Priscilla Anne Magrath

Interests

No activities entered.

Courses

Scholarly Contributions

Chapters

• Magrath, P. A. (2022).

  Regulating midwives: Foreclosing alternatives in the policy making process in West Java, Indonesia

  . In Anthropologies of Global Maternal and Reproductive Health: From Policy Spaces to Sites of Practice.(p. 35). Springer.

Journals/Publications

• Kimaru, L. J., Magrath, P., Hu, C., Nagalingam, S., Connick, E., Ernst, K., & Ehiri, J. (2025). The influence of perceived neighborhood disorder on HIV care-related decisions: A qualitative study. PloS one, 20(4), e0322994.
  More info

  The study used a qualitative approach to explore how perceived neighborhood disorder influences health-related decisions among people living with HIV. Recognizing the crucial role environmental factors play in health behaviors, this research seeks to bridge a gap in understanding how neighborhood dynamics affect individuals with HIV. A qualitative research design with interpretive qualitative analysis was used. The interview guide and analysis were guided by the Broken Windows Theory and Social Cognitive Theory, enabling an exploration of the intersection between environmental perceptions and healthcare behaviors. Data were collected through telephonic in-depth interviews with 18 participants from two HIV clinics from June 2022 to February 2023. Interviews were analyzed using the Dedoose software 9.0.17 and narratives were enriched using their survey data from a cross-sectional study with a validated scale to measure perceived neighborhood disorder. Our findings show that perceived neighborhood disorder influences HIV care-related decisions through a diminished sense of control pathway. Also, healthcare settings emerge as a mitigator of the influence of perceived neighborhood disorder on HIV care-related decisions by offering a sense of control. Perception of lower neighborhood disorder correlates with a strong sense of control and a preference for specialized care. As the perception of neighborhood disorder increases, there is a shift toward care settings that balance specialized services with a supportive care environment. A higher perception of neighborhood disorder leads to prioritized care settings that provide a sense of community support, and discretion, reflecting adaptations to a compromised sense of control. This research underscores the influence of neighborhood disorder on health-related decisions through the pathway of self-control, emphasizing the role that healthcare environments play as mitigators. For chronic disease management, such as with HIV, the development of healthcare settings that reinforce patient autonomy and control, alongside community efforts to diminish signs of disorder, and their underlying causes is crucial.
• Magrath, P. A. (2024). A qualitative study exploring the factors influencing maternal healthcare access and utilization among Muslim refugee women resettled in the United States. PLoS ONE, 19(8). doi:https://doi.org/10.1371/journal.pone.0307192
• Magrath, P. A. (2024). The downstream effects of Covid-19 on adolescent girls in the Peruvian Amazon: qualitative findings on how the pandemic affected education and reproductive health. . BMJ Global Health. doi:10.1136/bmjgh-2023-012391
• Mantina, N. M., Smith, J., Miiro, F. N., Magrath, P. A., McClelland, D. J., Barraza, L., Ruiz, J., & Madhivanan, P. (2025). Perspectives of HPV vaccine decision-making among young adults: A qualitative systematic review and evidence synthesis. PloS one, 20(5), e0321448.
  More info

  Despite the demonstrated safety and effectiveness of HPV vaccines in preventing HPV-related cancers, global vaccine coverage remains low. The suboptimal adolescent HPV vaccine coverage rate leaves many young adults at increased risk for developing vaccine preventable HPV-related cancers. This qualitative evidence synthesis (QES) aims to examine the HPV vaccination perspectives of young adults globally and identify the barriers and facilitators to HPV vaccine uptake and decision-making processes.
• Yeo, S., Lee, I., Ehiri, J., Magrath, P., Ernst, K., Kim, Y. R., & Alaofè, H. (2025). Developing and validating a HEalthCare NAvigation Competency (HECNAC) Scale for refugees in the United States. PloS one, 20(1), e0314057.
  More info

  The complex healthcare system in the United States (US) poses significant challenges for people, particularly minorities such as refugees. Refugees often encounter additional layers of challenges to healthcare navigation due to unfamiliarity with the system, limited health literacy, and language barriers. Despite their challenges, it is difficult to identify the gaps as few tools exist to measure navigation competency among this population and many conventional tools assume English proficiency, making them inadequate for refugees and other immigrants. To address this gap, this study developed and validated a HEalthCare NAvigation Competency (HECNAC) Scale tailored to refugees' needs. The scale development process followed three phases: domain identification through a literature review and stakeholder interviews (n = 15), content validation through the Delphi method (2 rounds, n = 12), and face validity assessment via cognitive interviews (2 rounds, n = 4). Based on a literature review and stakeholder interviews, the initial version of the scale was developed, including ten domains and 47 items. An introductory email concerning the scale and the Delphi process was subsequently sent to 21 eligible experts, including staff from refugee resettlement agencies, health care providers serving refugee communities, and refugees. Twelve experts completed the two rounds of the Delphi, resulting in a consensus on 39 items. After conducting cognitive interviews with 4 Afghan refugees, the scale was finalized with ten domains and 35 items. The finalized scale captures multifaceted aspects of healthcare navigation crucial for refugees, organized into domains such as health system knowledge, insurance, making an appointment, transportation, preparing for a visit, in the clinic, interpretation, medicine, medical bills, and preventive care. Overall, the HECNAC Scale represents a significant step towards understanding and assessing refugees' competencies in navigating the US healthcare system. It has the potential to guide tailored interventions and standardized training curricula and ultimately mitigate persistent barriers faced by refugees in accessing healthcare services.
• Kimaru, L. J., Hu, C., Nagalingam, S., Magrath, P., Connick, E., Ernst, K., & Ehiri, J. (2024). Perceived neighborhood disorder and achieving HIV viral suppression among adults living with HIV: A cross-sectional study. PLOS global public health, 4(12), e0004060.
  More info

  Adherence to antiretroviral therapy (ART) is crucial for achieving and maintaining viral suppression in people living with HIV (PLWH). While individual factors affecting HIV viral suppression have been extensively studied, there is less attention on community-level factors, specifically perceived neighborhood disorder. This study aims to assess the relationship between perceived neighborhood disorder and achieving virologic suppression among people living with HIV. One hundred and eighty-eight PLWH 18 years of age and older from two HIV clinics completed a cross-sectional study. We assessed perceptions of neighborhood disorder, ART self-efficacy, social support, alcohol and drug use, depression, HIV stigma, provider-patient relationship, demographics, and length at the zip code. HIV viral loads were obtained from the clinical record. The analysis involved the use of Fisher's Exact test, Spearman's Rank test, Wilcoxon rank sum test, and Firth logistic regression. All analyses were conducted using STATA 17. Most participants were male (79%), white (62%), and identified as non-Hispanic (66%). Individuals with no perceived neighborhood disorder had median scores of 10 for integration and perseverance in ART self-efficacy. Those with high perceived disorder displayed decreased scores of 8.4 and 8.3 for integration and perseverance respectively. Both integration and perseverance showed statistically significant negative correlations with perceived neighborhood disorder, (Spearman's rho -0.2966; p
• Magrath, P. A. (2024). Optimizing post-partum care in rural communities: Insights from women in Arizona and implications for policy. Maternal and Child Health Journal, 28, 1148-1159. doi:https://doi.org/10.1007/s10995-023-03889-w
• Okechukwu, A., Magrath, P., Alaofe, H., Farland, L. V., Abraham, I., Marrero, D. G., Celaya, M., & Ehiri, J. (2024). Optimizing Postpartum Care in Rural Communities: Insights from Women in Arizona and Implications for Policy. Maternal and child health journal, 28(7), 1148-1159.
  More info

  Optimal postpartum care promotes healthcare utilization and outcomes. This qualitative study investigated the experiences and perceived needs for postpartum care among women in rural communities in Arizona, United States.
• Woodson, L. L., Garcia Saldivar, A., Brown, H. E., Magrath, P. A., Antunez de Mayolo, N., Pettygrove, S., Farland, L. V., Madhivanan, P., & Blas, M. M. (2024). The downstream effects of COVID-19 on adolescent girls in the Peruvian Amazon: qualitative findings on how the pandemic affected education and reproductive health. BMJ global health, 9(4).
  More info

  Due to COVID-19, schools were closed to mitigate disease spread. Past studies have shown that disruptions in education have unintended consequences for adolescents, including increasing their risk of school dropout, exploitation, gender-based violence, pregnancy and early unions. In Peru, the government closed schools from March 2020 to March 2022, declaring a national emergency that affected an estimated 8 million children. These closures may have unintended consequences, including increased adolescent pregnancy, particularly in Peru's rural, largely indigenous regions. Loreto, located in the Peruvian Amazon, has one of the highest adolescent pregnancy rates in the country and poor maternal and child health outcomes. The underlying causes may not be fully understood as data are limited, especially as we transition out of the pandemic. This qualitative study investigated the downstream effects of COVID-19 on adolescent education and reproductive health in Loreto's districts of Nauta and Parinari. In-depth interviews (n=41) were conducted with adolescents and community leaders. These were held in June 2022, 3 months after the reinstitution of in-person classes throughout Peru. Focus group discussions (FGDs) were also completed with community health workers and educators from the same study area in October 2022 to supplement our findings (3 FGDs, n=15). We observed that the economic, educational and health effects of the COVID-19 pandemic contributed to reduced contraceptive use, and increased school abandonment, early unions and adolescent pregnancy. The interplay between adolescent pregnancy and both early unions and school abandonment was bidirectional, with each acting as both a cause and consequence of the other.
• Woodson, L. L., Garcia Saldivar, A., Brown, H. E., Magrath, P. A., Farland, L. V., Blas, M. M., & Madhivanan, P. (2024). 'You have a lot of mirrors': structural and socioecological factors impacting adolescent pregnancy and reproductive health in the Amazon basin, Peru, a qualitative study. Culture, health & sexuality, 26(10), 1268-1284.
  More info

  Loreto, in the Peruvian Amazon, has one of the highest adolescent pregnancy rates in the country. However, underlying causes of adolescent pregnancy are not fully understood as data are limited in Indigenous and remote Amazonian communities. This study investigated adolescent reproductive health within Loreto using an ecological systems framework. Forty-one semi-structured interviews were conducted in June 2022: community leaders ( = 12) and adolescent participants between 15 and 17 years of age (pregnant girls,  = 11; never pregnant girls,  = 9; and boys,  = 9). We also conducted focus group discussions with community health workers and educators in October 2022 (three focus groups,  = 15). Adolescent reproductive health is complex with multi-layered factors that put girls at higher risk of pregnancy. We found a paradoxical relationship between expected social and gender norms and individual desires. This research provides a contextual understanding of the lived experience of adolescents and young people in the Amazon region of Peru. Our findings suggest the need for greater exploration of the contradictory ideas surrounding adolescent pregnancy and female sexuality.
• Yeo, S., Ehiri, J., Magrath, P., Dawson, A., Ernst, K., & Alaofè, H. (2024). Walking into their lives: Applying the go-along method to explore refugee health. International journal of qualitative methods, 23.
  More info

  The go-along method is a way of interviewing people in situ. Combining participant observation and interviewing, the method capitalizes on the advantages of both approaches. This places study participants in context and allows researchers to elicit the interpretations, practices, and experiences of those participants within the contexts. Based on a refugee maternal health study that involved the go-along method in the United States, we reflect on the specific research questions that this approach can help answer, the advantages and limitations of employing this methodological approach and delineate the process of conducting the go-along. The go-along method has numerous benefits in studying refugee health. It can assist in identifying the needs and challenges of people with limited language skills or low educational levels, as well as providing a more nuanced understanding of life skills and language proficiency. It can aid in the observation of interactions between study participants and people around them and provide more detailed information based on spatial cues. It can assist researchers in observing how services are delivered on the ground. More importantly, it can facilitate researchers' vicarious experiences for those who may struggle in their lives. In doing so, it can facilitate contextualized understanding of refugee and their experiences. Although this method has several limitations, such as being more time-consuming and labor-intensive compared to traditional sit-down interviews and being susceptible to external conditions, the go-along method has significant potential for exploring the health of refugees.
• Yeo, S., Kim-Hines, Y., Ehiri, J., Magrath, P., Johnson-Agbakwu, C., Ernst, K., Ibrahimi, S., & Alaofè, H. (2024). A qualitative study exploring the factors influencing maternal healthcare access and utilization among Muslim refugee women resettled in the United States. PloS one, 19(8), e0307192.
  More info

  Although a large number of Muslim refugees have resettled in the United States for the last decades, few studies have looked into maternal healthcare access and utilization among Muslim refugee women in the country. This qualitative study was conducted to explore the factors influencing maternal healthcare access and utilization among Muslim refugee women resettled in the United States. In-depth interviews were conducted among Afghan, Iraqi, and Syrian refugee women (n = 17) using an interview guide informed by Social Cognitive Theory and its key constructs. The interviews were recorded and transcribed verbatim, imported into MAXQDA 2020 (VERBI Software), and analyzed based on qualitative content analysis. Data analysis revealed several themes at the micro, meso, and macro-levels. Micro-level factors included women's attitudes toward hospitals and prenatal care, as well as their life skills and language proficiency. Meso-level factors, such as cultural norms and practices, social support and network, as well as health care provider characteristics, were also identified. Macro-level factors, such as the complex healthcare system and access to insurance, also appeared to influence maternal healthcare access and utilization. This study revealed the complex contextual factors that refugee populations face. Given the population's heterogeneity, a more nuanced understanding of refugee maternal health is required, as are more tailored programs for the most vulnerable groups of refugee women.
• Mantina, N. M., Nakayima Miiro, F., Smith, J., McClelland, D. J., Magrath, P. A., & Madhivanan, P. (2023). Perspectives of HPV vaccination among young adults: a qualitative systematic review and evidence synthesis protocol. BMJ open, 13(12), e076234.
  More info

  Human papillomavirus (HPV) is the causative agent of nearly all cervical cancers. Despite the proven safety and efficacy of HPV vaccines in preventing HPV-related cancers, the global vaccine coverage rate is estimated to only be 15%. HPV vaccine coverage rates are more actively tracked and reported for adolescents 17 years and younger but there is still a critical window of opportunity to intervene and promote HPV vaccination among young adults aged 18-26 years who are still eligible to be vaccinated. This protocol for a qualitative evidence synthesis aims to review perspectives of HPV vaccination among young adults (18-26 years) and identify facilitators and barriers that influence HPV vaccination uptake and decision-making.
• Okechukwu, A., Abraham, I., Okechukwu, C., Magrath, P., Marrero, D. G., Farland, L. V., & Alaofe, H. (2023). Extended Medicaid coverage will improve access but insufficient to enhance postpartum care utilization: a secondary analysis of the 2016-2019 Arizona Medicaid claims. Frontiers in public health, 11, 1281574.
  More info

  Postpartum Medicaid eligibility extensions may increase access to healthcare for low-income women. However, its implications for healthcare utilization are unknown.
• Yeo, S., Park, Y., McClelland, D. J., Ehiri, J., Ernst, K., Magrath, P., & Alaofè, H. (2023). A scoping review of maternal health among resettled refugee women in the United States. Frontiers in public health, 11, 1157098.
  More info

  Globally, refugee women continue to face higher maternity-related risks from preventable complications during pregnancy and childbirth, partly due to high health care costs, unfamiliarity with the healthcare system, language barriers, and discrimination. Nevertheless, there is still a paucity of literature that evaluates the available evidence in the US. This scoping review delineated the body of literature on maternal health among refugee women resettled in the US in order to identify knowledge gaps in the literature and highlight future research priorities and directions for maternal health promotion.
• Alaofe, H., Okechukwu, A., Yeo, S., Magrath, P. A., Hounkpatin, A., Ehiri, J., & Rosales, C. (2022). Formative Qualitative Research: Design Considerations for a Self-Directed Lifestyle Intervention for Type-2 Diabetes Patients Using Human-Centered Design Principles in Benin. Int J Environ Res Public Health, 19(18), 11552.
• Magrath, P. A., & Nichter, M. (2022). Moral framing in health promotion: lessons from an Indonesian case study. Global Health Promotion, 0(0), 1-9.
• Mantina, N. M., Block Ngaybe, M., Johnson, K., Velickovic, S., Magrath, P., Gerald, L. B., Krupp, K., Krauss, B., Perez-Velez, C. M., & Madhivanan, P. (2022). Racial/ethnic disparities in influenza risk perception and vaccination intention among Pima County residents in Arizona. Human vaccines & immunotherapeutics, 18(7), 2154506.
  More info

  While influenza cases in Arizona have nearly tripled since 2018, vaccination rates continue to lag. Statewide, Hispanics and African Americans had the lowest vaccination rates despite having higher influenza infection rates than Whites. Given Arizona's racial influenza vaccination disparity and the general increase in vaccination hesitancy due to COVID-19, the purpose of this study was to better understand the influences of seasonal influenza vaccination in Arizona during the COVID-19 pandemic using qualitative methods. Findings from this study revealed that many participants were motivated to get the influenza vaccine to protect their family and close friends. The heightened concern for COVID-19 prompted some Hispanic/Latino focus group discussion participants to consider getting vaccinated. However, many Hispanic/Latino participants also expressed that they stopped getting influenza vaccine due to negative vaccination experiences or concern about sickness following immunization. African American participants primarily discussed receiving the vaccine as part of their routine health visit. Compared to other races, more White participants believed that vaccination was unimportant because they were healthy, and the people they interacted with never got sick. Distinct factors influence risk perception and vaccination intention across different racial/ethnic groups. Effective interventions can account for these factors and be tailored to the target population to maximize vaccination uptake.
• Yeo, S., Magrath, P., Alaofè, H., & Okechukwu, A. (2022). Qualitative research on maternal care access among Arabic-speaking refugee women in the USA: study protocol. BMJ open, 12(3), e055368.
  More info

  Refugees tend to have greater health needs and pre-existing medical conditions due to poor living conditions, lack of health services, exposure to a variety of risk factors, and a high level of stress and trauma prior to entry to a host country. Notwithstanding distinctive needs and inherent conditions, there is a paucity of literature on refugee maternal health, especially for Arabic-speaking refugee women resettled in the USA.
• Magrath, P. (2019). Right to Health: A Buzzword in Health Policy in Indonesia. Medical anthropology, 38(6), 464-477. doi:10.1080/01459740.2019.1604701
  More info

  The "right to health" operates as a buzzword in Indonesia to frame health policies as beneficial to citizens. Right to health is equated with access to Western biomedical services. Within the policy on partnership between biomedical and traditional midwives, only the biomedical midwife can fulfill the right to health. The "traditional" midwife is reframed as her assistant. Right to health language hides underlying tensions in relationships between these two categories of midwives by presenting the policy as mutually beneficial. Right to health language is effective in the post-Suharto era as it aligns with other incontestable values, including democracy and modernity.

Presentations

• Moore-Monroy, M. J., Carbajal, B., Yuan, N. P., Ehiri, J. E., Nuno, V. L., & Magrath, P. A. (2021, April 9).

  Community and campus partnerships key role in identifying and addressing social determinants of health impacting MCH

  . 2021 Resiliency in Maternal and Child Health Populations Conference. Virtual: ASU College of Health Solutions.
• Moore-Monroy, M. J., Yuan, N. P., Ehiri, J. E., Magrath, P. A., & Nuno, V. L. (2021, 4-12-2021).

  River of Life: Application of a visual method to promote inclusion and build partnerships for a statewide maternal and child health assessment in arizona

  . Rescon. Virtual: Resilience con.
• Moore-Monroy, M. J., Yuan, N. P., Magrath, P. A., Nuno, V. L., & Ehiri, J. E. (2021, Spring).

  River of Life: Application of a visual method to promote inclusion and build partnerships for a statewide maternal and child health needs assessment in Arizona.

  . Resilience ConLife Paths Research.
• Yuan, N. P., Ehiri, J. E., Magrath, P. A., Moore-Monroy, M. J., Nuno, V. L., Kram, N., Palmer, K., Butler, S., Okechukwu, A., & Celaya, M. (2021, April).

  “Work with us and not against us”: Creating a safe space for hearing the voices of African-American and refugee parents for a statewide maternal and child health needs assessment

  . ResilienceCon. Virtual.
• Moore-Monroy, M. J., Yuan, N. P., Ehiri, J. E., Magrath, P. A., & Nuno, V. L. (2020, August).

  Presentation of results of Title V MCH assessment

  . Arizona Rural Women's Health Symposium. Sedona. Arizona: Arizona Rural Women's Health Department.
  More info

  Present on the Title V MCH assessment unfortunately the conference was canceled.
• Yuan, N. P., Ehiri, J. E., Moore-Monroy, M. J., Magrath, P. A., Nuno, V. L., Bingham, L., Welter, A., Balland, L., & Celaya, M. (2020, October).

  Stakeholder engagement for a maternal and child health needs assessment: Application of the River of Life tool at statewide meetings

  . APHA. Virtual.
• Ehiri, J. E., Moore-Monroy, M. J., Cotes, A., Yuan, N. P., Baland, L., Magrath, P. A., Welter, A., Welter, A., Baland, L., Magrath, P. A., Cotes, A., Yuan, N. P., Moore-Monroy, M. J., Ehiri, J. E., Ehiri, J. E., Cotes, A., Baland, L., Welter, A., Magrath, P. A., , Yuan, N. P., et al. (2019, June). River of Life Activity for Annual Arizona Community Health Worker Confernce. Annual Arizona Community Health Outreach Worker Conference.
• Ehiri, J. E., Moore-Monroy, M. J., Moore-Monroy, M. J., Cortes, A., Magrath, P. A., Magrath, P. A., Welter, A., Yuan, N. P., Yuan, N. P., Nuno, V. L., Nuno, V. L., Nuno, V. L., Welter, A., Welter, A., Yuan, N. P., Cortes, A., Cortes, A., Magrath, P. A., Moore-Monroy, M. J., , Ehiri, J. E., et al. (2019, August). Calling for input on Maternal and Child Health Services in the State of Arizona. Arizona Rural Health Conference. Flagstaff, Arizona: Arizona Center for Rural Health.
• Moore-Monroy, M. J., Ehiri, J. E., Magrath, P. A., Nuno, V. L., Welter, A., Yuan, N. P., Welter, A., Yuan, N. P., Nuno, V. L., Magrath, P. A., Ehiri, J. E., Moore-Monroy, M. J., Moore-Monroy, M. J., Magrath, P. A., Welter, A., Yuan, N. P., Nuno, V. L., & Ehiri, J. E. (2019, June). River of Life Activity for MCH Title V Community Assessment. Arizona Rural Women's Health Symposium. Sedona, Arizona: Alliance of Community Health Centers.

Poster Presentations

• Magrath, P. A. (2019, April). The Use of Plastic Straws on University of Arizona Campus. Southwestern Anthropological Association annual meeting. Garden Grove, Orange County, California: Southwestern Anthropological Association.
  More info

  Presentation of a poster based on research conducted as part of my HPS 607 Qualitative Research Methods in Public Health on Use of Plastic Straws on University of Arizona Campus
• Magrath, P. A. (2019, November). Framing of Messages around Plastic Straws: A Comparison of Skip the Straw and the Trump Campaign's Plastic Straw Sale. American Anthropological Association annual conference. Vancouver, Canada: American Anthropological Association.

Creative Productions

• Magrath, P. A. (2019. Maternal Health Policy in Indonesia. Western Regional Public Health Training Center. Tucson, AZ: Western Regional Public Health Training Center.
  More info

  Podcast interview. I was interviewed by MEZCOPH graduate students Sana Khan and Lisa Balland about my research on Maternal Health Policy in Indonesia focusing on policies towards Skilled and Traditional Birth Attendants.