Current Research from the Director
“Who should be treated? The ethical challenges of administering opioid agonist treatment (OAT) for people who inject drugs during COVID-19."
Roberto Abadie, University Nevada, Lincoln
Celia B. Fisher, Fordham University
Funded by the Greenwall Foundation
There have been a number of highly influential public health ethics theoretical frameworks, a recently revised American Public Health Association (APHA) Public Health Ethics Code, and ethical guidance for public health emergencies developed for the Center for Disease Control and Prevention. All provide broad guidance for ethical decision-making regarding access to medical care during the COVID pandemic, but due to the novelty of the current pandemic and the crises in Opioid Agonist Treatment it has created, little is known regarding it’s applicability to the challenges facing patients and clinicians providing addiction care in economically marginalized regions of the U.S. This study will provide a critical analysis of the extent to which the core values articulated in current models for public health ethics reflect the moral values of PWID and ethical decision-making challenges faced by OAT staff in Puerto Rico. Drawing on the perspectives of key stakeholders this project will also contribute to the development of tailored, contextually-based ethics guidelines for OAT and other forms of addiction treatment for current and future infectious disease crises.
Current Research from the Lab
"COVID-19 Vaccine Hesitancy Among Economically Marginalized Hispanic Parents of Children Under Five Years in the United States"
Celia B. Fisher, Fordham University
Purnima Madhivanan MBBS, MPH, Ph.D.
Elise Bragard, MA, Fordham University (HDSJ Lab Doctoral Student)
Hispanic children have high rates of COVID-19 related hospitalizations and related deaths. Following FDA emergency approval of COVID-19 vaccination for children under five, vaccination rates have been alarmingly low, especially in border states with significant Hispanic populations. The aim of the current study was to identify demographic, health belief, structural and cultural factors associated with COVID-19 vaccine hesitancy among economically marginalized Hispanic parents of children under five living in US border states. In July, 2022, 309 Hispanic female guardians in Texas, Arizona and New Mexico responded to an online survey assessing parental intent to vaccinate their child, demographic parent and child characteristics, COVID-19 health and vaccine beliefs, trust in traditional sources of health information, physician and community support, and acculturation to Anglo American norms. Data indicated 45.6% of parents did not intend to vaccinate their child (resistant parents), 22.0% were unsure, and 32.4% intended to vaccinate their child (accepting parents). Bivariate correlations followed by multinomial logistic regression indicated vaccine acceptance was positively associated with perceived child COVID-19 susceptibility, trust in traditional health resources, a doctor’s recommendation for vaccination, community support, child’s age, higher parental income and education, and if the child had private compared to government or no health insurance. Vaccine acceptance was negatively associated with vaccine misconceptions, belief vaccination was unnecessary, general vaccine mistrust, nativity, time living in the US, and preference for English language. This study demonstrates how misinformation and distrust regarding vaccine safety, lack of community and other structural supports, and acculturation to perceived Anglo American norms are risk factors for vaccine hesitancy among economically marginalized Hispanic families. The research highlights the importance of public health strategies that draw on Hispanic community partnerships and on early and enhanced pediatrician-parent communication about routine and COVID-specific vaccinations are important public health strategies.
Associations between Sexting Motivations and Consequences among Adolescent Men who have Sex with Men (AMSM)
Elise Bragard, MA
Sexting is defined as the sending/receiving of sexual messages, photos, or videos via online communication (including via text message, email, social media platform, or dating/hook-up app). Research indicates that LGBTQ youth, and specifically AMSM, sext more frequently than their heterosexual peers. However, there is a dearth of research that provides a comprehensive descriptive analysis of sexting motivations and consequences specific to the AMSM population. Additionally, there has been no research to date that examines the associations between reported motivations and actual consequences of sexting. This online quantitative project will survey 400 AMSM (14-17 years) who have prior sexting experience from diverse backgrounds to examine the associations between their reported motivations for setting and the consequences they experienced as a direct result of sexting.
Risks and Benefits of Online Social Media Advocacy Work for LGBT Youth
Xiangyu Tao, MA
Research indicates that LGBTQ youth are more likely to experience cyberbullying than their peers, especially among those who engaged in advocacy work against anti-LGBTQ attitudes. Qualitative work also shows that social media networks can serve as an important support resource for them. It is unclear whether the negative mental health impact of sexual and gender social media discrimination can be buffered by such supportive networks for LGBTQ youth living in different social-political environments. This online mix-method project will survey 450 LGTBQ youth from diverse backgrounds to examine the associations among their online advocacy work for promoting LGBTQ equality, exposure to social media sexual/gender discrimination, perceived and seeking of social support on social media, and mental health and substance use.
Current Master's Theses and Doctoral Dissertations
Parental Messaging And Attitudes Toward Sex And Sexuality Among Ethnically Diverse Adolescent Girls
Elise Bragard, MA
There is a lack of empirical data on the relationships among different types of parental messaging about sex, adolescent girls’ positive and negative sexual attitudes, and their subjective sexual experiences. Elise’s dissertation research will examine these relationships among 14–18-year-old adolescent girls across diverse racial/ethnic backgrounds through online survey methods.
Social Media Use, Social Media Racial/Ethnic Discrimination, and Mental Health Among BIPOC Adolescents During the COVID-19 Pandemic
Xiangyu Tao, MA
Offline and online racial discrimination has been associated with mental health problems among adolescents of color. Pandemic shelter-at-home policies and the reignited racial justice movement increased the use of social media among youth of color, potentially exposing them to social media racial discrimination. Yet, it is unclear which aspects of social media significantly contributed to youth exposure to racial discrimination and associated mental health issues during this period. This study assessed the relationships among social media use (hours, racial intergroup contact, and racial justice civic engagement), individual and vicarious social media discrimination (defined as personally directed versus observing discrimination directed at others), and mental health among 115 Black, 112 East/Southeast Asian, 79 Indigenous, and 101 Latinx adolescents (N = 407, 82.31% female, aged 15-18 years, M = 16.47, S.D. = .93). Structural equation modeling (SEM) analyses indicate that hours of use and racial justice civic engagement were associated with increased social media racial discrimination, depressive symptoms, anxiety, alcohol use disorder, and drug use problems. Further, individual social media racial discrimination fully mediated the relationship between racial justice civic publication and depressive and alcohol use disorder. Vicarious social media racial discrimination fully mediated the relationship between racial justice activity coordination with depressive symptoms, anxiety, and alcohol use disorder. Alternative SEM models indicate that exposure to individual and vicarious social media racial discrimination increased depressive symptoms and drug use problems among youth of color, further increasing their social media use frequency and racial justice civic publication. The findings call for strategies to mitigate the effects of social media racial discrimination in ways that support adolescents’