College students (usually between the ages of 18 and 24) are in a transitional period in their lives in which they are expected to adapt to many overwhelming and sudden changes. Mental health problems that college students experience most commonly arise from extreme academic, relationship, financial, and psychosocial strains. Despite these high rates of stressors and mental health problems, these same college students demonstrate a persistently low level of perceived need for help and actual service utilization which leads to non-treatment seeking behaviors. This study examined common barriers that prevent college students from seeking mental health treatment by using standardized measures. Two hundred and fifty college students in the Psychology Subject Pool (PSP) at the University of Washington volunteered to participate in the study which was conducted by using online survey software. Information collected included past/current mental disorder diagnoses and mental health treatment, duration of the treatment, and knowledge of on-campus resources (e.g., Counseling Center, Hall Health). Further, participants answered seven questionnaires about attitudes toward, barriers to, and fear of treatment, in addition to participants’ ambivalence concerning emotional expressiveness. The results are primarily descriptive in nature and focused on exploring common barriers, attitudes, and issues that interfere with reaching out to and receiving mental health treatment. By identifying the barriers we hope to bring the target consumer audience closer to effective treatments via distributing our findings to local counseling centers. We also examined how demographic variables relate to college students’ attitudes toward mental health treatment which will help local universities and colleges to tailor advertising efforts with greater specificity to ensure that college students in need of mental health services are aware of and engaged in available services.

Tribal communities often lack access to high-quality healthcare, prevention programs, cancer education, cancer screening tests, and cancer clinical trials. As a result, American Indians and Alaska Natives experience the worst cancer-related disparities and the poorest survival rates of all racial and ethnic groups in the U.S. Comic books have long been used as an educational tool to improve public health. In 2008, the Native Comic Book Project was launched as a youth-focused community education project of Native People for Cancer Control, a Community Network Program Center funded by the National Cancer Institute. The purpose of this ongoing project is to use comic book creation as a way to educate Native youth about cancer, especially methods of cancer prevention. Along with basic art skills, participants learn about traditional foods and wellness, non-ceremonial tobacco use, human papillomavirus, and obesity prevention. Modeled after Dr. Michael Bitz’s Comic Book Project, the Native Comic Book Project has been adapted for both urban and reservation-based youth by incorporating Native storytelling and traditional values. Its ultimate goal is to promote healthy decision-making for Native youth and their communities. We are currently conducting a formal evaluation of this project by using pre- and post-intervention assessments to measure knowledge, habits, and decision-making among youth participants regarding tobacco use, healthy eating, exercise, and human papillomavirus. The Native Comic Book Project has been implemented at 10 sites and has enrolled 55 participants. Data will be fully analyzed in Summer 2013.  Future planned activities for research and education include developing more youth-oriented health interventions.

Immigrant farmworkers have been an integral part of Eastern Washington communities for decades. Their health and well-being are essential for the health of our communities. But for many farmworkers, health care access is unavailable or limited by a lack of insurance, health providers, discrimination, and social marginalization, making it difficult to assess their health status and burden of disease. A lack of basic information about farmworker health complicates the decision-making of state and local officials, physicians, and other advocates dedicated to improving farmworker health. In partnership with the Migrant Clinicians Network and the Pacific Northwest University of Health Sciences, I used community-based research techniques to design a farmworker public health study which could provide the necessary data to inform policies to improve farmworker health. Our survey research was designed to assess the serious injuries, diseases and causes of death among farmworkers and their families.

Male circumcision has been found to lower the risk of heterosexual transmission of HIV infection in men by up to 60%. In efforts led by the Ministry of Health and Child Welfare in Zimbabwe in upscaling male circumcision, the new Prepex™ device, a double plastic ring that necrotizes the foreskin, has been suggested in resource poor settings as an alternative to surgical methods of circumcision. For a comparison of the Prepex™ device vs. surgical methods psychosocial behavioral interviewing and clinical safety testing was conducted on a group of men in Zimbabwe (N=240) at three intervals: immediately prior to the procedure, and at two weeks and three months following the procedure. This provided a measure of the clinical safety of both methods as well as the effects on daily living, sexual relations, and perceptions regarding the procedure. In both study arms positive attitudes increased throughout the trial, with satisfaction of 'very' or 'extremely' satisfied with the procedure at 95% in the surgical group and 88% in the device group. Other than pain being slightly more of an issue in the device group there were few differences among expectations, perceptions, and experiences between the two groups. This study suggests that the switch from surgical methods to Prepex ™ device will not change the psychosocial barriers limiting the current male circumcision programs in Zimbabwe.

President Obama’s recent inaugural speech included the call for equal rights for members of the GLBT community. Among the issues transgender people especially face are access restrictions to transition related health care. This project examines the implications for transgendered people in terms of access to gender-confirming surgical procedures and how this affects their quality of life. The sites of this study were the United States and Germany, two countries using the same parameters to determine if a person suffers from Gender Identity Dysphoria, the clinical diagnosis required to undergo gender-confirming procedures. In the U.S. these procedures are widely not covered because they are labeled elective or cosmetic. German law on the other hand mandates full health insurance coverage as surgery is considered a necessary and effective treatment of a clinically established condition. This project uses quantitative data collected with questionnaires and qualitative data in the form of life history interviews. It compares the results of the National Transgender Discrimination Study (n=6,540) with responses to the same questionnaire by transgender Germans (n=88). Findings indicate that access to transition related care via health insurance improves the mental and physical well-being of individuals whereas access limited due to lack of coverage can be detrimental. Life histories provided by five individuals, three Americans and two Germans, evaluated in open and closed coding according to the Grounded Theory approach, also indicate lower rates of depression and drug use in people after gender-confirming procedures. Yet due to the small size of the German sample these findings may not be representative. Furthermore, even though gender-confirming procedures are effective, they should not be understood as mandatory for everyone diagnosed with Gender Identity Dysphoria.