Dr. Jeanne Miranda is Assistant Director of the Center and a Professor in the Department of Psychiatry and Biobehavioral Sciences. She is a mental health services researcher who has focused her work on providing mental health care to low-income and minority communities. She holds a Ph.D. in Clinical Psychology from University of Kansas and completed post-doctoral training at University of California, San Francisco.
Dr. Miranda’s major research contributions have been in evaluating the impact of mental health care for ethnic minority communities. She conducted a trial of treatment of depression in impoverished minority patients at San Francisco General Hospital. Traditional care for depression was contrasted with traditional care supplemented by case management. Case management offered additional benefits for Latino patients but were not beneficial for African American and white participants. Her most recent NIMH-funded trial is a study of care for depression in low-income, minority women screened through county entitlement programs. She is an investigator in two UCLA centers focusing on improving disparities in health care for ethnic minorities. She directs community cores and an innovative research core focusing on translating lifestyle interventions (diet and exercise) for low-income and minority communities. She was the Senior Scientific Editor of “Mental Health: Culture, Race and Ethnicity, A Supplement to Mental Health: A Report of the Surgeon General,” published August 2001.
She became a member of the Institute of Medicine in 2005. Dr. Miranda is the 2008 recipient of the Emily Mumford Award for Contributions to Social Medicine from Columbia University. She is currently working with two community partners, TIES for Families and the Center for Adoption Support and Education to developed evidence-based care for families adopting older children from foster care.
Since President Clinton’s 1996 adoption initiatives, rates of adoption from foster care in the United States have dramatically increased. The mean age at adoption from foster care is now six years old. Older children often have histories of prenatal substance exposure, abuse, neglect, and multiple placements, all factors that predict behavior problems over time. Nonetheless, evidence-based psychosocial interventions are not tailored to the unique clinical needs of families with adopted children. Adoption-specific clinical services are also needed to address the emotional underpinnings of the child’s adoption experience. To address this gap, we have developed and are testing in a randomized trial a manualized Adoption-Specific Intervention (ADAPT) for families adopting older children from foster care.
Nearly 1 in 25 Ugandan youths are HIV+; the rate recently climbed to 1 in 10 among young people living in the slums of Kampala. Because 70% of the population of Uganda is below age 30, it is critical for the nation to slow the rate of HIV transmission among youth. As of March, the Ugandan government will provide antiretroviral (ARV) therapy for all HIV+ individuals regardless of CD4 count, offering substantial hope for improving the health of HIV+ individuals and decreasing HIV transmission. However, 75% of youth in the slums of Kampala are depressed, a comorbidity that results in decreased adherence to HIV care (Swahn, Palmier, Kasirye, & Yao, 2012). This pilot proposal culturally adapts a depression intervention for HIV+ Ugandan youth. Specifically, this project will tailor a cognitive behavioral depression intervention shown to be effective when given by lay health workers (Muñoz & Miranda, 1996) (Munoz, Aguilar-Gaxiola, & Guzmán, 2000) for use with HIV+ youth from the slums of Kampala, Uganda, and will combine the culturally-adapted intervention with evidence-based CLEAR intervention to promote health and increase medical linkage, retention and adherence to anti-retroviral medications.
The Ministry of Gender Labor and Social Development provide micro-loans to young Ugandans to start business. Our team is evaluating the program through a randomized design to learn how best to provide these loans. Specific areas we are evaluating is the appropriate number of youth within groups to best insure successful business, resources necessary to support business, and need for mentorship in business development. We have conducted a qualitative study of the program, throughout seven districts and Kampala. We are now engaging in a randomized trial and will evaluate the impact of the program on Ugandan youth’s ability to develop an income generating business.
Community Partners in Care (CPIC) is a collaborative research project of community and academic partners working together to learn the best way to reduce the burden that depression places on our communities and other vulnerable populations. We work in the communities of South Los Angeles (SPA 6) and Hollywood-Metro LA (SPA 4). CPIC was developed out of five years of collaborative work on how to address depression in our communities, on many years of prior research on how to improve depression care in primary care settings, and on extensive efforts to address health disparities through community-partnered initiatives.