Research By CEMHD Associates

AIMS: Albany Infant and Mother Study: Allison Appleton, Ph.D., Principal Investigator. Gestation is one of the most critical periods of development where maternal social experiences and aspects of the environment may influence child health for year to come. The Albany Infant and Mother Study (AIMS) was designed to identify biologic and epigenetic mechanisms that may help explain how psychological factors and environmental toxicants in the prenatal period may jointly shape disparities in infant health outcomes. Our study blends expertise in epidemiology, obstetrics, psychology, environmental health, and epigenetics to advance the science of health disparities and identify novel risk and resiliency factors among disadvantaged populations. The study began in June of 2015 and data collection is ongoing. A total of 300 mother and infant pairs are sought for the study. AIMS enrolls women between the ages of 18-40 with singleton pregnancies who are between 24-28 weeks gestation at an outpatient obstetrics clinic at Albany Medical Center (Albany, NY). For more information about AIMS please go to https://www.albany.edu/aims/index.php 

Reproductive Health of Akwesasne Women: Lawrence Schell, Ph.D. Principle Investigator; Mia V. Gallo, Ph.D.; and David Carpenter, M.D Co-Investigators. This project seeks to determine whether the reproductive health of women of the St. Regis Mohawk Tribe (Akwesasne) on the St. Lawrence River has been adversely affected by exposure to chemical pollutants, primarily polychlorinated biphenyls (PCBs). The community is adjacent to one federal, and two state Superfund sites and the levels of PCBs among residents of the community are high, near the 95th percentile of CDC reference values. There is considerable concern in the Akwesasne community regarding difficulties in conceiving and bearing healthy children as well as for other health outcomes. This project is a collaborative effort between the St. Regis Mohawk Health Service (SRMHS), and the University at Albany/CEMHD. Between 2009 and 2014 the study recruited 215 women between 21 and 38 years of age. Analyses of the data to date showed a reduced chance of ovulation in relation to specific polychlorinated biphenyls (the mono-ortho congeners) and no relationship with other PCB congeners or with HCB or p,p’-DDE. BMI was another significant predictor of the chance of ovulation. Data reflecting other aspects of reproductive health, cardiovascular and immune system health continue to be analyzed. Publications are listed on the publication page.                                                                                                                                                 

Project SMART: Funded by NIDA R21DA039842-01A1) PI: Frederick L. Altice, M.D., M.A.; Co- I: Archana Krishnan, Ph.D.: Use of cocaine and other substance use disorders have been shown to significantly worsen the health outcomes of HIV+ persons by decreasing adherence to medications, health care utilization, and HIV outcomes. The purpose of Project SMART is to examine the feasibility and acceptability of mHealth intervention tools (electronic pill boxes and smartphones) on medication adherence among people living with HIV (PLH) who use cocaine. The mHealth tools will measure real-time adherence to medication intake and send text message reminders and feedback to patients. Participants will be randomized to one of four groups: 1) control, 2) automated feedback, 3) automated feedback + clinician feedback, and 4) automated feedback + social network feedback. 

Protecting the Health of Future Generations: Charles Buck, David O. Carpenter, Pamela Miller and Frank von Hippel, Principle Investigators. Assessing and preventing exposures to endocrine-disrupting flame retardant chemicals & PCBs in two Alaska Native Arctic Communities on St. Lawrence Island (to be funded NIEHS 8/1/17). The objectives of this community-based participatory research (CBPR) project are to investigate exposures, endocrine effects and mechanisms of developmental disruption associated with legacy contaminants and emerging flame retardant chemicals in two Yupik communities on St. Lawrence Island (SLI) in arctic Alaska. The Arctic is subject to atmospheric deposition of globally distilled persistent organic pollutants (POPs), acting as a hemispheric sink for POPs that are transported from lower latitudes and contains some of the most highly contaminated animals and people in the world. This study addresses a primary public health concern of the people of SLI by focusing on the levels and effects of legacy and emerging contaminants on the development of children in an arctic indigenous population that is vulnerable, underserved, and experiences significant health disparities. As young children are more highly exposed than adults, we will use innovative and minimally invasive techniques to assess exposure of children to polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), and emerging halogenated and non-halogenated organophosphate flame retardants. We will quantify PCBs and flame retardant chemicals in household dust, known to be an important exposure route. We will assess relationships among contaminant levels and evidence of health disruption via transcriptomics and endocrinology. We will use chemical concentrations in household dust and utilization of a subsistence diet as determined by stable isotope analysis to assess exposure pathways of these compounds. In order to understand the mechanistic basis of developmental disruption, and to have a reference for interpretation of human data, we will monitor patterns of gene expression, endocrinology and histology of our resident fish model, the stickleback, from both contaminated and reference sties. Collectively, we will increase our understanding of routes of exposure, endocrine disruption, and effects on the transcriptome of Yupik children exposed to high levels of PCBs and flame retardant chemicals. This study provides an opportunity to investigate the levels of PBDEs and emerging flame retardants in nails and blood in relation to health outcomes of arctic indigenous children for the first time. Our CBPR project will also empower SLI communities with the knowledge and tools they need to address important health disparities in their communities. Our results will inform public health interventions and improve health outcomes in arctic children broadly. Furthermore discovery of bioindicators relevant to early detection of developmental disruption will enable early intervention and improve health outcomes. Importantly we will build capacity through our CBPR approach, public health interventions and policy outreach, which will mitigate future exposure of SLI children to toxic chemicals.

The Transmissions of Violence and Mental Health Problems within Social Networks: Melissa Tracy Principle Investigator. University at Albany, Faculty Research Award Program-B Sponsor. The goal of this project is to examine the spread of violence and mental health problems through different types of social relationships (e.g., between parents and children; between intimate partners; between peers) over the life course. We are using secondary data from population-based longitudinal studies (e.g., the Avon Longitudinal Study of Parents and Children, the National Longitudinal Study of Adolescent to Adult Health) to inform an agent-based model of violence, substance use, and mental health outcomes in a simulated urban population. This model will be used to test alternative theories about the role of social connections as both increasing and decreasing risk for adverse outcomes. In addition, we plan to test hypothetical interventions aimed at reducing racial/ethnic and socioeconomic disparities in adverse outcomes.

 Women’s Health Project: Annis G. Golden, Ph.D. Principle Investigator. Matthew D. Matsaganis, Ph.D., and Anita Pomerantz, Ph.D. Co-Investigator. The goal of this project has been to identify successful strategies for overcoming barriers that contribute to underserved women in smaller towns and cities not obtaining adequate reproductive healthcare services. The study (referred to locally as the Women’s Health Project) investigated how women’s preventive reproductive healthcare seeking is affected by particularities of the place in which they live, including privacy concerns created by the nature of their social networks, organizational images of healthcare providers, shared ways of talking about fears associated with reproductive health screenings, and disjunctures in the local communication networks linking residents and organizations. The project has utilized a mixed-method design, informed by principles of community-based participatory research and a social ecological perspective on community health promotion, to conduct and evaluate the efficacy of a variety of interventions. In tandem with the study’s goals of identifying effective intervention strategies for encouraging women to obtain regular reproductive health services, the project seeks a better understanding of how local organizations’ interactions with community members and with one another impact their community’s health. At the forefront of the project’s current activities is a peer health advocate initiative, which employs women drawn from the community to function as a bridge between the local residents and the health service providers. Wilkin, H. A., Matsaganis, M. D., & Golden, A. G. (in press). Implementing communication infrastructure theory-based strategies in community health access interventions: Lessons learned from two projects in two cities.  In Y.-C. Kim, M. D. Matsaganis, H. A. Wilkin, & J.-Y. Jung, (Eds.), The Communication ecology of 21st century urban communities. New York, NY: Peter Lang. Scott, M. E., Elia, A. R., & Golden, A. G. (2015). A communicative analysis of a sexual health screening intervention conducted in a low-income housing complex. Journal of Applied Communication Research, 43, 450-467. Matsaganis, M. D., & Golden, A. G. (2015). Interventions to address reproductive health disparities among African American Women in a small urban community: The communicative construction of a ‘field of health action.’ Journal of Applied Communication Research, 43, 163-184. DOI:10.1080/00909882.2015.1019546. Published online March 13, 2015. Golden, A. G., & Pomerantz, A.  (2015). Interpretative repertoires that shape African American women's reproductive healthcare seeking: “Don't Want to Know” and “Take Charge of Your Health.” Health Communication, 30, 746–757. DOI: 10.1080/10410236.2014.89836. Published online August 21, 2014. Matsaganis, M. D., Golden, A. G., & Scott, M. E. (2014). Communication infrastructure theory and reproductive health disparities: Enhancing storytelling network integration by developing interstitial actors. International Journal of Communication, 8, 1495-1515. Available http://ijoc.org/index.php/ijoc/article/view/2566/1145 Golden, A. G. (2014). Permeability of public and private spaces in reproductive healthcare seeking: Barriers to uptake of services among low income African American women in a smaller urban setting. Social Science & Medicine, 108, 137-146. DOI:10.1016/j.socscimed.2014.02.034