Bio

Professional Education


  • Fellowship, Stanford University, Infectious Diseases & Geographic Medicine
  • DTM&H, Gorgas Memorial Institute of Tropical & Preventive Medicine, Tropical Medicine (2018)
  • Board Certification, American Board of Internal Medicine (2017)
  • Residency, University of Washington, Internal Medicine (2017)
  • MD, Emory University, Medicine (2014)
  • BA, University of California, San Diego, African Studies (2007)
  • BS, University of California, San Diego, Human Biology (2007)

Stanford Advisors


Community and International Work


  • Revitalising Informal Settlements and their Environments, Indonesia & Fiji

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    No

  • Cervical Cancer Screening in rural Kenya, Mbita, Kenya

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Elimu Africa, Moshi, Tanzania

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Minjeni Women's Group Community Health Department, Moshi, Tanzania

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

Publications

All Publications


  • Cervical Cancer Screening Knowledge and Behavior among Women Attending an Urban HIV Clinic in Western Kenya JOURNAL OF CANCER EDUCATION Rosser, J. I., Njoroge, B., Huchko, M. J. 2015; 30 (3): 567–72

    Abstract

    Cervical cancer is a highly preventable disease that disproportionately affects women in developing countries and women with HIV. As integrated HIV and cervical cancer screening programs in Sub-Saharan Africa mature, we have an opportunity to measure the impact of outreach and education efforts and identify areas for future improvement. We conducted a cross-sectional survey of 106 women enrolled in care at an integrated HIV clinic in the Nyanza Province of Kenya 5 years after the start of a cervical cancer screening program. Female clinic attendees who met clinic criteria for cervical cancer screening were asked to complete an oral questionnaire assessing their cervical cancer knowledge, attitudes, and screening history. Ninety-nine percent of women had heard of screening, 70 % felt at risk, and 84 % had been screened. Increased duration of HIV diagnosis was associated with feeling at risk and with a screening history. Nearly half (48 %) of women said they would not get screened if they had to pay for it.

    View details for DOI 10.1007/s13187-014-0787-7

    View details for Web of Science ID 000360918700025

    View details for PubMedID 25595965

  • Barriers to Cervical Cancer Screening in Rural Kenya: Perspectives from a Provider Survey JOURNAL OF COMMUNITY HEALTH Rosser, J. I., Hamisi, S., Njoroge, B., Huchko, M. J. 2015; 40 (4): 756–61

    Abstract

    Although cervical cancer is highly preventable through screening, it remains the number one cause of cancer-related death in Kenyan women due to lack of funding and infrastructure for prevention programs. In 2012, Family AIDS Care and Education Services in partnership with the Kenya Ministry of Health began offering free screening at eleven rural health facilities. We sought to explore why screening coverage remains low at some sites. We examined the barriers to screening through a survey of 106 healthcare staff. The most frequently cited barriers to service delivery included staffing shortages, lack of trained staff, insufficient space, and supply issues. The patient barriers commonly perceived by the staff included inadequate knowledge, wait time, discomfort with male providers, and fear of pain with the speculum exam. Despite multilateral efforts to implement cervical cancer screening, staff face significant challenges to service provision and increased education is needed for both providers and patients.

    View details for DOI 10.1007/s10900-015-9996-1

    View details for Web of Science ID 000357342800020

    View details for PubMedID 25677728

  • Changing knowledge, attitudes, and behaviors regarding cervical cancer screening: The effects of an educational intervention in rural Kenya PATIENT EDUCATION AND COUNSELING Rosser, J. I., Njoroge, B., Huchko, M. J. 2015; 98 (7): 884–89

    Abstract

    Cervical cancer screening uptake may be influenced by inadequate knowledge in resource-limited settings. This randomized trial evaluated a health talk's impact on cervical cancer knowledge, attitudes, and screening rates in rural Kenya.419 women attending government clinics were randomized to an intervention (N=207) or control (N=212) group. The intervention was a brief health talk on cervical cancer. Participants completed surveys at enrollment (all), immediately after the talk (intervention arm), and at three-months follow-up (all). The primary outcomes were the change in knowledge scores and the final screening rates at three-months follow-up. Secondary outcomes were changes in awareness about cervical cancer screening, perception of personal cervical cancer risk, cervical cancer and HIV stigma, and screening acceptability.Mean Knowledge Scores increased by 26.4% (8.7 points increased to 11.0 points) in the intervention arm compared to only 17.6% (8.5 points increased to 10.0 points) in the control arm (p<0.01). Screening uptake was moderate in both the intervention (58.9%; N=122) and control (60.9%; N=129) arms, with no difference between the groups (p=0.60).A brief health talk increased cervical cancer knowledge, although it did not increase screening over simply informing women about free screening.Screening programs can increase patient understanding with just a brief educational intervention.

    View details for DOI 10.1016/j.pec.2015.03.017

    View details for Web of Science ID 000355708800011

    View details for PubMedID 25858634

    View details for PubMedCentralID PMC4437717

  • Knowledge about cervical cancer screening and perception of risk among women attending outpatient clinics in rural Kenya INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS Rosser, J. I., Njoroge, B., Huchko, M. J. 2015; 128 (3): 211–15

    Abstract

    To evaluate cervical cancer knowledge, risk perception, and screening intention among women attending outpatient clinics in rural Kenya.A cross-sectional oral survey was conducted among non-pregnant women aged 23-64 years who attended one of 11 western Kenyan health facilities for any reason between March 25 and April 26, 2013. Demographic and clinical predictors were identified using bivariate and multivariate regression analyses.Among 419 participants, 327 (78.0%) had heard of cervical cancer screening. Nevertheless, their specific knowledge was low (mean score 8.6±2.4 [out of 15.0]). Overall, 288 (68.7%) women felt at risk for cervical cancer, and 333 (79.5%) stated that they would undergo screening if offered. Women who intended to undergo screening were less likely to attend a district hospital (adjusted odds ratio [AOR] 0.4; 95% confidence interval [CI] 0.2-0.6) and more likely to have been diagnosed with HIV more than 4 years previously (AOR 0.4; 95% CI 0.2-0.6). Additionally, increased screening acceptance was associated with high knowledge scores (P=0.004).Educational interventions to increase knowledge about cervical cancer might increase screening uptake in low-income settings. Additionally, improvements in services at local health facilities could have a large effect.

    View details for DOI 10.1016/j.ijgo.2014.09.006

    View details for Web of Science ID 000350096400006

    View details for PubMedID 25467908

    View details for PubMedCentralID PMC4329271

  • Men's knowledge and attitudes about cervical cancer screening in Kenya BMC WOMENS HEALTH Rosser, J. I., Zakaras, J. M., Hamisi, S., Huchko, M. J. 2014; 14: 138

    Abstract

    A number of studies have identified male involvement as an important factor affecting reproductive health outcomes, particularly in the areas of family planning, antenatal care, and HIV care. As access to cervical cancer screening programs improves in resource-poor settings, particularly through the integration of HIV and cervical cancer services, it is important to understand the role of male partner support in women's utilization of screening and treatment.We administered an oral survey to 110 men in Western Kenya about their knowledge and attitudes regarding cervical cancer and cervical cancer screening. Men who had female partners eligible for cervical cancer screening were recruited from government health facilities where screening was offered free of charge.Specific knowledge about cervical cancer risk factors, prevention, and treatment was low. Only half of the men perceived their partners to be at risk for cervical cancer, and many reported that a positive screen would be emotionally upsetting. Nevertheless, all participants said they would encourage their partners to get screened.Future interventions should tailor cervical cancer educational opportunities towards men. Further research is needed among both men and couples to better understand barriers to male support for screening and treatment and to determine how to best involve men in cervical cancer prevention efforts.

    View details for DOI 10.1186/s12905-014-0138-1

    View details for Web of Science ID 000345718000001

    View details for PubMedID 25416335

    View details for PubMedCentralID PMC4254217

  • Cancers That U.S. Physicians Believe the HPV Vaccine Prevents: Findings from a Physician Survey, 2009 JOURNAL OF WOMENS HEALTH Saraiya, M., Rosser, J. I., Cooper, C. 2012; 21 (2): 111–17

    Abstract

    There is strong scientific evidence that human papillomavirus (HPV) vaccines, which protect against two oncogenic HPV types (16 and 18), can prevent cervical, vaginal, and vulvar cancers in women. In addition, recent research has established that the HPV vaccine can prevent anal cancer and has implied that it may also prevent oropharyngeal cancers.A 2009 web-based survey of 1500 physicians from four specialties (pediatricians, family practitioners, internists, and obstetrician-gynecologists) explored knowledge about which female cancers the HPV vaccine was effective in preventing. Physician characteristics associated with the belief that the HPV vaccine prevents cervical, vaginal, vulvar, anal, and other cancers were examined using logistic regression models.Nearly all respondents (97.8%) identified cervical cancer as being prevented by the HPV vaccine; however, lower awareness that the vaccine prevents vaginal (23.8%), vulvar (27.8%), and anal cancer (28.4%) was found. Physician specialty was the most significant covariate identified, with obstetrician-gynecologists being more likely than other physicians to report that the HPV vaccine protected against vaginal (p<0.001), vulvar (p<0.001), and anal (p<0.001) cancers.Physicians may benefit from educational efforts clarifying which noncervical cancers can be prevented by the HPV vaccine. Education is needed across all medical specialties, but it is particularly important for pediatricians and family practitioners, the physicians most likely to administer the HPV vaccine to young adolescents.

    View details for DOI 10.1089/jwh.2011.3313

    View details for Web of Science ID 000300240400001

    View details for PubMedID 22216920

    View details for PubMedCentralID PMC5555392

  • Effect of physiological levels of caffeine on Ca2+ handling and fatigue development in Xenopus isolated single myofibers. American journal of physiology. Regulatory, integrative and comparative physiology Rosser, J. I., Walsh, B., Hogan, M. C. 2009; 296 (5): R1512–7

    Abstract

    The purpose of the present study was to determine whether exposure to exogenous physiological concentrations of caffeine influence contractility, Ca(2+) handling, and fatigue development in isolated single Xenopus laevis skeletal muscle fibers. After isolation, two identical contractile periods (separated by 60-min rest) were conducted in each single myofiber (n = 8) at 20 degrees C. During the first contractile period, four fibers were perfused with a noncaffeinated Ringer solution, while the other four fibers were perfused with a caffeinated (70 microM) Ringer solution. The order was reversed for the second contractile period. The single myofibers were stimulated during each contractile period at increasing frequencies (0.16, 0.20, 0.25, 0.33, 0.50, and 1.0 tetanic contractions/s), with each stimulation frequency lasting 2 min until fatigue ensued, defined in this study as a fall in tension development to 66% of maximum. Tension development and free cytosolic [Ca(2+)] (fura-2 fluorescence spectroscopy) were simultaneously measured. There was no significant difference in the peak force generation, time to fatigue, cytosolic Ca(2+) levels, or relaxation times between the noncaffeinated and caffeinated trials. These results demonstrate that physiological levels of caffeine have no significant effect on Xenopus single myofiber contractility, Ca(2+) handling, and fatigue development, and suggest that any ergogenic effects of physiological levels of caffeine on muscle performance during contractions of moderate to high intensity are likely related to factors extraneous to the muscle fiber.

    View details for DOI 10.1152/ajpregu.90901.2008

    View details for PubMedID 19261915

    View details for PubMedCentralID PMC2689837