topic. Demonstrated understanding of their patients’ views of disease and medicine will potentially help the patients feel more comfortable in the clinic. In addition, it will enable both sides to be as open as possible with one another about treatment pathways.

Hill, Stephanie L. 2012. The Meaning of Diabetes for Boston Latinos

The purpose of this study is to understand the health beliefs and behaviors of Puerto Rican and El Salvadorian adults’ living with Type 2 diabetes in the Jamaica Plain neighborhood of Massachusetts. What explanatory models do Puerto Rican and El Salvadorian adults’ frame with regard to Type 2 diabetes mellitus? Which of the multiple etiologies and available treatments shape diabetes health beliefs, and how do these relate to the explanatory models of physicians, and how might they impact diabetes behaviors? I sought to gain understanding of these ideas by looking beyond the biomedical definition that may have been imprinted into their descriptions to examine these Puerto Rican and El Salvadorian adults’ point of view of diabetes. The research will aid health care professionals in understanding how Puerto Rican and El Salvadorian adults’ perceive and discuss diabetes prevention, etiologies, treatments, and aid in creating a care management plan for patients. This project is designed to learn about the views of diabetes causation and treatments for Puerto Ricans and El Salvadorians living with type 2 diabetes in the Jamaica Plain neighborhood.

Laurens, Vivian. 2012. Developing a Sense of Belonging: The Immigration Experience of Latin American Women in Boston

This thesis explores the experience of immigration of Latin American women living in Boston, and how they develop a sense of belonging and identity in American society. By looking into different aspects of participants’ lives (work, family life, community, healthcare), I examine various circumstances in which their sense of belonging is supported and those in which it is jeopardized. The primary site of recruitment for this study was a Baptist congregation, which serves the Latino population in the Boston area. I used qualitative data collection methods including, individual interviews with the women and participant observation at the congregation, to gather participants’ immigration stories. As an in-depth grounded theory analysis this study reveals the fluid nature of participant’s sense of belonging; it is ever-changing, it is always moving back and forth from insider to outsider, and it is constantly brought into question. As a result the immigration experience of participants is immersed within tensions between a cohesive and fragmented sense of belonging.

Publications

Mitchell, Suzanne E., Vivian Laurens, Gabriela M. Weigel, Karen B. Hirschman, Allison M. Scott, Huong Q. Nguyen, Jessica Martin Howard et al. 2018. “Care transitions from patient and caregiver perspectives.” The Annals of Family Medicine 16(3): 225-231.

Laurens, Vivian, César Abadía‐Barrero, and Mario Hernández. 2023. “Latin American Social Medicine in Colombia: Violence, neoliberalism, and Buen Vivir.” The Journal of Latin American and Caribbean Anthropology 28:93–105.

Palmer, Alexandra M. 2012. Pathways Into Care for Pediatric Asthma

Studies have demonstrated that patients may not adhere to the treatment prescribed by the physician because their respective models of the disease are different. Studies have also demonstrated that the patient may feel inferior to the health care provider and not share his or her model with the doctor for fear of being perceived as ignorant. The interaction between the provider and patient is especially significant to asthma because asthma is a chronic condition that may require management for life. However, there is a gap in the social science literature for studies related to asthma. This thesis presents the way pediatric asthma health care providers and a sample of Boston Puerto Rican parents of children with asthma perceive asthma based on data collected through informal interviews. Puerto Ricans are one of the Latino subgroups who remain most at risk for asthma morbidity and are the most represented Latino subgroup in Boston. Research tends to generalize all of the Latino subgroups and it is important to consider each one separately in order to develop effective public health prevention and intervention strategies. Making each other aware of the other’s asthma model will provide an avenue to help the health care providers and Puerto Ricans work together through any differences to an agreed-upon management regimen for the child’s asthma. An understanding of why the health care provider is suggesting a particular treatment and why the patient is managing the disease in a particular way may help improve outcomes.

Soya, Christine. 2012. The Effects of Direct-To-Consumer Antidepressant Advertising on Doctor-Patient Relationships

Objective: This qualitative study looks at how doctors and patients feel direct-to-consumer antidepressant advertising affects the doctor-patient relationship. Methods and Results: I conducted open-ended interviews with eight primary care physicians to understand their feelings about direct-to-consumer antidepressant advertising. I performed a content analysis of eight antidepressant and antidepressant add-on advertisements available on YouTube. I also collected and analyzed comments for each YouTube ad to represent the general public’s opinions. Using an ethnomedical framework, I looked at the many factors surrounding direct-to-consumer antidepressant advertising including: the object of concern (depression), the social practice of advertising, patients’ cultural specific concerns, doctors’ values, and managed care organizations (the institutional level). Conclusions: My study points to both physician and societal perceptions of the current practice of direct-to-consumer antidepressant advertising, and its perceived risks or benefits to the doctor-patient relationship.

Aba Jebel, Sofia. 2011. Parkinson’s Dance!: A Meaning-Centered Analysis of the Emergence of Dance Therapy

Objectives: The purpose of this study is to understand the experiences of dance advocates, instructors who engage in either dance therapy or dance in health-related settings, and Parkinson’s dance students who participate in the Jewish Family & Children’s Center’s (JFCS) Dance for Parkinson’s program. The study is designed to collect narratives from participants, to gather meaning-based definitions of therapy and healing. Methods: In order to collect data reflective of participant experiences, I participated in and observed dance classes held at the JFCS over six weeks. I conducted qualitative interviews with dance advocates, instructors and students. Dance students were all recruited from JFCS Dance for Parkinson’s program, whereas the advocates and dance instructors were recruited from both JFCS and Boston dance therapy networks. Results: The data collected from the study reveal that participants’ explanatory models of illness and health are complex and multi-dimensional. Similarly, the unique dynamics of dance indicate that it functions as a viable intervention to address the complex and multidimensional aspects of Parkinson’s disease (PD). Dance students heal through dance because dancing is fun, liberating and provides a social context that Parkinson’s Disease would otherwise remove. Conclusions: The professionalization of dance therapy has resulted in the specific appropriation of the term, requiring a certified dance therapist to be present. Dance students are affected by the narrow use of the term “dance therapy” and offer conflicting statements about the beneficial nature of dance; sometimes therapeutic, sometimes not. As a creative art therapy, programs like Dance for Parkinson’s have a long future ahead as long as they are not subject to qualification by the biomedical community.

Crespo, Cristina M. 2011. Experiences and Barriers to Engagement of Low Income Urban Minority Expectant Fathers

Expectant fathers‘ experiences of their partners‘ pregnancy and their own transition to parenthood has not been significantly researched across demographic differences to include low-income African American, Haitian Latino men in an urban environment. This is a qualitative case study of a health center in Boston, Massachusetts that examines what men in this category expect, perceive and experience during the prenatal process and what, in turn, the health professionals who interact with them expect and perceive. Research participants include men who are engaged in the prenatal process and healthcare professionals who interact with expectant couples at the chosen health center. This study focuses on a population scarcely addressed in the literature of fatherhood and who has historically experienced low levels of paternal engagement. As an in-depth grounded theory analysis of the experiences and opinions of expectant fathers and health professionals, this study reveals the pervasive influence of an idealized trope of American fatherhood which, in actuality, is often inaccessible to low income minority expectant fathers. The social barriers to involvement are discussed and clinical recommendations to improve paternal engagement are suggested.

De Santa, Meghen. 2011. “It’s About Having a Fertile Mind”: A Meaning-Centered Analysis of Hypnosis for Infertility

Objectives: This study examines the use of hypnosis for fertility and reproductive health in the United States.  I present practitioners’ views on the nature and causes of infertility, and on its treatment in both biomedicine and hypnotherapy.  I discuss the social and cultural significance of hypnosis as an alternative and complementary therapy for infertility. Methods:  I used anthropological research methods, including interviews, surveys, and participant observation, to gather the narratives of HypnoFertility consultants in the U.S.  I invited all 208 consultants certified through the HypnoFertility Foundation, Inc. to participate in an interview and/or anonymous online survey, and to extend the same invitation to their current and former clients, as appropriate.  In addition, I participated in a Fertility and Birth by Hypnosis training course with a Foundation-certified trainer. Results: The data I collected for this study is based on in-depth, semiformal interviews with 15 HypnoFertility consultants, and the survey responses of 18 consultants and five clients.   Detailed field notes document my interactions with participants, and my experience as a participant in the Fertility and Birth by Hypnosis training program. Conclusions: The use of hypnosis for fertility has social and moral significance for its practitioners.  The definition of infertility according to consultants differs markedly from biomedical definitions in its inclusion of social, emotional, and spiritual factors that contribute to the condition.  Hypnotherapists feel that the medicalization of fertility can obscure patients’ self-knowledge and intuitive reproductive abilities.  Gender-power disparities and shifts in family structure are said to be stressors that contribute to the degradation of clients’ self-healing abilities.  Social critiques present within consultants’ narratives inform the significance of the practice as a complement to biomedical treatments for infertility.

St. John, Meryl Kopy. 2011. Virtual Lay Therapy: The Role of the Internet, Illness Narratives and Experiential Knowledge in Health Decision-Making

This thesis describes and analyzes the culture and behavior of an online health community focused on female sexual and reproductive health. 263 participants were asked to describe the ways in which they utilized the community and how their health-seeking behaviors and interactions with medical professionals had altered since they had turned to the Internet to supplement their medical care. The women reported using the community not just for medical information, but in a search for empowerment and a medical space perceived as non-judgmental. Often, participants had been inspired to use the Internet to cope with or evade feelings of marginalization they received when engaging in professional care. Study participants described sophisticated methodologies for evaluating online information, and some then used this information in an attempt to transform and improve both their clinical encounters and their medical decision-making. Lay And experiential knowledge contributed by community participants was used to evaluate, and sometimes challenge, expert knowledge offered by medical professionals. The study has implications for a new era of medical pluralism in which individuals negotiate and combine traditional care avenues with a virtual form of lay therapy management. The thesis also reviews the history of both self- care and Internet communication, traditions whose legacies eventually led to modern communities like the one investigated here.

Publications

McCloskey, Lois, Marlena L. Sherman, Meryl St. John, Hannah Siegel, Julie Whyte, Ronald Iverson, Aviva Lee-Parritz, and Judith Bernstein. 2019. Navigating a ‘perfect storm’on the path to prevention of type 2 diabetes mellitus after gestational diabetes: lessons from patient and provider narratives.” Maternal and Child Health Journal 23: 603-612.