Daryl Mangosing, DrPH, MPH | University of California, Berkeley (original) (raw)
Videos by Daryl Mangosing, DrPH, MPH
The CDC-funded Prevention Research Center (PRC) of the University of California San Francisco (UC... more The CDC-funded Prevention Research Center (PRC) of the University of California San Francisco (UCSF) employs a broad definition of TA to address HIV health disparities for a global audience through a breadth of topics and services. We used our website, social media, email, print materials, and word of mouth to reach academics and researchers, health departments and service providers, and community organizations. The first point-of-contact staff triages the TA request to an expert within UCSF PRC to respond, and we ensure the referral and connection. We assessed the TA recipient's satisfaction through a REDCap survey.
-Mangosing, D., Kumalo-Sakutukwa, G., Bourdeau, B., Rebchook, G., Lightfoot, M., & Myers, J. (2020, October). Supporting community partners in reducing HIV-related health disparities: A novel, alternative approach to technical assistance. APHA 2020 Virtual, American Public Health Association. San Francisco, CA. https://apha.confex.com/apha/2020/meetingapp.cgi/Paper/482526
8 views
Two-part presentation on my doctoral research interests and dissertation proposal in-progress: "S... more Two-part presentation on my doctoral research interests and dissertation proposal in-progress: "Sexualized Drug Use Within the Sexual and Gender Diverse Community: A Counterpublic Health Perspective" (spring 2021) and a summary of my graduate MPH capstone project: "Developing a Media Strategy to Minimize Loss to Follow-Up in the Pediatric HIV/AIDS Cohort Study (PHACS) Using Photovoice" (spring 2015).
Watch original video of my full MPH capstone presentation here: https://www.youtube.com/watch?v=IJsC95YuVHA
7 views
Teaching Documents (syllabi) by Daryl Mangosing, DrPH, MPH
This course focuses on understanding health disparities and health inequities from the historical... more This course focuses on understanding health disparities and health inequities from the historical and contemporary perspectives of LGBT (lesbian, gay, bisexual, and transgender) communities. The course also explores how cultural expression in the health humanities through popular culture (e.g., artwork, photography, video, theater, literature, and music), campaigns, and social movements can impact LGBT health concepts and enable communities to reflect on and respond to LGBT specific health crises and emerging issues as well as resiliencies and wellness.
Additionally, the course will provide students a general introduction to sexual and gender minority (SGM) health research in the context of public health interventions. Students completing the course should expect to have a working knowledge of terminology and perspectives related to LGBT health, information about who LGBT populations are, and what health disparities they face, as well as an appreciation for the role and influence that cultural expression and the arts play in LGBT health. While the class is not an exhaustive survey of all LGBT health issues and experiences, students will be introduced to a variety of these topics.
Doctoral Papers (UC Berkeley) by Daryl Mangosing, DrPH, MPH
UC Berkeley, 2024
Sexualized drug use (SDU) involves using drugs to enhance sexual activity with chemsex or party a... more Sexualized drug use (SDU) involves using drugs to enhance sexual activity with chemsex or party and play being prevalent among gay and bisexual men and men who have sex with men. This practice is linked to significant health risks, including mental health problems and HIV/STI transmission. Despite extensive research, traditional public health approaches often focus on the pathological aspects of SDU, ignoring broader social and cultural contexts.Particularly for harm reduction, lived experiences and personal strategies practiced by people who use drugs also tend to be excluded from intervention conceptualization. This dissertation addresses these gaps by adopting a counterpublic health (CPH) perspective, focusing on the health of sexual and gender diverse (SGD) people. This research is presented in three papers. Paper 1 is a narrative review of CPH literature focused on subaltern counterpublics, defining its tenets and identifying contexts where CPH is relevant. This review highlights the need for inclusive, context-sensitive public health approaches, proposing an emergent framework to enhance the understanding and application of CPH principles. Paper 2 critiques the assumption that all individuals conform to mainstream public health discourses, using harm reduction to explore how SGD individuals engaging in SDU navigate HIV/STI prevention and drug use risk reduction strategies. Through interviews with users of sexual networking apps, it captures their experiences, informing more nuanced harm reduction interventions. Paper 3 examines the interplay of moral agency, empathy, and stigma among SGD individuals in SDU contexts within a CPH framework. It investigates how participants perceive and exercise moral action and empathy while navigating stigma, emphasizing collective responsibility and inclusivity in harm reduction strategies. This dissertation advocates for reimagining public health through CPH, promoting inclusive and contextually-aware health interventions. By centering marginalized voices and valuing local knowledge, it aims to improve health outcomes and reduce disparities among marginalized communities.
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2022
The HIV epidemic remains a public health threat in the U.S., and the dissemination and implementa... more The HIV epidemic remains a public health threat in the U.S., and the dissemination and implementation of evidence-based prevention and care programs are critical to addressing significant HIV health disparities. The provision of technical assistance (TA) to program providers and evaluators is key for uptake of these programs. The University of California San Francisco Prevention Research Center (UCSF PRC) model for TA delivery uses topics and strategies adapted to address HIV health disparities for a global audience. This model specifically matches TA requests to a TA provider who has expertise in that area upon receiving a request through various communication channels. Areas of expertise include research methods, community engagement strategies, interventions, and Implementation Sciences. Our evaluation of diverse TA services indicates that on-demand TA is effective for light-touch requests and well-suited for moderate to intensive requests. The model is a promising, broad-reaching, and responsive alternative for providing TA to a multitude of HIV workforce recipients.
The Clinical Teacher, 2022
Background: LGBTQ+ people experience significant barriers in accessing health care including inad... more Background: LGBTQ+ people experience significant barriers in accessing health care including inadequate provider knowledge and stigma in health care settings. Undergraduate medical education programs have increased efforts to integrate LGBTQ+ health topics, such as comprehensive sexual history taking and gender-affirming practices, into their curriculums to provide clinically inclusive care for LGBTQ+ patients.
Approach: A Topic Steward was appointed to oversee the integration of LGBTQ+ health topics throughout the existing undergraduate medical curriculum. The aim was to expand the LGBTQ+ health curriculum for undergraduate medical students through teaching comprehensive sexual history taking; offering specialty-specific LGBTQ+ health education through clerkships; describing the difference between sex assigned at birth, gender identity, and gender expression; describing the difference between sexual orientation and sexual behaviour; identifying health care disparities that LGBTQ+ people experience; and developing an inclusive approach to providing medical care for LGBTQ+ patients.
Evaluation: The program started in July 2017 with UCSFSOM students in their first, second, or third years ( 150 medical students per year) participating in the integrated curriculum that included didactic lectures, small group discussions, and LGBTQ+ clerkship opportunities. The hours of LGBTQ+ health curriculum at the UCSFSOM increased from 4.5 hours to 15–20 hours in approximately 2 years under the Topic Steward approach.
Implications: The next step is to develop standardised tools for assessing LGBTQ+ health competencies for medical students. This involves integrating more questions regarding LGBTQ+ health topics in traditional exams at UCSFSOM and developing specialty-specific assessment instruments that other medical schools could administer to test core competencies in LGBTQ+ health.
Graduate Papers (Tufts University) by Daryl Mangosing, DrPH, MPH
Abstract: "Public Health" focuses on the upstream causes of poor health, particularly those relat... more Abstract: "Public Health" focuses on the upstream causes of poor health, particularly those related to social and environmental factors that impact health status. However, biomedical advances in the last century have shifted the public's health to another aspect of care: individual causes and manifestations of illness and disease. This transition has led to what we call medicalization or “the process by which previously nonmedical problems become defined and treated as medical problems.” The medicalization of human conditions releases a ripple of effects, one being whether a consumer of health care recognizes a health problem that needs to be medically addressed. These problems are generally the result of failures in biology, hygiene, and behaviors, and they are resolved through biomedical treatments delivered by providers. If such is the case, two significant questions surrounding health care arise: what is the relationship between medicalization and health care spending and health policy, and is the medicalization of human conditions generally justified at the public health level?
Mangosing, D.A. (2015). The medicalization of human conditions and health care: A public health perspective. TuftScope, 19-20. Retrieved from http://s3.amazonaws.com/tuftscope_issues/pdfs/35/Spring%202015%20TuftScope.pdf
With the lack of attention to the attrition of child participants, loss to follow up (LTFU) holds... more With the lack of attention to the attrition of child participants, loss to follow up (LTFU) holds significant implications for the health of young adults in the Pediatric HIV/AIDS Cohort Study (PHACS), a multi-center cohort study with children either perinatally infected with HIV (PHIV) or HIV-exposed uninfected (HEU). Young adults (18+) face barriers to being retained in the study, including competing time demands, geographic relocation, study fatigue, stigma, and low health literacy. Formative research, Photovoice (participatory photo elicitation), and a focus group informed the design of a web-based media strategy based on the Elaboration Likelihood Model (ELM) to increase study engagement. Six members of the Young Adult and Adult Community Advisory Boards (CABs) were recruited via email and given Photovoice training via Prezi. Photos were taken around the theme of self-identity. A teleconference focus group facilitated reflections and salient themes for the video compilation exhibit. Themes included: 1) stereotypes, 2) layered-identities, 3) stigma, and 4) self-identity. Additional meta-themes were also codified. Media strategy recommendations included: 1) participatory media and photography, 2) digital story maps, 3) social media, and 4) content and topics. Based on the results of this project with a limited sample, participatory media like Photovoice may have a positive impact on participants at risk for LTFU by increasing study engagement. While some research supports this qualitative methodology, limitations must be considered. Future PHACS projects should incorporate a needs assessment and evaluation. Moreover, further research in this area of public health and health communication needs to continue overall.
International Association for Media and Communication Research (IAMCR) 2015 Conference, Oct 23, 2014
HIV and AIDS are generally thought to be synonymous, but one can be infected with HIV and still n... more HIV and AIDS are generally thought to be synonymous, but one can be infected with HIV and still not develop AIDS. The development of antiretroviral therapy (ART) has made HIV no longer the deadly disease it once was. However, the AIDS epidemic has left a terrible lingering legacy, especially for those who are HIV-positive. An estimated 1.1 million people in the U.S. are currently living with HIV due to better treatments, whereas globally, approximately 35 million are living with HIV as of 2013. These epidemiological trends will continue to capture the attention of public health professionals, but what is overlooked in the race for a cure is the communication surrounding HIV and more so around those who have it. The purpose of this paper is to characterize the meaningful portrayals of the HIV-positive condition and to analyze its messages that are communicated from a variety of channels (i.e. literary metaphors, personal narratives, and news and popular media) to better understand the overall perceptions of living with HIV in American society alongside other global perspectives. Perceptions of health and illness in HIV discourse, collective themes described in metaphors, the media’s portrayal of HIV, and expressions of identity through narratives are discussed. Following the analysis of these messages are implications for future direction that shed light on the considerations necessary for handling this historically devastating disease that lives on today. HIV has persevered through society from its birth in the AIDS epidemic to the manageable chronic disease it could be for those adhering to ART. As a result, there are now individuals living with HIV who are undetectable, have a non-compromised immune system, live a normal lifespan, and are unlikely to transmit the virus. Despite the perpetual impact of stigma and erroneous claims by media outlets, people with HIV continue to form positive metaphors, realize their own humanness, and ultimately frame their identities in a more sanguine outlook that sustains their health, livelihood, and resilience in society.
Oral presentation given at the International Association for Media and Communication Research (IAMCR) 2015 Conference, Université du Québec à Montréal (UQAM), July 12-16, 2015.
Research has shown that African-born immigrants to the U.S. have a high risk of HIV infection, an... more Research has shown that African-born immigrants to the U.S. have a high risk of HIV infection, and more than half of them reside in one of seven states with Massachusetts being home to more than 66,000 residents. As of 2009, the largest proportion of non-U.S. born persons in MA diagnosed with HIV infection was from Sub-Saharan Africa. Because only a few studies have focused on HIV-testing attitudes and stigma in this population, very little is known about how to provide culturally appropriate HIV prevention and screening activities, particularly among African-born men. Not only to they have a high rate of HIV seropositivity and present at a late stage of HIV disease, but they also experience significant HIV-related stigma. Moreover, barriers and misconceptions about the U.S. healthcare system and legal and linguistic challenges persist. Thus, the need to provide interventions to reduce barriers to HIV testing, decrease stigma, and increase access to healthcare services in this community emerged.
The European honey bee, Apis mellifera, is well-known for its role in honey production, its ecolo... more The European honey bee, Apis mellifera, is well-known for its role in honey production, its ecological importance in plant reproduction and biodiversity, and more importantly, the pollination of many economically significant crops in the United States (Staveley, Law, Fairbrother, & Menzie, 2014; vanEngelsdorp & Meixner, 2010). The food we eat from the most nutritious crops in our diets – key fruits and vegetables – as well as some crops used as fodder in meat and dairy production significantly depend on the key ecosystem service that honey bees provide: natural insect-mediated pollination (Tirado, Simon, & Johnston, 2013). As the predominant and most economically important group of pollinators in most geographical regions, both managed and wild honey bees pollinate most wild plants so that they may reproduce, thereby directly or indirectly supporting wild habitats that provide other ecosystem services (Tirado et al., 2013). One can then see the possible ramifications of the ongoing bee colony decline in recent years; however, the economic and ecological consequences tend to be viewed separately in their own scope, and it is not entirely clear how the two areas intersect.
The following paper proposes the design and creation of a mobile smartphone app – Healthy MSM – f... more The following paper proposes the design and creation of a mobile smartphone app – Healthy MSM – for enhancing the health and sexual practices of men who have sex with men. The app design process will be delineated in the following sections: background, needs assessment of the target population, personas and their scenarios, competitive analysis, description of design, wireframes, evaluation plan, development plan, marketing plan, limitations, and references. With the tagline “Where Health and Safe Sex is a Plus,” the objective of the app is to serve as a comprehensive sexual health resource for men who have sex with men in light of their generally high rates of sexually transmitted diseases (STDs) and contact with the Human Immunodeficiency Virus (HIV). The app equally serves as an effective channel for delivering a multifaceted public health intervention that hypothetically addresses various issues that this population is experiencing, but more importantly, it proposes a novel feature that has not been made available yet: linkage of care between the user and their health care provider.
Recent immigrant or in-the-closet API MSMs are more likely to have unprotected sex. Among APIs, M... more Recent immigrant or in-the-closet API MSMs are more likely to have unprotected sex. Among APIs, MSMs are the most likely to be infected with HIV. HIV/STDs can be transmitted by sexual fluids, blood, and genital skin-to-skin contact. If you know your STD status, you can take steps to protect yourself and others.
Undergraduate Papers (Berea College) by Daryl Mangosing, DrPH, MPH
As one departs from the stages of identity-ridden adolescence and intimacy-filled early adulthood... more As one departs from the stages of identity-ridden adolescence and intimacy-filled early adulthood, a new stage is set for the individual to perform; this stage of development is known as “middle adulthood.” Erikson’s crisis for this stage, Generativity Versus Stagnation, was initially grounded on the concept of caring for the next generation by either rearing one’s own children or educating and guiding younger individuals (Berger, 2010, p. 456). Given this general schema, society prematurely views procreation as the proper starting point as well as one of the main contributors to the quality of one’s generativity. Erikson further supports this notion by stating, “…parenthood is the ‘procreative core’ of generative adulthood” (Hoare, 2002, p. 192). Thus, it is not surprising that genital sexuality, hence sexual intercourse, is hypothetically deemed as a sublimation of generativity (Hoare, 2002, p. 192). If generativity aims to instill faith in the human species and the future generation, then adults must channel their own needs to ensure its livelihood and success (Hoare, 2002, p. 190). Procreation must therefore play a vital role in affecting generativity in this context. Nevertheless, various viewpoints must be analyzed and interpreted before conclusions are made about the morality of whether to have children.
In the face of disaster, the affected population calls for the delivery of immediate aid and reli... more In the face of disaster, the affected population calls for the delivery of immediate aid and relief, but that can only be done with effective management. The goal of emergency relief organizations must therefore be to prioritize the improvement of operations through two overarching elements: logistics and the supply-chain. More so, the enhancement and reconceptualization of emergency logistics can potentially lead to better outcomes by extending current practice to a more integrated and appropriate process. To support this, the author of the following paper provides a comprehensive outline of logistics in disaster preparedness and relief. Relevant topics that are discussed include the role of humanitarian logistics, emergency organizations and past disasters, current models of emergency relief logistics, and its challenges and limitations. The author then proposes significant improvements through the appropriate integration of commercial/business logistics concepts and the implementation of solutions that other professionals have implicated. Overall, logistics and supply chain management can serve a vital role in the successful operation of relief agencies, bolstering the overall impact on the transition from crisis to development.
As an “icon” in mainstream popular culture, Lady Gaga has imbued a new standard of super stardom ... more As an “icon” in mainstream popular culture, Lady Gaga has imbued a new standard of super stardom as a performance artist and transformative fashionista in today’s generation and thus challenged orthodoxy. Her interpretation and expression of Christianity, in particular, places the iconic goddess under the critical spotlight of the religious community. Born a Roman Catholic, Lady Gaga experienced a series of life-changing events that has brought her to integrate risky biblical references into her lyrics. Her music is only one perspective, however, upon which this can be analyzed: her fashion, often unpredictable yet impressive, is equally influenced by her religious roots and ideas. The art of Lady Gaga’s music and fashion brings together new meaning both insightful and controversial to the Christian body, which elicits a response to examine and criticize the superstar’s interpretive messages. As a result, subjective interpretations of those references lie at the heart of Christian argument as well as Lady Gaga’s.
More research on children’s health has focused on the school environment and surrounding communit... more More research on children’s health has focused on the school environment and surrounding community due to their impact on behavioral and preventive interventions. The Kentucky Cabinet of Health and Family Services (2013) states that programs initially designed to improve academic performance are now being recognized as public health interventions. To analyze this movement, the following review centers around rural Appalachia for its vulnerable youth population and characteristic circumstances that lead to higher illness and morbidity rates related to childhood overweight and obesity. Nutrition and physical activity – both of which significantly contribute to health behaviors –serve as the main topics of discussion based on the Coordinated School Health approach. The review also considers factors at the community level. The author poses the following recommendations: conducting the School Health Index, employing a school health coordinator, modeling after a successful pilot project, and implementing school policies. Applying these proposed interventions to similar regions merits further research to improve the health of America’s youth by working at the school level and reaching out to the community.
![Research paper thumbnail of Causal Association between Mobile Phone Use and Brain Cancer: A [Modest] Epidemiological Analysis](https://attachments.academia-assets.com/35077177/thumbnails/1.jpg)
](The advent of mobile phones has expanded our mode of communication to lengths that we, as consume... more The advent of mobile phones has expanded our mode of communication to lengths that we, as consumers of modern technology, seem to have taken for granted. Whether this is truly the case, however, depends on the degree to which the users of such a commodity pay attention to negative exposures that are essentially voluntary and possibly controllable (Wood, 2005). The case to which this matter refers to is one of the most debated topics in public health today: whether a causal association between mobile phone use and cancers of the brain exists. Despite attempts to investigate and elucidate the issue, epidemiological studies from the past and present predominantly continue to yield inconsistent evidence and views. More importantly, the analyses of biological plausibility and epidemiological study design and methodology reveals a polarized spectrum of findings and explanations that lead to an inconclusive consensus. This occurrence, conversely, does not entail the failure of such research but rather an impending need to improve future studies in their quest to find clear answers. As Olsen (2010, p. 281) states, “…we will need to address questions about the safety of these new, frequent, and avoidable exposures.”
African American women within the United States continue to have the highest breast cancer mortal... more African American women within the United States continue to have the highest breast cancer mortality rate despite higher incidence in Caucasian women. This racial disparity is attributed to unaddressed factors such as lower socioeconomic status, lesser utilization of medical services, and lower screening rates. The present study investigates social determinants (socioeconomic status, cultural beliefs and attitudes, psychosocial perceptions, and community/social support) influencing adherence and effectiveness in ongoing treatment. The study utilizes a randomized control trial design with a pre-test/post-test and time series component. A pilot intervention consisting of four phases is assigned to the experimental group in addition to conventional biomedical treatment; the comparison group only receives the latter. Subjects include African American women who are 18 or older, diagnosed with invasive breast cancer within the past six months, and are residing in minority, urban, and socioeconomically disadvantaged areas; sampling is conducted via probability multistage clustering. Health-related quality of life (HR QoL) will be measured through the European Organization for Research and Treatment of Quality of Life Questionnaire (EQRTC QLQ-C30) and the Quality of Life in Adult Cancer Survivors (QLACS) questionnaire. Correlations between type of intervention and the biological stage of breast cancer, HR QoL and survivorship will then be generated. Findings within this report will be integrated into a theoretical social framework aimed towards optimizing cancer care. Nursing implications entail enhancing patient-physician communication, establishing the role of “navigator” from oncology nurses, providing psychosocial assessment and intervention, and encouraging engagement in breast cancer support groups.
Papers by Daryl Mangosing, DrPH, MPH
The Clinical Teacher, Feb 3, 2022
The CDC-funded Prevention Research Center (PRC) of the University of California San Francisco (UC... more The CDC-funded Prevention Research Center (PRC) of the University of California San Francisco (UCSF) employs a broad definition of TA to address HIV health disparities for a global audience through a breadth of topics and services. We used our website, social media, email, print materials, and word of mouth to reach academics and researchers, health departments and service providers, and community organizations. The first point-of-contact staff triages the TA request to an expert within UCSF PRC to respond, and we ensure the referral and connection. We assessed the TA recipient's satisfaction through a REDCap survey.
-Mangosing, D., Kumalo-Sakutukwa, G., Bourdeau, B., Rebchook, G., Lightfoot, M., & Myers, J. (2020, October). Supporting community partners in reducing HIV-related health disparities: A novel, alternative approach to technical assistance. APHA 2020 Virtual, American Public Health Association. San Francisco, CA. https://apha.confex.com/apha/2020/meetingapp.cgi/Paper/482526
8 views
Two-part presentation on my doctoral research interests and dissertation proposal in-progress: "S... more Two-part presentation on my doctoral research interests and dissertation proposal in-progress: "Sexualized Drug Use Within the Sexual and Gender Diverse Community: A Counterpublic Health Perspective" (spring 2021) and a summary of my graduate MPH capstone project: "Developing a Media Strategy to Minimize Loss to Follow-Up in the Pediatric HIV/AIDS Cohort Study (PHACS) Using Photovoice" (spring 2015).
Watch original video of my full MPH capstone presentation here: https://www.youtube.com/watch?v=IJsC95YuVHA
7 views
This course focuses on understanding health disparities and health inequities from the historical... more This course focuses on understanding health disparities and health inequities from the historical and contemporary perspectives of LGBT (lesbian, gay, bisexual, and transgender) communities. The course also explores how cultural expression in the health humanities through popular culture (e.g., artwork, photography, video, theater, literature, and music), campaigns, and social movements can impact LGBT health concepts and enable communities to reflect on and respond to LGBT specific health crises and emerging issues as well as resiliencies and wellness.
Additionally, the course will provide students a general introduction to sexual and gender minority (SGM) health research in the context of public health interventions. Students completing the course should expect to have a working knowledge of terminology and perspectives related to LGBT health, information about who LGBT populations are, and what health disparities they face, as well as an appreciation for the role and influence that cultural expression and the arts play in LGBT health. While the class is not an exhaustive survey of all LGBT health issues and experiences, students will be introduced to a variety of these topics.
UC Berkeley, 2024
Sexualized drug use (SDU) involves using drugs to enhance sexual activity with chemsex or party a... more Sexualized drug use (SDU) involves using drugs to enhance sexual activity with chemsex or party and play being prevalent among gay and bisexual men and men who have sex with men. This practice is linked to significant health risks, including mental health problems and HIV/STI transmission. Despite extensive research, traditional public health approaches often focus on the pathological aspects of SDU, ignoring broader social and cultural contexts.Particularly for harm reduction, lived experiences and personal strategies practiced by people who use drugs also tend to be excluded from intervention conceptualization. This dissertation addresses these gaps by adopting a counterpublic health (CPH) perspective, focusing on the health of sexual and gender diverse (SGD) people. This research is presented in three papers. Paper 1 is a narrative review of CPH literature focused on subaltern counterpublics, defining its tenets and identifying contexts where CPH is relevant. This review highlights the need for inclusive, context-sensitive public health approaches, proposing an emergent framework to enhance the understanding and application of CPH principles. Paper 2 critiques the assumption that all individuals conform to mainstream public health discourses, using harm reduction to explore how SGD individuals engaging in SDU navigate HIV/STI prevention and drug use risk reduction strategies. Through interviews with users of sexual networking apps, it captures their experiences, informing more nuanced harm reduction interventions. Paper 3 examines the interplay of moral agency, empathy, and stigma among SGD individuals in SDU contexts within a CPH framework. It investigates how participants perceive and exercise moral action and empathy while navigating stigma, emphasizing collective responsibility and inclusivity in harm reduction strategies. This dissertation advocates for reimagining public health through CPH, promoting inclusive and contextually-aware health interventions. By centering marginalized voices and valuing local knowledge, it aims to improve health outcomes and reduce disparities among marginalized communities.
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2022
The HIV epidemic remains a public health threat in the U.S., and the dissemination and implementa... more The HIV epidemic remains a public health threat in the U.S., and the dissemination and implementation of evidence-based prevention and care programs are critical to addressing significant HIV health disparities. The provision of technical assistance (TA) to program providers and evaluators is key for uptake of these programs. The University of California San Francisco Prevention Research Center (UCSF PRC) model for TA delivery uses topics and strategies adapted to address HIV health disparities for a global audience. This model specifically matches TA requests to a TA provider who has expertise in that area upon receiving a request through various communication channels. Areas of expertise include research methods, community engagement strategies, interventions, and Implementation Sciences. Our evaluation of diverse TA services indicates that on-demand TA is effective for light-touch requests and well-suited for moderate to intensive requests. The model is a promising, broad-reaching, and responsive alternative for providing TA to a multitude of HIV workforce recipients.
The Clinical Teacher, 2022
Background: LGBTQ+ people experience significant barriers in accessing health care including inad... more Background: LGBTQ+ people experience significant barriers in accessing health care including inadequate provider knowledge and stigma in health care settings. Undergraduate medical education programs have increased efforts to integrate LGBTQ+ health topics, such as comprehensive sexual history taking and gender-affirming practices, into their curriculums to provide clinically inclusive care for LGBTQ+ patients.
Approach: A Topic Steward was appointed to oversee the integration of LGBTQ+ health topics throughout the existing undergraduate medical curriculum. The aim was to expand the LGBTQ+ health curriculum for undergraduate medical students through teaching comprehensive sexual history taking; offering specialty-specific LGBTQ+ health education through clerkships; describing the difference between sex assigned at birth, gender identity, and gender expression; describing the difference between sexual orientation and sexual behaviour; identifying health care disparities that LGBTQ+ people experience; and developing an inclusive approach to providing medical care for LGBTQ+ patients.
Evaluation: The program started in July 2017 with UCSFSOM students in their first, second, or third years ( 150 medical students per year) participating in the integrated curriculum that included didactic lectures, small group discussions, and LGBTQ+ clerkship opportunities. The hours of LGBTQ+ health curriculum at the UCSFSOM increased from 4.5 hours to 15–20 hours in approximately 2 years under the Topic Steward approach.
Implications: The next step is to develop standardised tools for assessing LGBTQ+ health competencies for medical students. This involves integrating more questions regarding LGBTQ+ health topics in traditional exams at UCSFSOM and developing specialty-specific assessment instruments that other medical schools could administer to test core competencies in LGBTQ+ health.
Abstract: "Public Health" focuses on the upstream causes of poor health, particularly those relat... more Abstract: "Public Health" focuses on the upstream causes of poor health, particularly those related to social and environmental factors that impact health status. However, biomedical advances in the last century have shifted the public's health to another aspect of care: individual causes and manifestations of illness and disease. This transition has led to what we call medicalization or “the process by which previously nonmedical problems become defined and treated as medical problems.” The medicalization of human conditions releases a ripple of effects, one being whether a consumer of health care recognizes a health problem that needs to be medically addressed. These problems are generally the result of failures in biology, hygiene, and behaviors, and they are resolved through biomedical treatments delivered by providers. If such is the case, two significant questions surrounding health care arise: what is the relationship between medicalization and health care spending and health policy, and is the medicalization of human conditions generally justified at the public health level?
Mangosing, D.A. (2015). The medicalization of human conditions and health care: A public health perspective. TuftScope, 19-20. Retrieved from http://s3.amazonaws.com/tuftscope_issues/pdfs/35/Spring%202015%20TuftScope.pdf
With the lack of attention to the attrition of child participants, loss to follow up (LTFU) holds... more With the lack of attention to the attrition of child participants, loss to follow up (LTFU) holds significant implications for the health of young adults in the Pediatric HIV/AIDS Cohort Study (PHACS), a multi-center cohort study with children either perinatally infected with HIV (PHIV) or HIV-exposed uninfected (HEU). Young adults (18+) face barriers to being retained in the study, including competing time demands, geographic relocation, study fatigue, stigma, and low health literacy. Formative research, Photovoice (participatory photo elicitation), and a focus group informed the design of a web-based media strategy based on the Elaboration Likelihood Model (ELM) to increase study engagement. Six members of the Young Adult and Adult Community Advisory Boards (CABs) were recruited via email and given Photovoice training via Prezi. Photos were taken around the theme of self-identity. A teleconference focus group facilitated reflections and salient themes for the video compilation exhibit. Themes included: 1) stereotypes, 2) layered-identities, 3) stigma, and 4) self-identity. Additional meta-themes were also codified. Media strategy recommendations included: 1) participatory media and photography, 2) digital story maps, 3) social media, and 4) content and topics. Based on the results of this project with a limited sample, participatory media like Photovoice may have a positive impact on participants at risk for LTFU by increasing study engagement. While some research supports this qualitative methodology, limitations must be considered. Future PHACS projects should incorporate a needs assessment and evaluation. Moreover, further research in this area of public health and health communication needs to continue overall.
International Association for Media and Communication Research (IAMCR) 2015 Conference, Oct 23, 2014
HIV and AIDS are generally thought to be synonymous, but one can be infected with HIV and still n... more HIV and AIDS are generally thought to be synonymous, but one can be infected with HIV and still not develop AIDS. The development of antiretroviral therapy (ART) has made HIV no longer the deadly disease it once was. However, the AIDS epidemic has left a terrible lingering legacy, especially for those who are HIV-positive. An estimated 1.1 million people in the U.S. are currently living with HIV due to better treatments, whereas globally, approximately 35 million are living with HIV as of 2013. These epidemiological trends will continue to capture the attention of public health professionals, but what is overlooked in the race for a cure is the communication surrounding HIV and more so around those who have it. The purpose of this paper is to characterize the meaningful portrayals of the HIV-positive condition and to analyze its messages that are communicated from a variety of channels (i.e. literary metaphors, personal narratives, and news and popular media) to better understand the overall perceptions of living with HIV in American society alongside other global perspectives. Perceptions of health and illness in HIV discourse, collective themes described in metaphors, the media’s portrayal of HIV, and expressions of identity through narratives are discussed. Following the analysis of these messages are implications for future direction that shed light on the considerations necessary for handling this historically devastating disease that lives on today. HIV has persevered through society from its birth in the AIDS epidemic to the manageable chronic disease it could be for those adhering to ART. As a result, there are now individuals living with HIV who are undetectable, have a non-compromised immune system, live a normal lifespan, and are unlikely to transmit the virus. Despite the perpetual impact of stigma and erroneous claims by media outlets, people with HIV continue to form positive metaphors, realize their own humanness, and ultimately frame their identities in a more sanguine outlook that sustains their health, livelihood, and resilience in society.
Oral presentation given at the International Association for Media and Communication Research (IAMCR) 2015 Conference, Université du Québec à Montréal (UQAM), July 12-16, 2015.
Research has shown that African-born immigrants to the U.S. have a high risk of HIV infection, an... more Research has shown that African-born immigrants to the U.S. have a high risk of HIV infection, and more than half of them reside in one of seven states with Massachusetts being home to more than 66,000 residents. As of 2009, the largest proportion of non-U.S. born persons in MA diagnosed with HIV infection was from Sub-Saharan Africa. Because only a few studies have focused on HIV-testing attitudes and stigma in this population, very little is known about how to provide culturally appropriate HIV prevention and screening activities, particularly among African-born men. Not only to they have a high rate of HIV seropositivity and present at a late stage of HIV disease, but they also experience significant HIV-related stigma. Moreover, barriers and misconceptions about the U.S. healthcare system and legal and linguistic challenges persist. Thus, the need to provide interventions to reduce barriers to HIV testing, decrease stigma, and increase access to healthcare services in this community emerged.
The European honey bee, Apis mellifera, is well-known for its role in honey production, its ecolo... more The European honey bee, Apis mellifera, is well-known for its role in honey production, its ecological importance in plant reproduction and biodiversity, and more importantly, the pollination of many economically significant crops in the United States (Staveley, Law, Fairbrother, & Menzie, 2014; vanEngelsdorp & Meixner, 2010). The food we eat from the most nutritious crops in our diets – key fruits and vegetables – as well as some crops used as fodder in meat and dairy production significantly depend on the key ecosystem service that honey bees provide: natural insect-mediated pollination (Tirado, Simon, & Johnston, 2013). As the predominant and most economically important group of pollinators in most geographical regions, both managed and wild honey bees pollinate most wild plants so that they may reproduce, thereby directly or indirectly supporting wild habitats that provide other ecosystem services (Tirado et al., 2013). One can then see the possible ramifications of the ongoing bee colony decline in recent years; however, the economic and ecological consequences tend to be viewed separately in their own scope, and it is not entirely clear how the two areas intersect.
The following paper proposes the design and creation of a mobile smartphone app – Healthy MSM – f... more The following paper proposes the design and creation of a mobile smartphone app – Healthy MSM – for enhancing the health and sexual practices of men who have sex with men. The app design process will be delineated in the following sections: background, needs assessment of the target population, personas and their scenarios, competitive analysis, description of design, wireframes, evaluation plan, development plan, marketing plan, limitations, and references. With the tagline “Where Health and Safe Sex is a Plus,” the objective of the app is to serve as a comprehensive sexual health resource for men who have sex with men in light of their generally high rates of sexually transmitted diseases (STDs) and contact with the Human Immunodeficiency Virus (HIV). The app equally serves as an effective channel for delivering a multifaceted public health intervention that hypothetically addresses various issues that this population is experiencing, but more importantly, it proposes a novel feature that has not been made available yet: linkage of care between the user and their health care provider.
Recent immigrant or in-the-closet API MSMs are more likely to have unprotected sex. Among APIs, M... more Recent immigrant or in-the-closet API MSMs are more likely to have unprotected sex. Among APIs, MSMs are the most likely to be infected with HIV. HIV/STDs can be transmitted by sexual fluids, blood, and genital skin-to-skin contact. If you know your STD status, you can take steps to protect yourself and others.
As one departs from the stages of identity-ridden adolescence and intimacy-filled early adulthood... more As one departs from the stages of identity-ridden adolescence and intimacy-filled early adulthood, a new stage is set for the individual to perform; this stage of development is known as “middle adulthood.” Erikson’s crisis for this stage, Generativity Versus Stagnation, was initially grounded on the concept of caring for the next generation by either rearing one’s own children or educating and guiding younger individuals (Berger, 2010, p. 456). Given this general schema, society prematurely views procreation as the proper starting point as well as one of the main contributors to the quality of one’s generativity. Erikson further supports this notion by stating, “…parenthood is the ‘procreative core’ of generative adulthood” (Hoare, 2002, p. 192). Thus, it is not surprising that genital sexuality, hence sexual intercourse, is hypothetically deemed as a sublimation of generativity (Hoare, 2002, p. 192). If generativity aims to instill faith in the human species and the future generation, then adults must channel their own needs to ensure its livelihood and success (Hoare, 2002, p. 190). Procreation must therefore play a vital role in affecting generativity in this context. Nevertheless, various viewpoints must be analyzed and interpreted before conclusions are made about the morality of whether to have children.
In the face of disaster, the affected population calls for the delivery of immediate aid and reli... more In the face of disaster, the affected population calls for the delivery of immediate aid and relief, but that can only be done with effective management. The goal of emergency relief organizations must therefore be to prioritize the improvement of operations through two overarching elements: logistics and the supply-chain. More so, the enhancement and reconceptualization of emergency logistics can potentially lead to better outcomes by extending current practice to a more integrated and appropriate process. To support this, the author of the following paper provides a comprehensive outline of logistics in disaster preparedness and relief. Relevant topics that are discussed include the role of humanitarian logistics, emergency organizations and past disasters, current models of emergency relief logistics, and its challenges and limitations. The author then proposes significant improvements through the appropriate integration of commercial/business logistics concepts and the implementation of solutions that other professionals have implicated. Overall, logistics and supply chain management can serve a vital role in the successful operation of relief agencies, bolstering the overall impact on the transition from crisis to development.
As an “icon” in mainstream popular culture, Lady Gaga has imbued a new standard of super stardom ... more As an “icon” in mainstream popular culture, Lady Gaga has imbued a new standard of super stardom as a performance artist and transformative fashionista in today’s generation and thus challenged orthodoxy. Her interpretation and expression of Christianity, in particular, places the iconic goddess under the critical spotlight of the religious community. Born a Roman Catholic, Lady Gaga experienced a series of life-changing events that has brought her to integrate risky biblical references into her lyrics. Her music is only one perspective, however, upon which this can be analyzed: her fashion, often unpredictable yet impressive, is equally influenced by her religious roots and ideas. The art of Lady Gaga’s music and fashion brings together new meaning both insightful and controversial to the Christian body, which elicits a response to examine and criticize the superstar’s interpretive messages. As a result, subjective interpretations of those references lie at the heart of Christian argument as well as Lady Gaga’s.
More research on children’s health has focused on the school environment and surrounding communit... more More research on children’s health has focused on the school environment and surrounding community due to their impact on behavioral and preventive interventions. The Kentucky Cabinet of Health and Family Services (2013) states that programs initially designed to improve academic performance are now being recognized as public health interventions. To analyze this movement, the following review centers around rural Appalachia for its vulnerable youth population and characteristic circumstances that lead to higher illness and morbidity rates related to childhood overweight and obesity. Nutrition and physical activity – both of which significantly contribute to health behaviors –serve as the main topics of discussion based on the Coordinated School Health approach. The review also considers factors at the community level. The author poses the following recommendations: conducting the School Health Index, employing a school health coordinator, modeling after a successful pilot project, and implementing school policies. Applying these proposed interventions to similar regions merits further research to improve the health of America’s youth by working at the school level and reaching out to the community.
The advent of mobile phones has expanded our mode of communication to lengths that we, as consume... more The advent of mobile phones has expanded our mode of communication to lengths that we, as consumers of modern technology, seem to have taken for granted. Whether this is truly the case, however, depends on the degree to which the users of such a commodity pay attention to negative exposures that are essentially voluntary and possibly controllable (Wood, 2005). The case to which this matter refers to is one of the most debated topics in public health today: whether a causal association between mobile phone use and cancers of the brain exists. Despite attempts to investigate and elucidate the issue, epidemiological studies from the past and present predominantly continue to yield inconsistent evidence and views. More importantly, the analyses of biological plausibility and epidemiological study design and methodology reveals a polarized spectrum of findings and explanations that lead to an inconclusive consensus. This occurrence, conversely, does not entail the failure of such research but rather an impending need to improve future studies in their quest to find clear answers. As Olsen (2010, p. 281) states, “…we will need to address questions about the safety of these new, frequent, and avoidable exposures.”
African American women within the United States continue to have the highest breast cancer mortal... more African American women within the United States continue to have the highest breast cancer mortality rate despite higher incidence in Caucasian women. This racial disparity is attributed to unaddressed factors such as lower socioeconomic status, lesser utilization of medical services, and lower screening rates. The present study investigates social determinants (socioeconomic status, cultural beliefs and attitudes, psychosocial perceptions, and community/social support) influencing adherence and effectiveness in ongoing treatment. The study utilizes a randomized control trial design with a pre-test/post-test and time series component. A pilot intervention consisting of four phases is assigned to the experimental group in addition to conventional biomedical treatment; the comparison group only receives the latter. Subjects include African American women who are 18 or older, diagnosed with invasive breast cancer within the past six months, and are residing in minority, urban, and socioeconomically disadvantaged areas; sampling is conducted via probability multistage clustering. Health-related quality of life (HR QoL) will be measured through the European Organization for Research and Treatment of Quality of Life Questionnaire (EQRTC QLQ-C30) and the Quality of Life in Adult Cancer Survivors (QLACS) questionnaire. Correlations between type of intervention and the biological stage of breast cancer, HR QoL and survivorship will then be generated. Findings within this report will be integrated into a theoretical social framework aimed towards optimizing cancer care. Nursing implications entail enhancing patient-physician communication, establishing the role of “navigator” from oncology nurses, providing psychosocial assessment and intervention, and encouraging engagement in breast cancer support groups.
The Clinical Teacher, Feb 3, 2022
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2022
The HIV epidemic remains a public health threat in the U.S., and the dissemination and implementa... more The HIV epidemic remains a public health threat in the U.S., and the dissemination and implementation of evidence-based prevention and care programs are critical to addressing significant HIV health disparities. The provision of technical assistance (TA) to program providers and evaluators is key for uptake of these programs. The University of California San Francisco Prevention Research Center (UCSF PRC) model for TA delivery uses topics and strategies adapted to address HIV health disparities for a global audience. This model specifically matches TA requests to a TA provider who has expertise in that area upon receiving a request through various communication channels. Areas of expertise include research methods, community engagement strategies, interventions, and Implementation Sciences. Our evaluation of diverse TA services indicates that on-demand TA is effective for light-touch requests and well-suited for moderate to intensive requests. The model is a promising, broad-reachin...