I am a research fellow at City University of London School of Health Sciences, Division of Health Services Research and Management. I am trained in medical sociology and study health care disparities, health behaviors, mental health care, and clinical communication using mixed methods. My work speaks to a broader theoretical and social agenda by exposing the micro-level processes that underlie macro-level disparities in patients’ experiences of stratified healthcare systems.
I received my PhD in Sociology from the University of California Los Angeles in 2019. My dissertation examines how physicians attempt to enforce behavior change in primary care. This work explores (1) whether and when people treat practitioners as having the right to recommend behavior change, (2) how implicit and explicit attributions of blame impact the healthcare encounter, and (3) how conversations about behavior change differ between healthcare centers that serve low-income Black neighbourhoods, low-income Hispanic neighbourhoods, and high-income white neighbourhoods. A good example of this work is my recent publication in Social Science and Medicine exploring patients’ overwhelming acceptance of behavior-change advice framed as medical treatment and resistance towards generic advice framed as preventive care.
Trained in conversation analysis, I collected 180 video recordings of diverse community based primary care encounters across seven clinics. Relying on skills in statistics and quantitative methods, I also administered pre-visit surveys to have access to sociodemographic variables that might shape the encounters. Finally, drawing on ethnographic methods, I conducted select post-visit interviews with patients to gain better insight into their perspectives on these encounters. I continue to analyze and publish on these data, as well as share these data with co-authors and student mentees.
Directly after completing my PhD, I began a three-year postdoctoral fellowship at City University of London School of Health Sciences. At City, so I use a translational approach to identify behaviors that can be used by health care professionals. For instance, I explore the micro-level processes underlying the barriers to patient use and benefit from mental health services. Examples of my work include a recent publication with Rose McCabe in Social Science and Medicine on how practitioners respond to patients’ treatment hesitancy towards stigmatized mental health interventions such as talking therapies. We reveal the critical roles that establishing and demonstrating understanding of the patient’s concerns play in promoting treatment acceptance. I am also leading papers on how disbelief of patient symptoms impacts mental health assessments and how practitioners can promote young people’s agency in mental healthcare encounters, among other topics.
While at City, I have worked under the Youth Agency in Mental Health Engagement Award (Medical Research Council) and with the ASsuRED Program Grant (National Institute for Health Research). I have experience using qualitative analysis to inform the execution of a randomized controlled trial and developing communications training programs for healthcare practitioners.