Research /Professional Interests:

Women’s Health, Racial/Ethnic Health Disparities and Health Equity

Social Cohesion, Cultural Norms, Racial, Ethnic and Gender Identity, and Health Behaviors

Community-Level Determinants, System-Level Determinants, Place and Health

Co-Morbidities and Cancer Prevention for People Living with HIV/AIDS

I broadly characterize my research interests as explorations of health disparities at a community-level, among people of African descent related to prevention and treatment of HIV infection, and their participation in clinical screening for one of three generally treatable cancers (breast, cervical, and colon).  I partition these interests into three directions.  First, to describe the variations in knowledge and attitudes among residents about their health status and risk for either of these diseases, as well as, their access and use of resources that can help prevent these diseases.

Secondly, delve more deeply into the specific variations related to challenges, perceptions, and effective strategies associated with a person’s self-defined membership in a community by gender (male, female, or transgender), ethnicity (i.e., African American versus Dominican or Peruvian), and nativity (native to the US or immigrant) to participate in screening activities, prevent, and treat these diseases.  Relatedly, examine the influence of culture on the decisions of people to engage in medical services and its influence on the expectations and preference of services that people wish to receive.

Particularly to this last point, I would like to continue to examine the influence of culture in health seeking behaviors domestically and abroad.  My postdoc is my initial effort to broaden my understanding of the relationship between cultural or social norms related to health and life in general among women of African descent to: (1) women’s perceptions about cancer and cancer prevention, and (2) their decisions to complete a pap smear or colposcopy.  I hope to continue research specific to mammograms and colonoscopies in other Caribbean or Latin American settings.

Within the second area, I would also like to work with community stakeholders to identify gaps in services, develop strategies tailored to the community’s cultural, social, and economic context, and collectively evaluate the effectiveness of the strategies. My professional activities prior to my dissertation were strongly in the areas of program evaluation, data collection and coordination of multi-site research projects.  Likewise, for my dissertation I applied many of the processes important to participatory-based research, for example developing a community-advisory board and integrating community members in the interpretation of the data. I therefore would apply these strategies to my future research on these health issues.

Thirdly, I have two preliminary ideas as an expansion of my research agenda.  The first is to explore the effectiveness of initiatives such as the “Test and Treat” program or the access and use of pre-exposure prophylaxis (PrEP) in lower-income communities within the Delta region of the US.  UNAIDS and other global organizations are promoting these programs as tools to reduce stigma about HIV and the spread of the virus.  I have observed the importance of both for the management of patients’ health within the context of a clinical setting during my postdoc tenure in the Dominican Republic.  However, the available evidence on the effectiveness and efficacy of these programs is mixed with higher-income countries having better outcomes, and little evidence exists on possible within-country variations by community.  I think a more informed understanding about the benefits of these programs in the US context is warranted.  Therefore, I would like to compare communities in the Delta area to an economically varied group of communities in the US and, if possible, abroad to explore these variations.

Finally, I am interested in contributing towards a better understanding about the long-term survival of people living with HIV, particularly the intersection of aging with the processes associated with the prevention or treatment of cancer.  Both antiretroviral (ARV) and cancer medications are very toxic and hard on the body.  Because of the natural progression of HIV, few opportunities existed previously to experience the treatment of both indications.  But, with survival of HIV extending well beyond 20 years because of advances in treatment, etc., individuals in public health and medicine may need to collaboratively revisit its approach to supporting people living with HIV.  More specifically, what do we need to understand to offer the appropriate guidance to the public health center, the hospital, and health provider within areas of the Delta so they can be able to care for their patients who may be managing their diabetes, hypertension, or asthma and simultaneously receiving ARV therapies and chemotherapy?  Moreover, how does the long-term use of both therapies effect cognition and quality of life in groups disproportionately affected by dementia? Furthermore, what is the experience of people of African descent in the incidence and survival of “cancer A” that is dually diagnosed (HIV+ and cancer)? I find the prospect of investigating these lines of research related to health disparities within the Delta region as very exciting.

Positions and Honors:

• Global Health Equity Scholars Program, Fogarty International Center (NIH), TW009338, post-doctoral fellowship recipient (Summer 2017- Fall 2018)
• National Institute of General Medical Sciences – Research Initiative for Scientific Enhancement (NIH/NIGMS T34 GM061347), Graduate Student Support, Florida International University, Miami, FL (2015-current)
• Board of Directors, Member, Whitman Walker Clinic, Washington, DC, 2010
• Community Advisory Board, Member/Chairperson, Max Robinson Center of Whitman Walker Clinic, Washington, DC, 2007-2009
• Urban Fellow, the Mid-Atlantic Laboratory for Student Success, Temple University’s Center for Research in Human Development and Education, 1996

Selected Peer-reviewed Publications:

1. Mukherjee, S., McKinney, S. & Darrow, W. Sexuality & Culture (2018). Stigma Towards Homosexuality and AIDS Among Students of a Large Hispanic-Serving University. https://doi.org/10.1007/s12119-018-9516-4
2. McKinney, S. & Palmer, R. C., (2014). The influence of gender on colorectal cancer knowledge, screening intention, perceived risk and worry among African Americans in south Florida. Journal of Community Health,39, 230-238.
3. Madhivanan P., Barreto, G.A., Revawala, A., Anderson, C., McKinney, S. & Pierre-Victor, D. (2013). Where are we with partner treatment in bacterial vaginosis? A critical appraisal of the latest systematic review. Sex Transm Dis. 40(6):518.
4. Palmer, R.C. & McKinney, S. (2011). Health care provider tobacco cessation counseling among current African American tobacco users. J Natl Med Assoc, 103(8):660-667.
5. Palmer, R.C., Chhabra, D. & McKinney, S. (2011). Colorectal cancer screening adherence in African-American men and women 50 years of age and older living in Maryland. J Communit Health, 36(4):517-524.

Research Support:

• Global Health Equity Scholars Program, Fogarty International Center (NIH), TW009338, post-doctoral fellowship recipient (Summer 2017- Fall 2018)
• National Institute of General Medical Sciences – Research Initiative for Scientific Enhancement (NIH/NIGMS T34 GM061347), Graduate Student Support, Florida International University, Miami, FL (2015-current)

Dr. Shelia McKinney CV