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.

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.

Research Assistants: Lorie Okada, Devin Barnes, Shari Brown, Vincent Nguyen

Partners: Dr. Frankie Wong & Dr. Grace Ma

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 (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.

Research Assistant: Joy Agner

Partners: Dr. Misty Pacheco, HHHRC, DOH Harm Reduction Branch

Department of Health ICC HIV Project

Research Assistants: Joy Agner & Devin Barnes

Partners: DOH Harm Reduction Branch

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.

Research Assistants: Devin Barnes, Cassidy Webb


Community Mental Health Projects

Hawaii 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.

Research Assistants: Joy Agner

Partners: DOH Clubhouse Coalition

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, Dominic Stone

Partners: HHHRC

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 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: Dr. Anna Pruitt, Dominic Stone, Natalie, Reisnerm & Marissa Minami

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.

Researchers: Dr. Anna Pruitt & Dr. Jack Barile

Research Assistants: Dominic Stone, Talia Schwartz, & Marissa Minami

Partners: Partners in Care

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: Dr. Anna Pruitt, Natalie Reisner, & Marissa Minami

Partners: Insitutue for Human Services, Inc.

Residential Youth Services & Empowerment (RYSE) Eval

Research Assistants: Cassidy Webb & Sarah Combs

Partners: RYSE