Community Engagement and partnership

Abby Lohr, PhD, MPH is a Senior Associate Consultant I-Research - Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota

Collaborative Scientist; and is an Assistant Professor of Epidemiology for Mayo Clinic College of Medicine and Science.

Tell me about yourself.

I was born in St. Louis Park, Minnesota but moved to Rochester when I was 9. I attended the University of Wisconsin Madison for my undergraduate degree. I then joined the Peace Corps in rural Guatemala from 2009 to 2011, driven by a motivation to learn Spanish, immerse myself in a different culture, and serve others. During this time, I partnered with a local clinic to disseminate public health information and taught diverse groups, including students, women, and teachers. This experience highlighted the effectiveness of direct engagement with communities facing health disparities and inspired my commitment to health equity in the United States. Upon returning, I worked as a Spanish interpreter at a migrant health clinic in Rochester, Minnesota, where I collaborated with Dr. Mark Wieland, MD, MPH, my C2DREAM pilot and current mentor.

I successfully applied to a Coverdell Returned Peace Corps Fellowship Program at the University of Arizona. There, I completed my Master of Public Health in Maternal Child Health/Global Health and PhD in Health Behavior Health Promotion. During my doctoral training from 2017 to 2021, I coordinated two community-based participatory research (CBPR) studies for the Arizona Prevention Research Center (AzPRC). Award numbers are U48DP005002 and U48DP006413.

In 2021, I returned to Rochester, Minnesota, and worked alongside Dr. Wieland by joining the Mayo Clinic as a postdoctoral fellow with the Rochester Healthy Community Partnership (RHCP). RHCP is a nationally recognized 21-year CBPR partnership that aims to improve health equity among immigrants in Minnesota and nationally through partnered research and community engagement. With over 16 years of continuous NIH funding, RHCP brings together researchers, community advocates, and public health partners to address health equity concerns using CBPR. This is foundational work upon which I am building my career.

My research aligns with RHCP’s community priorities, which adapt to evolving contexts. However, over the last 20 years, RHCP partners have broadly focused on the problem statement that, on average, immigrants arrive in the United States with lower cardiovascular risk factors than the general population (diabetes, hypertension, hyperlipidemia, etc.). Still, the longer they reside here the more they approximate and exceed the risk of the general population. Therefore, we developed participatory interventions using rigorous methods to reduce risk accumulation and manage diseases like diabetes when they arise.

I have family in Wisconsin, Texas, and Minnesota. I have two younger brothers who are twins – one works for Wisconsin Public Television in Madison, Wisconsin as a camera engineer and the other is a middle school science teacher in Dallas, Texas. I’m married to Noah Van Gorden, and we have 2 children: Harriet (5 years old) and Shea (10 months old). My parents also live in Rochester, Minnesota.

Why did you pursue your current career? Why is health equity important to you?

I believe in health as a human right, that we all should have the resources we need to be healthy. Through my experiences in the Peace Corps, working at the migrant health clinic, and coordinating community-engaged research on the United States/Mexico border, I cultivated a strong foundation in community partnership and a deep commitment to advancing health equity.

Tell me about your experience and project during the C2DREAM Pilot Grant Scholars program.

With this funding, I examined the facilitators and barriers experienced by the social network opinion leaders (whom we called health promoters or HPs) in the Healthy Immigrant Community (HIC) study. The primary investigators for HIC are Drs. Irene Sia and Mark Wieland through P50 mechanism. Social network interventions often recruit and train HPs to implement health promotion interventions without examining the relationship between HP characteristics and study outcomes. My research is innovative because it explores HP characteristics that led to improved health outcomes in these interventions. I presented my findings at four regional academic conferences (where I received 3 top poster awards) and four national conferences (where I won 1 top poster award). The support provided by this grant was a critical stepping stone in my journey to establish myself as an independent investigator.

**A list of Dr. Lohr’s work and achievements can be found at the end of this narrative.

My project aims during the Pilot Grant Program include:

• Aim 1. Explore opinion leader (OL) recruitment, characteristics, and expectations for scale up. Conduct interviews with RHCP community partners (preintervention) and focus groups with the OLs (pre-, mid-, and post-intervention) to better understand OL recruitment, background, motivations, and suggestions for ways to scale and sustain HIC. This was completed and you can read access this work on BMC Public Health, "We worked together to change things about our lives": a longitudinal qualitative analysis exploring Hispanic/Latino and Somali immigrant health promoters' perspectives on a social network intervention to address cardiovascular disease disparities”

• Aim 2. Triangulate the data from Aim 1 with the HIC intervention results to visually display OL qualities and experiences that are associated with decreased CVD risk across a social network. We will compare the qualitative findings from Aim 1 with the cardiovascular risk outcomes of social network participants from each OL at 12 months. Outcomes will be derived from the American Heart Association’s “Life’s Simple 7”: BMI and waist circumference, blood pressure, fasting blood glucose, total cholesterol, physical activity level, dietary quality, and health-related quality of life. Create a visual display of OL characteristics that are associated with improved CVD health among social network participants that will be further refined and disseminated with community partners who co-created the HIC intervention. I have all the data but have not started the analysis. I hope to complete it this summer.

• Aim 3. Co-develop and disseminate lessons learned for scalability of HIC intervention. After the intervention, guided by Public Health Critical Race Praxis and the National Institute on Minority Health and Health Disparities (NIMHD) research framework, use Photovoice with the OLs. This aim was changed because I was able to gather lessons learned and additional ways to address CVD risk in Aim 1. Instead, we used the Photovoice project to learn about the health-related priorities of the HPs and advocate for change. The full project can be found at RHCP.

Currently, one paper was accepted but not published as part of the Health Equity Action Network American Journal of Public Health (HEAN AJPH) special issue: Evaluation of a Photovoice exhibit about immigrant health priorities in Southeast Minnesota. Currently, I am drafting a second paper, ‘We are all human beings that deserve the same opportunities as everyone else:’ Immigrant Perspectives on Health in Southeast Minnesota: A Photovoice Study.

Using this funding, I also completed the Op-ed project workshop with two of the Photovoice participants. With these skills, I just published one op-ed (alone) and am just beginning a second one with one of the HPs. This can be found on Post Bulletin, “How Immigrants Make Our Communities Better.”

What are you working on currently?

Currently, I’m working on writing up the Photovoice qualitative results and am planning to do my Aim 2 analysis this summer. Apart from C2DREAM, I have projects focused on Type 2 diabetes (award number F32DK135200), cancer screening, stress reduction, and cervical cancer screen self-collection (all others are internal Mayo Clinic funding). However, I’m working on a certificate in implementation science from the University of California San Francisco in addition to leading the development of a mentoring program for RHCP.

Anything else you’d like to share?

Thank you for the opportunity. I feel honored and privileged to work with both the community partners and academic mentors who’ve helped me in reaching this point in my career. I’m so grateful for their kindness, wisdom, and support.

A summary of Dr. Lohr’s work and achievements:

1)     A. Lohr, J. Vargas-Robles, G. Asiedu, Y. Ahmed, H. Dirie, L. Molina ea. Through the Lens, Immigrant Perspectives on Health in Southeast Minnesota: A Photovoice Study. Paper presented at: Mayo Clinic Quantitative Health Sciences, Scientific Sessions2024; Rochester, MN.

2)     15. Lohr A, Raygoza Tapia, JP., Porraz Capetillo, MGD., Nur, O., Molina, L., Goodson, M., Osman, A., Elmi, H., Mohamed, A., Salinas, M., Valente, TW., Griffin, JM., Wieland, ML., Sia, IG. Addressing Cardiovascular Disease Inequities: Qualitative Process Evaluation From A Co-investigation With Im/migrants Exploring How To Sustain A Community-driven, Social Network Intervention Using A Racism-conscious Approach: Preliminary Findings. Paper presented at: Center for Chronic Disease Reduction and Equity Promotion Across Minnesota (C2DREAM) Annual Conference2023; Rochester, MN.

3)     16. Lohr A, Raygoza Tapia, JP., Porraz Capetillo, MGD., Nur, O., Molina, L., Goodson, M., Osman, A., Elmi, H., Mohamed, A., Salinas, M., Valente, TW., Griffin, JM., Wieland, ML., Sia, IG. Addressing Cardiovascular Disease Inequities: Qualitative Process Evaluation From A Co-investigation With Im/migrants Exploring How To Sustain A Community-driven, Social Network Intervention Using A Racism-conscious Approach: Preliminary Findings. Paper presented at: American Heart Association Epidemiology & Lifestyle Conference2023; Boston, MA.

4)     17. Lohr A, Pratt, R., Dirie, H., Ahmed, Y., Elmi, H., Nur, O., Osman, A., Novotny, P., Mohamed, AA., Griffin, JM., Wieland, ML., Sia, IG. The Association between Perceived Discrimination and Age in the United States Among Somali Immigrants and Refugees: A Cross-sectional Analysis. Paper presented at: Center for Chronic Disease Reduction and Equity Promotion Across Minnesota (C2DREAM) Annual Conference2024; Duluth, MN.

5)     18. Lohr A, Vargas-Robles J, Asiedu G, et al. Through the Lens, Immigrant Perspectives on Health in Southeast Minnesota: A Photovoice Study. Paper presented at: Health Equity Action Network Annual Meeting2024; San Francisco, CA.

6)     19. Lohr AM, Ahmed Y, Dirie H, et al. Through the lens, immigrant perspectives on health in Southeast Minnesota: Photovoice dissemination mixed methods evaluation results. Paper presented at: APHA 2024 Annual Meeting and Expo2024; Minneapolis, MN.

7)     20. Lohr AM, Manisha S, Pardo LS, et al. My favorite part is to help the community: A longitudinal qualitative analysis of hispanic/Latino and somali immigrant health promoters’ experience in a social network intervention. Paper presented at: APHA 2024 Annual Meeting and Expo2024; Minneapolis, MN.

8)     21. Lohr AMM, Raygoza J, Porraz Capetillo MD, et al. Addressing Cardiovascular Disease Inequities: Qualitative Process Evaluation From a Co-Investigation With Im/Migrants Exploring How to Sustain a Community-Driven, Social Network Intervention Using a Racism-Conscious Approach. Paper presented at: Academy Health2023; Seatle, WA.