Maya Ragavan

• MD, MPH
• Boston University

Importance Despite constituting 8% of the US population, people who speak languages other than English (LOE) are consistently underrepresented in health-focused research. To make research more inclusive and generalizable, it is crucial to better understand researcher perspectives on barriers to inclusion of participants using LOE and solutions to p...

Language is our primary tool for communication and a salient component of acculturation status among Hispanic populations. Importantly, language is associated with behavioral health outcomes and can identify and confront health disparities among Hispanic adolescents. The purpose of this study was to evaluate the association between adolescent langu...

Youth-onset type 2 diabetes (T2D) is increasingly common and projected to impact over 200,000 adolescents and young adults by 2060. Youth with T2D frequently experience health-related social needs (HRSN) that increase their risk for poor outcomes. Using human-centered design methodology, we explored how best to address HRSN in pediatric endocrinolo...

Adolescent relationship abuse (ARA) has significant sequelae and is more prevalent among sexual and gender-diverse youth (SGDY). Increased parental involvement and communication has been linked to decreased prevalence of ARA and associated health risks. Parents of SGDY may have unique needs and experiences regarding communicating with their childre...

The Child Opportunity Index (COI) is a validated measurement that uses a composite index of 29 indicators of social determinants of health linked to the US Census. Patients post-Fontan palliation for single ventricle physiology often have reduced exercise capacity compared to the general population. Our hypothesis is that COI levels are directly as...

Adolescent relationship abuse (ARA) is prevalent among adolescents, including those who identify as Latine. However, there is limited research that has considered the cultural and structural mechanisms that may impact ARA experiences among Latine youth. Further, although parents play a crucial role in ARA prevention, few studies have investigated h...

To explore pediatricians’ perspectives on supporting intimate partner violence (IPV) survivors, including (a) clinical practices and resource use, (b) ideal resources, and (c) barriers to the use of existing resources, we conducted dyadic and individual virtual interviews with pediatricians recruited through Twitter and American Academy of Pediatri...

Purpose: The goal of this study was to examine plurisexual identity, intimate partner violence (IPV), reproductive coercion, and parental monitoring among pregnant 13-21-year-olds. Methods: We conducted a cross-sectional analysis of data collected from a cohort of pregnant adolescents and young adults between October 2019 and May 2023 (n = 398). Lo...

Objective The goal of this study was to partner with community organizations to understand the research experiences of communities who speak languages other than English (LOE). Methods We conducted semi-structured qualitative interviews in Spanish, Nepali, Mandarin, French, or Kizigua with LOE community members and community leaders who completed...

People who use languages other than English (LOE) are rarely included in research in the United States. LOE communities face numerous health disparities that are rooted in language injustice and other intersecting oppressions including racism and xenophobia. Equitable inclusion of LOE communities in research is an important step to disrupt health d...

Background: Intimate partner violence (IPV) has negative health impacts for pregnant people and their infants. Although inpatient postpartum units offer an opportunity to provide support and resources for IPV survivors and their families, to our knowledge, such interventions exist. The goal of this study is to explore (1) how IPV is currently discu...

Purpose The COVID-19 pandemic has increased challenges to intimate partner violence (IPV) service provision. This study aimed to explore administrative perspectives on the impacts of the COVID-19 pandemic on United States regional and national IPV service organizations. Methods We interviewed 35 administrators working within state, regional, or na...

Economic adolescent relationship abuse (ARA) includes coercive behaviors leading to interference with education, employment, and finances. To date, no study has examined help seeking among adolescents and young adults if they were to experience economic ARA. The goals of this article include examining: (a) help-seeking intentions of adolescents reg...

The American Academy of Pediatrics and its members recognize the importance of improving the physician's ability to recognize intimate partner violence (IPV) and understand its effects on child health and development and its role in the continuum of family violence. Pediatricians are in a unique position to identify IPV survivors in pediatric setti...

In this practice note, we document the development of a youth participatory action research (YPAR) program designed by and for Latine youth residing in a small but rapidly growing Latine community. Our community-academic team partnered to cocreate a YPAR curriculum focused on supporting Latine youth in learning about research and developing their o...

Adolescent relationship abuse (ARA) (i.e. physical, sexual, psychological, or economic abuse in the context of romantic relationships) is associated with adverse health outcomes, including anxiety, depression, suicidality, unintended pregnancy, and substance misuse. A related phenomenon, reproductive coercion involves interference with the reproduc...

This Viewpoint describes how pediatric health care systems can use health-related social needs screening implementation as an opportunity to reimagine more healing-centered systems.

Incorporating cultural sensitivity into healthcare settings is important to deliver high-quality and equitable care, particularly for marginalized communities who are non-White, non-English speaking, or immigrants. The Clinicians’ Cultural Sensitivity Survey (CCSS) was developed as a patient‐reported survey assessing clinicians’ recognition of cult...

Purpose: Supporting adolescents in developing healthy relationships and promoting sexual and reproductive health (SRH) is an important responsibility of pediatric primary care providers. Less is known about evidence-based interventions in pediatric settings focused on healthy relationships and SRH. Methods: We conducted a systematic review to de...

In this practice note, we document the progression of the Community Vaccine Collaborative (CVC), on which we first published in 2021. The CVC convened to address deep COVID-19-related disparities affecting the Black, Latine, immigrant/refugee, and lesbian, gay, bisexual, transgender, queer, (questioning), intersex, asexual, and (agender) (LGBTQIA+)...

Objective: Adolescent relationship abuse (ARA) is associated with myriad negative health outcomes. Pediatric primary care presents an opportunity to engage adolescents and parents (who can be protective against ARA) in ARA prevention; however, no family-focused, healthcare-based ARA interventions exist. The purpose of this study is to explore the...

In this community-partnered study we conducted focus groups with non-English speaking immigrant and refugee communities of color in 4 languages to understand their perspectives on COVID-19 vaccines, barriers to accessing vaccines, and recommendations for healthcare providers. We used a mixed deductive-inductive thematic analysis approach and human...

Introduction Black communities are deeply underrepresented in research, due, in large part, to research mistrust. It is critical to shift the burden of trust building from communities to researchers and research institutions, which have perpetrated harm against Black communities for centuries. In this study, we examine researchers’ perspectives on...

Relatively few studies have considered the impact of the COVID-19 pandemic on intimate partner violence (IPV) advocates or the agencies where they work. In this study, based on United States IPV advocates’ experiences working with survivors during the COVID-19 pandemic, we conducted interviews to explore: 1) personal challenges and resilience worki...

Importance: Black faculty and trainees remain underrepresented in academic medicine because of systemic racism. Years of diversity and inclusion efforts have not succeeded in eliminating the unique challenges faced by Black faculty in academic medicine. Objectives: To elicit expert faculty perspectives on anti-Black racism in academic medicine b...

Youths who are negatively affected by social determinants of health suffer adverse effects like increased risks of chronic health conditions and mental health issues. Part 1 of this series describes many underserved communities and the various ways their status affects their health. Available for purchase at https://shop.aap.org/pediatric-collectio...

Parent and caregiver intimate partner violence (IPV), to which 1 in 5 children are exposed, has profound health effects for survivors and their children.1-3 The health, economic, and social ramifications of the COVID-19 pandemic have created unique challenges for families experiencing IPV, by increasing isolation, decreasing available safe and secu...

Objectives : Child protective services (CPS) reporting for families experiencing intimate partner violence (IPV) is complex. The goal of this study was to develop expert-driven best practices for pediatric providers filing CPS reports in the context of IPV. Methods : We conducted a Delphi study with experts in IPV and child abuse and neglect (CAN)...

Objectives : Children experiencing family violence (child abuse and neglect and exposure to intimate partner violence) are at a particularly elevated risk for compounding challenges during the COVID-19 pandemic. In this study, we interviewed intimate partner violence (IPV) advocates, child protective services (CPS) caseworkers, and IPV and CPS admi...

CONTEXT Culturally sensitive interventions in the pediatric primary care setting may help reduce health disparities. Less is known on the development of these interventions, their target groups, and their feasibility, acceptability, and impact on health outcomes. OBJECTIVE We conducted a systematic review to describe culturally sensitive intervent...

Adolescent relationship abuse (ARA) is a significant public health issue that includes physical, sexual, psychological and cyber abuse, reproductive coercion, and/or sexual exploitation within an intimate relationship in which one or both partners is a minor. ARA is associated with numerous negative outcomes that include all domains of health. Many...

Background: To ensure equity in coronavirus disease 2019 (COVID-19) vaccine access, it is critical that Black and Latine communities receive trustworthy COVID-19 information. This study uses community-based participatory research to understand sources of COVID-19 information for Black and Latine adults, how trustworthy that information is, and rel...

We explored the challenges and lived experiences of intimate partner violence (IPV) survivors during the COVID-19 pandemic by interviewing 53 U.S.-based IPV advocates between June and November 2020. Advocates described how the COVID-19 pandemic limited survivors’ abilities to meet their basic needs. The pandemic was also described as being used by...

Background The COVID-19 pandemic has impacted children and young people experiencing child abuse and neglect. Child Protective Services (CPS) has played an important role in supporting children and families during the COVID-19 pandemic. Few studies to-date have evaluated the impact of the pandemic on CPS caseworkers and administrators in the United...

Teen dating violence (TDV; also called adolescent relationship abuse) remains a significant public health concern globally. Prevalence varies depending on the type of abuse (ie, physical, emotional, sexual) and the way it is measured (ie, past year, lifetime). In the US, the National Survey on Teen Relationships and Intimate Violence study demonstr...

Objectives : The American Academy of Pediatrics recommends discussing climate change with parents, particularly at well-child visits; however, parental opinions about receiving climate change information at their child's checkup are largely unknown. This exploratory study examines: (1) parents’ perspectives on frequency of climate change discussion...

Youth violence victimization continues to be pervasive and a significant cause of adolescent mortality. Since their 2014 “Connecting the Dots” report, the Centers for Disease Control and Prevention have encouraged researchers to identify shared protective factors that prevent multiple forms of youth violence. Parental monitoring, a bidirectional co...

Objectives: To explore expert perspectives on risks associated with the pediatric electronic health record (EHR) for intimate partner violence (IPV) survivors and their children and to identify strategies that may mitigate these risks. Methods: We conducted semi-structured interviews with multidisciplinary pediatric IPV experts (nursing, physicians...

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected communities of color. To dismantle these disparities, it is critical to promote COVID-19 vaccine equity, both through increasing vaccine access and addressing vaccine mistrust. This article describes a community–academic collaboration (the Community Vaccine Collaborati...

Background and objectives: Vaping has gained popularity among adolescents despite negative health consequences. Few studies have focused on factors that may protect against vaping. We sought to determine if future orientation, parental monitoring, school connectedness, and social support are associated with decreased risk of vaping and other forms...

Understanding and intervening at the intersection of climate change and child health disparities require pediatric providers to broaden their competency with structural determinants of health – even in the clinic. The environmental effects of climate change at the community level intersect in complex ways with structural racism and social influence...

Among 9th-to 12th-grade students who completed an anonymous health risk and protective behavior survey (n = 2346), positive future orientation was significantly and inversely associated with multiple forms of interpersonal violence including youth, community, and sexual/relationship violence. Designing interventions to promote future orientation ho...

Objectives: Academic general pediatrics (AGP) is a pediatric subspecialty with substantial faculty contributions in clinical care, research, education, and advocacy. However, AGP fellowship recruitment challenges exist. We aimed to describe AGP hiring practices from 2014 to 2019 and the role of fellowship training in hiring decisions. Methods: W...

Adolescent relationship abuse (ARA) has well-documented detrimental health effects. Adolescence is a window of opportunity to promote development of healthy relationship behaviors. Although peer-led interventions have a history of use in the health education field, there are few rigorously evaluated peer-led interventions targeting ARA. Start Stron...

Purpose We examined associations between electronic vapor product use (vaping) and violence victimization (adolescent relationship abuse (ARA), youth violence, bullying, and experiencing all three types of violence). Methods Data were drawn from the 2017 National Youth Risk Behavioral Survey. Logistic regression examined associations between vapin...

Researchers often describe use of “bilingual/bicultural” research teams, especially for research being conducted with marginalized communities. In this perspectives article, we argue that while increasing the diversity of research teams is imperative, using the term “bilingual/bicultural” without further explanation is problematic. We first review...

Purpose We examined associations between parental IPV exposure, perceived social support, and adolescent relationship abuse (ARA) victimization, specifically in a group of marginalized youth. Methods Data were drawn from surveys administered to marginalized youth as part of the Healthy Allegheny Teen Survey. Logistic regression examined (1) the as...

Objective: Childhood exposure to intimate partner violence (IPV) is a pervasive public health epidemic with profound impact on child health. While past work has demonstrated how abusive partners exert control over IPV survivors in a variety of settings (e.g. workplace, courts, home), scant research has examined how IPV power and control behaviors...

Intimate partner violence (IPV) has well-documented adverse impact on survivors and their children. In this article, we describe the development and formative evaluation of a trauma-informed, user-friendly Smartphone-based mobile application (app) to address the unmet health needs and improve the well-being of mothers who have experienced IPV. A mu...

Objectives: Incorporating culturally-sensitive care into well-child visits may help address pediatric preventive care disparities faced by racial and ethnic minorities, families with limited English proficiency, and immigrants. We explored parents' perspectives about the extent to which their children's pediatric care is culturally-sensitive and p...

Intimate Partner Violence (IPV) affects 21-40% of South Asian (SA) women in the United States. No screening tool has been validated in this population. This study sought to determine the validity of the Index of Spouse Abuse (ISA) as an IPV screening tool and to determine the prevalence of IPV among a SA immigrant population. Thirty-one percent of...

Introduction The American Academy of Pediatrics discourages spanking, especially of infants and young toddlers. This study examines the association between maternal immigrant generation and reported spanking of 1-year-old children, and whether this association is impacted by domestic violence (DV). Methods We conducted a cross-sectional secondary d...

Intimate partner violence (IPV) for South Asian immigrants is prevalent and has many unique sociodemographic and cultural factors associated with it. Current screening instruments do not address the unique cultural factors associated with IPV in this population. The South Asian Violence Screen (SAVS) is a 14-item screening tool for IPV designed bas...

Community-based participatory research (CBPR) is a methodological approach where community–academic teams build equitable relationships throughout the research process. In the domestic violence (DV) field, CBPR may be particularly important when conducting research with racial and ethnic minority DV survivors, as this group faces concurrent oppress...

Teen dating violence (TDV) has well-documented detrimental health effects. Scant research has examined the perspectives of ethnically diverse youth about the impact of culture on TDV. We sought to explore the intersection between culture and TDV specifically for South Asian youth residing in the United States. We conducted semi-structured interview...

Providing patients, parents, and families high-quality healthcare in the language of their choice is a fundamental component of patient-centered care in pediatric settings. However, language needs may be complex and dynamic, creating clinical and ethical challenges in cases of provider–parent discordance regarding the need for an interpreter. In th...

Objectives: Community-based research is a broad approach in which researchers work closely with practitioners and community members to enhance the understanding of a given phenomenon and promote positive outcomes. In the domestic violence (DV) field, community-based research is a particularly useful strategy to develop and evaluate interventions th...

The South Asian community is the fastest growing ethnic group in the United States, and past research suggests that South Asian domestic violence (DV) survivors may require culturally-specific resources. Similarly, South Asian children in the US exposed to DV may have unique responses and needs, but this has not been explored to date. The objective...

Objectives: Well-child visits are a critical component of pediatric healthcare; however, disparities in attendance and quality of care exist for Asian children. Limited research has explored Asian immigrant parents' perspectives about their well-child visit experience. Methods: Qualitative interviews were conducted with Chinese, Vietnamese, and...

In India, physical and psychological abuse perpetrated by a mother-in-law against a daughter-in-law is well documented. However, there is a dearth of literature exploring the perceived frequency and acceptability of mother-in-law abuse or options available for survivors of this type of abuse. The goal of this qualitative study was to add to the in-...

We used a community-based participatory research approach to develop, implement, and evaluate one of the first health curricula for female intimate partner violence (IPV) survivors residing at a transitional housing program. The curriculum comprised 12 workshops that were developed based on the survivors’ experiences, needs, and interests. Evaluati...

Introduction Intimate partner violence (IPV) affects the physical and psychological health of survivors and their children; however, to our knowledge, no comprehensive health curriculum exists for this population. As a partnership between a transitional housing program (THP) and an academic medical center, we developed a health education curriculum...

Few studies have explored the perspectives of survivors of intimate partner violence (IPV) regarding their health and their children’s health, their experiences accessing and utilizing health care, and health initiatives that would best serve their families’ needs. We facilitated focus groups with female IPV survivors and adolescents who witnessed...

We used qualitative methodologies to understand perceptions regarding options available for victims of physical intimate partner violence (IPV) in northern India. We interviewed male and female community members along with IPV experts. Interviews were transcribed, coded, and analyzed using grounded theory. Participants emphasized that a victim of p...

In this article, we examine perceptions about the definition of physical intimate partner violence (IPV) in northern India utilizing feminist perspectives as a framework. We interviewed 56 women and 52 men affiliated with a health services nongovernmental organization in the Udaipur district of Rajasthan. We transcribed, coded, and analyzed the int...