Quality of life is impacted through our unique histories and the environments in which we live. Our lab explores the role that the environment plays in shaping our quality of life. Our research includes the study of how social and built environments impact:
Adverse Childhood Experiences
Multiple Chronic Conditions
Prevention and Interventions to address Homelessness
Community Support Services
The Ecological Determinants Lab implements smaller, locally-based research programs and evaluations as well as larger scale disparities studies aimed at better understanding social determinants of health-related quality of life. We maintain ongoing research partnerships with local agencies and colleagues at the Centers for Disease Control, National Cancer Institute, and Center for Medicare and Medicaid Services. We have listed some of the projects we are currently working on below.
Social Determinants of Physical Health
Mechanisms of Disparities for HIV-related Hypertension
Beginning in the September 2018, this is a 5-year study with colleagues at Temple University to examines the impact of social determinants of health on biomedical markers associated with hypertension in Native Hawaiian and Asian Pacific Islander (Honolulu) and Black (Philadelphia) men that have sex with men (MSM) and living with HIV. The goal of this project is to construct and analyze a comprehensive longitudinal model aimed at understanding the socio-ecological risk factors associated with cardiovascular disease among ethnic and racial minority MSM living with HIV . For more information, see our recruitment website.
Researchers: Lorie Okada, Devin Barnes, Shari Brown, Vincent Nguyen,Leʻa Kane-Paulo, & Joy Agner
Partners: Dr. Frankie Wong & Dr. Grace Ma
Hawaiʻi Statewide HIV Needs Assessment
The Hawai‘i HIV Needs Assessment was conducted in 2018 in a joint effort between the Hawai‘i Health & Harm Reduction Center (HHHRC; formerly CHOW and Life Foundation), the Hawai‘i Department of Health, and the University of Hawai‘i at Mānoa. The purpose of the needs assessment is to shape and inform services for people living with HIV/AIDS (PLWH) in Hawai‘i from a social determinants of health perspective. We identify strengths as well as barriers to accessing a variety of social and health services with the goal of improving quality of life for PLWH. For more information, see our website.
Researchers: Joy Agner
Partners: Dr. Misty Pacheco, Hawaiʻi Health & Harm Reduction Center, Hawaiʻi Department of Health Harm Reduction Branch
Hawaiʻi Department of Health Intensive Coordinated Care Program
In partnership with the Hawaiʻi Department of Healthʻs Harm Reduction Branch, the lab has worked to devleop and evaluate a re-engagement in care program for individuals living with HIV/AIDS on Oʻahu, Maui, Hawaiʻi Island, and Kauaʻi.
Researchers: Joy Agner & Shari Brown
Med-Quest Evaluation Projects
This comprehensive 5-year project evaluates Med-Quest - Hawaiʻiʻs medicaid program. The project specifically examines the impacts of social determinants of health, home and community-based services, primary care, and community integration services.
Lead Researchers: Jack Barile & Joy Agner
Research Assistants: Monet Meyer
Community Mental Health Projects
Hawai‘i Clubhouse Program and Reciprocal Social Support
Beginning in January 2016, the goal of this project is to conduct an evaluation of clubhouses in Hawai‘i, with a specific focus on Honolulu clubhouses, and research into the role of reciprocal support in clubhouse members' lives. Clubhouses are psychosocial rehabilitation programs for people with severe and chronic mental illness. These program participants are members who run the Clubhouses. Therefore, members are responsible for creating and contributing to this community, which gives them a supportive environment in which to socialize and work. The evaluation is also participatory, &, long-term, the evaluation will be sustained by members.
Lead Researcher: Joy Agner
Law Enforcement Assisted Diversion (LEAD) Program
Since the spring 2018, the EcoLab has worked in collaboration with Hawai'i Health & Harm Reduction Center and local law enforcement to develop a pre-booking diversion program for low-level offenders. The LEAD program will work to divert individuals who commit low-level offenses (e.g., violating sit-lie laws, drug possession) from the criminal justice system into case management services. The program aims to reduce recidivism and increase access to services.
Research Assistants: Sophie Gralapp & Mark Willingham
Partners: Hawaiʻi Health & Harm Reduction Center
Community-based Participatory Research
The EcoLab conducts several participatory research projects, particularly using Photovoice methodology. By including members from marginalized groups as co-reasearchers, we hope to produce research that is useful to community members and inclusive of previously marginalized perspectives. Our current projects include a multi-site photovoice project with Hawai‘i Clubhouses and the Housing First Photovoice Projects.
Housing & Homelessness Projects
Housing First Program Evaluation
Since December 2014, the lab has been conducting an evaluation of the Institute for Human Services’ Housing First program. Based on national Housing First models, the program provides quick, low-barriers housing to homeless individuals and families in Honolulu and on the Wai‘anae Coast. Once housed, clients are provided access to services and continued case management. The evaluation project is a mixed-methods study, and data includes monthly client surveys and semi-structured interviews with clients, case managers, and service providers.
Research Assistants: Anna Pruitt, Marissa Minami, & Rachel Marshall
Partners: Institute for Human Services, Inc.
Partners in Care Research Partnership
Beginning in June 2019, the Ecolab entered a partnership with O‘ahu's local continuum of care, Partners in Care, to examine local pathways into and out of homelessness. In particular, this research will prioritize investigating disparities in Native Hawaiian and Pacific Islander rates of homelessness.
Lead Researchers: Dr. Anna Pruitt & Dr. Jack Barile
Research Assistants: Marissa Minami & Rachel Marshall
Hale Mauliola Evaluation
The Ecolab began evaluating the Hale Mauliola Emergency Shelter in June 2019. Hale Mauliola is a "low barriers" shelter that caters to individuals experiencing homelessness who are unnable to participate in traditional shelter programs. These individuals need accomodations for pets, parking, storage, and/or flexible hours due to employment.
Research Assistants: Marissa Minami, Anna Pruitt, & Rachel Marshall
Partners: Institute for Human Services, Inc.
Residential Youth Services & Empowerment (RYSE) Evaluation
Staying consistent with the Positive Youth Development philosophy, RYSE developed a tiered model that aims to service homeless youth at various states of readiness to move off the streets. The Ecolab worked with RYSE to evaluate existing program data from June 2018 - November 2019 and to develop new program intake and exit assessment for ongoing evaluation.
Research Assistants: Sarah Combs