This research focuses on characterizing and measuring the reproductive concerns of young adult cancer survivors, comparing reproductive concerns across gender and other characteristics, and informing strategies to reduce reproductive distress and improve quality of life for post-treatment cancer survivors. This work has been funded by the California Breast Cancer Research Program and American Cancer Society. Gorman (PI)

The goal of the project is to develop and implement a system, policy, or environmental intervention to increase awareness and acceptability of the human papillomavirus vaccine among college students at OSU. The project is in partnership with Student Health Services and uses the Community Action Model, a participatory research approach. The project is funded by the OHSU Knight Cancer Center, Community Partnership Program. Mojica (PI)

This project: 1) quantitatively explored a broad spectrum of measures capturing mental health, social health, and sexual health among transgender women residing in a relatively non-transphobic environment, and 2) qualitatively explored the contextual risk and protective behaviors relative to transgender women residing in a relatively non-transphobic environment regarding mental health, social health, and sexual health. Crosby, Garcia (MPI)

This study seeks to (1) Examine the relationships between: (a) developmental antecedents (e.g., adverse experiences in childhood/adolescence, HIV-related stigma, sexual identity development, trust), (b) PrEP awareness and adoption, and (c) PrEP-related attitudes/health beliefs (e.g., perceived health risks) among young adult MSM (YAMSM) in Portland; and (2) Describe the reach of and examine attitudes/beliefs towards current and emerging PrEP programs, including (a) venue-based linkage-to-care programs in Portland, (b) existing Internet-based systems, and (c) innovative PrEP programming (e.g., event-driven PrEP, over-the-counter PrEP, tele-medicine). This research funded by the Hallie Ford Center for Healthy Children and Families. Garcia (PI), Catania and Dolcini (Co-Is)

In this project we are developing a Latin American telenovela (soap opera) intervention based on critical consciousness theory to train young Latinx allies to combat social isolation experienced by their LGBTQ peers. Our approach prioritizes making health a shared value by: (1) Collaborating with Latinx LGBTQ youth to co-create a telenovela toolkit to train allies to combat social isolation, and (2) Piloting the adapted intervention among Latinx youth in the Outreach Leadership Institute operated by 4-H at OSU. This unique and culturally appropriate Latin American medium allows us to extend the culture of health to communities throughout Oregon using 4-H programs, rather than relying solely on formal school contexts. Our program will overcome challenges presented by the social environment that further isolates Latinxs, immigrants, especially those in rural areas and small towns in the U.S. This project is funded by the Robert Wood Johnson Foundation (PI: Garcia).

Engaging the Next Latinx Allies for Change and Equity (ENLACE)

This multi-year project, funded by the National Institute of Mental Health, examined barriers and facilitators of Oral self-implemented HIV testing performance fidelity and training acquisition among African-American men-who-have-sex-with-men age 17-24 and residing in low-income areas of Chicago, Illinois. This study addresses the role of performance fidelity in observed variations in test sensitivity and specificity. Catania (PI), Dolcini (Co-I)

By extending Medicaid coverage to low-income women prior to pregnancy, the Affordable Care Act Medicaid expansion had the potential to increase access to timely abortion services for women with unintended pregnancy. This ongoing study (PI: S. Marie Harvey) is funded by the Society for Family Planning and examines abortion access for low-income women in Oregon. We found evidence that Medicaid expansion increased receipt of Medicaid-financed abortions and may have reduced out-of-pocket payment among low-income women. Increased receipt of medication abortion may indicate that expansion enhanced earlier access to services. We have presented these findings at the Oregon Public Health Association Conference and publication is underway. We also published a methodological paper as part of this grant that contributes to the measurement of abortion services and will facilitate future research on this topic using insurance claims data. Funded by the Society for Family Planning Research Fund. Harvey (PI), Gibbs (Research Associate)

The Affordable Care Act provided states with resources to extend Medicaid coverage to millions of low-income adults who had previously gone without health insurance. In 2013, Dr. Marie Harvey received a 5-year grant from the Centers for Disease Control and Prevention to evaluate the effect of Medicaid expansion and other policies on the health of low-income women of reproductive age in Oregon. Research findings included evidence of increased access to preventive reproductive services following Medicaid expansion. A doctoral student trainee on the project, Dr. Linh Bui, also found evidence that Medicaid expansion resulted in fewer infant deaths in Oregon. The study also resulted in evidence regarding the transition to the Oregon Medicaid program’s innovative accountable care organization structure, which led to more timely access to prenatal care and reduced negative birth outcomes. This study is funded by the Centers for Disease Control and Prevention. Harvey, Luck (MPI), Gibbs (Research Associate)

The goals of this community-engaged research project are to 1) adapt and implement a mindfulness-based intervention to support women experiencing body image and sexual health difficulties after cancer, 2) assess the feasibility, acceptability, and preliminary effects of the program among breast and gynecologic cancer survivors; and 3) establish a strategy to sustain the program over the longer term based on feedback from stakeholders across Oregon. The project has been funded by the OHSU Knight Community Partnership Program. Gorman (PI)

As many as two-thirds of women diagnosed with breast or gynecologic cancers during young adulthood experience negative effects of cancer and cancer treatment on their reproductive and sexual health. These are among the most distressing, yet under-addressed, aspects of survivorship for young couples. Using a mixed methods design, this study will evaluate whether a coping and communication intervention for young survivors and their partners that has been adapted to address common concerns about reproductive and sexual health leads to greater improvements in outcomes than the original evidence-based intervention. This study is funded by the American Cancer Society. Gorman (PI), Harvey (Co-I)

The overall objective of the Proyecto De Salud Para Latinos (Latino Health Project), composed of two research studies funded by CDC and the Office of Population Affairs (OPA), was to examine the determinants of contraceptive use, sexual risk behavior and HIV/STI prevention among young Latino women and men in rural settings. We used both qualitative and quantitative methods to explore the influence of a broad range of factors and their interrelationships on these outcomes from the perspective of young Latino women and men as well as health care providers. We focused on issues related to health disparities to better understand how broader social and contextual issues such as racism, medical mistrust, poverty, health literacy, and culture interact and impact rural Latinos access to and use of reproductive health services. This study is funded by the CDC and the Office of Population Affairs (OPA). Harvey (PI)

Although prior research has demonstrated that relationship characteristics and partner type (e.g., casual vs. primary sexual partner) are associated with HIV risk behavior, research on the role of relationship dynamics in sexual risk behavior is limited. This 4 1/2-year project examined relationship dynamics within the heterosexual involvements of men and women of reproductive age at high-risk for HIV infection. The overall objective of the proposed research was to improve understanding of the influence of relationship dynamics on sexual risk perceptions, intentions, and behaviors. Findings from this study have had significant implications for the design of interventions for reducing the risk of HIV infection among individuals in close relationships by addressing the dynamics of sexual partnerships. This study is funded by the National Institutes of Health/National Institute of Child Health and Human Development. Harvey (PI)

This project is an exploratory, qualitative study with transgender/gender diverse cancer survivors and members of their support system to learn about 1) Experiences navigating cancer-related stressors and type of support received/needed, 2) Experiences navigating health systems, health decisions, and health care before and after cancer, with a focus on reproductive and sexual health, and 3) Possible intervention strategies to support them and their partners/support systems after cancer. Gorman (PI), Garcia (Co-I)

This multi-year project, funded by the National Institute of Child & Human Development, is examining strategies to improve performance of self-implemented Oral-HIV testing among high-risk youth in Tanzania. Based on a randomized clinical trial this study compares two training strategies utilizing low technology and literacy methods that have application to Tanzanian youth age 15-22 yrs. residing in low-income areas of Dar es Salaam. Catania (PI), Dolcini (Co-I)

This multi-year project, funded by the National Institute of Mental Health, will develop an intervention to increase the uptake of no-cost Oral Self-Implemented HIV testing (Oral-SIT) and facilitate Oral-SIT distribution through LGBTQ businesses, cultural events and community-based organizations in Portland, Ore. This approach, guided by the Push-Pull Infrastructure Model, addresses barriers to venue-based testing and poor Oral-SIT retail sales.