Social and Behavioral Sciences Commons^™

M-Chat Implementation Strategies To Improve Autism Screening Rates In Pediatric Clinics In Metro Detroit, Karamoja Monchamp

Medical Student Research Symposium

The Modified Checklist for Autism in Toddlers (M-CHAT) is the most widely used autism screening tool. However, current practices for M-CHAT roll-outs and follow-ups are not wide-reaching, culturally sensitive, or consistent. This study aims to address the existing barriers to universal autism screenings and design a sustainable implementation strategy for a successful M-CHAT roll-out. We implemented strategies in five Henry Ford Health pediatric clinics, incorporating iPad-administered M-CHAT in waiting rooms, multilingual options, task shifting for referrals, forced choice mechanisms, and audit-and-feedback support. A Clinical Screening Dashboard tracked real-time M-CHAT data, including demographic information, collected from EPIC. Our goal is to …

Development Of Model Vaccination Initiative In Detroit, Muhammad Tarar

Rushton Journal of Undergraduate Humanities Research

The distribution of vaccines to Detroit residents faced significant challenges during the COVID-19 health crisis. Vaccine distribution was slow, ineffective, and resulted in significant disparities in vaccine coverage among various racial and ethnic populations. This study examines existing data barriers to vaccination efforts in the United States, including common factors associated with vaccine hesitancy and attempts to identify factors that impact racial and ethnic disparities in vaccine coverage. Finally, this study examines successful vaccination initiatives from other cities in the United States to discuss a model vaccination initiative in Detroit.

Lead Bioaccessibility And Commonly Measured Soil Characteristics (Detroit, Mi, Usa) – Phase 1, Sabrina R. Good, Allison R. Harris, Patrick Crouch, Conor T. Gowan, William D. Shuster, Shawn P. Mcelmurry

Open Data at Wayne State

Contaminated urban soil is one of the major contributors to child Pb exposure. To gain a better understanding of Pb risk in urban areas, composite samples were collected from 142 residential, privately owned, parcels in Detroit, Hamtramck, and Highland Park, Michigan, with approval from the property owners. The proximity of soil sampling and former smelter locations were also reported. Sample were collected from areas covered with turf grass. Four samples were collected, one from each cardinal direction (north, south, east, and west), 20 cm from an aluminum tent stake driven into the center of the sampling site. Soils were collected …

Retrospective Assessment Of A Collaborative Digital Asthma Program For Medicaid-Enrolled Children In Southwest Detroit: Reductions In Short-Acting Beta-Agonist (Saba) Medication Use, Meredith Barrett, Rahul Gondalia, Vy Vuong, Leanne Kaye, Alex B. Hill, Elliot Attisha, Teresa Holtrop

Urban Studies and Planning Faculty Research Publications

Background
Real-world evidence for digitally-supported asthma programs among Medicaid-enrolled children remains limited. Using data from a collaborative quality improvement program, we evaluated the impact of a digital intervention on asthma inhaler use among children in southwest Detroit.

Methods
Children (6–13 years) enrolled with Kids Health Connection (KHC), a program involving home visits with an asthma educator, were invited to participate in a digital self-management asthma program (Propeller Health). Patients were provided with a sensor to capture short-acting beta-agonist (SABA) medication use, and given access to a paired mobile app to track usage. Patients’ healthcare providers and caregivers (“followers”) were invited …

Childhood-Onset Attention-Deficit/Hyperactivity Disorder Exacerbates Opioid Use Disorder Consequences: Mediation By Impulsive Phenotypes, Liam R. Browning, Ciara Cannoy, Tabitha E. H. Moses, Leslie H. Lundahl Phd, David M. Ledgerwood Phd, Mark K. Greenwald Phd

Medical Student Research Symposium

Background: Attention deficit hyperactivity disorder (ADHD) is highly prevalent and associated with opioid use disorder (OUD). Yet, little is known about the mechanisms by which ADHD (which is a heterogeneous construct/diagnosis) might alter the trajectory of OUD outcomes.

Aim: This cross-sectional study examines relationships between childhood ADHD (inferred as predating substance use) and the extent to which the effects of ADHD on lifetime heroin-use consequences are mediated by foreshortened time perspective and drug-use impulsivity.

Methods: Individuals who report heroin use (N=214) were screened using the Assessment of Hyperactivity and Attention (AHA), Impulsive Relapse Questionnaire (IRQ), Stanford Time Perception Inventory (STPI), …

Gender And Financial Implications Of Parental Leave Utilization At A Major Us Academic Institution, Maurgan Lee, Lucki Word, Mayra Shafique, Julie Crego, Leah Robinson Phd, Anil Aranha Phd, Beena Sood

Medical Student Research Symposium

Background and Purpose: In the United States, women on average are paid $0.83 for every dollar earned by male counterparts. Creating a family can promote heightened obligations for both parents, however, women tend to take on amplified responsibility associated with childrearing. Studies show females are more likely to utilize parental leave (PL) compared to men. Our study aims to evaluate the impact of PL usage on financial and earning potential based on gender.

Methods: Analysis of retrospective human resources data of WSU employees was conducted. Data parameters included: demographics, length, usage, and number of parental leaves. Data was analyzed using …

“Community Members Have More Impact On Their Neighbors Than Celebrities”: Leveraging Community Partnerships To Build Covid-19 Vaccine Confidence, Maria Tjilos Mph, Autumn L. Tamlyn, Elizabeth J. Ragan Mph, Sabrina A. Assoumou Md, Mph, Katherine Gergen Barnett Md, Petrina Martin Mba, Rebecca Perkins Md, Msc, Benjamin P. Linas Md, Mph, Mari-Lynn Drainoni Phd, Med

Medical Student Research Symposium

Vaccines are a strong public health tool to protect against severe disease, hospitalization, and death from COVID-19. Still, inequities in COVID-19 vaccination rates and health outcomes continue to exist among Black and Latino populations. Boston Medical Center (BMC) has played a significant role in vaccinating medically underserved populations, and organized a series of community-engaged conversations to better understand community concerns regarding the COVID-19 vaccine. We accessed and analyzed nine publicly available recordings of the community-engaged conversations which were held between Mar 2021-Sep 2021 (n=8-122 attendees). We employed a Consolidated Framework for Implementation Research-driven codebook to code our data and utilized …

The Role Of Vigorous And High Intensity Interval Training Physical Activity Counseling In Prenatal Care, Emily Lau, Brendan T. Lynch, Sonia Hassan

Medical Student Research Symposium

Background: Physical activity is becoming a more common component of preventative medicine and patient counseling; however, the prevalence of physical activity counseling and specific social determinants of health have prevented women, namely prenatal patients, from receiving this counseling from their providers¹. Physical activity, including high intensity interval training (HIIT), has been shown to be feasible for implementation in patient counseling³ and shown to be safe for pregnant women, even into the third trimester². We hypothesize that the current percentage of patients, including prenatal patients, being counseled on physical activity is lacking. In addition, we hypothesize …

Influenza Vaccination Coverage Among An Urban Pediatric Asthma Population: Implications For Population Health, Sarah J. Parker, Amy M. Delaroche, Alex B. Hill, Rajan Arora, Julie Gleason-Comstock

Urban Studies and Planning Faculty Research Publications

Introduction
Asthma is the most common chronic disease in children. Children with asthma are at high risk for complications from influenza; however annual influenza vaccination rates for this population are suboptimal. The overall aim of this study was to describe the characteristics of a high-risk population of children with asthma presenting to an urban pediatric emergency department according to influenza vaccination status.

Methods
The study was a retrospective chart review of 4355 patients aged 2 to 18 years evaluated in a Michigan pediatric emergency department (PED) between November 1, 2017 and April 30, 2018 with an ICD-10-CM code for asthma …

Refining The Nutrition Environment Measures Survey (Nems) For Healthy Community Stores: Adaptations To Capture Alternative Food Retailers And Align With Dietary Guidelines, Alex B. Hill, Ravneet Kuar, Samantha M. Sundermeir, Christina Kasprzak, Megan Winkler, Sara John, Rachael D. Dombrowski, Bree Bode, Joel Gittelsohn

Urban Studies and Planning Faculty Research Publications

Inadequate consumption of healthy food is an ongoing public health issue in the United States. Food availability measures of supply versus consumption of healthy foods are disconnected in many studies. There is a need for an objective assessment of the food environment in order to assess how the food supply aligns with the Healthy Eating Index (HEI). Data were collected as part of the Healthy Community Stores Case Study Project, including a refined Nutrition Environment Measures Survey for Healthy Community Stores (NEMS-HCS) and an updated Healthy Food Availability Index that aligns with the Healthy Eating Index (HFAHEI). This paper will …

A Commentary On The Healthy Community Stores Case Study Project: Implications For Retailers, Policy, And Future Research, Samantha M. Sundermeir, Megan R. Winkler, Sara John, Uriyoán Colón-Ramos, Ravneet Kuar, Ashley Hickson, Rachael D. Dombrowski, Alex B. Hill, Bree Bode, Julia Deangelo, Joel Gittelsohn

Urban Studies and Planning Faculty Research Publications

In the United States, low-income, underserved rural and urban settings experience poor access to healthy, affordable food. Introducing new food outlets in these locations has shown mixed results for improving healthy food consumption. The Healthy Community Stores Case Study Project (HCSCSP) explored an alternative strategy: supporting mission-driven, locally owned, healthy community food stores to improve healthy food access. The HCSCSP used a multiple case study approach, and conducted a cross-case analysis of seven urban healthy food stores across the United States. The main purpose of this commentary paper is to summarize the main practice strategies for stores as well as …

Language Preference Impact On The Outcomes Of Those Lost To Follow-Up After A Diagnosis Of Pregnancy Of Unknown Location, Erin A. Leestma, Mayra A. Shafique, Megan Mcnitt, Annmarie Vilkins

Medical Student Research Symposium

Pregnancy of unknown location (PUL) is a temporary diagnosis when there is a positive pregnancy test but an intrauterine gestational sac and/or fetal pole are not visualized with ultrasonography. The three potential outcomes for such a pregnancy are failed pregnancy, an early intrauterine pregnancy or an ectopic/abnormal pregnancy. Given the serious associated morbidity of ectopic pregnancy, these PUL require strict follow up of bHCG levels to help the clinician determine the likely outcome of the PUL (failed vs early vs ectopic) and choose the best intervention (expectant management, surgical management or medical management). One potential barrier to follow-up identified in …

Utilizing Primary Care To Engage Patients On Opioids In A Psychological Intervention For Chronic Pain, Sikander Chohan, Lyuba Gavrilova Bs, Leah Hect, Kristi Autio, Erin Tobin, Brian K. Ahmedani, Lisa R. Miller-Matero

Medical Student Research Symposium

Introduction: Chronic pain is commonly encountered in primary care. It is often treated with opioids, which can cause overdose and death. Psychological interventions are an effective alternative, yet difficulty engaging patients with opioid prescriptions has led to their underutilization. Offering these interventions in primary care settings may alleviate this barrier.

Objective: Determine whether opioid prescriptions are related to patients engaging in a brief psychological intervention for chronic pain management in primary care.

Study Design: Secondary analysis of a pilot randomized clinical trial (RCT) of a 5-session psychological intervention for chronic pain. Patients with chronic pain (N= 220) were approached to …

Recruitment, Retention, And Future Direction For A Heart Health Education And Risk Reduction Intervention Led By Community Health Workers In An African American Majority City, Julie Gleason-Comstock, Cindy Bolden Calhoun, Ghadir Mozeb, Cardell Louis, Alex B. Hill, Barbara J. Locke, Victor Harrell, Sadia Yasmin, Liying Zhang, John M. Flack, Nancy T. Artinian, Jinping Xu

Urban Studies and Planning Faculty Research Publications

Heart disease is a leading cause of death for African Americans. A community-academic partnership cross-trained community health workers to engage African American adults in a 6-month heart health education and risk reduction intervention. We conducted a one-group feasibility study using a one group (pre-posttest) design. A total of 100 adults were recruited from 27 zip codes in an African American majority city through community-based organizations (46%), churches (36%), and home visits (12%). Ninety-six percent were African American; 55% were female, 39% were male, and 6% were transgender. Their mean age was 44.6 years (SD=15.9). Ninety-two percent had health insurance. Seventy-six …

Assessing The Influence Of Food Insecurity And Retail Environments As A Proxy For Structural Racism On The Covid-19 Pandemic In An Urban Setting, Rachael D. Dombrowski, Alex B. Hill, Bree Bode, Kathrybn A. G Knoff, Hadis Dastgerdizad, Noel Kulik, James Mallare, Kibibi Blount-Dorn, Winona Bynum

Urban Studies and Planning Faculty Research Publications

A collaborative partnership launched the Great Grocer Project (GGP) in March 2021 in Detroit, Michigan where health inequities, including deaths due to COVID-19, have historically been politically determined and informed by socially entrenched norms. Institutional and structural racism has contributed to a lack of diversity in store ownership among Detroit grocers and limited access to high-quality, affordable healthy foods as well as disparate food insecurity among Detroit residents. The GGP seeks to promote Detroit’s healthy grocers to improve community health and economic vitality through research, programs, and policies that have the potential to advance health equity. A cross-sectional design was …

A Framework Of Social Media Messages For Crisis And Risk Communication: A Study Of The Covid-19 Pandemic, Nic Depaula, Loni Hagen, Stiven Roytman, Deaundre Dyson, Dana Alnahass, Mihir Patel, Alex B. Hill

Urban Studies and Planning Faculty Research Publications

Social media are important channels for crisis and risk communication by government agencies. However, existing frameworks for studying these messages use loose and inconsistent terminology, making it difficult to build on this research and understand how message features impact message diffusion. In this study, we provide a framework based on textual and media dimensions of messages for improved analysis of social media crisis and risk communication. We apply the framework to a sample of Twitter posts from United States local, state and federal public health agencies during a year of the Covid-19 pandemic. Results show reasonable reliability levels for coding …

Detroit Food Metrics Report 2020 (With 2021 Update), Alex B. Hill, Amy Kuras

Urban Studies and Planning Faculty Research Publications

This report provides a snapshot of data and information on Detroit’s food system as well as trends over time. The report includes a broad range of programs and initiatives that local organizations, the Detroit Food Policy Council, and the City of Detroit are undertaking to address food insecurity, increase healthy food access and awareness, and support a more sustainable and just food system.

From Pandemic Response To Portable Population Health: A Formative Evaluation Of The Detroit Mobile Health Unit Program, Phillip Levy, Erin Mcglynn, Alex B. Hill, Liying Zhang, Steven J. Korzeniewski, Bethany Foster, Jasmine Criswell, Caitlin O'Brien, Katee Dawood, Lauren Baird, Charles J. Shanley

Urban Studies and Planning Faculty Research Publications

This article describes our experience developing a novel mobile health unit (MHU) program in the Detroit, Michigan, metropolitan area. Our main objectives were to improve healthcare accessibility, quality and equity in our community during the novel coronavirus pandemic. While initially focused on SARS-CoV-2 testing, our program quickly evolved to include preventive health services. The MHU program began as a location-based SARS-CoV-2 testing strategy coordinated with local and state public health agencies. Community needs motivated further program expansion to include additional preventive healthcare and social services. MHU deployment was targeted to disease “hotspots” based on publicly available SARS-CoV-2 testing data and …

Factors Associated With Voluntary Refusal Of Emergency Medical System Transport For Emergency Care In Detroit During The Early Phase Of The Covid-19 Pandemic, Nicholas E. Harrison, Robert R. Ehrman, Andrea Curtin, Damon Gorelick, Alex B. Hill, Erin Brennan, Robert Dunne

Urban Studies and Planning Faculty Research Publications

Importance
Emergency department (ED) and emergency medical services (EMS) volumes decreased during the COVID-19 pandemic, but the amount attributable to voluntary refusal vs effects of the pandemic and public health restrictions is unknown.

Objective
To examine the factors associated with EMS refusal in relation to COVID-19 cases, public health interventions, EMS responses, and prehospital deaths.

Design, Setting, and Participants
A retrospective cohort study was conducted in Detroit, Michigan, from March 1 to June 30, 2020. Emergency medical services responses geocoded to Census tracts were analyzed by individuals’ age, sex, date, and community resilience using the Centers for Disease Control and …

The Biopsychosocial Model And Clinical Decision Science In The Age Of Black Lives Matter: A Clinical Reflection, Abdul-Rahman M. Suleiman, Samer Ilayan

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the biopsychosocial considerations of elevated blood pressure in teenage African American youth during the era of Black Lives Matter (BLM). Parallels are drawn between Dr. Engel’s biopsychosocial model and clinical decision science.

Substance Use Disorder Program Facilities In Detroit: A Geographic Analysis, Oksana Doubrovski

Medical Student Research Symposium

Background: Over 630,000 Michiganders have a substance use disorder (SUD) and about 80% are not receiving care (1). The rate of unmet need for SUD care in the Detroit-Dearborn-Livonia area is 81% (1). Geographic placement of facilities may serve as a barrier in patient access to SUD program services. This geographic analysis investigates current Detroit SUD program facility locations and their community demographics.

Methods: ArcGIS Pro was used to visualize and analyze data by creating 2D maps and tables. Data on SUD programs, medically underserved areas, and zip codes were retrieved from government data portals. Census tract data …

Detroit Food Metrics Report 2019, Alex B. Hill

Urban Studies and Planning Faculty Research Publications

This report provides a snapshot of data and information on Detroit’s food system as well as trends over time. The report includes a broad range of programs and initiatives that local organizations, the Detroit Food Policy Council, and the City of Detroit are undertaking to address food insecurity, increase healthy food access and awareness, and support a more sustainable and just food system.

Toxic Structures: Speculation And Lead Exposure In Detroit's Single-Family Rental Market, Alexa Eisenberg, Eric Seymour, Alex B. Hill, Joshua Akers

Urban Studies and Planning Faculty Research Publications

Foreclosure sales permitted investors to purchase large volumes of low-cost residential properties after the last financial crisis, reshaping patterns of property ownership in low-income housing markets across the US. This study links post-foreclosure property acquisitions by investor-landlords to subsequent lead poisoning cases among children under age six living in Detroit, Michigan. We find that the odds of exhibiting elevated blood lead levels (≥ 5 μg/dL) are higher for children living in investor-owned homes purchased through tax foreclosure sale. These findings highlight the potential for property speculation in post-foreclosure housing markets to exacerbate severe and racialized burdens of excess lead toxicity …

The Population Health Outcomes And Information Exchange (Phoenix) Program - A Transformative Approach To Reduce The Burden Of Chronic Disease, Steven J. Korzeniewski, Carla Bezold, Jason T. Carbone, Shooshan Danagoulian, Bethany Foster, Dawn Misra, Maher M. El-Masri, Dongxiao Zhu, Robert Welch, Lauren Meloche, Alex B. Hill, Phillip Levy

Urban Studies and Planning Faculty Research Publications

This concept article introduces a transformative vision to reduce the population burden of chronic disease by focusing on data integration, analytics, implementation and community engagement. Known as PHOENIX (The Population Health OutcomEs aNd Information EXchange), the approach leverages a state level health information exchange and multiple other resources to facilitate the integration of clinical and social determinants of health data with a goal of achieving true population health monitoring and management. After reviewing historical context, we describe how multilevel and multimodal data can be used to facilitate core public health services, before discussing the controversies and challenges that lie ahead.

Outcomes Of Utilizing Uber Health To Improve Access To Healthcare At An Urban Student Run Free Clinic, Ciara Ivanics Ms, Emily Lau, Julie Fynke Mph, Ralph Williams Md, Juliann Binienda Phd

Medical Student Research Symposium

Introduction: The patient population of the Robert R. Frank Student Run Free Clinic (SRFC) often cite transportation as their most significant barrier to receiving care. Utilization of ridesharing services may reduce this barrier and improve patient adherence to clinic appointments.

Methods: All patients at the SRFC from February 2019 through November 2019 were offered participation in this IRB-approved randomized control trial (n=37). The intervention group was offered a roundtrip, free, pre-scheduled Uber Health ride, while the control group was offered free public transportation or utilized their own transportation. Participants received an appointment reminder by phone within two days of their …

Evaluation Of The Impact Of Social Collaborations On Sexual And Reproductive Health Knowledge, Lucki Word, Jaila Campbell, Manar T. Edriss, Destiny Stroman, Jewel Evans, Melanie Hanna-Johnson, Md, Anil N. F. Aranha, Phd

Medical Student Research Symposium

Introduction: Developments in technology, such as the popularity of mobile devices and social media outlets, have enhanced the ability of individuals to communicate. Currently, search engines allow for easy exploration of information related to every topic of interest. Our study purpose was to evaluate the impact of technological and social collaborations on sexual and reproductive health knowledge (SRHK).

Methods: A 50-item survey instrument, integrating factors of sociodemographics, number/type of social collaborations, technological communication use, and SRHK, was developed to assess familiarity with sexual and reproductive health perceptions. The survey was provided to consenting patients in an ambulatory, primary care setting. …

The Use Of Urine Drug Testing For Risk Stratification And Efficacious Drug Monitoring In Pain Management Settings, Ahmad I. Hasan, Kareem Elhage, Brendan Farley, Khaled J. Saleh

Medical Student Research Symposium

Objective: To understand the current landscape of urine drug testing (UDT) guidelines as part of risk assessment for opioid abuse, and to offer recommendations towards adopting universal screening guidelines.

Background: There has been an opioid epidemic within the United States, and the role of prescription opioids has been well established. Despite proposed recommendations, there has yet to be a published universal screening guideline on the use of UDT in the setting of opioid abuse risk stratification as well as postoperative drug monitoring.

Methods: We explored current guidelines for UDT on two levels. First, we explore general indications for UDT within …

The Modifiability Of Risk Factors Associated With Adolescent Suicide And Its Preventions, Nastaeen Tajin

Honors College Theses

Adolescent suicide has been of major concern in the past few decades, with the rates steadily increasing every year. Suicide can be defined as the act of intentionally taking one’s life. Adolescent refers to children between the age of 13 and 19, although the term will be used interchangeably with ‘teen’ throughout this paper. The purpose of this study had been to identify the risk factors of suicide associated with children of this age range, and propose preventative measures based on the modifiability of these risk factors. In order to achieve this, the two search catalogs utilized were the Wayne …

Detroit Food Metrics Report 2018, Alex B. Hill, Amy Kuras

Urban Studies and Planning Faculty Research Publications

This report provides a snapshot of data and information on Detroit’s food system as well as trends over time. The report includes a broad range of programs and initiatives that local organizations, the Detroit Food Policy Council, and the City of Detroit are undertaking to address food insecurity, increase healthy food access and awareness, and support a more sustainable and just food system.

Detroit Food Metrics Report 2017, Alex B. Hill, Amy Kuras

Urban Studies and Planning Faculty Research Publications

This report provides a snapshot of data and information on Detroit’s food system as well as trends over time. The report includes a broad range of programs and initiatives that local organizations, the Detroit Food Policy Council, and the City of Detroit are undertaking to address food insecurity, increase healthy food access and awareness, and support a more sustainable and just food system.