Anna María Nápoles, PhD, MPH

Assistant Adjunct Professor of Medicine

Education

• 1995-1998 University of California, Berkeley, Ph.D., Epidemiology
• 1980-1983 University of California, Berkeley, M.P.H., Program/Clinic Administration
• 1976-1980 Pomona College, Claremont, B.A., Psychology

Postgraduate Training

• Research Fellow, Office of Behavioral and Social Sciences Research/National Institutes of Health Summer Training Institute for Randomized Clinical Trials Involving Behavioral Interventions

Research Program

My research activities are varied, although several themes occur throughout. These themes include: 1) measurement and recruitment issues that pertain to conducting research in ethnically diverse populations; 2) the interpersonal processes of care that occur during medical encounters; and 3) cancer control research in underserved populations.

1) Adequacy of Self-Report Health Measures and Recruitment Methods for Diverse Populations
I have a strong interest in the development of empirically defensible methodology for conducting health disparities research. I co-teach a seminar series on research methods appropriate for research among diverse populations and have completed several projects examining the effectiveness of various recruitment methods in ethnically diverse groups. Related projects include a study that identified modifiable attitudinal and methodological factors to enhance minority recruitment for clinical research, another comparing population and community based recruitment methods for a case-control study of lung cancer in minorities, and a randomized trial of advance notice letters to recruit African Americans and Whites for a mail patient satisfaction survey. I was involved in planning and hosting a conference with invited national experts to develop an agenda and priorities for measurement research related to health disparities and have developed symposiums, seminars and publications with the Measurement Core members of CADC to address measurement issues in health disparities research.

2) The Interpersonal Processes of Care (IPC) in Diverse Populations
I was co-investigator on a study of the effects of language and ethnic discordance between Latino hypertensive and diabetic patients and their physicians on health outcomes. The paper on this study is one of a few published studies linking the language concordance of patients and their providers with the outcomes of Latino patients. I have worked extensively with Dr. Anita Stewart to develop a conceptual framework and self-report survey to assess the quality of the interpersonal processes of care that includes the perspective of diverse patients. This work will facilitate studies potentially linking the interpersonal processes of care with ethnic disparities in technical processes and outcomes of care. I am conducting a study to assess the quality of interpersonal processes of care as a mechanism for explaining ethnic differences in treatment and outcomes of patients with chronic illness. Presently, I am examining the interpersonal processes of care that occur during medical encounters across four ethnic groups using qualitative and quantitative research methods. In another project, I am examining the effects of a videoconferencing medical interpretation system on the interpersonal processes of care occurring in the medical encounters of limited English proficient, low-income primary care patients.

3) Cancer Control Research in Underserved Populations
My research in cancer control in underserved groups has included working with a multidisciplinary team to develop culturally suitable survey instruments and community interventions related to cancer risk behaviors, attitudes and knowledge in Latino populations. Other projects in this area include analysis of ethnic differences in the timeliness of abnormal mammography and a review article of the risk factors for invasive cervical cancer in Latina women. I am a co-investigator on a study of biomarkers of lung cancer susceptibility in African Americans and Latinos of Northern California. Currently, I am working with a community-based partner to examine the predictors of participation in support groups among Latinas with breast cancer.

Publications (peer reviewed journal articles)

1. Chang SW, Kerlikowske K, Nápoles-Springer AM, Posner SF, Sickles EA, Pérez-Stable EJ. Racial differences in timeliness of follow-up after abnormal screening mammography. Cancer 1996; 78(7):1395-1402.

2. Pérez-Stable EJ, Otero-Sabogal R, Sabogal F, Nápoles-Springer AM. Pathways to early cancer detection for Latinas: En Accion Contra el Cancer. Hlth Educ Qtrly 1996; 23(suppl):S41-59.

3. Nápoles-Springer AM, Pérez-Stable EJ, Washington E. Risk factors for invasive cervical cancer in Latino women. J Med Systems 1996; 20(5):277-293.

4. Pérez-Stable EJ, Nápoles-Springer AM, Miramontes JM. The effects of ethnicity and language on medical outcomes of patients with hypertension or diabetes. Medical Care 1997; 35(12):1212-1219.

5. Stewart A, Nápoles-Springer AM, Posner SF, Pérez-Stable EJ, Bindman AB, Pinderhughes H, Washington AE. Interpersonal processes of care in diverse populations, Milbank Quarterly 1999; 77(3):305-339.

6. Stewart AL, Nápoles-Springer AM. Health-related quality of life assessments in diverse population groups in the United States, Medical Care 2000; 38(9 Suppl. II):II-102 - II-124.

7. Nápoles-Springer AM, Grumbach K, Alexander M, Moreno-John G, Forté D, Rangel-Lugo M, Pérez-Stable EJ. Clinical research in older African Americans and Latinos: Perspectives from the community, Research on Aging 2000; 22(6):668-691.

8. Kaplan CP, Nápoles-Springer AM, Stewart SL, Pérez-Stable EJ. Smoking acquisition among adolescents and young Latinas: the role of socio-environmental and personal factors, Addictive Behaviors 2001; 26(4):531-550.

9. Nápoles-Springer AM, Stewart AL. Use of health-related quality of life measures in older and ethnically diverse U.S. populations, Journal of Mental Health & Aging 2001; 7(1):173-179.

10. Washington AE, Nápoles-Springer A, Forté DA, Alexander M, PŽrez-Stable EJ. Establishing Centers to Address Treatment Effectiveness in Diverse Ethnic Groups: the MEDTEP Experience. Ethnicity & Health, 2002;7(4):231-42.

11. Cabral, DN, Nápoles-Springer AM, Miike R, McMillan A, Sison JD, Wrensch MR, Pérez-Stable EJ, Wiencke JK. Population and community-based recruitment of African Americans and Latinos: The San Francisco Bay Area Lung Cancer Study. American Journal of Epidemiology, 2003;158:272-9.

12. Stewart AL, Nápoles-Springer AM. Advancing health disparities research: can we afford to ignore measurement issues? Medical Care, 2003;41(11):1207-1220.

13. Nápoles-Springer AM, Fongwa MN, Stewart AL, Pérez-Stable EJ. The effectiveness of an advance notice letter on the recruitment of African Americans and Whites for a mail satisfaction survey. Journal of Aging and Health (in press).

Published Abstracts

1. Pérez-Stable EJ, Nápoles-Springer AM, Miramontes JM. The effects of ethnicity on medical outcomes in outpatients. J Genl Intern Med 1994; 9(suppl. 2): 107.

2. Pérez-Stable EJ, Nápoles-Springer AM, Miramontes JM. The effects of language concordance between patients and physicians on medical outcomes. J Gen Intern Med 1994; 9(suppl. 2):107.

3. Chang SW, Kerlikowske K, Nápoles-Springer A, Posner SF, Sickles EA, Pérez-Stable EJ. Racial differences in timeliness of follow-up after abnormal screening mammography. J Genl Int Med 1996; 11(suppl):66.

4. Casal E, Gonzalez M, Dryzun J, Nápoles-Springer A, Pérez-Stable EJ. Breaking bad news in the medical encounter: A patient perspective. J Genl Int Med 1996; 11(suppl):139.

5. Stewart AL, Nápoles-Springer AM. Overview of issues in assessing health-related concepts in diverse populations. The Gerontologist 1999; 39(special issue I): 388-389.

6. Nápoles-Springer AM, Posner S, Stewart AL. Measures of interpersonal processes of care in three racial/ethnic groups. The Gerontologist 1999; 39(special issue I): 389-390.

7. Nápoles-Springer AM. Recruitment of diverse populations for minority aging research. Gerontologist 2000; 40(special issue I):326.

8. Stewart AL, Nápoles-Springer AM. Quality of life research in diverse population groups: measurement issues. American Psychological Association meeting, San Francisco, August, 2001.

9. Nápoles-Springer AM, Santoyo J, Fike A, Stewart AL. Dimensions of interpersonal processes of care in diverse patients. Academy for Health Services Research and Health Policy meeting, Washington D.C., June 2002.

10. Nápoles-Springer AM, Santoyo J, Houston K, Pérez-Stable EJ, Stewart AL. Patients' perceptions of cultural factors affecting the quality of their medical encounters. Society of General Internal Medicine. Journal of General Internal Medicine, suppl., April 2003.

Other Publications

1. Nápoles-Springer AM, Pérez-Stable EJ, Washington AE. Risk factors for invasive cervical cancer in Latino women. BioMedicina 1998; 1(4):137-142 (adapted for publication).

2. Pérez-Stable EJ, Nápoles-Springer A. Interpreters and communication in the clinical encounter, Am J Medicine 2000; 108:509-510 (editorial).

3. Nápoles-Springer AM, Pérez-Stable EJ. The role of culture and language in determining best practices, J Gen Intern Med 2001; 16:493-495, (editorial).

4. Pérez-Stable EJ, Nápoles-Springer A. Physical health status of Latinos in the United States. In Lopez AG & Carillo E (ed.), The Latino Psychiatric Patient: Assessment and Treatment, American Psychiatric Publishing, Inc.: Washington D.C., 2001, (book chapter).