Current Research Topics:
Severe maternal morbidity and maternal mortality: I am currently working on a number of community and policy-oriented projects aimed at addressing the underlying issues that Black women face as they interact with the healthcare system. Since 2018 I have planned, implemented, and hosted the largest Black Maternal Health Symposium in the United States, with 700 people collectively in attendance. I also sit on the Boston Public Health Commission- Community Advocacy Network and the Preconception Health Working Group. I recently worked to develop and edit Bill H.4818 that was recently passed unanimously in the House of Representatives alongside Rep. Liz Miranda. The bill orders the creation of a 25-member special legislative commission made up of experts in the field of maternal health as well as members of the community with lay knowledge, expertise, or experience related to maternal mortality and severe maternal morbidity. The role of the commission is to examine and make recommendations with an aim of reducing or eliminating racial disparities in maternal mortality and severe maternal morbidity. I am also the Principal Investigator of an NIH R01 study and an RWJF funded study addressing maternal health disparities in Black women.
HIV/AIDS: My research interests in HIV/AIDS span over 15 years of experience. Specifically, I’m interested in HIV prevention, treatment, and medication adherence for women and adolescent females of color. I’ve worked in communities such as Washington DC, Baltimore, MD, Newark NJ, and Boston MA with community based organizations focused on the sexual and reproductive health needs of women.
Current research studies:
- Promoting Maternal Health Equity through Collaborative Community Partnerships: Teaming doulas, providers and families to create birth equity and empowerment is a 3 year study which strives to answer the following question: How has the growing awareness of the maternal crisis influenced women of color’s perceptions of their risk, maternity care choices, and patient empowerment? The study seeks to understand this through a mixed methods approach consisting of both qualitative and quantitative methods including: interviews, focus groups and hospital discharge data among Black women of reproductive age, their male partners/fathers, doulas and delivering clinicians to assess: (1) the perceptions of the maternal morbidity and mortality statistics and disparities from both the patient and providers perspective and (2) the perceptions of strategies to address this crisis to provide opportunities to assist Black moms in moving from awareness of this data to empowerment during the pregnancy, delivery and postpartum periods.
- R01 – This 5-year study will lead to a more systematic understanding of pregnancy outcomes for Black women at highest risk of SMM, thus establishing a foundation for development and testing of future interventions to improve maternal outcomes. The study aims are the following: 1) Use longitudinally linked hospital discharge data from PELL (2008-2018) to characterize preconception, prenatal and postpartum hospital encounters among women with SMM in order to identify key points where opportunities to intervene were missed; 2) among hospitals that serve black women, to assess the impact of implementing maternal safety bundles to ensure that black women are receiving quality obstetric care ; 3) examine how systems integrating community-based doula support could decrease the inequities of SMM among black and white mothers.
Wisdom Matters is a 6-week curriculum to increase health literacy and empower African American HIV+ women. With a sample size consisting of 20 HIV+ women from the Greater Boston area, the curriculum includes topics such as: health literacy, nutrition, and medication adherence. Using a mixed methods approach of pre/post tests and focus group discussions, Wisdom Matters collects data on the following outcomes of interest: critical health literacy, increases in knowledge attitudes and beliefs about HIV, PrEP, and increases in medication adherence. The data collected from Wisdom Matters showcases how improving low health literacy is essential for improving the health of families and reducing disparities in HIV/AIDS.
- The SHARE Research Study: Stopping the Spread of HIV/AIDS through Relationship Engagement is a study on mother-daughter communication, intergenerational trauma, PrEP and HIV risk. Broadly, the study is designed to explore and address some of the reasons why the prevalence of HIV/AIDS is experienced disproportionately among African American women. With the use of the Theory of Planned Behavior (TPB) as the theoretical foundation, The SHARE Study focuses on communication between HIV+ mothers and their daughters on issues such as perceptions of HIV risk, HIV/AIDS knowledge, and their attitudes and beliefs; the impact of intergenerational trauma and an adolescents’ HIV risk, and the knowledge, beliefs, and attitudes regarding use of PrEP in adolescents to reduce HIV incidence. The SHARE Study will be recruiting mothers and daughters from American cities with high HIV prevalence to participant in surveys and semi- structured interviews.
- Dr. Amutah-Onukagha’s newest study centers around food insecurity and HIV risk, and is titled Addressing Food Insecurity to reduce HIV: Intervening on the Continuum of risk for Adolescent Girls. The goal of this study is to examine the association between food insecurity and risky sexual behaviors in young women of color. Occurring in three phases, this study will employ mixed-methods to explore HIV risk and food insecurity among low-income young women of color in the Greater Boston area. This study hopes to address the critical gaps in the empirical knowledge base about food insecurity and exchange sex for food in young Black and Latina women by representing an essential next step in a program of research designed to reduce HIV risk in adolescent females.
Older research studies:
- Project THANKS: Turning HIV/AIDS Into New Knowledge for Sisters (THANKS) is an innovative and evidence-based intervention based on the conceptual framework of the socioecological model that aims to assist women in managing and improving their overall health and nutritional status when faced with complications associated with substance abuse disorders, HIV and other chronic diseases. There has been a need to focus on this in HIV+ women of color because HIV-positive substance abusers are able to live longer lives today with an overall better quality of health.
- Project DASH: (Divas Against The Spread of HIV/AIDS) I conducted a mixed-methods study to explore the relationship and communication characteristics between daughters and their HIV+ mothers, as predictors of sexual behaviors and HIV risk of the adolescent. Additionally, the study examined other key influences on mother-daughter communication; including the mother’s communication with her daughter with regard to her HIV positive status, as well as mental health related issues such as anxiety and self-efficacy.
Maternal and Child Health: My PhD in Public Health focused on Maternal and Child Health. Specifically, I examined neighborhood level disadvantage, race/ethnicity, and infant mortality in Washington DC using birth and death certificate data. For my post-doctoral fellowship I explored barriers and facilitators to family planning and reproductive health services among families enrolled in a home visitation program.
- Maternal Mortality: Every April during Black Maternal Health Week, Dr. Amutah-Onukagha hosts a Black Maternal Health Symposium. In the past two years since the symposium’s inception, almost 700 people have attended. Previous conference themes have encompassed Social Justice and Advocacy, and the role of Doulas and community health workers.
- PRAMS: Pregnancy Risk Assessment Monitoring System (PRAMS) is a study exploring the relationship between food security status and breastfeeding initiation and duration among US women. It is important to study food insecurity in populations of pregnant women as the results of the study serve to provide opportunities for intervention and health education for food insecure mothers. This in turn provides insight into the impact of food insecurity on breastfeeding practices.
- TBA: Traditional Birth Attendants (TBA) is a literature review examining the role of traditional birth attendants as a factor influencing maternal health in Nigeria. Study findings concur that policies focused on improving access to health services and importantly, education, are required to improve maternal health outcomes and underserved communities.
- Adolescent Health- Sexual and Reproductive Health is a study assessing sexual risk behavior in high school aged students using school characteristics such as levels of teacher discrimination and GPA. The study adds to the literature in examining contextual factors that are associated with adolescent sexual risk behavior and findings provide implications for future prevention work.
Health Disparities: My research interests are broadly framed within a health disparities and social justice framework. I approach research using the principles of community based participatory research to guide my work in communities of color as it pertains to the sexual and reproductive health of women and girls.