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• How Ethical AI Is Advancing HPV Vaccine Uptake and Dental Health Disparities Research

  

  By Lynette Hammond Gerido, Ph.D., M.P.H., M.B.A; Scott Emory Moore, Ph.D., RN, APRN; Hamid Reza Kohan Ghadr, Ph.D.; and Preeti Pushpalata Zanwar, Ph.D., M.P.H., M.S.
  Posted Nov. 1, 2024

  Clockwise from top left: Drs. Lynette Hammond Gerido, Hamid Reza Kohan Ghadr, Preeti Pushpalata Zanwar, and Scott Emory Moore

  Addressing health disparities requires innovative approaches that blend expertise across disciplines. Through the Science Collaborative for Health Disparities and Artificial Intelligence Bias Reduction (ScHARe), NIH’s collaborative, cloud-based platform for population sciences research, interdisciplinary research teams leverage advanced data science methodologies and artificial intelligence (AI) to uncover how social determinants of health contribute to health inequities and to identify opportunities for data-driven policy interventions.

  Each team is challenged to use best practices to make their analysis explainable and to mitigate the “black box of AI,” such as through:

  • Model cards
  • Concise documents that summarize how an AI model works
  • Its intended use
  • Possible limitations

  These teams, co-led by experts in data science and health disparities research, represent a unique convergence of disciplines focused on solving public health challenges using advanced computational tools.

  ScHARe research teams exemplify the future of health disparities research with members from diverse backgrounds—from undergraduate students to senior faculty, as well as scientists and practitioners from academic and industry settings collectively bringing multidisciplinary expertise at varying career levels. These multigenerational cross-functional research teams symbolize ScHARe’s success in fostering a paradigm shift in health disparities research to use big data and to train underrepresented populations, including women, in biomedical data science.

  Using Big Data to Understand HPV Vaccine Uptake Disparities

  One of the ScHARe teams, co-led by Dr. Lynette Hammond Gerido and Dr. Scott Emory Moore, focuses on disparities in HPV vaccine uptake among marginalized populations. By analyzing datasets such as the National Immunization Surveys, the team has used data-driven techniques to examine the distribution of vaccine access before and after 2020, when the COVID-19 pandemic began.

  Their goal is to identify the social determinants influencing disparities in HPV vaccine reach and to better understand the individual factors that may underpin those disparities. The insights generated may inform policy aimed at reducing disparities and promoting equitable access to essential, relatively low-cost, preventive health care services.

  

  Through their advanced analysis, the team aims to uncover patterns of inequality, offering a better understanding of how social, economic, and biological factors interplay to contribute to health care disparities. Their research will ultimately contribute to more informed public health strategies, with the potential to significantly reduce inequities in HPV preventive care and treatment impacting cervical cancer outcomes.

  Using Machine Learning to Understand Dental Health Disparities

  Another ScHARe team, co-led by Dr. Hamid Reza Kohan Ghadr and Dr. Preeti Pushpalata Zanwar, addresses disparities in dental care access, an issue that worsened during the COVID-19 pandemic. Their research utilizes the Medical Expenditure Panel Survey, a nationally representative dataset that includes information on health care use, costs, and insurance coverage.

  Through the application of advanced machine learning techniques, their research aims to identify key determinants of dental care access, such as out-of-pocket costs, preventive health behaviors, and socioeconomic factors. This work is particularly relevant given the pronounced disparities in dental care access in the United States, disproportionately affecting marginalized communities.

  

  In addition to exploring these disparities, the team also is addressing potential biases in AI models and their implications for health equity. Their analysis will contribute to the ongoing discourse on bias mitigation in AI, particularly in the context of health disparities, and they aim to offer methodological guidance on applying machine learning to public health data regarding oral health to inform equitable health care policies.

  The ScHARe platform is a critical enabler of these research efforts. It provides access to over 260 health disparities and social determinants of health (SDOH) datasets, along with cloud-based computational tools that support large-scale, interdisciplinary analyses.

  The collaborative efforts of these research teams highlight the transformative potential of combining AI, big data, and multidisciplinary expertise to address public health challenges. As their projects progress, they aim to generate evidence that will guide policy and practice, contributing to the broader goal of promoting health equity and reducing disparities across diverse populations.

  Lynette Hammond Gerido, Ph.D., M.P.H., M.B.A., is an information scientist and assistant professor in the Department of Bioethics at the Case Western Reserve University School of Medicine. She is also scientific director of the Department of Bioethics’ Center for Community Health ANd Genomic Equity (CHANGE) and a Population and Cancer Prevention Program member at the Case Comprehensive Cancer Center. She partners with communities in her research and uses population data to understand trends in ethical, legal, and social implications of clinical research, public health campaigns, and consumer health technologies.

  Scott Emory Moore, Ph.D., RN, APRN, AGPCNP-BC, FAAN, is an assistant professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University. His research centers on the biological, psychological, and social factors that influence health outcomes among LGBTQ+ adults. His nursing experience includes emergency and trauma nursing, acute and chronic stroke care, complex chronic diseases, and care for LGBTQ+ and other marginalized populations.

  Hamid Reza Kohan Ghadr, Ph.D., is a molecular and computational biologist and a healthcare data scientist serving as a principal scientific consultant at Akna Health. He previously served as an assistant professor at the Michigan State University College of Human Medicine. He has expertise in AI, cloud computing, and bioinformatics and his research advances biomedical innovation by applying cutting-edge technologies to addressing health care challenges.

  Preeti Pushpalata Zanwar, Ph.D., M.P.H., M.S., is a health economist and health services researcher who serves as a lecturer in Applied Health Economics & Outcomes Research and Health Policy at Thomas Jefferson University. She researches disparities in preventive health care access, socioeconomic pathways to cognitive aging, inequities in vaccine uptake, outcomes of viral infections, and modelling differences in health care costs of multimorbidity.

• African American Faith Communities: Foundations for Mental Wellness

  

  By Rebecca Selove, Ph.D., M.P.H.
  With contributors Rev. Neely Williams and Rev. Dr. Omaràn D. Lee
  Posted July 31, 2024

  
  

  Left to right, Dr. Rebecca Selove, Rev. Neely Williams, Rev. Dr. Omaràn D. Lee

  The role of the church in African Americans’ lives and communities is immense and multi-faceted. In his recent book, The Black Church, Henry Louis Gates wrote, “The Black Church was the cultural cauldron that Black people created to combat a system designed in every way to crush their spirit. Collectively and with enormous effort, they refused to allow that to happen.”

  
  

  A 2021 survey indicates that 47% of Black Americans attend church at least once a week, more than any other racial and ethnic group, and more than half of Black Americans who participate in church activities attend congregations that they identify as a Black church. These powerful and potent community centers’ historical and social roles align with NIMHD’s mission to improve minority health and reduce health disparities. They are addressing mental health needs as part of their dedication to supporting the health of their community’s soul. Researchers who focus on addressing African American health must engage leaders of these congregations as teachers and mentors for their research endeavors. These leaders already know much of what scientists want to understand.

  Sabbath services in Black churches are often joyful expressions of gratitude and support. Messages from the pulpit and choir that acknowledge challenges, such as physical suffering, financial stress, grief, and anxiety, are offered in the overarching context of appreciation for the support, power, and goodness of God.

  As someone of European Jewish ancestry, my education about Black churches began fairly recently. I am a member of the research team for the NIMHD’s Engaging Partners in Caring Communities (EPICC) project designed to build the capacity of congregations that serve African American communities to implement health promotion programs. I have enjoyed being welcomed into uplifting and inspiring Sunday morning services with our partners. “Good morning, Church” is a frequent greeting to all who are gathered in the sanctuary – everyone is included in the loving welcome.

  At the same time that I have been experiencing the joy and warmth of the African American faith community, my faith leader partners and teachers in the EPICC project have been sharing their concerns about mental health issues affecting many in the African American community. They tell me about being called to address high levels of suffering associated with bereavement, suicide, substance use disorders, anxiety, depression, and youth and family violence. Pastors feel responsible for addressing these concerns while being very aware that the larger community offers inadequate support and resources that are sensitive to the needs and culture of African Americans. They note disparities in mortality associated with COVID-19 in African American communities, anxiety about access to trustworthy healthcare, and isolation associated with virtual participation in church activities during the pandemic.

  The research literature reflects their leadership in health equity, social justice activism, and community-academic partnerships emerging to build on the long-standing strengths and mission of faith communities. Pastoral care and church-based programs to address depression and alcohol use disorders, and to reduce mental health stigma are examples.

  At a recent gathering of leaders from nine EPICC partner congregations, Ms. Gwen Hamer from the Tennessee Department of Health and Mr. Sheldon Walker of Davidson County Metro Health Department described the Suicide Prevention and the African American Faith Communities Coalition (SPAAFCC), which started in 2009. Gwen told us, “… leaders in the African American faith communities… are one of the first people to be contacted when one of their parishioners is contemplating suicide or if a family member or friend of someone who has died by suicide needs comfort and encouragement. We felt their input in developing strategies to raise suicide prevention awareness and to help save lives from suicide in their faith communities was absolutely vital.”

  SPAAFC provides monthly virtual meetings for members to support one another, as well as training in programs such as Question, Persuade, and Refer also known as the QPR Gatekeeper Training.

  Our EPICC project team benefits from the guidance of two leaders in the Nashville African American faith community. Rev. Neely Williams has a long history of community advocacy and collaboration with academic researchers. Rev. Williams counsels our EPICC research staff to listen for our faith community partners’ strengths and to acknowledge the insights and priorities of church leaders. Rev. Dr. Omaràn D. Lee, a pastor and mental health practitioner currently serving as regional director of the Tennessee Governor’s Faith-Based and Community Initiative, helped develop the EPICC proposal. He leads programs through the Reach One, Teach One Foundation and Centers for Well-Being to support pastors and faith leaders so they can better serve their congregations.

  Faith community leaders have been providing a foundation for mental wellness for centuries, building on the considerable strength and wisdom of their spiritual traditions, their response to being called to serve their congregations, and their deep compassion for fellow human beings. We are grateful to be invited to join them in this effort.

  Rebecca Selove, Ph.D., M.P.H., is director of the Center for Prevention Research at Tennessee State University. She has served as a clinical psychologist in a variety of community settings and is currently focusing on implementation science and community-engaged research to promote health equity.

  Rev. Neely Williams is a minister, a community advocate, and a community organizer who has actively participated in the work of the Patient-Centered Outcomes Research Institute (PCORI) since its inception over 10 years ago. She serves as a consultant to the EPICC project’s research and community partner staff, lifting and articulating the community perspective on health disparities and health equity.

  Rev. Dr. Omaràn Lee, formerly the director of the Congregational Health Network (CHN), helped develop the funding proposal for EPICC. He is a pastor, a pastoral counselor, and regional director of the Tennessee Governor’s Faith-Based and Community Initiative, where he oversees the collaboration and coordination of faith-based and community organizations to address social issues and improve the quality of life for Tennesseans.