In my role as the Director of the Health Equity Research (HER) Laboratory I lead research projects aimed on "Linking Basic Science to Community Health." This work is informed by my affiliation with the Health Equity Institute for Research, Practice and Policy at San Francisco State University (healthequity.sfsu.edu) since 2007. In these roles I work with other students and scientists at San Francisco State University (SF State), the University of California at San Francisco (UCSF), Children's Hospital Oakland Research Institute (CHORI), the Cancer Prevention Institute of California (CPIC), and the coordinating committee of the Region 6 Geographical Management of cancer health disparites Program (GMaP) to engage in the following research projects and activities.
Through a pilot grant from the Joint Venture Program of the CSU Program for Education and Research in Biotechnology we are working collaboratively with Dr. Elad Ziv at UCSF, and Dr. Steve Mack at CHORI to determine if a genetic link exists among women with triple-negative breast cancer (TNBC). TNBC are characterized by the absence of estrogen receptor, progesterone receptor, and HER-2 expression making them especially deadly because these are the targets for effective treatments of breast cancer. In the United States 15% of all breast cancers are TNBC and African American women have the highest incidence, while in sub-saharan Africa they comprise 82% of breast cancers. The high incidence of TNBC in African American and African women suggest a shared genetic ancestry for the disease. Thus we are determining genetic ancestry through mtDNA and HLA typing of DNA samples collected from Latinas with and without TNBC. Latinas are a heterogenous population group comprised of African, European, and Native American ancestries. We predict that Latinas with TNBC will share common mtDNA and/or HLA types indicative of African ancestry.
Through a second pilot grant from the Center for Aging and Diverse Communities at UCSF we are collaborating with Dr. Scarlett Lin Gomez at CPIC to measure biomarkers for chronic stress in a multi-ethnic cohort of breast cancer survivors. This pilot grant is matched by funds from the Center for Vulnerable Populations at SFGH/UCSF to support postdoctoral fellow, Dr. Julio Ramirez, who leads the funded collaboration with Dr. Gomez. In prior work Dr. Gomez found that the multi-ethnic breast cancer survivors reported different levels of racism and systemic discrimination, as well as social support, that appeared to affect their breast cancer outcomes. Therefore, the goal of this pilot is to measure biomarkers for chronic stress in biospecimens collected from these women as a first step towards understanding how racism and discrimination, as well as social support, "gets under the skin" to affect breast cancer outcomes. In particular, we are developing biochemical and molecular tools to measure cortisol levels in hair, and telomere lengths in DNA extracted from saliva that are collected from the multi-ethnic breast cancer survivors.
In a third collaborative project funded by the California Tobacco Related Disease Program we are working with Dr. Amanda Fallin at UCSF to conduct a student survey of tobacco related attitudes and perceptions at SF State. This work is part of a larger multi-center project to examine smoking policies and practices at 16 campuses in California. In addition to working collaboratively on the multi-center project, we are working with Dr. Fallin to write-up a case study on the events and actitivities that led to changes in the smoking policies at SF State that took place in the 2010-2011 academic year. These changes were sparked by a student-led project in my "Health Disparities in Cancer" class that was taught in spring 2009.
A student-led project in my "Health Disparities in Cancer" class that was taught in spring 2013 led to proposed implementation of an educational intervention to improve knowledge of cervical cancer and the PAP smear in the Mission District of San Francisco. Student scholars engaged in this intervention will use the 5E model for scientific teaching to increase knowledge of the biological cause of cervical cancer, and the biological basis of the PAP smear for its detection. The need for this intervention was documented by a survey conducted as part of the student-led project in spring 2013. The results of this survey showed that while mothers of children participating in the Head Start programs based in the Mission District were well educated, they failed to accurately describe the biological basis of cervical cancer and the PAP smear test for its early detection. Implementation of a 5E lesson on these biological concepts is expected to not only increase knowledge of women in the highly diverse Mission District of San Francisco, but to improve their compliance in obtaining annual PAP smears.
Increasing knowledge in relevant communities is also an overall goal of the GMaP activities led by the coordinating committee of Region 6. I am a member of this NCI-funded committee that oversees GMaP activities in California, Oregon, Washington, Montana, and the Pacific Islands. In the last couple of years we have engaged in science education activities aimed at increasing knowledge of the nature and utility of biospecimen research. The goal has been to increase knowledge in minority communities so as to increase accrual of biospecimens from individuals in these populations. The accrual of these biospecimens is necessary for biomedical research that benefits all members of our society.
Publications related to Cancer Health Disparities (*SF State Masters student, ~ underrepresented minority):
Peréz-Stable, E.~, Afable-Munsuz, A., Kaplan, C.P.~, Pace, L., Samayoa, C. *~, Somkin, C., Nickleach, D., Lee, M., Márquez-Magaña, L.M.~, Juarbe, T., and Pasick, R. 2013. Factors Influencing Time to Diagnosis after Abnormal Mammography Results in Diverse Women. J Women’s Health 22(2):159.
Márquez-Magaña , L.M~., Samayoa, C.*~, and Umanzour, C*~. 2013. Debunking “race” and Asserting Social Determinants as Primary Causes of Cancer Health Disparities, J Cancer Edu 28(2):314-318.
Publications from my prior work on bacterial geneetics can be found on pubmed.