Chronic pain affects 30% of children and adolescents, putting them at risk for physical and psychological impairments. Given poor access to pediatric pain care, psychological treatments such as cognitive behavioral therapy are more accessible through digital health interventions. One intervention our lab created is Web-based Management of Adolescent Pain (WebMAP). In this mobile app, youth with chronic pain develop pain management strategies by progressing through interactive modules. Although digital health interventions like WebMAP are transforming accessibility to chronic pain care, limited information is available to understand how best to enhance youth engagement in a mobile app or whether there are differences in engagement among youth with different background characteristics. Our project aimed to 1) identify barriers to engagement with WebMAP among subgroups defined by user demographics and 2) develop recommendations for enhancing engagement with WebMAP and extending its reach to target underserved populations. In a previous cluster randomized controlled trial, participants assigned to the WebMAP intervention were 73 youth aged 10 to 17 (84.3% female) with various chronic pain conditions. We analyzed the app metadata to assess module completion rates across various subgroups, including groups defined by age, race, sex, and annual household income. We also coded interview and questionnaire responses from users to identify app preferences and areas of improvement. Results indicated that although users liked WebMAP’s design and content, they suggested changes to its display and features. By viewing our findings on usage and perception through a health equity lens, we summarized the accessibility of WebMAP and outlined recommendations to enhance its cultural relevance to different groups. Ultimately, our research identified factors that impacted engagement with WebMAP and offered valuable insight into optimizing digital health psychological interventions for chronic pain management. Moving forward, we hope to apply these findings as we develop the next release of WebMAP.

Mytilid mussels are foundation species who serve a vital role in temperate coastal ecosystems. As ecosystem engineers, mussels modify the physical and local chemical environment, which can both inhibit or facilitate other species. Through a mussel’s metabolic process (i.e., respiration and calcification) they have the ability to alter their chemical environment which has been suggested to be influenced by their gaping behavior. The objective of this project is to associate a given gape behavior to a known mussel behavior (e.g. active/passive filter feeding or laying byssal threads). We installed Hall effect sensors – a specialized magnetic sensor– on the posterior end of the mussels to analyze how wide a mussel gapes. A video camera filmed the mussels concurrently with the sensors to verify the gape signal with a known behavior. We recorded and captured mussel behavior for three Mytilus mussel species (M. trossulus, M. galloprovincialis and M. californianus) for 24 hours (n=8 for each species). We hypothesize that behaviors in mussels that are more active (e.g. active filtering or laying byssal threads) may have more variation in gaping behavior than behaviors like passive filtering where mussels could be resting. We also expect that gaping behavior will differ among the three species, with M. californianus spending less time closed compared to M. trossulus and M. galloprovincialis. Our project takes the first step in interpreting how valve gaping and its relationship with a given mussel behavior may determine how a mussel’s behavior plays a role in their ability to modify their local chemical environment.

Implicit bias refers to unconscious attitudes and stereotypes in patient-provider communication that can lead to discrimination based on race, sexual orientation, gender, or other characteristics. This disproportionately impacts historically marginalized communities, including Black, Indigenous, and People of Color (BIPOC) and Lesbian, Gay, Bisexual, Transgender, Queer, and/or Questioning people (LGBTQ+). Although interventions have been developed to improve provider awareness of implicit bias, there has been little exploration of patient perspectives. With the help of my team, I conducted an analysis of 7 previously conducted co-design workshops with 32 BIPOC and LGBTQ+ people to understand patient perspectives on interventions to mitigate the impact of provider implicit bias in healthcare interactions. These workshops included group discussions about personal experiences with healthcare discrimination and a storyboarding activity to envision solutions for improving patient-provider interactions. Across workshops, participants created 13 storyboards that depict solutions in a primary care setting, several of which focus on improving patient-provider communication and promoting self-advocacy and empowerment. Through our collaborative qualitative analysis, my team and I identified two prominent themes from the workshops: communication tools and patient advocates. Participants shared experiences of feeling dismissed and unheard during healthcare visits, leading to storyboard proposals of communication tools, such as "smart boards" that allow patients to describe their symptoms in a nuanced manner. Another storyboard proposed a "panic button" that helps patients ask for help or request a different provider. Other storyboards focus on strategies to hold providers accountable, such as a "patient advocate" who approaches the provider about the patient's experience of discrimination and recommends a communication training intervention that raises awareness of bias. These findings can inform future research on interventions to address implicit bias in provider-patient communication. By prioritizing patient perspectives, we can create a healthcare system that is equitable and inclusive for all.

Massive stars place powerful constraints on stellar evolution and are observed in a menagerie of exotic evolutionary phases. These objects play a crucial role in regulating their environments. They drive the chemical evolution of their host galaxies, and set the energy balance of their surroundings via feedback processes. Due to the importance of massive stars, placing constraints on their evolution serves as a key to understanding galactic ecosystems. Notably, stellar variability is a powerful probe of the poorly-constrained physics of massive star evolution. In particular, variability studies on ensembles of evolved massive stars can significantly constrain stellar evolution. We aim to understand the variability of hot massive stars through a census of these objects. We accomplish this using data from the Gaia mission, cross-matched with light curves from the Zwicky Transient Facility (ZTF). We expect to characterize the evolution of massive star variability timescales and amplitudes along the main sequence and beyond. Our results will place key constraints on the evolution of massive stars. 

Emotional obstacles affecting those living with chronic Inflammatory Bowel Disease (IBD) are a pain point that often lacks support. Emotional obstacles include feelings of depression, anxiety, body image issues, experiencing isolation, or feeling unheard, which can impact one’s quality of life. Support systems, or individuals who provide emotional or physical support, can help people manage the effects of these obstacles to support illness self-management. Research on IBD and emotional support demonstrate that many people do not know how to best support their loved ones with IBD. Poor understanding of patients’ needs often results in ineffective support that is not perceived by IBD patients as beneficial; support system members are perceived as being overly worried, being hyper-fixated on physical IBD symptoms, or trying to distract the patient from emotional pain. These strategies carry the risk of IBD patients suppressing their emotional obstacles, withdrawing from their support system, and struggling on their own. I want to improve social support systems for IBD patients. As a first step, I administered online surveys asking people with IBD what emotional obstacles they face, and how these burdens affect their daily life. To date, respondents (n = 57) reported experiencing body image issues (57%), anxiety (68%), feeling hindered from their potential (51%), depression (66%), and social isolation (61%). Respondents stated that their emotional obstacles inhibit their IBD self-management (73%), ability to follow medical advice (38%), and ability to follow their medication regime (40%). These findings characterize common emotional obstacles and key impacts on self-management, a principal factor in disease remission. As we continue to survey people with IBD, we are conducting follow-up interviews to understand their experience and support needs in greater depth to inform improvements to social support systems.