CHOIR conducts a broad array of community-based public health research to understand and prevent the leading barriers to the health and wellbeing of children living in Los Angeles, such as diabetes, obesity, HIV/AIDS, drug use and violence.
The CHOIR faculty and their research teams establish meaningful and trusting community partnerships addressing the social, environmental and health-related concerns that matter most to the community.
CHOIR’s community research aims to produce and disseminate useful and accessible health information for deployment by clinicians, policy makers and other community members to deal with important health issues.
Community Health Research Projects at CHOIR include:
Healthy Young Men's Study (HYM)
A longitudinal study with young men ages 18 to 24 years, to explore the individual, familial, interpersonal and community factors that may influence drug use, HIV risk and mental health.
Learn more and see a video about the HYM Study
Drugs, Sexual Impulsivity, HIV; Psychosocial and Cognitive Risk Factors of YMSM
Recent reviews indicate a paucity of effective, theoretically based sexual and drug use risk reduction interventions for YMSM. Systematic development of theory has been identified as a crucial step in efficacious intervention development. The design of new YMSM interventions that are responsive to the developmental, social, and interpersonal, contexts of YMSM’s lives requires a theoretical understanding of how these contexts shape YMSM’s sexual and drug risk taking behaviors. Although existing research has contributed to our understanding of HIV risk behavior, previous models have often focused on a relatively limited array of explanatory constructs and have produced contradictory theoretical perspectives. Given the multitude of competing theoretical standpoints, the field could benefit from a comprehensive and well-integrated theory that captures and conceptualizes the range of factors involved in determining the relationship between substance use and sexual risk taking, and HIV transmission among YMSM.
One theory that holds great promise as a comprehensive model to address HIV risk among YMSM is Social Action Theory (SAT). This theory provides a comprehensive model of behavioral change emphasizing environmental, social, and psychological mechanisms that result in health promoting behavior. Because it includes social, contextual, and individual determinants, SAT provides an ideal model for examining the risk behavior of YMSM. SAT was originally developed as a general health promotion model for the adult population, and has been successfully applied to various health behaviors; however, its application to HIV risk behaviors––and to YMSM risk behaviors in particular––has not previously been empirically tested.
Using data from the Healthy Young Men’s Study (HYM), this study aims to empirically validate the chain of relationships depicted in SAT to determine if the theory addresses the interaction of individual, contextual, and social correlates of sexual and drug risk taking behaviors as they relate to YMSM. Additionally, we will further validate SAT by testing and incorporating competing theoretical relationships depicted in other behavioral theory models to develop a comprehensive theory of the social, psychosocial and cognitive risk factors for drug use, sexual impulsivity, and HIV among YMSM to guide prevention intervention efforts.
Principal Investigator: Dorian Traube
Asian Young Men's Study
The goal of this study is to inform the development of new HIV prevention interventions that are age appropriate and culturally relevant for young Asian men.
Learn more about the Asian Young Men's Study
HIV Prevention in African American Young Men
Young African American men who have sex with men (AAYMSM) now represent the largest proportion of new infections among all men who have sex with men in the US. Though HIV prevention efforts using bar settings or community-based organizations targeting the gay community have met with some success, research indicates that many at-risk AAYMSM do not frequent these venues. Instead, large numbers of AAYMSM can be reached through the Ball and House communities in Los Angeles.
The Ball community revolves around collectives called Houses. For its members, a House is a community which offers a network of friends and a place to turn to for support, positive affirming norms, collective identity, and connectedness among AAYMSM. Often young men join a House after having been rejected by their own family. The Balls, which are held several times a month, are lavish celebrations/competitions that serve as a social event for MSM of color, particularly AAYMSM.
Our previous research suggests that the Ball and House communities could be ideal settings in which to conduct HIV prevention research with AAYMSM. This project involves conducting ethnographic and survey research to better understand and examine the structural, social, and cultural characteristics of the Ball and House communities; Ball and House members' use of illicit drugs and involvement in HIV risk and protective behaviors; members’ social and sexual networks; and the role that rejection, discrimination, and internalized homophobia play with respect to encouraging drug use and HIV risk.
Principal Investigator: Michele D. Kipke
Community Diabetes Initiative
The Community Diabetes Initiative is designed to develop, implement, and evaluate new clinical and behavioral interventions to reduce the prevalence of obesity and diabetes in medically underserved East and South Los Angeles, which have the highest incidence of diabetes-related deaths in the County. Community-participatory research is being conducted to examine community-level risks and assets, as well as intervention strategies that can be employed in community, school, and community healthcare settings.
Principal Investigator: Valerie Ruelas
Non-Medical Prescription Drug Use Among High-Risk Youth
The use of prescription drugs for non-medical reasons is becoming increasingly common, particularly among high-risk youth and young adult populations. However, there is little information available about the use of these drugs, including what the substances are, how they are administered, and why people use them. Descriptive data is particularly lacking about the non-medical use of prescription drugs among high-risk youth populations.
This project is a two-city comparative study of high-risk youth aged 16 to 25 in New York City and Los Angeles, who may be homeless, participating in the street economy, polydrug users, and/or injection drug users. In particular, this study aims to: describe why high-risk youth initiate non-medical prescription drug use; describe variability in the forms of prescription drugs available and behavioral practices employed in their administration; chart the social trajectory of the transition from prescription drug use into other types of controlled substances; and assess the consequences of chronic use of prescription drugs on increased risk for onset of behaviors associated with exposure to HIV and STIs.
This study will take place in three phases, and will involve a six month community assessment to gather existing "local knowledge" about non-medical prescription drug use, a nine month qualitative study of 150 prescription drug users, and a 15 month cross-sectional, quantitative survey of 600 prescription drug users.
Study findings will inform the development of a curriculum for community-based organizations aimed at reducing non-medical prescription drug use among high-risk youth. Public health research on non-medical prescription drug use is extremely limited, and little is currently known about how high-risk youth maintain healthy living standards in the face of their risky behavior. Results from this study will fill a critical gap in the epidemiological literature on non-medical prescription drug use among high-risk youth who are at risk for negative health outcomes, including drug dependence, drug overdose, violence, victimization, and exposure to blood-borne pathogens.
Site Principal Investigator: Ellen Iverson
Childhood Autism Risks from Genetics and the Environment Study (CHARGE)
Autism has long been considered to have a genetic basis, which makes it difficult to explain the dramatic increase in incidence of this disorder over the last decade. Changes in diagnostic criteria and increasing awareness have been thought to contribute to this increase but these factors alone are not sufficient to explain the 57 percent increase seen between 2002 and 2006. The CHARGE study is examining the association between air pollution, a common exposure that induces inflammation and oxidative stress, and autism.
Research Outcomes
On December 16, 2010, in concert with study authors from the Keck School of Medicine of the University of Southern California and the UC Davis MIND Institute, Dr. Heather Volk of The Saban Research Institute of Children's Hospital Los Angeles published findings indicating that children born to mothers living within close proximity of a freeway appear to be twice as likely to have autism.
First Study Linked to Vehicle Pollutants with Autism Risk
Although exposure to air pollution during the first months of life has already been linked to cognitive development delay, this is the first study to link exposure to vehicular pollutants with autism risk.
Research Methods
Researchers examined the locations where the children’s families’ lived during the first, second and third trimesters of their mothers’ pregnancies, and at the time of the baby’s birth and looked at the proximity of these homes to a major road or freeway. The participants’ gestational ages were determined using ultrasound measurements and prenatal records.
Living within 1,000 Feet of Freeway
Dr. Volk and her colleagues found that living within 309 meters of a freeway (or just over 1000 feet) at birth was associated with a two-fold increase in autism risk. This association was not altered by adjustment for child gender or ethnicity, maximum education in the home, maternal age, or prenatal smoking. The researchers found no consistent pattern of association of autism with proximity to a major road.
“We expect to find many, perhaps dozens, of environmental factors over the next few years, with each of them probably contributing to a fraction of autism cases. It is highly likely that most of them operate in conjunction with other exposures and/or with genes," said Irva Hertz-Picciotto, PhD, chief of the division of environmental and occupational health in the Department of Public Health Sciences at UC Davis, and principal investigator on the CHARGE study.
More information regarding study outcomes is addressed in our Press Release
Media Coverage of Study Outcomes
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