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Center for Health Equity and Education Research

About

The Center for Health Equity Education & Research is an interdisciplinary group of clinicians, scientists, and community partners that aims to achieve optimal health outcomes for all individuals diagnosed with cancer by working to eliminate disparities among underserved and underrepresented communities. CHEER was launched in the winter of 2020/2021 as a new center, led by Co-Directors Jim Murphy, Brent Rose and Mateo Banegas. Through CHEER, we will work to support cancer health equity initiatives in our academic community, advance health equity efforts within our region and nation, and enable our mentees, students, fellows, and faculty to advance health equity through their work.


Our Mission

To facilitate transformative research focused on health equity across the translational spectrum and foster an educational environment aimed at improving health equity among underrepresented populations. A key component of fulfilling this mission is building strong partnerships throughout the community.


CHEER Directors

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James Murphy, MD, MS

CHEER Co-Director

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Brent Rose, MD

CHEER Co-Director

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Matthew Banegas, PhD

CHEER Co-Director



CHEER Members

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Kripa Guram, MD

Kripa is a radiation oncology resident physician in the Department of Radiation Medicine and Applied Sciences at UCSD.

Her research background includes basic and translational research related to cancer stem cells and cancer immunology. She is interested in studying the role of race and ethnicity in cancer characteristics, treatments, and outcomes, as well as understanding disparities in cancer health outcomes to promote health equity.

In her free time, she enjoys spending time with friends and family, doing various arts and crafts projects, and exploring the outdoors with her dog, Peanut.


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Liz Duran, MS

Liz is a research assistant. She investigates how social determinants of health impact access to care and health outcomes across the cancer care continuum. She received both a Master of Science and Bachelor of Science in earth sciences from UCSD, along with a minor in global health. Her research interests include environmental epidemiology, environmental justice, climate change, cancer epidemiology and health equity. In her free time, she enjoys rock climbing, long walks on the beach (and elsewhere!) and being a full-time dog mom.


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Kylie Morgan, BS

Kylie is a research data analyst. Her work includes data development, statistical analysis, and programming. Kylie has a Bachelor of Science in cognitive science, with a specialization in machine learning and neural computations, from the UCSD. She is interested in investigating the intersection of technology and neuroscience, specifically in the domain of intelligence. Outside of work, she enjoys surfing, hiking, and volunteering at a community garden.


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Leah Deshler, MPH

Leah is a research data analyst. She recently received a Master of Public Health degree from the University of South Florida, where her education focused on epidemiology, global communicable disease, and applied biostatistics. Her research interests include infectious disease epidemiology and the One Health approach. Outside of work, she enjoys reading, painting, trying new restaurants, and chasing the next sunset.


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Xinyi Huang, BS

Xinyi is a research assistant. She is a graduate student in Biostatistics and received a Bachelor of Science in statistics at UCSD. She designs and performs statistical analyses for numerous cancer research studies. Her primary research interests lie in the areas of semi-parametric theory, survey methodology, survival analysis and longitudinal data analysis. In her spare time, she loves cooking, biking, bird watching and working out.


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Kelly Fernandez, BA

Kelly Fernandez, BA, is a UC Los Angeles graduate where she studied Sociology. She works as a Program Coordinator for the OPTIMUS and SPARK program at UC San Diego. She is very passionate about volunteer work and serving underrepresented communities. Other interests include working out, traveling, and social justice.


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Carol Ochoa, PhD, MPH

Carol Ochoa is a recipient of the NCI F99/K00 award, a recent graduate of the USC Health Behavior Research Ph.D. program, and will be starting her Postdoctoral fellowship in the Department of Radiation Medicine and Applied Sciences at UCSD in June. Prior to starting her doctorate training, she served as the Cancer Survivorship workgroup ORISE Fellow within the Division of Cancer Prevention and Control (DCPC) at CDC. She joined DCPC in 2016 after receiving her MPH in Behavioral Science and Health Education from Emory University and her BA from UCLA in 2013. Carol is a cancer health disparities researcher trained in behavioral science within public health. She is a member of the American Association for Cancer Research, the American Association for Cancer Education, and the American Society of Preventive Oncology. Broadly, her research experience has centered on three areas of focus: 1) cancer survivors, 2) informal caregivers, and 3) cancer screening. Within this work, she uses a mixed-method approach to explore whether there are any racial/ethnic differences, the role of social determinants, and specific cultural factors that may be related to these outcomes.


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Daniel Sabater

Daniel is an undergraduate research assistant. He is currently a BS/MS student at UCSD in Biological Sciences. He hopes to address the disparity and burden of cancer across communities and linking researchers/providers to community members to promote health equity. He is interested in medical research and bioinformatics. In his free time, he enjoys spending time with friends and family, surfing, and playing hockey.



Featured Research Projects

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Clinical outcomes in African American men with prostate cancer. This retrospective cohort study of 8726 men with low  - risk prostate cancer found that African American men who underwent active surveillance suffered an increased risk of disease progression and definitive treatment compared with non  - Hispanic White men, but did not experience increased mortality. Published in JAMA.

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Pay‐for‐performance reimbursement. This nationwide research project found that hospitals caring for uninsured or underinsured individuals could potentially receive lower reimbursement under current pay  - for  - performance reimbursement models. This could potentially increase health disparities among at  - risk patients with cancer. Published in Cancer.

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Clinic - based Intervention for Financial Hardship CAFÉ. This ongoing NIH funded project assesses a clinic  - based intervention to address financial hardship for people with cancer using a randomized, stepped wedge trial designed to test the novel Cancer Financial Experience (CAFÉ) intervention. This study represents one of the first trials of an intervention focused on mitigating financial hardship specific to cancer patients.


Featured Research Education Initiatives

OPTIMUS program. The Outreach Program To Inspire Minority and Underrepresented Students ( OPTIMUS ) represents a summer cancer research fellowship for underrepresented high school students in San Diego. Students accepted into the program will work in cancer research labs, shadow physicians in clinic, and participate in community outreach efforts. Overall, the OPTIMUS program strives to help position our young students to become future leaders in clinical cancer care and cancer research.

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Legacy Speakers (LS) Project.
Federal law requires organizations that get federal funding to provide services in languages that can be understood by everyone. California has the largest population of non-English speakers. This can be a challenge for someone who is limited English proficient (LEP). Often LEP folks experience care delays, longer hospital stays, and sub-optimal care quality. One third of U.S. hospitals fail to provide interpretation services and one fourth of hospitals that serve patients that need language services do not provide them. In research primarily, language services are provided ad hoc, or improvised by the available bilingual research personnel which can lead to issues of loss of confidentiality and potential bias given there is no measure of quality or training for this additional labor. This impacts how materials are developed, scales measure, and data analyzed. Further, LEP and minority patients are routinely excluded from important clinical trials and research due to a language barrier. A lack of minorities in research like COVID-19 vaccine studies and cancer treatments could be improved by incorporating trained bilingual researcher assistants (BiRA). Though many bilingual students are often confident in conversational speaking, they might be unsure about using language skills in a research setting. Our project goal is to identify the barriers and facilitators in this group and develop culturally and linguistically appropriate training to support legacy speakers in their language and research capacity, in addition to providing cultural and clinically competent training in research with LEP and vulnerable populations.

The Legacy Speakers (LS) Project focuses on modernizing the way research and clinical trials recruit, retain, and include diverse and vulnerable patients by identifying barriers and facilitators related to ensuring a diverse research workforce. This project is identifying students and research assistants who are legacy speakers, meaning they acquired most of their native language informally in the U.S. versus a heritage speaker who received most or all their primary education in their native tongue. We seek these individuals who have used their bilingual skills in a health care setting. We are asking them what has, or has not, worked to prepare them to bridge language barriers and improve these processes in the context of their experiences.

Recruitment, retention, and inclusion of minoritized (and aging) individuals in research, which includes those with limited English proficiency (LEP), has been a key area of improvement for high-quality and equitable care delivery frameworks including NIA, NCI, and NIMHD. Language and race concordant participation in clinical trials is key for improving treatment outcomes for the increasingly diverse population of the U.S. Dr. Melody K Schiaffino, a core faculty member of the Center for Health Equity, Education, and Research (CHEER) at UC-San Diego Moores Cancer Center, is a nationally recognized expert in the delivery of hospital language services and care delivery systems science with a special focus on LEP populations. Language access has been a passion for Dr. Schiaffino who is a bilingual and bicultural Latina immigrant scientist, this project was inspired by her work and the curiosity of an SDSU undergraduate, Kathy Vu, who sought out Dr. Schiaffino after finding out they were at the same university. Kathy reached out to Dr. Schiaffino and found that this was a shared passion. As a member of Dr. Schiaffino’s lab, Kathy and another bilingual graduate student in the Health Management and Policy MPH program at SDSU, Azka Amer, co-wrote a student grant and received funds for this project. With Dr. Schiaffino’s mentorship they and 2 other students received evidence-based professional level certification in health services interpretation through the Bridging the Gap program, an internationally recognized program that prepares interpreters for federal and national certification exams. This training will allow the students in Dr. Schiaffino’s lab to develop a pilot training based on their findings from their interviews with legacy speakers to develop a culturally and linguistically appropriate research support training to improve recruitment and retention of researchers and participants into clinical research. To our knowledge this is the first training of its kind.

The CHEER Center is matching these funds to expand the study to UCSD medical students and resident legacy speakers. Through this partnership participants will include not only students that engage in research but also medical students that have used their bilingual skills in the clinical setting. The center is a new endeavor in the UC San Diego Department of Medicine, Division of Radiation Medicine. More recently, the Legacy Speakers Project has been funded for a second round, with Dana Patterson leading the Legacy Speakers Project II and Kathy Vu now doing post-bacc research with Dr. Schiaffino having graduated with honors in May 2022. Additionally, 4 more students will be added to the certified interpreter roster for the project to prepare evidence-based training for researchers and students. We hope to propose a clinical trial to test this training among research trainees and medical students seeking to maximize their language skills in research and support improvement in making clinical trial and care more equitable.

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Contact

Email us at CHEER@health.ucsd.eduTwitter: @UCSDHealthCHEER


Publications

Please email us at CHEER@health.ucsd.edu if you are unable to access any of our publications.