About

Bonnie N. Kaiser is an Associate Professor jointly appointed in the Department of Anthropology and the Global Health Program at UC San Diego. She is a specialist in qualitative and mixed-methods research, with training as an anthropologist (PhD), epidemiologist (MPH), and global health implementation scientist (postdoc). Her anthropology research focuses on elucidating cultural models of mental health and illness, exploring their connections to care-seeking behaviors, developing and adapting measurement tools for cross-cultural research and interventions, and critically examining concepts of trauma, risk, and resilience. Her scholarship advances both theory in psychological anthropology and practice in global mental health, with deep ethnographic engagement in Haiti and multi-sited research in Kenya, Nepal, Ethiopia, Nigeria, and the US. Her major research interests include Haiti, Kenya, psychological anthropology, global mental health, implementation science, idioms of distress, and cultural adaptation. Kaiser has led multiple research projects exploring mental health, oncofertility, and healthcare access, collaborating with organizations such as Zanmi Lasante/Partners in Health. Her work critically examines social and spiritual suffering, resilience, and meaning-making in diverse cultural contexts, contributing significantly to understanding mental health in global settings.

Research topics

• Computer Science
• Sociology
• Psychology
• Social Science
• Artificial Intelligence
• Clinical psychology
• Cognitive psychology
• Ecology
• Demography
• Epistemology
• Psychiatry
• Econometrics
• Physics
• Environmental health
• Mathematics
• Biology
• Medicine
• Statistics

Selected publications

• Improving Implementation of Fertility Preservation Benefit Mandates

  JAMA Health Forum · 2025-09-12

  articleOpen access

  Importance: More than 90 000 adolescents and young adults are diagnosed with cancer and exposed to treatments that may threaten their future fertility every year. Fertility preservation (FP) services, such as egg, embryo, and sperm freezing, are available to preserve future fertility but are often underused by patients in part due to high cost. Eighteen states and Washington, DC, recently began mandating health insurance coverage for FP services, yet patients and clinicians report difficulty accessing mandated services. Objective: To systematically identify determinants of implementing FP benefit mandates in fertility and oncology clinics to inform intervention development and future public policy. Design, Setting, and Participants: In this mixed-methods study, fertility and oncology clinics from California, Illinois, and New York were selected from the 8 states that had FP benefit mandates in place in 2020 to maximize diversity of the state-level characteristics that may impact mandate implementation. Fertility and oncology clinic representatives (health care clinicians, financial counselors, and other administrative personnel) identified as being the most knowledgeable regarding implementation of FP benefit mandates were interviewed or surveyed using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Interviews and surveys were conducted from July 2020 to November 2023, and data were analyzed from September 2022 to June 2024. Exposure: Passage of a state-level FP benefit mandate. Main Outcomes and Measures: Barriers and facilitators to implementing access to FP benefits after mandate passage at clinic and patient levels. Results: This study included 48 participants from 24 oncology and fertility clinics and 2 fertility pharmacies. Interviews (n = 48) and surveys (n = 17) were used to identify determinants of successful FP benefit mandate implementation. The top 3 barriers identified included (1) time-consuming nature of interactions between clinics and insurers, (2) patients' lack of knowledge on their benefits and how to find them, and (3) holes in coverage and heterogeneity of benefits across health insurance plans. The top 3 facilitators included (1) dedicated clinic financial counselors who guide patients on benefit verification, (2) clearly defined FP benefits in member handbooks, and (3) health insurance plan preexisting in vitro fertilization insurance benefit. Conclusions and Relevance: In this study, multiple barriers and facilitators were systematically identified to assist in improving implementation of FP benefit mandates. These findings support policies and intervention development for FP patients and clinics, and future legislative and regulatory efforts aimed at increasing timely access to FP insurance benefits.

  PublisherOA PDFDOI

• Feasibility and effectiveness of a health educational intervention to improve navigation of health insurance benefits for in vitro fertilization: a randomized controlled trial

  Journal of Assisted Reproduction and Genetics · 2025-12-02

  articleOpen access
  PublisherOA PDFDOI

• Navigating health insurance selection for in vitro fertilization (IVF) benefits: A study protocol

  Contemporary Clinical Trials · 2025-07-01 · 1 citations

  articleOpen access
  PublisherOA PDFDOI

• LACK OF REACH: STATE-MANDATED INSURANCE COVERAGE OF MEDICALLY-INDICATED FERTILITY PRESERVATION EXCLUDES VULNERABLE POPULATIONS

  Fertility and Sterility · 2025-12-01

  article
  PublisherDOI

• Navigating Health Insurance Selection for in Vitro Fertilization (IVF) Benefits: A Study Protocol

  medRxiv · 2025-03-28

  preprintOpen access

  Introduction: A large public university added health insurance coverage of 50% co-insurance for up to two cycles of in vitro fertilization (IVF) to eligible faculty and staff. Methods: We describe the design and conduct of a randomized controlled trial to evaluate the effectiveness of a health insurance educational intervention on health insurance literacy and IVF benefit utilization. The intervention materials included 1) Key insurance terms; 2) Examples of premiums and deductibles across the insurance plan options; 3) Examples of how premiums and deductibles affect out-of-pocket costs; and 4) A guide to find in-network providers/facilities. The primary outcome is health insurance literacy. Secondary outcomes are IVF services and insurance benefit utilization, out-of-pocket costs, and financial hardship related to fertility care. We collected validated patient-reported outcomes at three timepoints over 1 year. We will integrate mixed methods data to explore whether the intervention was effective, feasible, acceptable, and appropriate. Results: Among 394 faculty and staff screened, 217 (55%) reproductive-aged (18 to 50 years) employees consented, completed the baseline survey and were randomized in a 2:1 fashion. Participants were female (81%), married (63%), and worked as a staff employee (72%). Approximately 39% reported an infertility diagnosis, and 28% had undergone prior IVF treatment. Participants reported feeling slightly confident when using their health insurance plans and moderately confident being proactive when using their health insurance plans. Discussion: Our goal is to improve health insurance literacy and utilization of health insurance benefits for IVF care, thereby expanding family-building options for reproductive-aged individuals.

  PublisherOA PDFDOI

• IMPACT OF AN EDUCATIONAL INTERVENTION ON HEALTH INSURANCE LITERACY AND INSURANCE BENEFIT UTILIZATION: A RANDOMIZED CONTROLLED TRIAL

  Fertility and Sterility · 2024-10-01

  articleOpen access
  PublisherOA PDFDOI

• LACK OF REACH BY STATE FERTILITY PRESERVATION BENEFIT MANDATES

  Fertility and Sterility · 2024-10-01 · 1 citations

  articleOpen access
  PublisherOA PDFDOI

• HISPANIC ETHNICITY AND NEIGHBORHOOD POVERTY ARE ASSOCIATED WITH DECREASED ELIGIBILITY FOR MANDATED INSURANCE COVERAGE FOR MEDICALLY-INDICATED FERTILITY PRESERVATION

  Fertility and Sterility · 2024-10-01

  articleOpen access
  PublisherOA PDFDOI

• Implementation of state health insurance benefit mandates for cancer-related fertility preservation: following policy through a complex system

  Implementation Science · 2024-02-16 · 5 citations

  articleOpen access

  BACKGROUND: A myriad of federal, state, and organizational policies are designed to improve access to evidence-based healthcare, but the impact of these policies likely varies due to contextual determinants of, reinterpretations of, and poor compliance with policy requirements throughout implementation. Strategies enhancing implementation and compliance with policy intent can improve population health. Critically assessing the multi-level environments where health policies and their related health services are implemented is essential to designing effective policy-level implementation strategies. California passed a 2019 health insurance benefit mandate requiring coverage of fertility preservation services for individuals at risk of infertility due to medical treatments, in order to improve access to services that are otherwise cost prohibitive. Our objective was to document and understand the multi-level environment, relationships, and activities involved in using state benefit mandates to facilitate patient access to fertility preservation services. METHODS: We conducted a mixed-methods study and used the policy-optimized exploration, preparation, implementation, and sustainment (EPIS) framework to analyze the implementation of California's fertility preservation benefit mandate (SB 600) at and between the state insurance regulator, insurer, and clinic levels. RESULTS: Seventeen publicly available fertility preservation benefit mandate-relevant documents were reviewed. Interviews were conducted with four insurers; 25 financial, administrative, and provider participants from 16 oncology and fertility clinics; three fertility pharmaceutical representatives; and two patient advocates. The mandate and insurance regulator guidance represented two "Big P" (system level) policies that gave rise to a host of "little p" (organizational) policies by and between the regulator, insurers, clinics, and patients. Many little p policies were bridging factors to support implementation across levels and fertility preservation service access. Characterizing the mandate's functions (i.e., policy goals) and forms (i.e., ways that policies were enacted) led to identification of (1) intended and unintended implementation, service, and patient outcomes, (2) implementation processes by level and EPIS phase, (3) actor-delineated key processes and heterogeneity among them, and (4) inner and outer context determinants that drove adaptations. CONCLUSIONS: Following the midstream and downstream implementation of a state health insurance benefit mandate, data generated will enable development of policy-level implementation strategies, evaluation of determinants and important outcomes of effective implementation, and design of future mandates to improve fit and fidelity.

  PublisherOA PDFDOI

• The Somali Distress and Resilience Scale: Development of a novel measure for Somali adults

  Transcultural Psychiatry · 2024-08-31

  articleOpen access

  Although resilience has been identified as an important mediator of negative mental health outcomes among refugee populations, there are few culturally specific measures of resilience among such communities and no such measure among Somalis. In this study we aimed to develop a culturally appropriate measure of resilience specific to Somali adults in San Diego, as an example of a vulnerable refugee community. A community-based, exploratory sequential mixed method investigation was conducted via focus group discussions ( n = 4), cognitive interviews ( n = 4), and iterative survey adaptation. Somali refugee adults in San Diego ( N = 183) were surveyed with this novel scale, a standardized measure of resilience, and assessments of depression, anxiety, and PTSD. Results were analyzed via correlation coefficients and multivariate linear regression modeling. Qualitative findings supported the inclusion of items addressing both barriers and facilitators of good mental health, which resulted in the development of the Somali Distress and Resilience Survey (SDRS). Linear regression analysis revealed that the SDRS demonstrated significant associations with symptoms of depression and PTSD, while the standardized measure of resilience did not demonstrate associations with any of the mental health outcomes assessed. The SDRS identified obstacles to resilience among Somali individuals, placing them at risk of developing negative mental health outcomes. Our novel measure also demonstrated more robust relationships with these outcomes than a standardized measure of resilience, suggesting greater utility of the adapted scale. However, the SDRS's development raises larger questions about the limitations of developing and comprehensively evaluating novel resilience measures in a community-based setting.

  PublisherOA PDFDOI

Recent grants

• Community-sourced Interventions for Global Mental Health

  NIH · $58k · 2017–2018

Frequent coauthors

• Brandon A. Kohrt

  George Washington University

  52 shared

• Eve S. Puffer

  21 shared

• Ali Giusto

  19 shared

• Sally A.D. Romero

  University of California, San Diego

  18 shared

• Sauharda Rai

  George Washington University

  14 shared

• H. Irene Su

  University of California, San Diego

  14 shared

• Hunter Keys

  Carter Center

  14 shared

• Vincent C. Marconi

  Emory University

  12 shared

Education

• MPH, Epidemiology

  Emory University

  2015

• PhD, Anthropology

  Emory University

  2015

• BA, Anthropology

  University of Notre Dame

  2008

Awards & honors

• NSF BCS-1260270 Doctoral Dissertation Research Improvement G…
• Emory Global Health Institute ($25,500)
• Duke Global Health Institute ($4,000)
• Emory Global Health Institute ($12,000)
• Duke University Student Research Training Program ($40,000)