Digital Commons Network^™

A Serum Biomarker Panel And Miniarray Detection System For Tracking Disease Activity And Flare Risk In Lupus Nephritis, Chenling Tang, Gongjun Tan, Aygun Teymur, Jiechang Guo, Arturo Haces-Garcia, Weihang Zhu, Richard Williams, Jing Ning, Ramesh Saxena, Tianfu Wu

Faculty, Staff and Student Publications

Introduction: Lupus nephritis (LN) leads to end stage renal disease (ESRD), and early diagnosis and disease monitoring of LN could significantly reduce the risk. however, there is not such a system clinically. In this study we aim to develop a biomarker-panel based point-of-care system for LN.

Methods: Immunoassay screening combined with genomic expression databases and machine learning techniques was used to identify a biomarker panel of LN. A quantitative biomarker-panel mini-array (BPMA) system was developed and the sensitivity, specificity, reproducibility, and stability of the were examined. The performance of BPMA in disease monitoring was validated with machine models using a …

Dental Care Trajectories Among Formerly Incarcerated Older Adults In The United States, Alexander Testa, Luis Mijares, Mateus Renno Santos, Vahed Maroufy, Dylan B Jackson, Rafael Samper-Ternent, Rahma Mungia, Ana C Neumann

Faculty, Staff and Student Publications

A growing body of research has documented an association between prior incarceration and lower dental care use, yet the longitudinal impact of prior incarceration on dental care patterns over time among older adults remains unexplored. This study aims to investigate whether prior incarceration is associated with differing trajectories of dental care use among older adults in the United States. Data were drawn from the 2012-2020 waves of the Health and Retirement Study (HRS), a nationally representative longitudinal survey of older adults in the United States (n =  5,893). Group-based trajectory modeling was used to estimate dental care use patterns over …

Assessing Sun Protection Policies In Texas School Districts Located In Counties With The Lowest And Highest Melanoma Risk: Content Analysis And Cross-Sectional Study, Nabeel Ahmad, Brooke Bartley, Stephanie Zhang, Madison M Taylor, Karl Schrader, Kehe Zhang, Hung Quoc Doan, Cici Bauer, Kelly C Nelson, Jennifer Cofer

Faculty, Staff and Student Publications

Introduction

School policy can encourage sun safe habits, such as wearing hats and applying sunscreen. However, sun safety policies (SSP) have not been formally assessed for Texas independent school districts (ISDs), particularly in counties with the highest melanoma incidence relative risk (RR). This study aims to assess the presence, strength, and intent of SSPs across Texas ISDs located in counties with the highest and lowest melanoma incidence. We also identify factors correlated with stronger SSP.

Methods

Eleven components of SSPs from 102 ISDs were evaluated in this cross-sectional study by examining school district websites, official documents, social media, media appearances, …

Impact Of Pre-Transplant Immune Checkpoint Inhibitor Use On Post-Transplant Outcomes In Hcc: A Systematic Review And Individual Patient Data Meta-Analysis, Mohammad Saeid Rezaee-Zavareh, Yee Hui Yeo, Tielong Wang, Zhiyong Guo, Parissa Tabrizian, Stephen C Ward, Fatma Barakat, Tarek I Hassanein, Shravan Dave, Veeral Ajmera, Sherrie Bhoori, Vincenzo Mazzaferro, David M H Chascsa, Margaret C Liu, Elizabeth S Aby, John R Lake, Miguel Sogbe, Bruno Sangro, Maen Abdelrahim, Abdullah Esmail, Andreas Schmiderer, Yasmina Chouik, Mark Rudolph, Davendra Sohal, Heloise Giudicelli, Manon Allaire, Mehmet Akce, Jessica Guadagno, Clara Y Tow, Hatef Massoumi, Paolo De Simone, Elise Kang, Robyn D Gartrell, Mercedes Martinez, Ricardo Paz-Fumagalli, Beau B Toskich, Nguyen H Tran, Gabriela Azevedo Solino, Dra Mariana Poltronieri Pacheco, Richard S Kalman, Vatche G Agopian, Neil Mehta, Neehar D Parikh, Amit G Singal, Ju Dong Yang

Faculty, Staff and Student Publications

Background & aims: Treatment with immune checkpoint inhibitors (ICIs) for hepatocellular carcinoma (HCC) prior to liver transplantation (LT) has been reported; however, ICIs may elevate the risk of allograft rejection and impact other clinical outcomes. This study aims to summarize the impact of ICI use on post-LT outcomes.

Methods: In this individual patient data meta-analysis, we searched databases to identify HCC cases treated with ICIs before LT, detailing allograft rejection, HCC recurrence, and overall survival. We performed Cox regression analysis to identify risk factors for allograft rejection.

Results: Among 91 eligible patients, with a median (IQR) follow-up of 690.0 (654.5) …

Risk Of Post-Acute Symptoms Among Adults: A Comparison Study Of Severe Covid-19, Pneumonia, And Influenza, Caroline M Schaefer, Trudy Millard Krause, George L Delclos, Raymond S Greenberg

Faculty, Staff and Student Publications

Background: A retrospective cohort study was undertaken to assess the relationship between initial disease severity of COVID-19 and the risk of post-acute symptoms. The COVID-19 cohort was compared against influenza and pneumonia cohorts to assess whether risk of post-acute symptoms differed.

Methods: Administrative health claims data were obtained for commercially insured and Medicare Advantage covered adults (≥ 18 years) with symptomatic laboratory-confirmed COVID-19 diagnosed in 2020 (n=121,205), and similar cohorts of influenza (n=20,844) and pneumonia (n=29,052) patients diagnosed prior to the pandemic. Post-acute symptoms were assessed at four weeks, three and six months following initial diagnosis.

Results: Among the patients …

Protocol For The Houston Hospital-Based Violence Intervention Program, Alexander Testa, Eresha Bluth, Latanya Monroe, Karlton Harris, Sarah Beth Abbott, Mary E Aitken, Erin E Fox, Brian Heckler, Lillian S Kao, Ruosha Li, Susannah Meg Michael, Heidi M Mcpherson, Marisol Nieves, Christian P Owen, Kevin Rix, Hema Sarvani Jalaparthi, Vanessa Schick, Shreela V Sharma, Carlie Stratemann, Anne Marie V Thompson, Jack Tsai, Zixi Yang, Sandra Mckay

Faculty, Staff and Student Publications

Firearm violence is a leading cause of injury and mortality in the United States. Hospital-based violence intervention programs (HVIPs) are a promising public health strategy designed to reduce recurrent violence by engaging patients during hospitalization and connecting them to support services after discharge. This protocol describes the design and implementation of the Houston Hospital-Based Violence Intervention Program (Houston-HVIP), which will be evaluated by a randomized controlled trial conducted at a Level 1 trauma center in Houston, Texas. The study plans to enroll individuals aged 16-35 who present with gunshot wounds (GSW) at the Level 1 trauma center. Participants are randomized …

Hazardous Work Exposures And Working Conditions And The Risk Of Serious Injury Among Latino Day Laborers In Houston, Texas (2014–2021), Maria Eugenia Fernandez-Esquer, Cesar Leonardo Pinzon-Gomez, Celeste Monforton, Yuan Li, Vahed Maroufy, Martha Ojeda, Anabel Rodriguez

Faculty, Staff and Student Publications

Introduction: Latino day laborers (LDLs) are frequently exposed to workplace hazards that increase their risk of an injury. The purpose of this study was to assess the relative influence of worker and workplace characteristics on serious injuries reported by LDLs at four different time points. We examined the influence of demographic characteristics, hazardous chemical exposures and working conditions using data from four cross-sectional surveys conducted between 2014 and 2021.

Methods: A total of 740 LDL were randomly recruited from public job hiring locations (known as "corners") in Houston Texas to participate in surveys conducted as part of injury risk reduction …

Improved Depression Symptoms Among Low-Income Mexican Americans Participating In A Community-Clinical Diabetes Intervention, Minjae Lee, Joseph H Conroy, Zihan Yang, Sein Lee, Paul G Yeh, Juliana Z Lopez, Natalia I Heredia, Lisa A Mitchell-Bennett, Maribel Sifuentes, Belinda M Reininger

Faculty, Staff and Student Publications

Background: Adults with type 2 diabetes mellitus and comorbid depression face complex disease management. Salud y Vida, a diabetes management intervention for Mexican Americans in the Rio Grande Valley of Texas, may mitigate depression through social support and community-clinic referrals.

Methods: In a cohort study, 292 Salud y Vida participants completed the patient health questionnaire (PHQ-9) at baseline, month 6, and month 12. A PHQ-9 score of ≥5 indicated mild depression and activated a mental health referral. Using SAS 9.4 with significance set at < .05, we conducted multivariable longitudinal negative binomial regression to assess changes in depression level.

Results: The proportion of participants with a PHQ-9 ≥5 decreased from 36% at baseline to 18% …

Effects Of Cognitive Dual-Tasking On Biomechanics And Muscle Activity During Gait Initiation And Sit-To-Walk In Young Adults, Angeloh Stout, Kaye Mabbun, Ke'vaughn Waldon, Marvin Alvarez, Stacy Nguyen, Miguel Barcellano, Sandra Cuenca, Chuan-Fa Tang, Aanand D Naik, Gu Eon Kang

Faculty, Staff and Student Publications

The purpose of this study was to investigate the effects of cognitive dual-tasking on gait initiation and sit-to-walk. Twenty-eight healthy young adults performed gait initiation and sit-to-walk under two conditions: while engaging in serial subtraction (dual-task) and without any additional task (single-task). Motion data were collected using a 10-camera optoelectronic motion capture system, synchronized with force plates and surface electromyography. We analyzed spatiotemporal parameters, center of mass displacement, center of pressure trajectory, and lower limb muscle activation patterns. We found that dual-task conditions significantly affected both gait initiation and sit-to-walk patterns, increasing the duration of transitions and mediolateral center of …

A Comparison Of The Effect Of Remimazolam And Midazolam On Recovery And Preserved Memory Function For Patients With Dental Extraction Anxiety, Quan Jing, Weijia Wang, Limeng Wu, Lejunzi Wang, Boru Yuan, Yan Wang, Chengbin Wang, Lin Liu, Lei Guan, Riyue Yu, Yuelun Zhang, Daniel I Sessler, Yuguang Huang, Kuo Wan, Lijian Pei

Faculty, Staff and Student Publications

Purpose: Remimazolam is an ultrashort-acting benzodiazepine, which has been indicated to be effective in endoscopic surgery and general anaesthesia. Research on its use in outpatient dental procedures remains limited. This triple-blinded randomized clinical trial was designed to determine whether the quality of postoperative recovery is better with continuous intravenous remimazolam administration compared with midazolam administration for impacted wisdom tooth extraction in patients with dental anxiety.

Patients and methods: This study was a randomized, parallel triple-blinded, superiority trial conducted between 30 April 2022 and 24 June 2024. Participants aged ≥18 years who exhibited dental anxiety and who were eligible for impacted …

Navigating The Nexus Of Food Insecurity, Anxiety, And Depression In The Face Of Climate Change: A Longitudinal Study In Rural Kenya, Michael Goodman, Lauren Raimer-Goodman, Heidi M Hagen Mcpherson, Dawit Woldu, Shreela Sharma, Ryan Ramphul, Fridah Mukiri, Agnes Maigallo

Faculty, Staff and Student Publications

Objective: This study aims to address critical gaps in understanding the bidirectional relationships between food insecurity, anxiety, and depression in Meru County, Kenya. By employing a cross-lagged panel analysis, we seek to clarify these temporal dynamics, contributing to the design of targeted interventions that integrate food security and mental health in the context of climate change.

Methods: A cross-lagged panel analysis was conducted using data from 362 adult participants in a community-based empowerment program (2023) in Meru County, Kenya. Participants completed self-report measures of food insecurity, anxiety, and depression at two time points, 11 weeks apart.

Results: Food insecurity (T1) …

Prediction Of Preterm Birth Among Infants With Orofacial Cleft Defects, Katherine L Ludorf, Renata H Benjamin, Mark A Canfield, Michael D Swartz, A J Agopian

Faculty, Staff and Student Publications

Objective: To develop risk prediction models for preterm birth among infants with orofacial clefts.

Design: Data from the Texas Birth Defects Registry for infants with orofacial clefts born between 1999-2014 were used to develop preterm birth predictive models. Logistic regression was used to consider maternal and infant characteristics, and internal validation of the final model was performed using bootstrapping methods. The area under the curve (AUC) statistic was generated to assess model performance, and separate predictive models were built and validated for infants with cleft lip and cleft palate alone. Several secondary analyses were conducted among subgroups of interest.

Setting: …

Effect Of Digital Health Coaching On Self-Efficacy And Patient-Reported Outcomes In Individuals With Acute Myeloid And Chronic Lymphocytic Leukemia: A Pilot Randomized Controlled Trial, Jennifer Marvin-Peek, Valerie Shelton, Kelly Brassil, Bryan Fellman, Austin Barr, Kelly Sharon Chien, Danielle Hammond, Mahesh Swaminathan, Nitin Jain, William Wierda, Alessandra Ferrajoli, Courtney Dinardo

Faculty, Staff and Student Publications

Introduction: Promotion of self-efficacy can enhance engagement with health care and treatment adherence in patients with cancer. We report the outcomes of a pilot trial of a digital health coach intervention in patients with leukemia with the aim of improving self-efficacy.

Methods: Adult patients with newly diagnosed acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL) were randomized 1:1 to a digital health coach intervention or standard of care. The primary outcome of self-efficacy was measured by the Cancer Behavior Inventory (CBI) score.

Results: A total of 147 patients (37 AML, 110 CLL) were enrolled from July 2020 to December …

Perspectives On Smoking Cessation In The Oncology Environment: Insights From Brazilian Patients And Healthcare Providers, Raquel Descie Veraldi Leite, Ricardo Ribeiro Gama, Fabiana De Lima Vazquez, Gabriela Beltrami Massarão, Raiany Carvalho, Renan De Jesus Teixeira, Vinicius De Lima Vazquez, Irene Tami-Maury

Faculty, Staff and Student Publications

Objective: The aim of this study was to identify barriers and facilitators to smoking cessation among Brazilian cancer patients, considering the perspectives of both patients and healthcare professionals at a leading oncology center in the country.

Methods: A cross-sectional study was conducted, collecting smoking-related data from two groups: cancer patients and healthcare professionals at the Barretos Cancer Hospital (BCH) between 2019 and 2021. The questionnaire for healthcare professionals was adapted from the 2012 International Association for the Study of Lung Cancer and the Global Adult Tobacco Survey. For the cancer patient group, sociodemographic and clinical data were collected, along with …

Optimizing Community-Based Hepatitis B And C Care For Engaging Housing-Insecure Individuals, Vanessa Schick, Abigail Grace, F Tiffany Quan, Cathy Troisi, Jack Tsai

Faculty, Staff and Student Publications

Introduction

Hepatitis B and C (HBV/HCV) are bloodborne infections, with individuals who have histories of substance use and homelessness bearing a disproportionate risk. Long-standing difficulties in engaging these populations have made testing and treatment challenging. This retrospective observational study describes a community-based approach to HBV/HCV prevention and treatment, comparing the effectiveness of different engagement site types in reaching and engaging this high-need population.

Methods

GRASSROOTS HEALTH was launched in 2018 to improve HBV/HCV care by providing on-site testing, HBV vaccination, treatment navigation, and adherence support across various housing and drop-in centers. Outcomes were tracked through REDCap and analyzed by engagement …

Protective Effects Of Psychiatric Medications Against Covid-19 Mortality Before Vaccines, Rodrigo Machado-Vieira, Trudy M Krause, Gregory Jones, Antonio L Teixeira, Lokesh R Shahani, Scott D Lane, Jair C Soares, Chau N Truong

Faculty, Staff and Student Publications

The coronavirus disease pandemic caused by the coronavirus SARS-CoV-2, which emerged in the United States in late 2019 to early 2020 and quickly escalated into a national public health crisis. Research has identified psychiatric conditions as possible risk factors associated with COVID-19 infection and symptom severity. This study aims to determine whether specific classes of psychiatric medications could reduce the likelihood of infection and alleviate the severity of the disease. The objective of this study is to investigate the relationship between neuropsychiatric medication usage and COVID-19 outcomes before the widespread utilization of COVID-19 vaccines. This cross-sectional study used Optum's de-identified …

Cardiovascular Risk Factors And Genetic Risk In Transthyretin V142i Carriers, Naman S Shetty, Mokshad Gaonkar, Akhil Pampana, Nirav Patel, Alanna C Morrison, Alexander P Reiner, April P Carson, Bing Yu, Bruce M Psaty, Charles Kooperberg, Diane Fatkin, Eric Boerwinkle, Jerome I Rotter, Kent D Taylor, Lifang Hou, Marguerite R Irvin, Michael E Hall, Mathew Maurer, Myriam Fornage, Nicole D Armstrong, Nicole Bart, Parag Goyal, Stephen S Rich, Ramachandran S Vasan, Peng Li, Garima Arora, Pankaj Arora

Faculty, Staff and Student Publications

Background: Nearly 3% to 4% of Black individuals in the United States carry the transthyretin V142I variant, which increases their risk of heart failure. However, the role of cardiovascular (CV) risk factors (RFs) in influencing the risk of clinical outcomes among V142I variant carriers is unknown.

Objectives: This study aimed to assess the impact of CV RFs on the risk of heart failure in V142I carriers.

Methods: This study included self-identified Black individuals without prevalent heart failure from 6 TOPMed (Trans-Omics for Precision Medicine) cohorts, the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, and the All of …

Recovery Housing And On-The-Ground Research Priorities: A Scoping Study Through The Lens Of Community Based Participatory Research, Patrick F Hibbard, Cameron W Tice, Jodie M Dewey, Kathryn R Gallardo, James Tompkins, Justin S Bell, Jasleen Sandhu, Michelle A Cruz, Kathryn Babbitt, Amy A Mericle, Ashli J Sheidow

Faculty, Staff and Student Publications

Introduction: Though communities have featured recovery housing (RH) for several decades, the base of evidence for best practices continues to grow - especially evidence needed by, and known to, those who operate and receive these services. The Initiative for Justice and Emerging Adult Populations (JEAP) engaged with three community boards (CBs) - consisting of young adults with experience in recovery from substance use issues, people who have a history of criminal legal system involvement and recovery, and payers and provider of substance use services and harm reduction - to understand on-the-ground priorities for research into recovery support services.

Methods: JEAP …

Community-Involved Economic Evaluation And Development Of A Cost-Effectiveness Calculator For Two Peer-Driven Substance Use Interventions, Sierra Castedo De Martell, Margaret B Moore, Hannah Wang, Lori Holleran Steiker, J Michael Wilkerson, Sheryl A Mccurdy, Nalini Ranjit, H Shelton Brown

Faculty, Staff and Student Publications

Introduction: While peer-driven substance use interventions have proliferated across the U.S., economic evaluations of these interventions have lagged behind. A key characteristic of these interventions is the centrality of the "nothing about us without us" ethos, which should extend into economic evaluation research. To that end, this study sought to take a community-based participatory research (CBPR) approach to conducting a cost-effectiveness analysis (CEA) of peer recovery support services (PRSS) and turning that CEA and a CEA of bystander naloxone distribution (BND) into components of a free, web-based calculator for use by recovery community centers (RCCs).

Methods: We engaged staff and …

Confidence In Elections Among U.S. Local Officials: Effects Of Social Trust, Partisanship And Political Ambition, Rebecca Sager, Eric Plutzer, Gary Adler, Jonathan S. Coley, Damon Maryl

Sociology Faculty Works

The U.S. public’s confidence in elections is intensively studied in the last decade but little is known about election confidence among locally elected officials, whose roles and community status may influence public opinion. Using a nationally representative survey of local election officials, we compare election confidence among local elected officials with that of the general public. Local elected officials are more likely to trust both local and national elections. We theorize factors that affect local officials’ trust in elections, including partisan context, state leadership election denial levels, and political ambition. We show how social trust, partisan identity, and ambition significantly …

Magnetization Transfer Ratio In The Typically Developing Pediatric Spinal Cord: Normative Data And Age Correlation, Sara Naghizadeh Kashani, Iswarya Vel, Zahra Sadeghi Adl, Shiva Shahrampour, Devon Middleton, Mahdi Alizadeh, Laura Krisa, Scott Faro, Slimane Tounekti, Julien Cohen-Adad, Feroze Mohamed

Department of Radiology Faculty Papers

BACKGROUND AND PURPOSE: This study presents automated atlas-based magnetization transfer (MT) measurements of the typically developing pediatric cervical spinal cord (SC). We report normative MT ratio (MTR) values from the whole cervical cord white matter (WM) and WM tracts, examining variations with age, sex, height, and weight.

METHODS: MT scans of 33 healthy females (mean age = 12.8) and 22 males (mean age = 13.09) were acquired from the cervical SC (C2-C7) using a 3.0 T MRI. Data were processed using the SC Toolbox, segmented, and registered to the PAM50 template. Affine and non-rigid transformations co-registered the PAM50 WM atlas …

Wednesday In The Desert, Sabrina Fredrick

Mighty Pen Project Anthology & Archive

A young woman wakes up one beautiful morning, and realizes she has the power to change her own life.

Articles, stories, and other compositions in this archive were written by participants in the Mighty Pen Project. The program, developed by author David L. Robbins, and in partnership with Virginia Commonwealth University and the Virginia War Memorial in Richmond, Virginia, offers veterans and their family members a customized twelve-week writing class, free of charge. The program encourages, supports, and assists participants in sharing their stories and experiences of military experience so both writer and audience may benefit.

Type 2 Diabetes Polygenic Risk Score Interactions With Lifestyle Risk Factors In Black Americans, Ashley W Scadden, Aastha Kakar, Elizabeth M Litkowski, Mariah C Meyer, Nicole D Armstrong, Steven Buyske, Yanwei Cai, Iona Cheng, Burcu F Darst, Myriam Fornage, Mariaelisa Graff, Boya Guo, Christopher A Haiman, Heather M Highland, Charles Kooperberg, Loïc Le Marchand, Kari North, Ulrike Peters, Stephen S Rich, Jerome I Rotter, Vinodh Srinivasasainagendra, Hemant K Tiwari, Stephanie Waldrop, Kristin Young, Sridharan Raghavan, Ethan M Lange, Leslie A Lange, Marguerite R Irvin, Maggie A Stanislawski

The Brown Foundation: Institute of Molecular Medicine

Introduction: Prior work in predominantly European ancestry populations has explained how the risk associated with demographic, lifestyle, and health factors differs with underlying genetic susceptibility to type 2 diabetes (T2D), but less is known about these relationships in Black Americans.

Methods: We used covariate-adjusted logistic regression models of T2D to examine interactions between a published trans-ancestry derived T2D polygenic risk score (PRS) and various demographic, lifestyle, and health-related factors among 28,251 self-identified Black Americans from six cohort studies.

Results: The results are generally consistent with prior work in White populations. The PRS showed a significant interaction with body mass index, …

Disposition Outcomes Following Prehospital Use Of Naloxone In A Large Metropolitan City In The United States, James R Langabeer, Christine Bakos-Block, A Sarah Cohen, Ishmam Alam, Bhanumathi Gopal, Marylou Cardenas-Turanzas, Arlo F Weltge, David Persse, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

Objectives: During a drug overdose, research suggests individuals may not call 9-1-1 out of fear of criminal justice concerns. Of those that call, research is inconclusive about the disposition of the emergency transport. We evaluated transport outcomes for adults with opioid-related overdose in the Emergency Medical Services (EMS) of a large metropolitan city in the United States.

Methods: We reviewed the EMS incident report database from the patient care record system for years 2018 to 2022. We queried all records, searching for relevant terms, and two reviewers cross-checked the database to identify cases that did not result in death at …

Shifting Patterns In Primary Care Telehealth Utilization Among Medicare Beneficiaries And Providers, Yunxi Zhang, Lincy S Lal, Saurabh Chandra, John Michael Swint

Faculty, Staff and Student Publications

Introduction: The COVID-19 pandemic accelerated telehealth adoption, but disparities in its utilization persist. This study examines primary care patient sociodemographic characteristics, telehealth utilization patterns, and provider adoptions before and during the pandemic.

Methods: A retrospective cohort study analyzed data from Mississippi Medicare beneficiaries continuously enrolled in Parts A, B, and D who accessed primary care services from 2019 to 2021.

Results: Among 201 677 Medicare beneficiaries accessing primary care, 1364 used telehealth before the pandemic, compared to 73 994 during the pandemic. Telehealth utilization shifted during the pandemic to younger, female, White beneficiaries, and those enrolled in Medicare due to …

Phenotypic Variation In Disease Severity Among Hospitalized Pediatric Patients With Covid-19: Assessing The Impact Of Covid-19 In The Epico Study, María Camila Sossa-Alarcón, Mónica Paola Gutiérrez, Natalia Becerra, Luz Yessenia Ortegon, María Camila David, Melisa Naranjo Vanegas, Gabriela Friedrich, Pablo Vásquez-Hoyos, María Lucía Mesa-Rubio, Luis Miguel Navarro-Ramirez, Sergio Moreno-Lopez, Olga Lucía Baquero, Luz Marina Mejía, Juan Gabriel Piñeros, Sonia Restrepo-Gualteros, Carlos Álvarez-Moreno, Alejandro Díaz-Díaz, Iván Gutierrez-Tobar, Andrés Camilo Mesa, William Ricardo Bachiller Tuta, Clara Esperanza Galvis Diaz, Martha Africano, José Manuel Nieto, Paola Marsela Pérez Camacho, Claudia Beltrán-Arroyave, Rosalba Vivas Trochez, Irati Gastesi, Cinta Moraleda, Alfredo Tagarro García, Blanca Herrero, Lourdes Calleja, Carlos Grasa, Paula Rodriguez, Susana Melendo, Antoni Soriano-Arandes, Irene Gómez Pastrana, Sonsoles García García, Victoria Fumado, Andrea Ramírez Varela

Faculty, Staff and Student Publications

Objective: To characterize the clinical phenotypes of SARS-CoV-2 infection in hospitalized children as part of the EPICO multicenter cohort study.

Methods: We included hospitalized children with confirmed SARS-CoV-2 infection from Colombian and Spanish institutions to assess disease evolution and outcomes. Cluster analysis was performed to identify clinical phenotypes.

Results: A total of 2318 patients were included (55% male, 36% infants). Five phenotype clusters emerged: Cluster 1 (26.5%): infants without comorbidities, low PICU admissions and mortality; Cluster 2 (18.5%): respiratory comorbidities, high microorganism co-detection and mortality; Cluster 3 (11.5%): fever, gastrointestinal symptoms, high PICU admissions; Cluster 4 (32%): mild unspecific symptoms, …

Factors Influencing Implementation Of A Self-Measured Blood Pressure Program In Community Health Centers: An Implementation Mapping Approach, Serena A Rodriguez, Fernanda Velasco-Huerta, Mahalia Sampson-Ansah, Ella R Garza, William B Perkison, Patenne D Mathews, Catherine Pulicken, Maria E Fernandez

Faculty, Staff and Student Publications

Objectives: Uncontrolled hypertension is a leading cause of cardiovascular disease, particularly among adults aged 45 years and older. Self-measured blood pressure (SMBP) is an evidence-based intervention that can help patients manage hypertension outside of the clinical setting. We conducted a needs and assets assessment to identify (1) health center adopters and implementers and (2) barriers and facilitators to SMBP adoption and implementation in six community health centers in Texas.

Methods: Data sources included: (1) needs and assets assessment surveys and semi-structured interviews; (2) site visits with participating health centers; and (3) detailed meeting notes and logs. Leaders and administrators from …

Adaptation Using Im Adapt Of An Evidence-Based Lifestyle Intervention To Support The Management Of Metabolic-Dysfunction Associated Steatotic Liver Disease Among Hispanic/Latino Adults, Natalia I Heredia, Sylvia A Ayieko, Serena A Rodriguez, Jessica P Hwang, Lorna H Mcneill, Maria E Fernandez

Faculty, Staff and Student Publications

The high prevalence of metabolic-dysfunction associated steatotic liver disease (MASLD), formerly non-alcoholic fatty liver disease (NAFLD), necessitates the availability of an evidence-based intervention to manage the condition among patients to prevent severe chronic liver disease and other cardiometabolic-related illnesses. IM Adapt (Intervention Mapping for Adaptation) is a systematic approach for planning modifications in interventions to improve fit and potential effectiveness. Following this stepped approach, we conducted interviews with the target population, conducted a literature review, solicited expert advice, and created a logic model describing expected program outcomes for the new population and setting. We searched for, selected, and adapted an …

Co-Creation Of Staff Training To Address Health-Related Social Needs In Emergencies, Linda Highfield, Gayla Ferguson

Faculty, Staff and Student Publications

Background: Health-related social needs (HRSN), such as housing and transportation barriers, contribute to poor health outcomes and increased healthcare costs. Patient navigators help connect patients to community resources, but workforce training gaps are a challenge. The Strengthening Peer AHC Navigation (SPAN) study aimed to enhance navigation training during the COVID-19 Public Health Emergency.

Methods: Using a stakeholder-driven peer planning approach, SPAN co-developed a quality improvement plan for patient navigation training. Training focused on housing and transportation navigation and included didactic sessions, hands-on case studies, and biweekly expert consultations. Self-efficacy surveys measured navigator confidence pre- and post-training, and changes in navigation …

A Mixed-Methods Usability Pilot Of A Value-Goal Elicitation Tool In The Inpatient Setting For Older Adults Anticipating Post-Acute Care, Kirstin M Piazza, Caroline Pascal, Syama R Patel, Caroline Sefcik, Marilyn M Schapira, Caroline Madrigal, Katherine C Ritchey, Longyi Yip, Aanand D Naik, Robert E Burke

Faculty, Staff and Student Publications

Age-Friendly Health Systems (AFHS) emphasize aligning care with "What Matters" most to older adults. Hospitalization represents a critical period where value-based goals could shape key decisions about post-acute care transitions. However, few tools designed for eliciting such goals have been adapted for use in the inpatient setting, where the acute nature of care poses unique challenges. This mixed-methods study evaluates the usability of the Health Priorities Primer Tool (HPPT) in older hospitalized adults who anticipate needing post-acute care, aiming to identify necessary adaptations for the inpatient setting. We conducted interviews, observations, and surveys with older hospitalized patients to understand their …