Ashley Hagaman, PhD, MPH
Assistant Professor of Public Health (Social & Behavioral Sciences)Cards
Additional Titles
Affiliated Faculty, Yale Institute for Global Health
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About
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Assistant Professor of Public Health (Social & Behavioral Sciences)
Affiliated Faculty, Yale Institute for Global Health
Biography
Ashley Hagaman, PhD is an Assistant Professor of Public Health in the Department of Social and Behavioral Sciences at Yale School of Public Health. She is also a qualitative methodologist with the Center for Methods in Implementation and Prevention Science and holds a secondary appointment in the Department of Anthropology. Her research examines the complex collection of factors that influence depression and suicide in varying cultural contexts, particularly among vulnerable populations. She collaborates with several interdisciplinary teams around the world to develop and test innovative strategies to alleviate depression and enhance maternal health systems, with field sites in Nepal, Pakistan, and Ethiopia. She also contributes to the development of innovative qualitative and mixed-methods to improve the study and implementation of evidence-based health practices, incorporating and testing new passive data collection strategies and rapid analytic techniques.
Appointments
Social and Behavioral Sciences
Assistant ProfessorPrimaryAnthropology
Assistant ProfessorSecondary
Other Departments & Organizations
- Anthropology
- Center for Methods in Implementation and Prevention Science (CMIPS)
- Global Mental Health Promotion Program
- Janeway Society
- Qualitative Methods Innovation Program
- Social and Behavioral Sciences
- Yale Institute for Global Health
Education & Training
- PhD
- Arizona State University, Medical Anthropology (2017)
- MPH
- Emory University, Rollins School of Public Health (2012)
- BS
- University of Michigan - Ann Arbor, Neuroscience (2008)
Research
Overview
Medical Subject Headings (MeSH)
ORCID
0000-0002-8016-1036
Research at a Glance
Yale Co-Authors
Publications Timeline
Research Interests
Emilie Egger
Claire Masters, MS, PMP
Jeannette Ickovics, PhD
Jessica Lewis, PhD, LMFT
Shayna Cunningham, MHS, PhD
Bridget Basile Ibrahim
Depression
Qualitative Research
Suicide
Maternal Health
Maternal-Child Health Services
Publications
2024
Engaging husbands in a digital mental health intervention to provide tailored counseling for women experiencing postpartum depression: A mixed methods study in Nepal
Bhardwaj A, Maharjan S, Magar A, Shrestha R, Dongol A, Hagaman A, Van Heerden A, Caracoglia J, Gallo J, Murray S, Kohrt B. Engaging husbands in a digital mental health intervention to provide tailored counseling for women experiencing postpartum depression: A mixed methods study in Nepal. SSM - Mental Health 2024, 6: 100340. DOI: 10.1016/j.ssmmh.2024.100340.Peer-Reviewed Original ResearchConceptsPatient Health Questionnaire-9Postpartum depressionEmotional supportDigital mental health interventionsPPD interventionsTreatment of postpartum depressionPostpartum depressive symptomsThematic analysis of semi-structured interviewsMental health interventionsPostpartum depression treatmentMixed methods studyHusbands of womenAnalysis of semi-structured interviewsImpact of gender normsSemi-structured interviewsGender equitable normsPost-interventionDigital interventionsHealth interventionsSemi-urban regionsHealth componentCounseling interventionThematic analysisDepressive symptomsPrimary themesTrauma exposure among young children in rural Pakistan: Associations with gender, mental health, and cognitive skills
Frost A, Collins A, Chung E, Escobar Carias M, Hagaman A, Gupta S, Bibi A, Sikander S, Maselko J. Trauma exposure among young children in rural Pakistan: Associations with gender, mental health, and cognitive skills. BMC Psychology 2024, 12: 454. PMID: 39183356, PMCID: PMC11346172, DOI: 10.1186/s40359-024-01944-x.Peer-Reviewed Original ResearchMeSH Keywords and ConceptsConceptsChild mental healthMental healthLow-resource settingsAssociated with increased mental health difficultiesRural PakistanMental health difficultiesTrauma exposureMental health problemsStrength of associationSample of mother-child dyadsIncreased anxiety scoresChildren's lifetime exposureTrauma-informed interventionsMother-child dyadsCognitive healthAssociated with genderHealth difficultiesBackgroundThe burdenAnxiety scoresHealth problemsHealthLifetime exposureExperience traumaChildren's cognitive skillsCognitive skillsDisability severity and risk of new or recurrent intimate partner violence – Evidence from a cohort study in rural Pakistan
Collins A, Maselko J, Hagaman A, Bates L, Haight S, Kachoria A, Gupta S, Bhalotra S, Sikander S, Bibi A. Disability severity and risk of new or recurrent intimate partner violence – Evidence from a cohort study in rural Pakistan. Disability And Health Journal 2024, 101673. PMID: 39095292, DOI: 10.1016/j.dhjo.2024.101673.Peer-Reviewed Original ResearchConceptsSexual intimate partner violenceRisk ratioIntimate partner violenceDisability severityModified Poisson regression modelsRural PakistanPoisson regression modelsCohort of mothersSouth Asian contextDisability levelLow-incomeCohort studyPhysical intimate partner violencePsychological intimate partner violenceDisabilityAsian contextConsecutive wavesRegression modelsPartner violenceMothersRiskCohortCultural normsCross-sectionLow severityGuided internet-based LGBTQ-affirmative cognitive-behavioral therapy: A randomized controlled trial among sexual minority men in China
Yi M, Li X, Chiaramonte D, Sun S, Pan S, Soulliard Z, Eisenstadt B, Ljótsson B, Hagaman A, Pachankis J. Guided internet-based LGBTQ-affirmative cognitive-behavioral therapy: A randomized controlled trial among sexual minority men in China. Behaviour Research And Therapy 2024, 181: 104605. PMID: 39029333, DOI: 10.1016/j.brat.2024.104605.Peer-Reviewed Original ResearchAltmetricConceptsInternet-based CBTCognitive-behavioral therapySexual minority menSocial-cognitive mechanismsYoung sexual minority menMinority stressMinority menSession completionBehavioral healthSexual minority individualsModeration analysisAlcohol useMinority individualsMental healthInternalized stigmaFollow-upStigma experiencesRandomized controlled trialsSessionsTreatment efficacySecondary outcomesControlled trialsPrimary outcomeAffirmative supportHealthIntegration of passive sensing technology to enhance delivery of psychological interventions for mothers with depression: the StandStrong study
van Heerden A, Poudyal A, Hagaman A, Maharjan S, Byanjankar P, Bemme D, Thapa A, Kohrt B. Integration of passive sensing technology to enhance delivery of psychological interventions for mothers with depression: the StandStrong study. Scientific Reports 2024, 14: 13535. PMID: 38866839, PMCID: PMC11169515, DOI: 10.1038/s41598-024-63232-3.Peer-Reviewed Original ResearchAltmetricMeSH Keywords and ConceptsConceptsPsychological interventionsDepressive symptomsDelivery of psychological interventionsNon-specialist providersTreat maternal depressionLow-resource settingsBeck Depression InventoryPersonalized psychological interventionsDepression interventionsMaternal depressionMHealth solutionsRural NepalDepression InventoryYoung mothersInterventionDepressionData collectionMothersPassive sensingIncreased movementNon-specialistsPassive sensing technologyMHealthSymptomsCareChildhood parental bonding and depression in adulthood: A study of mothers in rural Pakistan
Frost A, Hagaman A, Bibi A, Bhalotra S, Chung E, Haight S, Sikander S, Maselko J. Childhood parental bonding and depression in adulthood: A study of mothers in rural Pakistan. Journal Of Affective Disorders 2024, 356: 715-721. PMID: 38663557, PMCID: PMC11103589, DOI: 10.1016/j.jad.2024.04.090.Peer-Reviewed Original ResearchMeSH Keywords and ConceptsConceptsParental Bonding InstrumentStructured Clinical Interview for DSM DisordersRisk of depressionPsychological controlParenting behaviorsMental healthAssociated with decreased risk of depressionParent-child relationship qualityMeasures of parental controlAssociated with increased risk of depressionDepression in adulthoodRural PakistanMental health of childrenBehavioral controlRetrospective self-reportsMothers' parenting behaviorImpact of parenting behaviorsChild mental healthChildhood parental bondingAssociated with decreased riskHealth of childrenCross-sectional studyAssociated with increased riskDSM disordersAdulthood depressionDiscrimination and perinatal depressive symptoms: The protective role of social support and resilience
Masters C, Lewis J, Hagaman A, Thomas J, Carandang R, Ickovics J, Cunningham S. Discrimination and perinatal depressive symptoms: The protective role of social support and resilience. Journal Of Affective Disorders 2024, 354: 656-661. PMID: 38484882, DOI: 10.1016/j.jad.2024.03.039.Peer-Reviewed Original ResearchAltmetricConceptsPerinatal depressive symptomsGroup prenatal careAdverse effects of discriminationSocial supportDepressive symptomsPrenatal careEffects of discriminationPregnant peopleAssociated with less depressive symptomsAssociated with depressive symptomsEffect of social supportModerating effect of social supportHigh social supportLess depressive symptomsPerinatal depressionSocial determinantsMonths postpartumLinear regression modelsSelf-report measuresPostpartum periodTrimester of pregnancyPostpartumPsychological factorsRegression modelsCareGroup prenatal care successes, challenges, and frameworks for scaling up: a case study in adopting health care innovations
Masters C, Carandang R, Lewis J, Hagaman A, Metrick R, Ickovics J, Cunningham S. Group prenatal care successes, challenges, and frameworks for scaling up: a case study in adopting health care innovations. Implementation Science Communications 2024, 5: 20. PMID: 38439113, PMCID: PMC10913654, DOI: 10.1186/s43058-024-00556-1.Peer-Reviewed Original ResearchAltmetricConceptsGroup prenatal carePrenatal careGroup prenatal care sessionsLeadership buy-inQuality of careHealth care innovationsNon-adoptersFocus group discussionsOrganization-wide goalsCare implementationCare innovationsIntervention designCare sessionsCase study approachImprovement initiativesTransformative changeAdministrative dataHealthcare innovationOrganizational goalsCareOrganization leadershipClinical sitesGroup careTrial registrationTheBuy-inPatient-Defined Cultural Safety in Perinatal Interventions: A Qualitative Scoping Review
Egger E, Ibrahim B, Nyhan K, Desibhatla M, Gleeson D, Hagaman A. Patient-Defined Cultural Safety in Perinatal Interventions: A Qualitative Scoping Review. Health Equity 2024, 8: 164-176. PMID: 38559847, PMCID: PMC10979693, DOI: 10.1089/heq.2023.0152.Peer-Reviewed Original ResearchCitationsConceptsCultural safetyCumulated Index to Nursing and Allied Health LiteratureNursing and Allied Health LiteratureCulturally safe carePerinatal interventionsAllied Health LiteratureCultural safety frameworkQualitative scoping reviewFull-text screeningPerinatal periodPatients' cultural needsSafe careCare providersPatient experiencePatient perspectiveScoping reviewHealth literatureQualitative literaturePatient careEquity-based frameworkCulturally specific knowledgePhysical needsQualitative studyTitle-abstractCare
2023
Maternal adverse childhood experiences on child growth and development in rural Pakistan: An observational cohort study
Chung E, Scherer E, LeMasters K, Bates L, Hagaman A, Staley B, Zalla L, Sikander S, Maselko J. Maternal adverse childhood experiences on child growth and development in rural Pakistan: An observational cohort study. PLOS Global Public Health 2023, 3: e0001669. PMID: 37878564, PMCID: PMC10599588, DOI: 10.1371/journal.pgph.0001669.Peer-Reviewed Original ResearchCitationsConceptsReceptive language developmentAdverse childhood experiencesMaternal adverse childhood experiencesLanguage developmentChild outcomesFine motorChildhood experiencesLevel of adversityMother-child dyadsCognitive developmentSocioemotional developmentSocioemotional problemsEmotional neglectEmotional abuseBehavioral outcomesToddler DevelopmentBehavioral developmentDifficulties QuestionnaireBayley ScalesPhysical abuseSocioemotionalChild growthIntergenerational transmissionNull relationshipAdapted version
Academic Achievements & Community Involvement
activity Co-designing a suicide prevention intervention for women in Pakistan (NIMH K01)
ResearchDetails07/19/2021 - PresentIslamabad, Islamabad Capital Territory, Pakistan; Rawalpindi, Punjab, PakistanAbstract/SynopsisIn LMIC, up to 20% of maternal deaths are due to suicide and in South Asia, suicide is a leading cause of death among women of reproductive age. Suicide is also highly stigmatized and a sensitive topic for community engagement. This research project uses a community-based co-design approach to explore the feasibility of engaging peer-volunteers in suicide detection and prevention in rural Pakistan, where findings will inform how task-shifted models for mental health care can successfully integrate suicide prevention practices, ultimately saving lives and improving community-based mental health services. Public health impacts may be substantial as results can be applied not only in similar South Asian contexts, but also in low-resourced settings in the US and abroad, where the suicide burden remains high.
activity CMIPS Qualitative Methods Innovation Lab
ResearchDetails12/01/2020 - PresentNew Haven, CT, United StatesAbstract/SynopsisWe are a hub for innovation of original methodological contributions to advance the use of qualitative approaches, including elicitation, study design, and analysis, in implementation science through research, training, and collaboration. Our team of faculty, students, and implementers are working on various qualitative methods projects including the integration of rapid approaches for data collection and analysis, methods for human-centered design in complex field sites, and a scoping review of qualitative methods used in implementation science.
activity Nepal Suicide Prevention
ResearchDetails01/01/2020 - PresentDhulikhel, Central Development Region, NepalAbstract/SynopsisThree-quarters of suicide deaths occur in low and middle-income countries (LMICs). Despite recent calls to advance the research agenda surrounding suicide, there is a dearth of evidence supporting effective strategies for early identification and prevention in low-resourced, culturally diverse contexts. To respond to the lack of mental health services in LMIC, there has been rapid dissemination of task-shifted interventions (the redistribution of health tasks from specialized providers to low-level or community-level workers) to treat common mental disorders, but these lack suicide-specific protocols. Given the high mortality of suicide, there is critical and urgent need to incorporate implementation strategies for suicide risk detection and referral within these programs. This young investigator grant will provide expert mentoring in adapting and implementing task-shifted suicide prevention evidence-based practices in a low-income setting. This project is situated in Nepal, a member of the South–East Asian region that holds the largest proportion of the world’s suicides and some of the highest suicide rates. We propose to explore several multi-level strategies for suicide prevention that have growing evidence-base in LMIC (e.g., screening, safety planning, and brief intervention contact) and adapt and pilot the implementation of a suicide prevention package (SuPP) in a low-resource setting. Infrastructure for this research includes collaborators and staff at Kathmandu University’s Dhulikhel Hospital (KUDH), the community’s existing multilevel task-shifted intervention for depression, and mentor Dr. Lakshmi Vijayakumar’s expertise testing suicide prevention EBPs in India. We use mixed-methods to complete three aims: (1) explore the multilevel targets of a Suicide Prevention Package (SuPP) including health system, institutional, provider, and patient preferences for cultural adaptation and optimization; (2) Create the initial implementation toolkit and training manual for SuPP for health system implementation; and (3) Conduct a small open, non-randomized, pilot trial to assess the feasibility and acceptability of SuPP within the existing health system. To accomplish these aims we will use the Dynamic Adaptation Process (DAP)and EPIS framework (Exploration, Preparation, Implementation, Sustainment). Qualitative in-depth interviews (n=60) with health system stakeholders and staff, community counselors, and adults with lived experience of suicidal behavior (SB) will address Aim 1 (exploration phase). For Aim 2, the establishment of an Implementation Resource Team of health staff (IRT, n=12) at KUDH and a Community Advisory Board (n=15) of individuals and caretakers of mental health service users with lived experience of SB will guide a systematic adaptation of components included and implementation strategies for the Suicide Prevention Package (SuPP). Aim 3 will include an open pilot trial testing the implementation of SuPP in KUDH with 12 health workers (including 2 community counselors) and 25 enrolled eligible participants at risk for suicide. This project will inform how task-shifted models for mental health care can successfully integrate suicide prevention practices, ultimately saving lives and improving community-based mental health services. Our work will result in a suicide prevention package and adaptation process that can be utilized in diverse and disadvantaged settings around the world.
activity The Bachpan Study
ResearchDetails01/01/2020 - PresentRawalpindi, Punjab, PakistanAbstract/SynopsisThis multidisciplinary project, led by Joanna Maselko at Gillings School of Global Public Health, UNC-Chapel Hill, focuses on identifying the early childhood mechanisms through which maternal depression, and its treatment, shapes child developmental trajectories in rural Pakistan. We use transdisciplinary approaches, including economics, social epidemiology, psychiatry, and anthropology, to better understand how to make lasting improvements in maternal health, parental investments, and child development.
activity Maternal and neonatal healthcare improvement
ResearchDetails01/01/2020 - PresentAddis Ababa, Addis Ababa, EthiopiaAbstract/SynopsisThis interdisciplinary project is using a systems-integrated quality improvement approach to improve maternal and neonatal health services across Ethiopia. Our team uses mixed-methods to develop, test, and assess the impacts of patient care on mothers and their families.
News
News
- August 05, 2024
Yale partnership seeks to improve HIV prevention and treatment training in Tbilisi, Georgia
- August 02, 2024
Loya Honored with Career Development Award from NIDA
- September 07, 2023
Orientation session introduces YSPH students to diverse community public health initiatives
- August 29, 2023
$4 Million Grant Will Help YSPH Team Implement New LGBTQ Mental Health Therapy