Faculty Spotlight: Samantha Garbers, PhD

Samantha Garbers, PhD, is Assistant Professor of Clinical Population and Family Health at Columbia University Mailman School of Public Health, where she has taught the Methods in Program Evaluation course since 2012. Before her faculty appointment, Dr. Garbers spent 15 years working for Public Health Solutions, where she designed and evaluated public health programs with a focus on sexual and reproductive health. In addition to her position in PopFam, Dr. Garbers currently serves as project director for the national Coordinating Center for the Healthy Weight Initiative for Lesbian & Bisexual Women. She received her PhD in Epidemiology at the Mailman School and an MPA in Health Policy & Management from New York University. In 2012, Professor Garbers received the William Farr Award in Epidemiology, recognizing her work addressing social inequalities in public health.

What are your roles and responsibilities at Mailman and beyond?

At Mailman, I am involved in both teaching and research. Since 2012, I have taught the Methods in Program Evaluation course. Some people may not love methods classes because they are conceptual, but the emphasis in this course is on how you do evaluation in the real world—how you evaluate a program that does not have a logic model or one that is being conducted by an organization that has not been doing program planning or integrating evaluation according to best practices.

What is the class format? Do your students do field work?

Each year, the class culminates in an opportunity for students to design an evaluation for a real organization. This year, students are working with the African Services Committee in Harlem developing an evaluation proposal for their programs, including case management for African immigrants with HIV, legal and housing services, and medical navigation. In previous semesters, students have designed evaluations for [Professor] Cassie Landers’ Imagination Playground and for Clowns without Borders—both of which assist children living in places affected by conflict—and Baby Basics—a low-literacy prenatal care education program, which operates in Baltimore and Liberia.

I hear you are also involved in a number of research projects, including helping inform a new television show for teens.

We just got a grant from the Population Media Center (PMC) to do formative research for a television-based serial drama, or an evidence-based soap opera, about African American teens living in Harlem. We will be helping PMC to create a theory-informed intervention that will use messages to promote healthy decision making and behavior, while portraying characters and contexts that reflect the reality of youth’s lives. The formative research will help the serial drama to identify and illuminate specific issues that should be addressed. As part of the same project, Professors John Santelli and Terry McGovern will be developing a policy framework so the serial drama reflects the actual legal and political contexts for teens in New York City. For example, how can teens get contraception, what are the age of consent laws, and what parental notification is necessary for getting health care.

I understand you are also involved in a new federal grant that is focusing on engaging young men in teen pregnancy prevention. Can you tell me about your role?

I will be serving as the lead evaluator for a teen pregnancy prevention project which was awarded by the U.S. Office of Adolescent Health, working with Drs. David Bell and Melanie Gold. Rates of teen fatherhood remain high in this country, and interventions that are specific to young men are rare, so this research has the potential to address one of the gaps in our recent progress addressing teen pregnancy. The project that our Department developed will adapt and implement a computer-assisted motivational interviewing (CAMI) intervention that was originally designed for girls. The project includes rigorous evaluation, so we will be conducting a randomized controlled trial, comparing the teen pregnancy prevention CAMI model to a CAMI intervention that focuses on diet, physical activity, and tobacco use.

Dean Linda Fried just announced that you have received of one of the Mailman School’s Calderone Awards for Junior Investigators to support a project focusing on the use of long-acting reversible contraception for adolescents. What will this research involve?

This award will facilitate a really interesting and important collaboration with Dr. Melanie Gold, the Medical Director of the School-Based Health Centers. The SBHCs that are affiliated with NYP [NewYork-Presbyterian Hospital] now offer long-acting reversible contraception (LARC) services, including IUDs and contraceptive implants. This award will allow us to test the feasibility of an app to support young women before and after they have gotten LARC services: what information do they need and where can they get answers to their questions or keep track of information.

Before joining the Mailman School as a faculty member, you spent more than a decade working for Public Health Solutions. Can you tell me about this work?

Public Health Solutions is a nonprofit organization that works to merge research and action. A significant piece of the organization’s work is service delivery. They are the largest WIC provider in the state and also operate reproductive health clinics. They also carry out research to help solve public health problems and improve responses. I was part of a “small but mighty” research and evaluation unit. Some of my work involved being an internal evaluator of PHS programs, but I also helped design and test interventions outside of PHS.

From what I understand, you were involved early on in using technology to connect underserved populations with sexual and reproductive health care. ?

Traditionally, my research area was sexual and reproductive health, specifically around contraceptive decision making. At Public Health Solutions, I led the development of a computer-based contraceptive method counseling tool for use in low-literacy clinical settings, which is now at www.whichmethod.org. In 2008, we developed the tool using ACASI [Audio Computer-Assisted Self-Interviewing] and touch-screen technology to help users identify contraceptive methods that would be appropriate for them, even if they had not heard of the method before. I ran a large randomized controlled study which found that the app not only helped women choose methods that were effective at preventing pregnancy and appropriate for them, but also to continue using the method they chose. I also worked on a theory-based video called “Get It and Forget It,” available on YouTube in both Spanish and English, which follows a teenage girl as she learns about and takes the steps needed to get an IUD.  We included a large evaluation component in the roll out of the video and found that, even among young people who had never heard of an IUD, there was interest in using this method once they knew about it.

How did you end up pursuing a career in public health?

I attended Brown, where I studied art history while also taking a lot of classes related to psychology, statistics, and women’s health. When I graduated, I took a job at Pathfinder International, an international family planning organization. After that, I got a job at NYU [New York University] in their epidemiology department. It was the early 1990s and there were concerns about the links between breast implants and autoimmune disease and other illnesses. I coordinated a retrospective cohort study investigating these questions and I saw all the complexity and messiness involved in conducting a large epidemiological study within a context that was also legally pressured and political. I basically never left the field after that.

What do you find most rewarding about the evaluation work you do and sharing your expertise with students?

I love sharing what I know about how to collect data; how to know when to trust what your data seem to be telling you; when to be more circumspect about your own data; and how to determine when you are missing data that could make a critical difference. I spent a long time working outside of academia and I know what it’s like when your best laid plans for measuring a phenomenon go astray from the original design. I’ve discovered that you can usually figure your way forward in those circumstances in a way that doesn’t have to sacrifice scientific rigor.