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Wednesday, July 6, 2022

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Drawing blood from a study participant at the South Bay Latino Research Center. Photo by South Bay Latino Research Center. Drawing blood from a study participant at the South Bay Latino Research Center. Photo by South Bay Latino Research Center.
 


Mentorship Thrives at South Bay Latino Research Center

SDSU professors Greg Talavera and Linda Gallo co-direct the center, which studies cardiometabolic conditions and health disparities in Latinx communities.
By Susanne Clara Bard
 

When first-generation undergraduate student Eduardo Hernandez Mozo began working with San Diego State University psychology professor Linda Gallo, he didn’t see himself as a researcher.

“Typically, there's not too many minority students of color in research, and having her doing so much work within the Latino community and having me a part of her lab boosted up my confidence,” he said.

Under Gallo’s mentorship, Hernandez Mozo became a research assistant with the South Bay Latino Research Center (SBLRC) in Chula Vista, investigating ways to decrease hospitalization among Latinxs with multiple cardiometabolic conditions. The biology and psychology double major now plans to pursue a Ph.D. in clinical psychology.

Hernandez Mozo is one of many budding researchers who have gotten their start at the center, which investigates health disparities in the Latinx community and develops culturally appropriate interventions. Preparing the next generation of researchers is central to that mission. 

“We're really strongly involved in mentorship from the undergraduate all the way to the early career level,” said Gallo. “A lot of our emphasis has been on working with people that are Latino themselves, or otherwise from underrepresented backgrounds. It’s another route through which we try to address health inequities: by building the workforce.”

Understanding Latinx Health
Gallo and fellow professor of psychology Dr. Greg Talavera co-direct the SBLRC, bringing in more than $73 million in grant funding since 2006. At its heart is the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), funded by the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health. 
 
HCHS/SOL tracks the cardiometabolic health of more than 16,000 Latinx people at the SBLRC and three other research centers around the country. Participants between the ages of 18 and 74 provided baseline cardiometabolic data, returning every six years so that the researchers can monitor the development and progression of chronic conditions. 
 
“Determining the number of new cases over time is one of the key things that we can do that prior research hasn't really been able to do,” said Talavera. 

For example, the study has revealed a high prevalence of undiagnosed diabetes in the Latinx community. It also shows the probability of developing high blood pressure over a six-year period is about 20% in Latinxs, but is significantly higher in people with Caribbean backgrounds than those of Mexican heritage. 


“We're really lucky that we have such great and comprehensive data from the Hispanic Community Health Study,” said Kim Savin, one of Gallo’s graduate students. In an ancillary study, Savin analyzed participants’ neighborhood environments, along with measures of physical activity and cardiovascular health, and found that socioeconomic deprivation, crime rates and liquor store density were all associated with an increased risk of hypertension six years later.

“People's neighborhoods, as we're finding, affect their health,” said Savin.

One possible explanation is that people may experience higher levels of stress when their neighborhood feels less safe, which is in turn linked to increased blood pressure, but the hypothesis needs further testing.

Culturally Informed Interventions
In addition to the landmark HCHS/SOL study, the SBLRC also conducts interventional research in collaboration with the University of California San Diego and local federally qualified  community health centers. One long-term partner is San Ysidro Health, a network of health centers and clinics serving communities with historical barriers to health care.

“I’ve been conducting randomized trials since about 2003 by recruiting from their clinic population,” said Talavera. “Most of our research with them has a direct benefit to the patients and to the organization –– and sometimes to the community at large.”

The partnership provides ample opportunities for student interns and research assistants to investigate culturally appropriate interventions and best practices in a real-life setting.

Paulina Mendoza is the project manager for joint studies between the SBLRC and San Ysidro Health. But when she first arrived at SDSU as an undergraduate, she planned to major in business and open a salon. Over time, though, she gravitated toward community health, and began working with Talavera in 2004. At first, she helped develop a research ethics curriculum for community health workers.
 
Mendoza says Talavera was always available and encouraged her to pursue a Master of Public Health (MPH) degree at SDSU. Now, she mentors interns and research assistants herself.

“I truly enjoy working with the next generation of students, seeing their potential, their motivation, and being able to serve as a role model and say I was a research assistant, too,” Mendoza said.

She was instrumental in coordinating the SBLRC’s LUNA-D study at San Ysidro Health, which compared a diabetes intervention focused on psychosocial well-being and delivered by an integrated bilingual care team, with usual diabetes care provided by the health center. The culturally informed intervention showed greater improvement in diabetes markers over six months for participants with multiple cardiometabolic risk factors. 

Now, Mendoza manages the next generation LUNA-E study, which also uses a similar approach linking behavioral health with medical care to improve diabetes self-management.

“This time around, we're focusing on an integrated approach using telehealth and health education, making it available through online videos,” she said. 

Tania Valdez, a graduate student intern at SBLRC, tailors these health education materials to the local patient population. Originally from Calexico, she is completing an MPH  at SDSU.

“The practical research experience I acquired and the guidance that Dr. Gallo and Dr. Talavera have provided during my time at SBLRC has given me the confidence needed to be successful in the MPH program,” she said. “Since I am a first-generation college student, I still have difficulty seeing myself as a scholar, but through their mentorship and guidance they’ve formed a pathway for students like myself.” 

Valdez plans to pursue a Ph.D. in clinical psychology, and hopes to use that expertise to give back to her hometown in the future. 

“My lived experiences as someone from the Latino community has exposed me to the type of barriers my community faces as they try to navigate or access healthcare. These lived experiences and my need to understand why these health disparities exist in the Latino community is the main reason why I ended up pursuing a career in research.” 

Growing up in Chula Vista, Dr. Dorathy Tamayo-Murillo also witnessed the toll health disparities could take. Her family lacked the means to afford health insurance.

“People in the community, they don't seek care until it's really too late,” she said. “It's not fair that there's such a disparity all based on income – your  ZIP code dictates your future health. That was the driving force to go to medical school, because I want to provide quality care to communities that are overlooked.”

Talavera was similarly inspired to go into medicine after learning of the health hazards faced by migrant workers. 

As an undergraduate at UCSD, Tamayo-Murillo volunteered at San Ysidro Health. Under the mentorship of Talavera, she then became a research assistant shadowing a physician in the clinic. The paid position gave her enough time to study for her MCAT. She got into Harvard Medical School, and is now an assistant professor of radiology at UCSD.

But she hasn’t forgotten about the South Bay. She recently co-authored a paper examining the impact of structural racism and COVID-19 in underrepresented communities, and is collaborating with Talavera to investigate health disparities with the SBLRC and San Ysidro Health.

Future Look
With more than a dozen active grants, the SBLRC continues to serve the Latinx community. The HCHS/SOL study is now collecting data from the participants for the third study visit, which will allow the researchers to get a long-term perspective on their cardiometabolic health. An offshoot of the study, the Hispanic Community Children’s Health Study/Study of Latino Youth, looks at cardiometabolic risk factors in children of the original HCHS/SOL participants, and another follows babies born between their parents’ first and second visit.
 
The center is also part of a national study of COVID-19 outcomes and complications, using baseline health data from the original cohort for comparison. 

“We had all this data before they got sick,” said Talavera. “One of the key questions that we would be able to answer is, what is the impact of long COVID?”