You do evaluation across so many areas of public health: what engages you most in your work?
I’m especially gratified and challenged by work in HIV. HIV encompasses all the major socio-psychological factors of human health in our culture; privacy, sexuality, morality, economic status, race, etc. These factors and the prejudices surrounding them create a sharp division that prevents people in this country from confronting the disease with the honesty required to discuss subjects that can help avoid transmission. We see this reflected everywhere—in the reluctance of public schools to teach sex education, in the national debate over women’s health, and contraceptive rights. The subjectivity that controls policy over these issues underscores the importance of the evidence-based interventions that JSI designs and executes.
Where did you start your career?
After two years in college, I followed my father and uncles in joining the military. I spent four years at Travis Air Force Base, an hour north of San Francisco. From there I moved to San Jose and enrolled in a Master’s program where I studied psychology, joined the cross-country team, trained for the Oakland and San Francisco marathons, and worked nights as a security guard, store clerk, and even caretaker of a psychological research 3,000-mouse colony.
From there, I went to Austin, Texas to pursue a PhD in Community Psychology at the University of Texas. I met my wife Dharma there: she had traveled from New York to attend a conference in Austin. I ended up following her back to the Bronx and took a job at the Albert Einstein Institute researching the incidence of asthma in the black and Latino communities. Then, I went to the University of Miami to complete a National Institute on Drug Abuse postdoctoral fellowship program before finally settling in Boston.
How did you end up at JSI?
I came to JSI in 2000 as an evaluator of the first cohort of 47 grantees charged with providing HIV and substance abuse prevention services under the Minority AIDS Initiative. I now serve as senior advisor or evaluator for about 20 projects that address health concerns in the U.S., such as substance abuse, aging, adolescent health, teen pregnancy, HIV and AIDS, and health disparities among minority populations. I came here because I saw the opportunity to work in areas that interest me. At JSI we have the perspective of policy, programs, and services—we get to see how a law made at the federal level affects a community, a family, a teenager.
What do you like most about working at JSI?
I never cease to be amazed by how committed, bright, and interesting my colleagues are. And the fact that my friends and peers at JSI are motivated by a mission or a cause–even in their off hours. At any point in time throughout the year you can find people raising funds for their favorite charity.
What’s an important theme you’re seeing in public health in the United States?
The issue of health equity is gaining in importance. For example, in my local newspaper, the leading daily item, they have on the front page in bold letters, “Am I a bigot?” followed by essays and columns from local people telling them about their experiences being obese, or being gay, or about being a person of color. So there is a renewed emphasis on matters related to equity and talking about social determinants of health.
Can you tell me about your work with preventing teen pregnancy in the U.S.? How has that project demonstrated success?
I was part of a team working on the President’s Teen Pregnancy Prevention Initiative. Because the initiative had the word ‘President’ in the title, it was very serious and important. We worked with the CDC (Centers for Disease Control and Prevention) and helped them consider the impact of social determinants of health on teenage pregnancy. Our goal was to take a more contextual, ecological view of youth–to find out where young people live, play, go to school, and explore how these factors affect their behavior and even encourage the issue of teenage pregnancy.
The Teen Pregnancy Prevention Initiative really demonstrated success; by the end of the Obama Administration, there was a marked reduction in teenage pregnancy in this country [since 2007, when, on average, there were 41.5 births per 1000 teenagers, to 24.2 per 1,000 women aged 15–19 years in 2014–a 42% reduction in teen pregnancies], and that was partly due to the Presidential Initiative for Teenage Pregnancy Prevention.
What we learned in this project, when we apply it in Guatemala or Mexico, we see the importance of social determinants in teenage pregnancy. So we are aware of the problem of the Zika virus in Guatemala, we are aware of the influence of violence against women in that region. So the U.S. project helped us inform the implementation of related projects in an international setting.
What have you been working on recently that’s exciting you?
While I’m typically focused on evaluation activities here in the United States, I’m currently working on developing a pilot study with the Population Council in Mexico and Guatemala to create text message interventions to engage young people–adolescents–to seek teenage pregnancy prevention services with local providers. We’re developing an app and text message service to link young people with teen-pregnancy prevention providers at the local level. These kids are mostly Mayan, and they have one of the highest rates of teenage pregnancy and obesity in the hemisphere. They all have access to cell phones, but they have little knowledge or awareness about the availability of services or the need for services. So developing and implementing this program is pretty exciting.
What do you do for fun?
My favorite hobby is still long-distance running. It’s very meditative. Although my biggest interest in life and in my work has been about connecting with people and communities, there is something I really enjoy about the solitude and personal challenge of long-distance running.
When did you start running?
I started running competitively when I was 12, racing neighbors and school mates in Puerto Rico, my home. I’d label myself as just a little better than mediocre, but I have qualified for multiple marathons and spots on the track and cross-country teams at Colegio Regional de Aguadilla, UPR, and San Jose State University, and have completed over 10 marathons.
What’s something your co-workers might not know about you?
In college at CR Aguadilla, in addition to my studies and team commitments, I earned money as a street magician, performing card, sponge, silk, and rope tricks for passersby. I had practiced magic tricks as a kid and learned English by obsessively reading magic books. I was pretty good too! In fact, once, while performing for the crowd on the Fajardo-Vieques ferry, I was accused of being ‘El Hijo del Diablo’ (the son of the devil) by a Christian proselytizer. That name stuck and from then on, to my friends, I was ‘El Hijo del Diablo!’