Hard to Reach Populations
Promoting Community Conversations About Research to End Native Youth Suicide in Rural Alaska
Principal Investigator: Patrick Habecker
With rates up to 18 times higher for rural Alaska Native (AN) young people when compared to all American youth (124 vs 6.9 per 100,000), suicide disproportionately affects rural Alaskan communities and has been difficult to detect early, prevent and reduce. Like in other rural Indigenous communities, the majority of AN youth never receive mental health care, even when showing signs of anxiety, anger, depression, or other mental distress and when actively suicidal. Instead, vulnerable AN youth are likely to take risks and receive healthcare for alcohol-related injuries and interface with law enforcement. Unfortunately, these village workers are not trained to recognize risk, support vulnerable people, and to collaborate for prevention before an acute event. This project, Promoting Community Conversations About Research to End Suicide (PC CARES), brings together AN community members, village-based paraprofessionals, and regional professionals from multiple sectors to attend 9 monthly 3-hour learning circles. Learning circles use scientific knowledge to spark community conversations that help those in key positions identify vulnerable persons before they become suicidal, work together and within different spheres of influence to reduce risk factors, and create conditions that support safety and help-seeking. Basically, PC CARES creates regular opportunities to learn prevention science, discuss and plan how to adapt and apply suicide prevention information to fit local and cultural realities. This innovative community intervention increases village and regional providers' capacity to find self-determined and culturally-responsive ways to reduce suicidal behavior and related adverse outcomes. We believe that participation in PC CARES will result in increased collaboration for prevention among village members and providers, and will result in decreases in suicidal behavior and related adverse outcomes.
Biomarkers for Dysbiosis-Related HIV-Associated Cognitive Disorders among Persons Who Inject Drugs in Puerto Rico
Principal Investigator: Charles Wood | Co-Investigator: Bilal Khan
The current opioid injection incidence in the United States has risen to epidemic levels and is associated with increased risk of HIV-1 transmission and disease progression as well as with other infections in several US states. Given that most HIV+ people who inject drugs (PWID) are now likely to receive anti-retroviral therapy, traditional bio-markers such as HIV viral load and CD4 counts are unlikely to provide a comprehensive assessment of disease progression especially as it affects neurocognitive performance. New biomarkers are needed to track the effects of ongoing HIV infection as it impacts neurocognitive functions. The research team will make use of a well-established cohort of PWID in Puerto Rico, a region with historically high levels of injection drug use and an HIV incidence rate that is disproportionately associated with drug use. A prospective, multi-cohort longitudinal study will allow repeated measures from the study population and compare them with similar measures from control groups of HIV negative PWID and HIV-1 infected non-drug users from the same location. This longitudinal evaluation will allow our team to test the hypothesis that HIV-1 infection in PWID intensifies dysbiosis and inflammation which, in turn, exacerbates HIV replication, HAND and HIV treatment failures. We expect that this hypothesis, if true, will have important implications for the emerging drug epidemic in remainder of the United States.
Immigrant + Refugee Health
Systems-based Community Intervention Development: A Multilevel CBPR Approach to Enhancing Health Care Services and Communication in Meatpacking Communities
Co-Investigators: Virginia Chaidez & Angela Palmer-Wackerly
In recent months, rural communities with meatpacking plants have been hit hard by SARS-COV-2 and its related disease, COVID-19, exacerbating already existent health disparities among rural and im/migrant individuals and families. In Nebraska, counties with meatpacking plants have led the state in confirmed cases per capita, while Latinx residents have comprised the majority of confirmed COVID-19 cases statewide despite representing only 11.4% of the state population. In order to minimize the risk and effects of resurgent spread, effective community interventions will need to engage multiple systems, including increasing effective cooperation across trusted systems that may improve public health engagement and communication. Building on our history of effectively partnering with rural communities across Nebraska, we propose a qualitative study design with an interdisciplinary team across two NU institutions (UNL and UNMC), who will conduct focus groups (and individual interviews when necessary) with multiple stakeholders—health care providers, community health workers, adult community members, adolescent community members, schools, health departments, and cultural/religious leaders—to (1) identify systemic factors contributing to overall risk and impact of COVID-19, including attitudes, behaviors, experiences, challenges, resources, policies, and trusted communication and information sources related to COVID-19; and (2) provide feedback on an extant statewide mobile phone application (i.e., Answers4Families: Nebraska Resource and Referral System), which is in its early implementation phase. The current study will serve as pilot data to inform a future multilevel intervention to ensure reliable, timely, and accurate dissemination of COVID 19 risk and mitigation information across the most at-risk rural communities.
Latinx Health
Systems-based Community Intervention Development: A Multilevel CBPR Approach to Enhancing Health Care Services and Communication in Meatpacking Communities
Co-Investigators: Virginia Chaidez & Angela Palmer-Wackerly
In recent months, rural communities with meatpacking plants have been hit hard by SARS-COV-2 and its related disease, COVID-19, exacerbating already existent health disparities among rural and im/migrant individuals and families. In Nebraska, counties with meatpacking plants have led the state in confirmed cases per capita, while Latinx residents have comprised the majority of confirmed COVID-19 cases statewide despite representing only 11.4% of the state population. In order to minimize the risk and effects of resurgent spread, effective community interventions will need to engage multiple systems, including increasing effective cooperation across trusted systems that may improve public health engagement and communication. Building on our history of effectively partnering with rural communities across Nebraska, we propose a qualitative study design with an interdisciplinary team across two NU institutions (UNL and UNMC), who will conduct focus groups (and individual interviews when necessary) with multiple stakeholders—health care providers, community health workers, adult community members, adolescent community members, schools, health departments, and cultural/religious leaders—to (1) identify systemic factors contributing to overall risk and impact of COVID-19, including attitudes, behaviors, experiences, challenges, resources, policies, and trusted communication and information sources related to COVID-19; and (2) provide feedback on an extant statewide mobile phone application (i.e., Answers4Families: Nebraska Resource and Referral System), which is in its early implementation phase. The current study will serve as pilot data to inform a future multilevel intervention to ensure reliable, timely, and accurate dissemination of COVID 19 risk and mitigation information across the most at-risk rural communities.
Biomarkers for Dysbiosis-Related HIV-Associated Cognitive Disorders among Persons Who Inject Drugs in Puerto Rico
Principal Investigator: Charles Wood | Co-Investigator: Bilal Khan
The current opioid injection incidence in the United States has risen to epidemic levels and is associated with increased risk of HIV-1 transmission and disease progression as well as with other infections in several US states. Given that most HIV+ people who inject drugs (PWID) are now likely to receive anti-retroviral therapy, traditional bio-markers such as HIV viral load and CD4 counts are unlikely to provide a comprehensive assessment of disease progression especially as it affects neurocognitive performance. New biomarkers are needed to track the effects of ongoing HIV infection as it impacts neurocognitive functions. The research team will make use of a well-established cohort of PWID in Puerto Rico, a region with historically high levels of injection drug use and an HIV incidence rate that is disproportionately associated with drug use. A prospective, multi-cohort longitudinal study will allow repeated measures from the study population and compare them with similar measures from control groups of HIV negative PWID and HIV-1 infected non-drug users from the same location. This longitudinal evaluation will allow our team to test the hypothesis that HIV-1 infection in PWID intensifies dysbiosis and inflammation which, in turn, exacerbates HIV replication, HAND, and HIV treatment failures. We expect that this hypothesis, if true, will have important implications for the emerging drug epidemic in remainder of the United States.
Community Health Workers: Building a workforce to improve health disparities
Principal Investigator: Virginia Chaidez
Nebraska is home to a fast-growing Hispanic population in both urban and rural settings. This unique population change represents an opportunity to address health disparities in this young and growing population. With its increasing immigrant and migrant populations, particularly Hispanics, Nebraska must be prepared to deal with the complex ways in which race/ethnicity, socioeconomic status, racism, stress, health behaviors, language proficiency, culture, and religious involvement affect physical and mental health and access to healthcare. There is currently a national movement to bring Community Health Workers (CHW) into the mainstream of healthcare and promotion of healthy communities. Over time CHWs have demonstrated a proven track record of improving health and saving lives. However, current research methods based on narrowly-focused clinical interventions fail to capture complex systems and community changes that affect health. Thus, more research using qualitative and ecological approaches are needed to understand the role CHWs play in improving population health. The proposed project builds on an existing qualitative research project currently underway to explore CHW viewpoints. The objectives are to 1) identify CHW workforce retention factors that contribute to job satisfaction and effectiveness in improving health outcomes, and 2) develop and disseminate a statewide Employer Survey that can measure such retention factors related to CHW workforce sustainability and effectiveness. This research will help inform best practices for utilization of CHWs; provide new research opportunities to measure the effects of best practices on various health outcomes; and have potential to inform future healthcare policy in Nebraska.
Community Health Workers: A Qualitative Study
Principal Investigator: Virginia Chaidez
With the passage of the Affordable Care Act (ACA), our healthcare system is rapidly evolving to meet the needs of a growing diverse population. The social and behavioral influences on human health are vastly understudied, particularly in multicultural and underserved populations. With its increasing immigrant and migrant populations, Nebraska must be prepared to deal with the complex ways in which race/ethnicity, socioeconomic status, racism, stress, health behaviors, language proficiency, culture and religious involvement affect physical and mental health. There is currently a national movement to bring Community Health Workers (CHW) into the mainstream of healthcare and promotion of healthy communities. In this process, the voice of the CHW is a critical but understudied aspect of redefining healthcare and their role in population health in both urban and rural settings. This research project will provide new insight to the strengths, challenges and barriers CHWs face in doing their work across various settings. These findings will 1) provide insight to help frame relevant and timely research questions related to CHW utilization in a largely rural state and 2) be shared Nebraska’s Community Health Worker stakeholder groups.
Drawing Our Story to Encourage Communication about Family, Health, and Education among Latinx Adolescents
Co-Investigators: Angela Palmer-Wackerly & Virginia Chaidez
This study is designed to help rural Latinx teenagers communicate about health and educational issues that concern them. Students will be asked to draw a ‘story’ that explains how they feel about a health issue. This process of drawing a story important to their life is called “Narrative Mapping”. Participants will share this story with a partner in groups of 4-6 via zoom and will practice listening sensitively to another’s story. We will then discuss these stories as a group and ask them their ideas on what would help them talk with others about their health concerns. We will also ask teenagers to answer questions about what they hope to do in their future (education, occupation), as well as concerns. The findings of this exploratory study are designed to gather preliminary data to inform future studies about rural, Latinx adolescents and issues that are important to them.
Stress + Mental Health
Promoting Community Conversations About Research to End Native Youth Suicide in Rural Alaska
Principal Investigator: Bilal Khan
With rates up to 18 times higher for rural Alaska Native (AN) young people when compared to all American youth (124 vs 6.9 per 100,000), suicide disproportionately affects rural Alaskan communities, and has been difficult to detect early, prevent and reduce. Like in other rural Indigenous communities, the majority of AN youth never receive mental health care, even when showing signs of anxiety, anger, depression, or other mental distress and when actively suicidal. Instead, vulnerable AN youth are likely to take risks and receive healthcare for alcohol-related injuries, and interface with law enforcement. Unfortunately, these village workers are not trained to recognize risk, support vulnerable people, and to collaborate for prevention before an acute event. This project, Promoting Community Conversations About Research to End Suicide (PC CARES), brings together AN community members, village-based paraprofessionals and regional professionals from multiple sectors to attend 9 monthly 3-hour learning circles. Learning circles use scientific knowledge to spark community conversations that help those in key positions identify vulnerable persons before they become suicidal, work together and within different spheres of influence to reduce risk factors, and create conditions that support safety and help-seeking. Basically, PC CARES creates regular opportunities to learn prevention science, discuss and plan how to adapt and apply suicide prevention information to fit local and cultural realities. This innovative community intervention increases village and regional providers capacity to find self-determined and culturally-responsive ways to reduce suicidal behavior and related adverse outcomes. We believe that participation in PC CARES will result in increased collaboration for prevention among village members and providers, and will result in decreases in suicidal behavior and related adverse outcomes.
Daily Experiences of Sexual and Gender Minorities Living in Rural Nebraska
Principal Investigator: Rebecca Brock
Sexual and gender minorities (SGM) have long been marginalized within society and encounter a range of stressors related to their minority status. One prevailing theory for understanding the origins and impact of these experiences is Meyer’s (2003) minority stress model, which holds that SGM individuals endure a host of distal and proximal stressors including discrimination, harassment, and stigma. According to this model, these stressors perpetuate structural, systematic, and interpersonal disadvantage, resulting in dysfunction. As challenging as these experiences are more generally, stigma and related prejudices towards sexual and gender non-conformity are higher in rural locations, which may expose rural SGM persons to increased stress. The objective of this project is to understand the daily experiences of SGM individuals living in rural Nebraska, including forms of discrimination, stigmatization, and marginalization that cause distress and impairment.
Rainbow Project
Principal Investigator: Deb Hope
Under the umbrella of the the Rainbow Project, we have a line of research on stigma and discrimination. This research focuses on LGBTQ (Lesbian, Gay, Bisexual, Transgender and Queer) populations and has expanded to include mental health impacts of discrimination more broadly, including the provision of clinical services to individuals who report discrimination in employment, housing, etc. Our recent work includes Trans Collaborations, a community-based partnership between transgender and gender non-conforming people and academic researchers to improve health care services for TGNC people living in underserved areas.
Queer Women's Body Attitudes and Sexual Health Study
Principal Investigator: Kathryn Holland
This work will examine how queer women’s attitudes toward their body shape, genitals, and menstrual periods are associated with key sexual health outcomes (e.g., sexual satisfaction, accessing preventative care). Moreover, this work will test key mechanisms that help to explain the consequences of such body attitudes on sexual health outcomes, including feelings of dehumanization and comfort communicating with partners and providers. Finally, this work will consider the role of minority stressors unique to queer women in these proposed relationships, such as internalized homonegativity/bi-negativity and the anticipation of heterosexism from healthcare providers.
Cycle effects on Mood, Behavior, and Inflammation in Trauma Survivors (CyMBIoTS); Funded by the Brain & Behavior Research Foundation
Principal Investigator: Tierney Lorenz
Survivors of sexual trauma have significantly higher risk for premenstrual dysphoric disorder (PMDD) and other cycle-related mental health disturbances. PMDD is itself a serious mental health condition, but it can also increase risk for other mood disorders such as depression and bipolar disorders. While there is some research showing survivors of sexual trauma have hormone imbalances that can contribute to their higher rates of menstrual cycle-related mental health problems, other research fails to find any hormonal effects, suggesting hormones are not the only factor. Based on our prior work showing higher inflammation among sexual trauma survivors, we are studying a new possible explanation: sexual trauma survivors may have larger changes in inflammation across the menstrual cycle, particularly if they are sexually active. Inflammation has recently emerged as an important driver of psychopathology, contributing to negative mood, social withdrawal, and anhedonia. However, changes in inflammation across the menstrual cycle may be an evolutionary adaptation to reduce immune interference during fertile windows, while also protecting women during non-fertile times. If so, inflammation changes should only be expected among women who could conceive that cycle – that is, among sexually active women. Indeed, across several studies, we have found that sexually active women have significantly higher inflammation during the early and late phase of the cycle but significantly lower inflammation around ovulation, while sexually abstinent women have little change across the cycle. This pilot study brings together these two lines of research, in order to (a) replicate prior research showing that changes in inflammation across the menstrual cycle contribute to mood and anxiety symptoms among sexual trauma survivors, and (b) novel to this study, test if sexual trauma and sexual behavior interact to predict changes in inflammation across the menstrual cycle. Specifically, we will measure pro-inflammatory cytokines, reproductive and stress hormones, mood symptoms, and sexual activity across the menstrual cycle in women who self-report cycle-related mood symptoms. We will collect online daily diary measures of mood and sexual behavior; weekly measures of psychological stress, health behaviors (e.g., diet, exercise, and substance use), and depression/anxiety symptoms; and every-other-day salivary measures of immune and endocrine biomarkers. Saliva samples will be tested for a suite of pro-inflammatory cytokines that have been shown to contribute to mood symptoms (IL-6, IL-1β, TNF-α, and IFN-γ), as well as levels of reproductive hormones (estrogen, progesterone) and stress hormones (cortisol) that have been implicated in premenstrual symptoms. Knowledge gained from this research will identify factors that lead to individual differences in risk for PMDD and other cycle-related mood disorders, and contribute to biopsychosocial models of sex/gender differences in mental health that contribute to women’s disproportionately higher risk for mood disorders.
Desire, Arousal and Immunity across the LifeSpan (DIALS); Funded by the Patty Brisben Foundation
Principal Investigator: Tierney Lorenz
This project is investigating how chronic stress and inflammation may contribute to the development and maintenance of sexual dysfunction in pre- and post-menopausal women. Approximately 1 in 10 women in the US report problems with sexual desire, with post-menopausal women disproportionately at risk for low libido. A big part of the problem in developing good treatments is that, despite much research, we still do not understand what causes low sexual desire in women, particularly in post-menopausal women. Recent work from our lab suggests that we may be overlooking a critical element - the possible role of inflammation. In two small pilot studies, we found that inflammation levels predicted pre-menopausal women’s self-reported sexual desire levels, as well as how aroused a woman could become to a sexual stimulus. The proposed study will examine how inflammation may lead to problems with women’s sexual desire and arousal. We will recruit women for a study of inflammation to a standardized sexual stimulation paradigm in a controlled lab setting. We will recruit equal numbers of women with sexual desire dysfunction and healthy controls, and equal numbers of pre- and post-menopausal women; this 2x2 design will allow us to compare the effects of inflammation on sexual desire across women’s reproductive life stages. We will test if markers of inflammation predict sexual desire and vaginal sexual arousal as measured in the lab. We will also test if differences in inflammation account for differences in sexual desire among pre- and post-menopausal women.
Heteroflexibility, Arousal, and Substance Use Habits (HASH); Funded by the UNL RDAR Center pilot grants program
Principal Investigator: Tierney Lorenz
Mostly heterosexual women (MHW) have been identified as particularly at risk for substance use issues, even above and beyond that of other sexual minority women. Large, nationally representative studies have found that MHW report marijuana use at twice the rate of bisexual women and three times that of lesbian women; similarly, MHW report heavy alcohol use 1.5 times that of bisexual women. One potential pathway to the substance use among MHW is through the use of substances for sexual enhancement. To date, MHW women’s use of substances for sexual enhancement has largely been ignored. However, there is strong evidence that MHW have significantly higher sexual interest and arousal, and lower sexual inhibition, than exclusively heterosexual women, potentially increasing the risk they will use substances for increased sexual enhancement. We are collecting data on young adult women grouped by sexual orientation (exclusively heterosexual/mostly heterosexual/bisexual). Using behavioral testing, surveys, and psychophysiological measurements of sexual response, we will create new model to evaluate the increased risk of substance use in MHW. The central hypothesis of this model is that MHW have higher sexual interest and sexual response, and find sexual stimulation more rewarding, which leads them to have higher expectations of sexual enhancement from substance use. This in turn may lead MHW to increased substance use in sexual contexts. In addition to creating a pathway to greater substance use overall, using substances in sexual contexts increases risks of sexually transmitted infection and sexual victimization – both of which have also been shown to be higher among MHW.
Network Science
Open Dynamic Interaction Network (ODIN)
Principal Investigator: Bilal Khan
ODIN is a very cost-effective mobile platform for social and behavioral research. ODIN embraces a new paradigm for scientific exploration, moving beyond simple “surveying” and “social network analysis” of populations, by enabling the collection and analysis of continuous and contextualized individual and interpersonal data. Using ODIN, social science can extend beyond static snapshots of individual/social life, yielding new insights through the analysis of high dimensional data streams collected from study participants over long timescales. ODIN was designed by interdisciplinary teams as part of National Science Foundation project 1338485 and its development is supported by National Institutes of Health grant RO1 GM118427.
Social Network Analysis by Perceptual Tomography (SNAPT)
Principal Investigator: Bilal Khan
SNAPT combines network sampling approaches with third party reporting. Randomly chosen individuals are shown a random sample of photographs from a group to which they belong and asked to bin the photographs according to whether or not the individuals in the photographs are “close to one another”. Following this, reports on perceptions of the social characteristics of these same individuals are gathered from the same respondent. Together, these data can be used to infer perceived ties (or the absence of ties), and the perceived attributes of those involved. SNAPT greatly simplifies what are otherwise complex issues of network sampling.
Racism + Discrimination
Rainbow Project
Principal Investigator: Deb Hope
Under the umbrella of the the Rainbow Project, we have a line of research on stigma and discrimination. This research focuses on LGBTQ (Lesbian, Gay, Bisexual, Transgender and Queer) populations and has expanded to include mental health impacts of discrimination more broadly, including the provision of clinical services to individuals who report discrimination in employment, housing, etc. Our recent work includes Trans Collaborations, a community-based partnership between transgender and gender non-conforming people and academic researchers to improve health care services for TGNC people living in underserved areas.
Daily Experiences of Sexual and Gender Minorities Living in Rural Nebraska
Principal Investigator: Rebecca Brock
Sexual and gender minorities (SGM) have long been marginalized within society and encounter a range of stressors related to their minority status. One prevailing theory for understanding the origins and impact of these experiences is Meyer’s (2003) minority stress model, which holds that SGM individuals endure a host of distal and proximal stressors including discrimination, harassment, and stigma. According to this model, these stressors perpetuate structural, systematic, and interpersonal disadvantage, resulting in dysfunction. As challenging as these experiences are more generally, stigma and related prejudices towards sexual and gender non-conformity are higher in rural locations, which may expose rural SGM persons to increased stress. The objective of this project is to understand the daily experiences of SGM individuals living in rural Nebraska, including forms of discrimination, stigmatization, and marginalization that cause distress and impairment.
Ethnic-Racial Identity, Identity Tensions and Psychological Well-Being in Personal, Familial, and Professional Relationships
Principal Investigator: Jordan Soliz
Guided by communication theory of identity, the project focuses on perceived identity tensions in personal relationships, family relationships, and the professional environment to examine associations with psychological well-being (e.g., life satisfaction, self-esteem). Focus on comparing and contrasting monoethnic-racial individuals.
Family Communication, Ethnic-Racial Identity, and Well-Being in Young Adults and Mixed-Ethnic-Racial Heritage
Principal Investigator: Jordan Soliz
Focus on the socialization process and ethnic-racial identity development of multiethnic-racial individuals (i.e., individuals with parents from different ethnic-racial backgrounds). Project examines how family processes and behaviors (e.g., parental and grandparent messages, perceived discrimination and bias in the family) in multiethnic-racial families facilitates or hinders the development of a secure ethnic-racial identity and well-being (e.g., self-esteem, depression, loneliness).
Rural Health
Systems-based Community Intervention Development: A Multilevel CBPR Approach to Enhancing Health Care Services and Communication in Meatpacking Communities.
Co-Investigators: Angela Palmer-Wackerly & Virginia Chaidez
This purpose of this study is to identify systemic gaps and opportunities for COVID-19 interventions across stakeholder groups representing multiple community systems (i.e., health care providers, community health workers, adult community members, adolescent community members, schools, health departments, and cultural/religious leaders) across rural, meatpacking communities in Nebraska. We specifically aim to (1) identify systemic factors contributing to overall risk and impact of COVID-19, including attitudes, behaviors, experiences, challenges, resources, policies, and trusted communication and information sources related to COVID-19; and (2) provide feedback on an extant statewide mobile phone application (i.e., Answers4Families: Nebraska Resource and Referral System), which is in its early implementation phase.
Drawing Our Story to Encourage Communication about Family, Health, and Education among Latinx Adolescents
Co-Investigators: Angela Palmer-Wackerly & Virginia Chaidez
This study is designed to help rural Latinx teenagers communicate about health and educational issues that concern them. Students will be asked to draw a ‘story’ that explains how they feel about a health issue. This process of drawing a story important to their life is called “Narrative Mapping”. Participants will share this story with a partner in groups of 4-6 via zoom and will practice listening sensitively to another’s story. We will then discuss these stories as a group and ask them their ideas on what would help them talk with others about their health concerns. We will also ask teenagers to answer questions about what they hope to do in their future (education, occupation), as well as concerns. The findings of this exploratory study are designed to gather preliminary data to inform future studies about rural, Latinx adolescents and issues that are important to them.
Promoting Community Conversations About Research to End Native Youth Suicide in Rural Alaska
Principal Investigator: Bilal Khan
With rates up to 18 times higher for rural Alaska Native (AN) young people when compared to all American youth (124 vs 6.9 per 100,000), suicide disproportionately affects rural Alaskan communities, and has been difficult to detect early, prevent and reduce. Like in other rural Indigenous communities, the majority of AN youth never receive mental health care, even when showing signs of anxiety, anger, depression, or other mental distress and when actively suicidal. Instead, vulnerable AN youth are likely to take risks and receive healthcare for alcohol-related injuries, and interface with law enforcement. Unfortunately, these village workers are not trained to recognize risk, support vulnerable people, and to collaborate for prevention before an acute event. This project, Promoting Community Conversations About Research to End Suicide (PC CARES), brings together AN community members, village-based paraprofessionals and regional professionals from multiple sectors to attend 9 monthly 3-hour learning circles. Learning circles use scientific knowledge to spark community conversations that help those in key positions identify vulnerable persons before they become suicidal, work together and within different spheres of influence to reduce risk factors, and create conditions that support safety and help-seeking. Basically, PC CARES creates regular opportunities to learn prevention science, discuss and plan how to adapt and apply suicide prevention information to fit local and cultural realities. This innovative community intervention increases village and regional providers capacity to find self-determined and culturally-responsive ways to reduce suicidal behavior and related adverse outcomes. We believe that participation in PC CARES will result in increased collaboration for prevention among village members and providers, and will result in decreases in suicidal behavior and related adverse outcomes.
Daily Experiences of Sexual and Gender Minorities Living in Rural Nebraska
Principal Investigator: Rebecca Brock
Sexual and gender minorities (SGM) have long been marginalized within society and encounter a range of stressors related to their minority status. One prevailing theory for understanding the origins and impact of these experiences is Meyer’s (2003) minority stress model, which holds that SGM individuals endure a host of distal and proximal stressors including discrimination, harassment, and stigma. According to this model, these stressors perpetuate structural, systematic, and interpersonal disadvantage, resulting in dysfunction. As challenging as these experiences are more generally, stigma and related prejudices towards sexual and gender non-conformity are higher in rural locations, which may expose rural SGM persons to increased stress. The objective of this project is to understand the daily experiences of SGM individuals living in rural Nebraska, including forms of discrimination, stigmatization, and marginalization that cause distress and impairment.
Sexual + Gender Minority Health
Daily Experiences of Sexual and Gender Minorities Living in Rural Nebraska
Principal Investigator: Rebecca Brock
Sexual and gender minorities (SGM) have long been marginalized within society and encounter a range of stressors related to their minority status. One prevailing theory for understanding the origins and impact of these experiences is Meyer’s (2003) minority stress model, which holds that SGM individuals endure a host of distal and proximal stressors including discrimination, harassment, and stigma. According to this model, these stressors perpetuate structural, systematic, and interpersonal disadvantage, resulting in dysfunction. As challenging as these experiences are more generally, stigma and related prejudices towards sexual and gender non-conformity are higher in rural locations, which may expose rural SGM persons to increased stress. The objective of this project is to understand the daily experiences of SGM individuals living in rural Nebraska, including forms of discrimination, stigmatization, and marginalization that cause distress and impairment.
Rainbow Project
Principal Investigator: Deb Hope
Under the umbrella of the the Rainbow Project, we have a line of research on stigma and discrimination. This research focuses on LGBTQ (Lesbian, Gay, Bisexual, Transgender and Queer) populations and has expanded to include mental health impacts of discrimination more broadly, including the provision of clinical services to individuals who report discrimination in employment, housing, etc. Our recent work includes Trans Collaborations, a community-based partnership between transgender and gender non-conforming people and academic researchers to improve health care services for TGNC people living in underserved areas.
Queer Women's Body Attitudes and Sexual Health Study
Principal Investigator: Kathryn Holland
This work will examine how queer women’s attitudes toward their body shape, genitals, and menstrual periods are associated with key sexual health outcomes (e.g., sexual satisfaction, accessing preventative care). Moreover, this work will test key mechanisms that help to explain the consequences of such body attitudes on sexual health outcomes, including feelings of dehumanization and comfort communicating with partners and providers. Finally, this work will consider the role of minority stressors unique to queer women in these proposed relationships, such as internalized homonegativity/bi-negativity and the anticipation of heterosexism from healthcare providers.