Adolescent Medicine Investigators and Current Research Projects

Division Chief:  Amy DiVasta, MD, MMSc

Associate Chief, Clinical Chief:  Sara Forman, MD

S. Bryn Austin, ScD

• Sexual and gender minority (lesbian, gay, bisexual, and transgender youth) health. With a series of studies, Dr. Austin is examining the causes and consequences of disparities in health outcomes such as eating disorders, obesity, alcohol use, and smoking adversely affecting sexual and gender minority youth and adults. Her projects range from biological studies of stress response to abuse and discrimination to policy studies of the effects of discrimination on economic outcomes and quality adjusted life years. www.hsph.harvard.edu/sogie

Ariel Beccia, PhD

• COVID-19-related mental health inequities. Dr. Beccia is the PI of a study using data from the Channing COVID-19 Sub-Study to examine mental health inequities during the COVID-19 pandemic, with a particular focus on how pandemic-related policies (e.g., lockdowns, income support) have influenced depressive and anxiety outcomes for US-based young adults along axes of gender, sexual orientation, and race/ethnicity. Opportunities are available to be involved with literature reviews, table and figure making, and manuscript writing/editing.
• Structural discrimination and mental health across the life-course. Dr. Beccia is also leading a series of studies using data from the Growing Up Today Study (GUTS) to examine how exposure to structural forms of discrimination (i.e., discriminatory laws, policies, practices, and norms) during early life-course shape mental health trajectories from adolescence into young adulthood. Opportunities are available to be involved with literature reviews, table and figure making, and manuscript writing/editing.

David S. Bickham, PhD, LEAH Director of Research Training

• Media and depression. Dr. Bickham studies links between media use and mental health including work that showed that young adolescents’ cell phone use predicted increases in symptoms of depression. Results from his study using Ecological Momentary Assessment have identified how characteristics of the individual and the communication moment contribute to the impact of social media use on adolescents’ affect.
• Problematic Interactive Media Use (PIMU).  In collaboration with other members of the CIMAID (Clinic for Interactive Media and Internet Disorders) team, Dr. Bickham is conducting research to identify key risk factors of PIMU by investigating common characteristics among CIMAID patients.  He and the team are currently developing research questions and protocols to examine the effectiveness of newly designed manualized treatment for treating young people suffering from PIMU.
• Children’s play and media use. Dr. Bickham directed a longitudinal study in the US and Mexico that examined how children’s play is linked to their media use and their healthy development. This work used Ecological Momentary Sampling and other techniques to assess play in children’s real life to help determine if media use is replacing play and how children’s health and development might be impacted.
• Media and obesity. Dr. Bickham studies the different pathways linking electronic media use to obesity among children and adolescents.  His work examines how digital advertising can influence children’s food choice, how attending to television is linked to obesity, and how reducing media use can enhance physical activity and sleep.
• Longitudinal impact of media use on health. Using various existing databases, Dr. Bickham investigates various adolescent health consequences of early media use including aggression and risky sexual behaviors.
• Dating apps and sexual risk behaviors.  Dr. Bickham is currently fielding a study examining links between dating app use, depression, and sexual risk behaviors among emerging adults.  This work will help answer whether mental health issues increase the risk of dating app use contributing to sexual risk behaviors. 

Joshua Borus, MD, MPH

• Educational Research Opportunities: There are many opportunities to participate in projects related to adolescent education and evaluation of residents.  Some projects are ready to go and need person-power to convert a good idea into reality, also excited to hear about what might be exciting to you.

• Quality Improvement: Quality Improvement efforts generate lots of data and opportunities to reflect on the care we provide. Recent projects have looked at potential disparities in the patient experience amongst different groups within our clinic, referral completion, immunizations, transitions to adult care, asthma care, STI testing rates, Depression follow up and many others.  There are exciting projects which have data and need person-power to explore further–is chlamydia treatment with doxy as good in real life as azithro?  how can we help patients access PAP smears? Does following up ED visits result in better care for our patients? What happens to patients with high scores on our GAD-7 or PHQ-9 screeners? many others!– which could be easily turned into academic products.

Michael Carter, PhD

Michael Carter received his PhD. in Communication from University of California, Davis, where his research has focused on the intersection of media and mental health among young adults and adolescents. Most recently, his work advocates for a shift in social media effects research towards studying social media within the bounds of a personal social media use framework. His current work often takes a mixed methods approach, largely centering on advancing conceptual and methodological inlets to help uncover the role social media design may have in engendering positive or negative effect outcomes. He is also working with the Center for Interactive Media and Internet Disorders (CIMAID) clinic to help advance clinical and research insights around problematic (interactive) media use.

Amy DiVasta, MD, MMSc

• Boston Center for Endometriosis: Working together with researchers from Brigham and Women’s Hospital, our team is compiling the largest database and biorepository of adolescents and young adults with endometriosis in the United States. We will utilize these data to learn more about the etiology of endometriosis, appropriate therapies, and prognostic information for the future. Dr. DiVasta is also conducting active clinical trials investigating new non-hormonal therapies for endometriosis. We now have 7+ years of longitudinal data on both young people with and without endometriosis, including information on nutritional status, pain, exercise, health history, medication use. We also have stored serum samples on n=30 young women with endometriosis who were treated with a GnRH agonist, and data regarding their clinical outcomes, hormonal levels, etc. during participation in a one year clinical trial.
• Reproductive Endocrine: Drs. DiVasta and Pitts are launching a project exploring future health outcomes of our AYA with PCOS, and to determine whether treatments utilized during adolescence impact these outcomes. Opportunities exist for collaboration on pilot studies to explore renal disease in adolescents with PCOS, bone health in patients using spironolactone, and pharmacology of norethindrone acetate use in adolescents.
• LARC: Drs. DiVasta and Pitts started a national LARC QI collaborative to benchmark the adolescent LARC experience. We have longitudinal data regarding the experience of young people with LARC devices, and opportunities to collaborate on projects with other adolescent medicine institutions across the country.
• Eating Disorders: Dr. DiVasta previously conducted a clinical trial of a vibrating platform for use in preventing bone health complications of anorexia, both during hospitalization as well as in the outpatient setting. There is an opportunity to launch a new clinical study of our inpatients, particularly now that our length of stay is longer than previous. Additionally, there is a completed but yet-to-be-analyzed project exploring the use of nuclear medicine PET scans to evaluate malnutrition in adolescents hospitalized for AN, a rat model of starvation and PET/CT changes, and a rich database of nutritional information/hormonal measures in a cohort of adolescents with anorexia participating in a clinical trial for 6 months.

Shannon Fitzgerald MD MPH

• MICON/adolescent pregnancy QI – part of a team in the adolescent clinic providing outreach and coordination for our patients with positive pregnancy tests. We also collect data as a part of a QI effort to ensure appropriate and timely follow up.  Through the MICON team, we are currently looking into rates of anxiety and/or depressive symptoms in newly pregnant patients as well as STD testing rates for these patients.
• PCOS – part of a team looking into long term effects of PCOS and different treatment options for people who have PCOS. We are currently collecting data from prior patients to review their trajectory with PCOS.

Sara Forman, MD

• National Eating Disorders Quality Improvement Collaborative: An 18+site collaborative that looks at outcomes for teens with restrictive and other types of eating disorders via retrospective chart review and data sharing.
• Accountable Care Organization: Sara Forman also directs the ACO for BCH for the Division of Adolescent/Young Adult Medicine. The ACO has supported efforts for Care coordination in Complex care, behavioral health and social determinants of health. Quality data within our division have been collected on our priority areas, and is available for individuals to review.

Carly Guss, MD, MPH

• Bone density and transgender youth: Dr Guss is working with Dr. Catherine Gordon on a NIH-funded study to evaluate changes in bone density and bone marrow composition in transgender youth who use GnRH analogues in order to block puberty as part of their gender affirming care.
• HIV/PrEP and transgender youth: Dr. Guss is holding focus groups with transgender teens and young adults in order to learn more about where they learn about HIV and pre-exposure prophylaxis (PrEP) in order to develop an educational intervention

Sion Kim Harris, PhD, CPH

• Teen substance abuse screening, prevention, and brief intervention research: Dr. Harris recently completed two NIH-funded trials testing a computer-assisted adolescent substance use screening and brief intervention system implemented on tablet computers in primary care offices. Prior projects included the first large international multi-site evaluation of the effects of computer-facilitated screening and clinician brief advice to address adolescent substance use in primary care settings, evaluation of a pediatric SBIRT residency training program, and evaluation of student and parent perspectives on SBIRT implementation in a school setting.
• Risks for, and effects of, problematic substance use on adolescent brain development: Dr. Harris collaborates with developmental neuroscientists at the McLean Imaging Center on longitudinal brain imaging studies of adolescent brain development and the effects of alcohol and drug use.
• Building character strengths/resilience among youth in Zambia to prevent problematic substance use: Dr. Harris is collaborating with a multi-national team to conduct a pilot trial of a positive youth development curriculum for youth ages 10-13 years old in Zambia, a country with early initiation of alcohol and drug use among youth and high HIV prevalence.

Areej Hassan, MD, MPH

• Currently working with international colleagues abroad in India (transgender care, availability of adolescent health services) as well Guatemala (adolescent health services, adolescent medical education) with end goal of creating sustainable adolescent medicine programming and policy changes to increase access to services
• Examining Popular vulvovaginal trends and impact of social media on health behaviors among adolescent/young adult population

Grace Jhe, PhD

Current Research Projects:

• Atypical Anorexia Nervosa: Co-PI on exploring youth’s, caregivers’, and providers’ attitudes toward weight restoration for adolescents with atypical anorexia nervosa.
• CBT phone app study (“RxWell” study): Co-I on the randomized controlled trial to evaluate the efficacy of a digital mental health intervention embedded in routine care compared to treatment as usual in adolescents and young adults with moderate depressive symptoms

Current QI Project:

• Evaluating the prevalence of traumatic stressors in AYAM population and implementing a consistent use of trauma measures

Sabra L. Katz-Wise, PhD

• LGBTQ+ health. Dr. Katz-Wise is the Principal Investigator of a NIH-funded study to analyze data from the 2015 US Transgender Survey to understand how prejudice affects mental health and substance use among transgender and nonbinary young adults at the intersections of gender identity, sexual orientation, and race/ethnicity. Opportunities are available to be involved with quantitative data analysis and manuscript writing for this project.
• Sexual orientation and gender identity development and sexual fluidity. Dr. Katz-Wise is the Principal Investigator of a NIH-funded study to understand measurement of sexual orientation fluidity over time among adolescents and young adults. Opportunities are available to be involved with quantitative or qualitative data analysis and manuscript writing for this project.
• Psychosocial functioning of families with transgender youth. Dr. Katz-Wise is the Principal Investigator of a NIH-funded study, which uses a community-based longitudinal mixed methods approach to understand how the family environment affects transgender and nonbinary (TNB) youth’s health and well-being and to develop a family-level intervention to support families with TNB youth. Opportunities are available to be involved with quantitative or qualitative data analysis and paper writing for this project.

Pamela J Murray, MD, MHP

·         Making Healthy Decisions: Integrated Group-Individual Curriculum to Prevent Teen Pregnancy with Julie Downs, PhD (CMU): Multisite randomized clinical trial of an integrated teen pregnancy prevention interactive video intervention and classroom curricular materials delivered to at risk teen girls in groups compared to control (healthy eating) interventions in geographically diverse communities. Effectiveness to decrease rates of teen pregnancy, increase contraceptive and condom use and improve self-efficacy around these behaviors are being evaluated. Evaluating primary and secondary outcomes.

·         Emergency Contraception Access on College Campuses: Mentor/Co-PI for Amie Ashcraft, WVU; Assessment of emergency contraception access at tertiary care institutions with patient-simulated phone calls, building on project assessing EC access in community pharmacies in West Virginia. 

·         Chronic Fatigue Syndrome and Orthostatic Intolerance: Anticipating developing a protocol to assess use of a passive standing test and other standard measures for patients with chronic fatigue, ‘brain fog’, POTS, orthostatic intolerance and long-haul COVID presentations.

• PCOS Long-term follow-up and drospirenone-only treatment.: with Amy DiVasta and Shannon Fitzgerald, BCH. 1. Review of long-term follow-up data from existing BCH AYAM/Gyn database, 2. Developing protocol and proposal for evaluating effect of drospirenone-only pill on patients with PCOS. 

Sarah Pitts, MD, Medical Fellowship Program Director, LEAH Program Director

• LARC: Drs. DiVasta and Pitts created a national LARC QI collaborative to benchmark the adolescent LARC experience. We have longitudinal data regarding the experience of young people with LARC devices, and opportunities to collaborate on projects including device insertion under conscious sedation. Numerous publications have been generated to date.
• Medical Education. Dr. Pitts is an Adolescent Medicine representative on APPD SPIN, a collaborative of fellowship program directors across pediatric subspecialties engaging in research. Med Ed research proposals can be submitted to APPD SPIN.

Michael Rich MD, MPH, is the Founder and Director of the Digital Wellness Lab (digitalwellnesslab.org) which is on a mission to understand and promote positive and healthy digital media experiences for young people, from birth through young adulthood. Dr. Rich is also the Founder and Co-Director of the Clinic for Interactive Media and INternet Disorders (CIMAID) (https://digitalwellnesslab.org/cimaid/), the first evidence-based clinical program designed to address Problematic Interactive MEdia Use (PIMU) in children, adolescents, and young adults. Using a multidisciplinary approach, Dr. Rich works with young people and their families to help them to adopt and sustain healthy approaches to engaging with interactive media and technology. 

Dr. Rich has developed innovative media-based research methodologies, including Video Intervention/Prevention Assessment (VIA) and Measurement of Youth Media Exposure (MYME). Having served as PI on research projects funded by the National Institutes of Health and foundations in the United States and Canada, Dr. Rich is currently leading projects investigating how young people engage with diverse interactive online environments, and how we can mitigate negative effects of these engagements while maximizing potentially positive effects. 

An Associate Professor of Pediatrics at Harvard Medical School and Associate Professor of Social and Behavioral Sciences at Harvard T.H. Chan School of Public Health, Dr. Rich has authored more than 50 peer-reviewed research papers, 40 book chapters and research reports, pediatric practice policies, and testified to the US Congress and other policymakers about his research findings. His research innovation has been honored with awards from the American Academy of Pediatrics and the Society for Adolescent Health and Medicine, and he has served as Visiting Professor at medical schools and universities around the globe.

Tracy Richmond, MD, MPH

Dr. Richmond is interested in weight-related disorders as well as macrosocial influences on health.

• **The Registry of Eating disorders and their Co-morbidities OVER time in Youth (RECOVERY) RECOVERY is a longitudinal registry of patients with eating disorders. Participants complete web-based surveys semi-annually including validated measures of eating disordered cognitions and behaviors, depression and anxiety. Additionally, parents and clinicians provide assessments re: the patient’s recovery and treatment. 3 years’ worth of data has been collected.
• **Avoidant Restrictive Food Intake Disorder: Dr. Richmond is the Co-Director of the ARFID Program, a multi-disciplinary program that is a collaboration between the Divisions of Gastroenterology and Adolescent Medicine. The ARFID program collects detailed information regarding development as well as validated measures that capture ARFID-related behaviors. Dr. Richmond is also leading a study using the Pediatric Health Information System (PHIS) database to document national changes in ARFID hospital stays.
• **Weight stigma: Dr.Richmond, with Drs. Idia Thurston and Kendrin Sonneville, conduct studies examining the impact of weight perception, body satisfaction, and internalization of weight-related stigma on health-related outcomes in youth with overweight/obesity. They have used the National Longitudinal Study of Adolescent to Adult Health as well as the WRAP study, a primary data collection from a cohort of youth attending a MidSouth university.
• Dieting and social contexts: Examining the impact of multiple social contexts (schools and peer networks) on weight perception and dieting behaviors.
• **Weight trajectories: Determining sensitive periods in BMI trajectories in youth with severe v. non-severe obesity and their genetic predictors. Dr. Richmond will be applying similar techniques to a population with anorexia nervosa and ARFID.

**readily available data to be analyzed

Lydia A. Shrier, MD, MPH, Research Director for the Division of Adolescent/Young Adult Medicine and Co-Director (with Dr. Sion Harris) of the Center for Adolescent Behavioral Health Research.

• Risk behaviors, social context, and mental health. Dr. Shrier uses mobile technology and momentary sampling methodology to collect data and intervene on sexual and drug use behaviors and mental health states in youth in real-life contexts. Her current projects include
  • evaluating the efficacy of MARSSI, a motivational interviewing and cognitive behavioral skill intervention to reduce sexual risk behaviors in high-risk young women with depressive symptoms, and
  • developing a virtual form of the motivational enhancement counseling in MOMENT, a counseling-plus-mhealth intervention to reduce cannabis use in youth who use frequently
• Substance use screening and brief intervention. Dr. Shrier is co-investigator with Dr. Harris on two NIH-funded studies,
  • a randomized controlled trial of the computer-facilitated Screening and clinician Brief Intervention system for primary care, being implemented in pediatric practices in the AAP’s Pediatric Research in Office Setting (PROS) network, and
  • a project to integrate the computerized Screening and provider Brief Advice system for adolescent substance use and the CHADIS online clinical process support system for pediatric primary care.
• Screening for early psychosis symptoms in primary care. Dr. Shrier is collaborating with Dr. Kristen Woodberry (Maine Medical Center) on research and education to improve early detection and treatment for psychosis in adolescents and young adults.

Zhiying (Zoey) Yue, PhD

• Parental Mediation and Adolescents’ Problematic Interactive Media Use: Utilizing multiple cross-sectional datasets, Dr. Yue’s research investigates the associations between various parental mediation strategies and adolescents’ interactive media use, as well as their well-being. This comparative analysis across datasets aims to uncover patterns to assist parents in effectively managing their children’s media interactions.
  • Adolescent Gaming and Social Well-being: Dr. Yue’s is currently exploring whether adolescents with social struggles, like social anxiety, loneliness and autism, engage with and perceive gaming environments differently. This research seeks to provide insights into how gaming might be both a reflection and a factor of social well-being among youth.
  • Adolescents’ Perception and Use of AI for Mental Health: Dr. Yue’s ongoing projects include exploring the potential for AI-facilitated entities to influence adolescents’ information seeking and processing behaviors. A notable component is a survey experiment that evaluates adolescents’ responses to different AI message framings for managing healthy media use, aiming to understand which approaches are most effective in supporting mental health.

Gabriela Vargas, MD, MPH

·         Young Men’s Health Site. Dr. Vargas is the director of the young men’s health site (youngmenshealthsite.org). It helps young men and their caregivers understand health and development, including specific diseases and conditions. The website aims to empower young men around the world to take an active role in their health and health care. The young men’s health site serves an international audience and has 100,000-300,000 site visits per month. There are multiple opportunities to become involved, including the development of health guides and blog posts. 

·        Young Men’s Health Research. Dr. Vargas is collaborating with Dr. Borus on a qualitative study of adolescent male’s views on healthy relationships. Dr. Vargas is also collaborating with Dr. Bickham on assessing how to improve young men’s access to health information, both online as well as in clinic (via pediatric resident education). 

• Quality Improvement. Dr. Vargas is the associate director of Quality Improvement in the Division of Adolescent/Young Adult Medicine. There is an array of opportunities for quality improvement geared towards fellows’ specific area of interest.