My major research interests include mental health, maternal and child health, racial/ethnic disparities, social determinants of health, aging care provision, and machine learning applications in epidemiological studies, and innovative mobile health solutions for vulnerable populations. I am especially interested in understanding the health disparities and improving health outcomes in vulnerable populations, including racial/ethnic minorities, children with special healthcare needs, perinatal women, adolescents/young adults, and older adults. 

Major ongoing research projects/directions:

Dankotuwa, Sri Lanka

With my research collaborators

With my Sri Lankan advisor 

In a public health meeting 

My first global health project took place in Sri Lanka, where I researched the prevalence and risk factors of postpartum depression in two rural areas in Sri Lanka. I learned from the health records of over 1300 postpartum mothers and learned the socioeconomic disparities related to postpartum depression. I also learned from the interviews with public health midwives and medical doctors about the screening practices and transferring practice of postpartum depression in Sri Lanka. After this project, I wrote a policy brief with my classmates at Duke Global Mental Health classes, and the findings of my study were discussed at the meeting of regional public health officers. After this project, prenatal depression screening was introduced in the communities to intervene early and prevent postpartum depression. The findings of the study were also published in the Asian Journal of Psychiatry.

Using the National Survey on Drug Use and Health, my analysis found that major depressive episode (MDE) prevalence in adolescents grew from around 8 percent in 2010 to more than 14 percent in 2018. 

At the same time, use of mental health services remained low, with only about one-third of adolescents getting help from qualified professionals. 

Adolescents in racial and ethnic minority populations had higher MDE rates and lower services use than white adolescents. 

This study published in the Journal of Affective Disorders also found an association between participating in school, community or other activities and lower MDE prevalence.

Hypertension and related complications are major contributors to morbidity and mortality in Nepal. In this study, we explored existing workflows, needs and challenges for hypertension care coordination and to assess the feasibility of establishing a Female Community Health Volunteer (FCHV)-based hypertension management program in Kavre, Nepal.

We found that health literacy related to hypertension was low among both community members and Female Community Health Volunteers in Nepal. Additionally, delay in treatment initiation and loss to follow-up were common despite relatively high anti-hypertensive medication compliance. Health system-related barriers in research sites included underutilization of primary health-care institutions, communication gaps, and lack of grass-roots level educational campaigns

This study was published in the Journal of Global Heart, and we recommended that Female Community Health Volunteers should be provided with adequate training and financial incentives to promote hypertension management.

Antenatal care (ANC), delivery by skilled birth attendants, and postnatal care (PNC) are critical components of maternal health services for reducing maternal mortality. The study examined the utilization of maternal health services in the two most recent rounds of Ethiopia Demographic and Health Surveys (EDHS) and identify the factors influencing the utilization of these services using the 2016 EDHS.

The study was published in the Maternal and Child Health Journal, and highlighted the inequalities in the utilization of maternal health services between rural and urban areas, and the need of addressing the social, economic, and physical barriers that prevent women from using these services in Ethiopia. Further, programs should be targeted at promoting the use of professional birth and postnatal services in Ethiopia.

Caregiving for individuals living with Dementia

There are currently about 5.8 million older adults living with Alzheimer’s dementia, and the numbers are only expected to grow in the coming decades. The majority of care for persons living with dementia (PLWD) is provided by family members who lack formal training in caregiving and thus need education, information, and assistance. 

I am involved in this important collaborative project -Caregiver Assistance, Resources, and Education for Seniors (CARES) study, involving industrial, academic, and community partners, supported by the National Institute of Aging (NIA). This study is oriented to developing a digital platform (Olera.Care) based on a novel Dementia Care Personalization Algorithm and initial feasibility assessment and evaluating its acceptance and usability of the developed digital platform across racial/ethnic populations.

Our recent results were published in JMIR Aging. In this thematic analysis paper, we presented the challenges of caregiving related to functional care needs and financial and legal challenges. In addition, participants identified the need for an integrative digital platform where information could be supplied to foster education, share resources, and provide community support, enabling family caregivers to improve the quality of care and reducing caregiver burden.

I am ranked in the top 1% most highly cited authors publishing on topics in Mental Health over the past 4 years according to OpenAlex. These citations come from independent and leading researchers from well-regarded institutions and organizations around the world presented below.