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 Mental Health 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.
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 .
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.
Treatment as Prevention (TasP): HIV Case Management Program
Beginning in the June 2017 and in collaboration with Hawai'i Health & Harm Reduction Center and the John A. Burns School of Medicine, this project engages HIV-positive individuals living on O‘ahu who have a history of noncompliance with HIV treatment. This pilot study seeks to: (1) identify individuals most in need & not currently engaged in HIV treatment; (2) characterize barriers to HIV treatment; & (3) evaluate the effectiveness of an innovative re-engagement program aimed at promoting HIV treatment adherence and sustained treatment & suppression of HIV viral loads among these individuals.
Hawai‘i Clubhouse Program Evaluation
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 to develop an evaluation design that can be sustained internally after our initial evaluation is complete. 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.
Community Empowerment Resources Intensive Case Management Program
Beginning in January 2016, Community Empowerment Resources provides intensive case management and psychosocial rehabilitation services to homeless individuals living with serious mental illness in Honolulu. The Ecological Determinants lab is conducting an evaluation of the program to-date and is developing an evaluation model that can be sustained long-term. Data collection methods include case manager interviews, document content analysis, and client surveys.
Housing First Program Evaluation
Since December 2014, the lab has been conducting an evaluation of the Institute of 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 Waianae 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.
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 a follow-up Photovoice project with Housing First clients.