Alexa conducts research and evaluation in the areas of public health systems, rural health, emergency preparedness, and traffic safety, among other public health topics. 

Her recent work involves initiatives designed to support and strengthen the capacity and performance of the U.S. governmental public health system. These efforts include, for example, evaluating the national, voluntary accreditation program for public health departments; assessing national data collection from Tribal public health organizations delivering public health services; exploring innovations in public health to identify successes, challenges, and lessons learned to support replication of innovations; and providing evaluation support for federal investments related to public health infrastructure and performance. She also leads public health preparedness and response research, including for rural populations. For example, she recently led efforts to examine factors affecting the implementation of evidence-based practices by health departments in public health preparedness. She also provides leadership to develop rural evidence-based toolkits, housed on the Rural Health Information Hub (RHIhub) website. The toolkits highlight evidence-based and promising strategies for improving the health and well-being of rural residents.

Through her research and evaluation efforts, she has engaged public health agency leadership, practitioners, and partners to inform the development of toolkits, case studies, and other products that support public health practice, with the goal of improving community health outcomes. She has also published her work in numerous peer-reviewed scientific journals, including the Journal of Public Health Management and Practice.