Research Professor, Primary Care Research Institute
Addictions; Behavioral Health; Community Health Research; Criminal Justice Involvement; Health Disparities Research; Health Services Research; Health Services Research; Implementation Science; Medical Anthropology; Opioid Overdose; Program Evaluation; Qualitative Methods; Substance Use Disorder; Translational Research
As a medical anthropologist and health services researcher, my work examines the social, cultural, economic and political factors that influence health and risk behavior among vulnerable and complex populations. For two decades, my “research laboratory” has consisted of the community setting, medical practices, and recently the drug treatment courts. Multidisciplinary research, incorporating diverse teams, is central to my work.
Throughout my career, I have used a community-based research approach to nurture and sustain academic-community partnerships and initiatives to improve public health. Since 2017, I have served as lead evaluator/research principal investigator (PI) on funded public health initiatives addressing the opioid epidemic. These include: The Bureau of Justice Assistance (BJA)-funded Buffalo Treatment Court Opioid Intervention Program (“Opioid Court”); an Office of Women’s Health-funded initiative to implement universal screening, brief intervention and referral for treatment (SBIRT) in community-based OB-GYN practices; and a BJA-funded Opioid Overdose Outreach Enhancement Program to improve first response to opioid overdose and linkage to treatment. In these projects I work closely with the Erie County Department of Health and the New York State Eighth Judicial District. I am co-principal investigator, together with Dr. Greg Homish on a CDC R01 (#1 R01 CE003144) to conduct a rigorous evaluation of the nation’s first “public health court:” the Opioid Intervention Court.
My current research focuses on harm reduction and recovery support among people living with substance use disorders. We utilize in-depth interviews to elicit people’s first-hand experiences, and our findings inform clinical practice and policy. In one study we interviewed people enrolled in a transitional care-management program that adapts the critical time intervention (CTI) model to link justice-involved clients to addiction treatment, medical care, housing, benefits, and social supports. Using recovery capital (RC) theory to interpret findings, we found that subjects’ adherence to addiction treatment competes with other issues, including justice system requirements and obtaining social services. We recently published an ethnographic, qualitative study of 35 adult opioid overdose survivors who had been rescued one or more times with naloxone. Participants were recruited from community settings in Erie County. Results suggest that naloxone reversal is not necessarily a turning point in the opioid use trajectory. Rather, it keeps people alive until they are ready to engage in treatment. Study findings also support the need for ongoing community naloxone distribution initiatives and other harm reduction programs.
I am a creative, energetic teacher who engages novice researchers, especially medical students and clinical faculty with limited research experience. From 2016-2021 I directed a NRSA T32 institutional research training grant for postdoctoral candidates pursuing careers in biomedical/behavioral health research related to primary care (T32HP30035). Throughout my career I have taught, trained, and mentored diverse students at all levels: undergraduate, graduate, postdoctoral, medical students, residents, and junior faculty. By combining scientific rigor with a trainee-centered approach I help mentees achieve their goals while promoting a supportive, inclusive environment.