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RESEARCH PROJECTS
Ongoing Projects
All research project inquiries should be directed to research@borregohealth.org.
Examining Multi-Level Predictors of Patient Diabetes Rates within Clinics Belonging to a Federally Qualified Health Center
Abstract:
Background: This study analyzes patient-level characteristics, as well as the environment (i.e. clinic and clinician characteristics) of patients with controlled and uncontrolled diabetes.
Aims: 1. Describe the socio-demographic characteristics of patients with diabetes that is controlled (HbA1c levels are <9%) vs. uncontrolled (HbA1c levels are ≥9%).
2. Identify predictive features to identify future patients at high risk of uncontrolled diabetes.
Methods: Secondary data analysis of de-identified electronic health record (EHR) dataset of patients with diabetes.
Clinic Sites: n/a
Time Period: November 2019 – Present
Community Partners and PIs: USC (Mónica Pérez Jolles, Ph.D)
Funding Source: n/a
HPV Vaccination Among LGBTQ Young Adults
Abstract:
Background: Despite an effective human papillomavirus (HPV) vaccine, HPV remains the most common sexually transmitted infection in the US, where ~33,000 people develop HPV-related cancers and one million develop genital warts annually. HPV disparities notably affect sexual and gender minority people (SGM) (i.e. those whose sexual orientation or gender varies from an exclusively heterosexual, cisgender [birth sex matches current gender] orientation; LGBTQ). Compared to non-SGM, SGM assigned male at birth are at greater risk for anal cancer, and SGM assigned female at birth are less likely to be screened for cervical cancer. SGM also disproportionately have behaviors linked with HPV-related morbidity (e.g. smoking).
Aims: 1. Demonstrate target audience can be reached through targeted social media advertisements and community engagement.
2. Obtain preliminary quantitative data on the target populations’ sociodemographics, HPV/HPV vaccine knowledge, barriers and facilitators to HPV vaccination, use of electronic communications (e.g., text messaging) for healthcare-related activities, and HPV vaccination status through a brief online survey (N=300).
3. Identify key behavior change and implementation targets via qualitative in-depth interviews with the target population (N=30).
Methods: Participants will be invited to participate in the web-based/mobile phone delivered HPV survey (Aim 2) and a smaller number will be invited to participate in the in-depth interview (Aim 3)
Clinic Sites: All sites
Time Period: February 2020 – Present
Community Partners and PIs: SDSU (Heather Corliss, MPH, Ph.D)
Funding Source: n/a
MyPlate Dissemination for Latinos in Rural Communities
Abstract:
Background: Latinx have the highest rates of obesity compared to other US racial/ethnic groups, which contributes to diabetes and cardiovascular disease. Recent findings indicate following recipes based on the USDA federal nutrition guidelines (e.g. MyPlate) affects health outcomes in low-income, urban Latinos. This project proposes to disseminate evidence-based MyPlate recipes to rural Latinx communities in the Eastern Coachella Valley (ECV). While the ECV is one of the richest agriculturla areas in the world, it is also one of the most impoverished areas of California, where many of the predominately Latinx residents cannot easily access the fruits and vegetables many of them harvest.
Aims: 1. Establish a collaborative project leadership structure composed of patients, providers, clinical administrators, and community partners;
2. Convene a dissemination workgroup to adapt the existing Spanish-language MyPlate recipes so they are responsive to the patient population’s language needs (i.e., Purépecha), health literacy levels, and local food sources;
3. Disseminate tailored MyPlate recipes to the patient communities through cooking demonstrations, accompanied by nutrition education
Methods: Using a community-partnered participatory research (CPPR) model, patient, provider, and community stakeholders will produce a culturally vetted cookbook tailored to the rural Latinx patient communities in the Eastern Coachella Valley. CPPR emphasizes the equitable distribution of power, shared decision-making, and resource sharing among community and academic partners.
Clinic Sites: Centro Medico Oasis; Centro Medico Coachella
Time Period: January 2020 – Present
Community Partners and PIs: UCR (Ann Cheney, Ph.D); FIND Food Bank (Indio, CA)
Funding Source: PCORI
Completed/Archived Projects
All research project inquiries should be directed to research@borregohealth.org.
Cultural Pride Reinforcement for Early School Readiness (CPR4ESR):
Development of a Clinic-Based Literacy Program to Promote Cultural Pride and School Readiness in Early Childhood
Abstract:
Background: The Reach Out and Read (ROR) program is a national effort to promote early literacy, providing books and literacy advice at pediatric well-child visits, reaching a third of those living in poverty. Minority children disproportionately experience poverty and racial bias, both of which are linked to school failure, toxic stress, and health disparities.
Aims: This program aims to develop a clinic-based early literacy program that provides families with book sharing guidance and culture-specific books at well-child visits. Specifically, the program goal is to foster an increase in 1) parental delivery of cultural pride messages, 2) child cultural pride, 3) child health, and 4) child school readiness.
Methods: For parents who have consented to the study, pediatric well-child visits at two Borrego Health clinics will be accompanied by a 30-minute session with a researcher that includes a survey and handouts on cultural literacy. Parents will be randomized to receive either book for their children aged 6 months to 5 years to help with general literacy (i.e. books normally received as part of the ROR program), or books that feature cultural themes and messages.
Clinic Sites: Arlanza Family Health Center; Eastside Health Center
Time Period: July 2018 – November 2019
Community Partners and PIs: UCR (Ashaunta Anderson, MD, MPH, MS)
Funding Source: First Five
Patient-Centered Medical Home as a Complex Health Intervention
Abstract:
Background: Despite financial and human capital investment in transforming primary care settings to deliver patient-centered coordinated care (Patient-Centered Medical Home), national evidence of the effectiveness of this care model, once it is delivered in real life, has been mixed and disappointing.
Aims: The purpose of this project is to conceptualize the Patient-Centered Medical Home (PCMH) model as a complex health intervention and evaluate the feasibility of novel data collection methods. The project will characterize the local context of service arrangements and other elements of PCMH. Borrego Health participating clinics and QI department leadership will receive customized tools and reports from the study team.
Methods: The information is gathered through document reviews, key informant interviews, and job shadowing. A total of 24 administrators, providers, staff, and patients will be invited to participate.
Clinic Sites: Eastside, Desert Hot Spring Community Health Center, and Centro Medico Coachella
Time Period: September 2018 – August 2019
Community Partners and PIs: University of Southern California (Mónica Pérez Jolles, Ph.D)
Funding Source: USC Keck School of Medicine and Suzanne Dworak-Peck School of Social Work
Phase II Trial of Tesamorelin for Cognition in Aging HIV-Infected Persons
Abstract:
Background: HIV-associated neurocognitive disorders (HAND) remain highly prevalent (occurring in up to 50%), are disabling, and even the mildest form, asymptomatic neurocognitive impairment (ANI), bears a high risk of accelerated progression to symptomatic neurocognitive disability. Longitudinal neurocognitive trajectories are worse in aging HIV+ as compared to HIV negative individuals and that among HIV+, worse trajectories are seen in those with abdominal obesity, immune activation, inflammation, and metabolic disturbances. Novel therapies are available to decrease abdominal obesity and reduce systemic inflammation/immune activation.
Aims: This clinical trial is testing Egrifta as a treatment to improve brain function in HIV positive people with abdominal obesity, which increases the risk of impaired thinking. The central goals of this study are to 1) determine if reducing VAT, which we postulate will attenuate VAT-related inflammation, immune activation and metabolic disturbances as in other populations and/or 2) increasing IGF-1 neurotrophic hormone status, will improve neurocognitive scores in obese, virally suppressed HIV+ patients as occurs in HIV negative persons. The conceptual basis for the proposed study is related to the fact that tesamorelin (Tes) selectively reduces VAT and has independent neurotrophic effects via increases in insulin-like growth factor type 1 (IGF-1).
Methods: Participants are assigned to immediate versus deferred treatment with tesamorelin (Egrifta) for 6 months. There is no placebo. Participants’ memory and ability to solve problems are tested, and MRI images of their abdomen and brain before and at the completion of the 6-month period are captured.
Clinic Site: Stonewall Medical Center
Time Period: June 2016 – March 2020
Community Partners and PIs: University of California: San Diego (Ronald Ellis, MD, Ph.D)
Funding Source: National Institute on Aging
Assessing Barriers to Contraceptive Care Among Resettled Refugee Women: A Mixed-Methods Investigation of Disparities in Quality and Access
Abstract:
Background: The purpose of this study is to understand the unique needs and preferences of resettled refugee women for receiving reproductive healthcare, including family planning services, prenatal care, gynecological cancers, and maternal mental health.
Aims: The results of this study will be used to inform clinician training and initiatives to improve access to and quality of reproductive healthcare for resettled refugee women.
Methods: A 10-20-minute-long survey with approximately 200 resettled refugee women between the ages of 18 and 55.
Clinic Site: Centro Medico El Cajon; La Mesa Women’s Health and Wellness Center
Time Period: February 2019 – May 2019
Community Partners and PIs: University of California, San Diego (Morgen Chalmiers, MA)
Funding Source: Society of Family Planning
Mexican Migrant MSM, Sexual Networks, and Prevention Hotspots in San Bernardino County
Abstract:
Background: San Bernardino County has a high rate of migration of people from neighboring regions, including Los Angeles County. There are sparse data on the reasons for these migrations, especially for marginalized communities.
Aims: Study goals include a.) performing formative research examining the social and structural context of immigration, mobility, and HIV among Mexican and Central American migrant men who have sex with men (MSM) in San Bernardino, CA; b.) identifying, developing, and refining measures of migration that may predict reductions in risky sexual behavior and increased in HIV preventive care (e.g. PrEP); and c.) developing methods to characterize mobility and sexual network patterns for at-risk Mexican and Central American migrant MSM in the San Bernardino area.
Methods: Interviews with at least 20 MSM of Mexican or Central American origin who reside in San Bernardino to discuss their migration history; experiences with HIV; and sexual history.
Clinic Site: D Street Medical Center
Time Period: May 2018 – March 2019
Community Partners and PIs: UCSB (Susan Cassels, Ph.D, MPH)
Funding Source: PIMSA
Prior Experience with Dolutegravir-based Two-drug Regimen and Outcomes (PEDTRO): Motivation behind the use of DTG-based 2DRs for Treatment of HIV in the United States
Abstract:
Background: In 2016 it was estimated that approximately 13,000 patients were receiving 2DR in the US. However, the current literature on the physician drivers for prescribing 2DR is sparse.
Aims: The study aims to evaluate if a two-drug regimen (2DR) comprising of only two antivirals can provide the required clinical efficacy of a three- or four-drug regimen whilst minimizing the toxicity associated with antiretroviral therapy.
Methods: To address the evidence gap, ViiV Healthcare has partnered with Borrego Health to conduct a retrospective review of chart data for patients prescribed a 2DR to understand motivations for physicians prescribing 2DR at a patient-specific level and 2DR patient characteristics. Approximately 20 HIV treatment sites in the US are participating. At each site, data will be abstracted from the medical records for an overall sample size of up to approximately 350 patients.
Clinic Site: Stonewall Medical Center
Time Period: May 2018 – August 2018
Community Partners and PIs: Adelphi (Jenna Roberts, Ph.D)
Funding Source: Adelphi Group