Anna Rivara, PhD, MPH
Cards
Titles
Affiliated Faculty, Yale Institute for Global Health
Contact Info
About
Titles
Associate Research Scientist in Epidemiology (Chronic Diseases)
Affiliated Faculty, Yale Institute for Global HealthBiography
I am an evolutionary anthropologist that focuses on human biology, and the evolution of health and disease in modern populations. My research aims are to better understand how immune and metabolic responses, in association with poverty and gendered pressures, construct non-communicable and infectious diseases in women, and perpetuate poor health outcomes. My background is in Applied Biological Anthropology, Public Health, and African Studies. Currently I work with Yale University's Olaga Research Lab in Samoa studying inflammation, non-communicable diseases, and physical activity. My previous work has taken me to Brazil to study the interactions between parasitism and reproductive health in women of the Kalunga Quilombo, and to Tanzania to study the impact of HIV on children and family structures.
Appointments
Chronic Disease Epidemiology
Associate Research ScientistPrimary
Other Departments & Organizations
Education & Training
- Global Health Equity Scholars Fellow
- Yale University (2019)
- PhD
- University of South Florida, Applied Anthropology (2017)
- MPH
- University of South Florida, Global Health Infection Control (2014)
- MA
- University of Illinois, Urbana-Champaign, African Studies (2009)
- BS
- University of Oregon, Anthropology (2005)
Research
Overview
As an Associate Research Scientist in the Department of Chronic Disease Epidemiology, I currently am investigating factors associated with diabetes care engagement, retention, and loss in high-risk low-resource environments. Specifically, my research heretofore has focused on diabetes risk and care engagement in adult Samoans. As a NIH Fogarty Global Health Postdoctoral Fellow through the Global Health Equity Scholars Program at Yale University in the Department of Epidemiology, Microbial Diseases, I worked under the mentorship of Dr. Nicola Hawley in the Department of Chronic Diseases Epidemiology. With funding secured from the NIH Fogarty International Center and NIH Institute of Digestive, Diabetes and Kidney Diseases (NIDDK), I led a project focused on investigating physical, and socio-cultural barriers to physical activity in adult Samoan women. The results of this project will inform my development and implementation of effective localized interventions that increase physical activity in this demographic and increase their chances of improving overall health. Additionally, I am analyzing how the physical activity patterns of these women are influencing the physical activity of their children through tracked accelerometry in order to better understand how to disrupt transgenerational obesogenic environments. I am also analyzing how pro-inflammatory responses (C-reactive protein, IL-6) in adult Samoans are associated with health status, body composition, and cardiometabolic disease risks.
My postdoctoral career contributions are focused on 1) analyzing factors associated with engagement in diabetes and hypertension cascades of care in Pacific Islanders; and 2) identifying culturally sensitive and preferred care intervention strategies to improve diabetes care retention and efficacy.
Additionally, as a visiting professor in anthropology at the University of Notre Dame, I developed courses in evolutionary medicine and the history of human health and diseases for undergraduate and graduate students. I have been able to use my expansive academic background to construct anthropologically oriented public health courses to provide anthropology, health sciences, and biology, students with a nuanced understanding of human health outcomes.
Research conducted during my graduate career focused on three major foci. 1) Identifying and analyzing immune responses to reproduction, and infectious, and hypersensitivity-producing, pathogens. During my dissertation research, I collected and analyzed biological, reproductive, socio-economic, and ecological data from two different populations: adult women in the United States using National Health and Nutritional Examination Survey (NHANES) data, and adult women of the Kalunga quilombo in Brazil. Using a life history framework, I established that reproduction is positively associated with IgE antibodies, and negatively associated with stature, in both populations. Based on my results, I proposed an innovative means of understanding the evolution of IgE responses to internal gestation in mammals (Rivara and Miller, 2017). Additionally, my research highlighted how health disparities are constructed within both populations due to biological, and external socio-political, pressures. 2) Identifying socio-economic, demographic, biological, and immunological, risk factors of healthcare associated infections in an urban tertiary-level hospital in Florida. My Masters of Public Health thesis focused on epidemiological analyses of healthcare associated infections of toxigenic C. difficile in a major Florida hospital. Through the collection of surveillance, qualitative, and biological data, I established that sex, health history, hospital unit, and healthcare and environmental services workers’ compliance to infection control protocols, were associated with previous and current outbreaks. 3) Understanding how socio-economic and health conditions impact the implementation of effective public health interventions. My role as a project coordinator on a study analyzing the effectiveness of video-conferencing based interventions for smoking cessation in people living with HIV further advanced my skills in participant recruiting and interview, identifying barriers to health intervention, and the use of innovative techniques for public health programming.
Medical Subject Headings (MeSH)
Research at a Glance
Yale Co-Authors
Publications Timeline
Nicola Hawley, PhD
Mayur M. Desai, PhD, MPH, FACE
Parmida Zarei
Tracy Rabin, MD, SM
Publications
2024
Associations between fasting glucose rate-of-change and the missense variant, rs373863828, in an adult Samoan cohort
Rivara A, Russell E, Carlson J, Pomer A, Naseri T, Reupena M, Manna S, Viali S, Minster R, Weeks D, DeLany J, Kershaw E, McGarvey S, Hawley N. Associations between fasting glucose rate-of-change and the missense variant, rs373863828, in an adult Samoan cohort. PLOS ONE 2024, 19: e0302643. PMID: 38829901, PMCID: PMC11146712, DOI: 10.1371/journal.pone.0302643.Peer-Reviewed Original ResearchMeSH Keywords and ConceptsConceptsType 2 diabetesAllele of rs373863828Body mass indexFasting glucoseAdult SamoansDevelopment of type 2 diabetesOdds of type 2 diabetesReduction of modifiable risk factorsRs373863828 genotypeAssociated with higher body mass indexType 2 diabetes developmentGlucose rate of changeMass indexHousehold asset scoreUrbanization of residenceHigher body mass indexRisk factorsModifiable risk factorsRate of changeBaseline variablesMultivariate linear regressionPhysical activityDiabetes preventionType 2 diabetes mellitusSmoking statusAccelerometer-Based Estimates of Physical Activity and Sedentary Time Among Samoan Adults.
Hawley N, Zarei P, Crouter S, Desai M, Pomer A, Rivara A, Naseri T, Reupena M, Viali S, Duckham R, McGarvey S. Accelerometer-Based Estimates of Physical Activity and Sedentary Time Among Samoan Adults. Journal Of Physical Activity And Health 2024, 21: 636-644. PMID: 38621669, DOI: 10.1123/jpah.2023-0590.Peer-Reviewed Original ResearchAltmetricConceptsModerate to vigorous physical activityVigorous physical activityEstimates of physical activityPhysical activitySamoan adultsSedentary timeLight physical activityPhysical activity levelsAccelerometer-based devicesModifiable risk factorsClass II/III obesitySedentary activitiesWeight statusHealthy weightAdult SamoansParticipant characteristicsObesity-related diseasesCardiometabolic diseasesCensus regionActivity levelsGeneralized linear modelRural areasObesity-related cardiometabolic diseasesRisk factorsAdults
2023
Identifying patient preferences for diabetes care: A protocol for implementing a discrete choice experiment in Samoa
Rivara A, Galárraga O, Selu M, Arorae M, Wang R, Faasalele-Savusa K, Rosen R, Hawley N, Viali S. Identifying patient preferences for diabetes care: A protocol for implementing a discrete choice experiment in Samoa. PLOS ONE 2023, 18: e0295845. PMID: 38134044, PMCID: PMC10745180, DOI: 10.1371/journal.pone.0295845.Peer-Reviewed Original ResearchProtocol: Implementation and evaluation of an adolescent-mediated intervention to improve glycemic control and diabetes self-management among Samoan adults
Hawley N, Rivara A, Naseri J, Faumuina K, Potoa’e-Solaita N, Iopu F, Faiai M, Naveno E, Tasele S, Lefale T, Lantini R, Carlson J, Rabin T, Semaia P, Mugadza P, Rosen R. Protocol: Implementation and evaluation of an adolescent-mediated intervention to improve glycemic control and diabetes self-management among Samoan adults. PLOS ONE 2023, 18: e0279084. PMID: 36795707, PMCID: PMC9934313, DOI: 10.1371/journal.pone.0279084.Peer-Reviewed Original ResearchMeSH Keywords and ConceptsConceptsGlycemic controlPrimary efficacy outcomeCardiovascular risk factorsChronic disease riskType 2 diabetesSelf-care strategiesSelf-care practicesHealth behavior changeBehavior changeEfficacy outcomesUsual careDiabetes InterventionsAdult family membersRisk factorsDiabetes knowledgeSamoan adultsIntervention acceptabilityFamily-centered culturePositive behavior changeDisease riskHealth disparitiesActive interventionDisproportionate riskInterventionEthnic minority groups
2022
Associations between diabetes-related symptoms, glycemic control, and health-related quality of life in adult Samoans
Rivara A, Pomer A, Wetzel A, Viali S, Naseri T, Reupena M, Kershaw E, McGarvey S, Hawley N. Associations between diabetes-related symptoms, glycemic control, and health-related quality of life in adult Samoans. Pacific Health Dialog 2022, 21: 638-655. DOI: 10.26635/phd.2022.142.Peer-Reviewed Original ResearchConceptsHealth-related qualityDiabetes-related symptomsGlycemic controlAdult SamoansSymptom presenceDiabetes self-care behaviorsSymptom checklist questionnairesHigh symptom burdenDiabetes-related complicationsMultivariate logistic regressionType 2 diabetesSelf-care behaviorsMann-Whitney U testEarly evaluationChi-square testSymptom burdenDiabetes statusCommon symptomsDiabetes symptomsWhitney U testHeart painSeries of anthropometricHigh prevalenceDiabetes experiencePrediabetesCardiovascular risk factors across different levels of urbanization in Brazilian Afro‐derived communities (quilombos)
Paiva S, Rivara A, de Castro Nóbrega M, de Cesare Parmesan Toledo R, de Nazaré Klautau‐Guimarães M, Madrigal L, de Oliveira S. Cardiovascular risk factors across different levels of urbanization in Brazilian Afro‐derived communities (quilombos). American Journal Of Human Biology 2022, 35: e23839. PMID: 36426735, DOI: 10.1002/ajhb.23839.Peer-Reviewed Original ResearchCitationsMeSH Keywords and ConceptsConceptsCardiovascular risk factorsCVD risk factorsRisk factorsCardiovascular diseaseExact testCardio-metabolic disease riskDisease riskPrevalence of hypertensionChronic disease riskCross-sectional studyFisher's exact testChi-square testBlood pressureChronic diseasesBlood samplesKruskal-Wallis testIndependent sample t-testEpidemiological transitionSignificant sex differencesSample t-testDiseaseT-testHigh frequencySex differencesStandard protocolValidity of anthropometric equation‐based estimators of fat mass in Samoan adults
Heinsberg L, Hawley N, Duckham R, Pomer A, Rivara A, Naseri T, Reupena M, Weeks D, McGarvey S, Minster R. Validity of anthropometric equation‐based estimators of fat mass in Samoan adults. American Journal Of Human Biology 2022, 35: e23838. PMID: 36428275, PMCID: PMC10023273, DOI: 10.1002/ajhb.23838.Peer-Reviewed Original ResearchCitations
2020
Evaluating the feasibility and effectiveness of self-monitoring of health among Samoan women: a randomized trial
Kocher E, Desai M, Rivara A, Naseri T, Hawley N. Evaluating the feasibility and effectiveness of self-monitoring of health among Samoan women: a randomized trial. Pacific Health Dialog 2020, 21: 309-318. DOI: 10.26635/phd.2020.636.Peer-Reviewed Original Research
Academic Achievements and Community Involvement
activity Genome Wide Association Study of Adiposity in Samoans
ResearchDetails08/01/2018 - 07/31/2019New Haven, CT, United States; Apia, Upolu, SamoaAbstract/SynopsisOlaga Research study of adiposity and metabolism in Samoa
honor Global Health Equity Scholars Fellowship
National AwardNIH Fogarty InstituteDetails08/01/2018United Statesactivity Parasitism and Reproductive health in the Kalunga Quilombo
ResearchDetails03/01/2016 - 05/18/2016Tampa, FL, United States; Brasília, DF, BrazilAbstract/SynopsisDissertation Research
Links & Media
News
- March 08, 2023
Faculty Network Spotlight: NGN