Health Informatics Professor Working to Reduce Inequities — one app at a time

Yale School of Public Health Assistant Professor of Biostatistics (Health Informatics) Terika McCall knows how important it is for Black women to be able to secure reliable mental health care.

She struggled with anxiety and depression herself, wrestling with the conflict many find between the strength of faith and the need for help. And she found she wasn’t alone.

Talking to friends and family about their own mental health journeys, McCall realized there was an opportunity for her to put her public health skills to use: creating community-centered smartphone applications to make it easier for members of traditionally underserved groups to locate reliable and culturally relevant mental health resources.

“Within the Black community, receiving mental health services or taking medication for mental health conditions is becoming less stigmatized, but it is still more stigmatized than within other populations,” said McCall, PhD, MPH., MBA.

McCall joined the Yale School of Public Health’s Department of Biostatistics last year, after working as a postdoctoral researcher at Yale. Since then, she’s cultivated a growing body of research centered on consumer-focused health informatics, helping with everything from a mobile app for Black women dealing with anxiety and depression, to collaborating with Dr. Karen Wang, assistant professor of internal medicine (general medicine) and of biostatistics (health informatics) at Yale, on an app for individuals with a history of incarceration that are rejoining their communities.

Health informatics is the science of developing, evaluating, and applying innovative approaches to information and knowledge management in biomedical research, clinical care, and public health. At YSPH, researchers in health informatics are developing and evaluating new methods in areas as diverse as data mining, natural language processing, and cognitive science as well as human-computer interaction, decision support, databases, and algorithms for analyzing the large amounts of data generated in public health, clinical research and genomics, and proteomics.

In McCall’s case, expanding the use of smartphone applications for health care could serve as a powerful resource in addressing systemic inequities.

“What you’ll find, even when you go into different communities, whether it be here in the United States or abroad, most people — no matter what their income is — have a phone,” she explained. “If we know they have this technology, the question becomes, “How can we deliver services and resources to them using something they already have access to?’”

She’s already found significant success.

McCall was recognized with the Yale School of Public Health’s 2022 Health Equity Research Award for a study of the usability of an app that helps connect Black women with mental health resources.

More generally, the Consumer Health Informatics Lab she started, otherwise known as CHIL @ Yale, has experienced impressive growth. It is not unusual for McCall to be helping with as many as seven projects related to consumer health informatics at one time. And not all of those projects deal with mental health services. For instance, one research endeavor she is working on focuses on limiting the chance of surgical site infections through the use of a clinical decision support tool.

McCall admits that smartphone applications are not going to solve the big problems that exist in health equity and public health. Still, she says, they can go a long way in helping to mitigate or remove barriers to health services that are disproportionately affecting marginalized populations.

“It may be that the app can serve as the primary solution or it can be complementary to some other intervention or resource that’s available to the community,” she said.

In developing new smartphone applications, McCall combines her skills in user interface and user experience design with a concerted effort to engage stakeholders at all levels in the development process to make sure her projects are as effective as possible. In doing so, McCall said she wants “to make sure that whatever we’re developing is going to be co-created with the communities that it’s intended for so that it can be more useful for them.”

The support she has found at the Yale School of Public Health has been a huge help, she said. Mentorship opportunities with senior faculty such as Dr. Cynthia Brandt, director of the Yale Center for Medical Informatics, and Susan Dwight Bliss Professor of Public Health Trace Kershaw, chair of the YSPH Department of Social and Behavioral Services, helped hone her research questions. In addition, the school’s ample resources have powered a wide range of health informatics projects associated with the CHIL @ Yale lab, she said. Communities in and around New Haven have provided valuable assistance, too.

With ongoing help from New Haven communities and YSPH, McCall believes her work can unlock new ways of addressing systemic barriers surrounding mental and physical health services — and, of course, encourage more research into mobile applications toward those ends.

Through this collaborative process, McCall said, “we can make tools that are more effective, more useful, and really are reflective of the community.”