Helen-Maria Lekas, PhD

I am a sociologist by training with an extensive funded research portfolio, teaching, and mentoring experience in the public health field. All of my work is focused on reducing health disparities and my grants include psychosocially vulnerable populations, including patients who are minoritized and discriminated against due to their race, ethnicity, gender, sexual orientation, age, mental illness and substance use.

Engagement in medical care, stigma and discrimination, and patient-provider relationships are my primary research areas. I have expertise in qualitative and mixed methods research. I have an extensive background in research with HIV-infected and at-risk populations, including patients disengaged from medical care, coinfected with HIV and HCV, engaged in substance use, older adults, and gender- and sexually- minoritized patients.

Currently, I co-lead community-informed interventions to provide access to treatment for persons with mental illness and substance use diagnoses, including persons with or at risk for HIV. These interventions integrate both well-established supportive strategies, such as coaching by peers, and newer strategies that are based on AI-driven texting tools.  

My work is theoretically guided. The theory of gender and power, the socioecological theory, the person-centered care framework, and the theory of health lifestyle have informed my research. Using extensive mixed-methods data from a hospitalized sample of racially and ethnically minoritized patients disengaged from outpatient care, I have revised the theory of health lifestyle to include cultural influences and attend to intersectionality and specifically, to intersectional stigma as a barrier to medical care. Based on this theoretical framework, with my colleagues Dr. Crystal Lewis and Kerstin Pahl, we have designed a training for the mental health workforce originally called, the Cultural and Structural Humility (CSH) training. The CSH training has been updated to the Humility in Public Health Practice (HIPP) following almost a decade of the CSH's implementation, evaluation, and after integrating CSH with the motivational interviewing communication approach designed to be used by healthcare providers.  A summary description of the CSH training has been published as: Lekas HM, Pahl K, Fuller Lewis C. Rethinking Cultural Competence: Shifting to Cultural Humility. Health Serv Insights. 2020 Dec 20;13:1178632920970580.

My research on enhancing patient-provider relationships resulted in the development of a theoretical framework that synthesizes the concepts of health habitus, stigma, and institutional settings for understanding discontinuity of medical care and patient-directed discharges (formerly AMA discharges) among psychosocially vulnerable patients. This framework can be found in the chapter, Reframing the phenomenon of discharges Against Medical Advice: A sociologist’s perspective. David Alfandre (Editor). Against Medical Advice Discharges from the Hospital: Optimizing Prevention and Management to Promote High-Quality, Patient-Centered Care. Springer International Publishing.