Medicine and Health Sciences Commons^™

The Experience Of Intimate Partner Violence Among Pregnant Women Seeking Treatment For Opioid Use Disorder, Julia Dewey, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Intimate partner violence (IPV) is a major health issue among those with substance use disorder. A history of partner violence is associated with increased health problems and less improvement in treatment. The perinatal period is a time of increased risk of IPV for women, as well as a key opportunity for opioid use disorder treatment intervention. The purpose of this study is to characterize the experience of partner violence and evaluate the typology of sequelae associated with it in a population of pregnant women seeking medication assisted treatment for opioid use disorder.

Methods: The population of interest in this …

Lgbt Elder Initiative Thrivers Program Evaluation, Darcy Curtis, David Griffiths

Phase 1

Introduction: Aging with HIV is a critical area of study, especially as the generation that was initially affected by the disease grows older. The LGBT Elder Initiative (LGBT EI) is an organization in Philadelphia that supports and advocates for older members in the LGBT community. The LGBT EI Thrivers program is a community group that meets monthly to discuss what it means to “thrive” with HIV. The purpose of this study is to evaluate the LGBT EI’s Thrivers program and determine what motivates older individual with HIV to become involved in this program and identify the impact of the program. …

A Photovoice Project With Latino Youth In Easten North Philadelphia, Maria F. Arisi, Vincent Pepe, John Mckeegan, Caleb Dafilou, Mph, Rickie Brawer, Mph, Phd

Phase 1

Introduction: Eastern North Philadelphia is home to both the highest density Latino population in Philadelphia and some of the poorest health measures of the city. This Latino population is known to face a multitude of barriers to health, such as high rates of poverty, low educational attainment, and language barriers. There is little data showing what the self-identified priority needs of these Latino populations are, and even less showing the needs of Latino youth. Understanding how youth perceive the impact of their social and built environments can bring attention to the issues that the community needs addressed.

Methods: We conducted …

Quality Improvement Study Of Behavioral Health Resources Access In 19121 And 19132, Courtney Kaye, Rickie Brawer, Mph, Phd, Mches, Jeanne Felter, Phd, Lpc

Phase 1

Introduction: Children who have experienced four or more ACES (adverse childhood events) are shown to have negative mental health outcomes. Adolescents living in the Philadelphia zip codes 19121 and 19132 have higher ACE scores. This makes it necessary for adolescent providers to screen for behavioral health issues in their patients and refer out to appropriate resources.

Objective: The purpose of this quality improvement study is to see what current barriers exist relating to physician referral and access to behavioral health resources for their patients.

Methods: A guide of behavioral health resources available to adolescents in 19121 and 19132 was …

Health Concerns In The Juvenile Justice System In Philadelphia: An Analysis, Sarah Humrich

Phase 1

Introduction: There are more than 40,000 minors nationwide that are incarcerated, and yet there remains to be no standardized way to offer this population health care. Time spent in prison offers a unique opportunity that could allow healthcare workers to intervene, providing needed health care to an otherwise neglected population. This research seeks to better understand the healthcare offered to youth in juvenile detention centers in Philadelphia and to determine the unique health concerns of this population.

Methods: The target population of this study is the incarcerated youth in the juvenile detention centers of Philadelphia. I intend to collect data …

Constructing And Implementing A Summer Wellness Curriculum: Bridging The Gaps At Yes, Lauren Lynch, Julia Gong, Tim Massaquoi, Ma

Phase 1

Introduction: Youth experiencing homelessness lack learning experiences during the summer months, potentially leading to delinquent activities and hazardous situations. The project created and implemented a summer wellness curriculum at Youth Emergency Service (YES) that aimed to identify gaps in and educate the youth on various health and wellness topics. Daily exercise actively promoted physical wellbeing.

Methods: The curriculum aimed at a mixed group of adolescents facing homelessness integrated various educational and/or physical activities with wellness activities by YES staff and Title I programming. Activity description, cost, location, time and date, and number of attendees were recorded in a logbook. Qualitative …

Investigating Chronic Illness In Pathways To Housing Clients, Joshua Malerich, Lara Weinstein, Md, Dph

Phase 1

Approximately 553,000 individuals were homeless in the US each night in 2017, each at significant risk for substance use disorder, severe mental illness, and untreated chronic disease. Housing First (HF) is an evidence-based model for reaching high risk homeless individuals by providing a personal home to clients without the requirement for abstinence. HF has been shown as effective as other frameworks in remission of substance use, connectedness in the community, and client perceived quality of life, but there is a gap in the literature regarding the impact of HF services on clinical measures of chronic health, which could help further …

A Report From The Grndad Multi-Site Registry For Sickle Cell Disease: Iron Overload Is Under-Recognized And Under-Managed, Matthew Sears, Phd, Sophie Lanzkron, Md, Mhs, Carolyn Hoope, Md, Joshua J. Field, Md, E. Leila Jerome Clay, Md, Mcts, Faap, Susan Padrino, Md, Payal C. Desai, Md, Lynne D. Neumayr, Deepa Manwani, Md, Jane Little, Md

Phase 1

Introduction: GRNDaD is a prospective registry for people with SCD that opened to enrollment in 2016. Nine comprehensive SCD centers from across the United States are currently enrolling patients. The registry includes iron status and management data, important in SCD because chronic transfusion therapy is a mainstay of prophylactic management. Each unit of transfused blood introduces approximately 250 mg of iron into the blood, which can lead to systemic iron deposition, and untreated may lead to organ dysfunction or death.

Methods: GRNDaD currently contains prospective baseline and annual update information on approximately 1000 people with SCD. We analyzed ferritin levels …

Housing First For People With Opioid Use Disorder (Oud) And Engagement With Medication-Assisted Treatment (Mat) And Harm Reduction Services, Husayn Siddiqui, Ashley Katzenstein, Lara Weinstein, Md, Drph

Phase 1

Intro: Opioid Use Disorder (OUD)is one of the most prevalent and deadly SUD’s in the country and many barriers exist for individuals living with homelessness and concurrent psychiatric illnesses when hoping to engage in Medication-Assisted-Recovery/Treatment (MAR/MAT). The current study evaluates the Pathways to Housing PA’s (PTHPA) Housing First(HF) model which provides scatter-site housing with social and maintenance services to individuals with a history of chronic homelessness and a diagnosis of OUD.

Methods: A retrospective chart analysis was completed for to assess factors relating to MAT engagement using PTHPA’s Credible BH recording system. MAT engagement prior to HF, psychiatric, homelessness, and …

Applying Design Thinking For Community-Provider Collaboration: Designing A Culture- And User-Friendly Refugee Wellness Center, Oluwatoni Okuboyejo, Ellen Solomon, Shandon Coffman, Brandon Joa, Bon Ku, Md, Mpp

Phase 1

Background: Designing South Philadelphia’s first permanent healthcare facility dedicated to immigrant and refugee health presents a unique opportunity to integrate cultural sensitivity with principles of community health. Philadelphia is a city saturated with many medical institutions and hospitals, yet there are large health disparities within miles of each other. Bringing together healthcare providers with a common goal of improving community health needs from a cultural standpoint can be tasking, even when all are on the same page. Design thinking is an underexplored perspective that has the potential to address these concerns in an efficient way that improves both provider and …

Needs Assessment: Northeast Philly Opioid Epidemic, Davis Witt, Ms, Christopher Chambers, Md

Phase 1

Introduction: Philadelphia has the 3rd highest rate of opioid-related overdoses in the nation. This crisis is worsening in Northeast Philadelphia and the Department of Public Health lacks necessary information to intervene in an informed manner.

Objective: This study aims to better understand the crisis in this community and to provide key information to guide future harm reduction interventions in the Northeast Philadelphia region.

Methods: Using a designed discussion guide, qualitative interviews were completed with key stakeholders and community members. Information regarding personal experiences and opinions about the epidemic was gathered and interviews were analyzed using narrative analysis. In addition, needle …

Comorbidities And Treatments In United States Youth With Chronic Musculoskeletal Pain, Matthew T. Taylor, Sabrina Gmuca, Alexis Boneparth, L. Nandini Moorthy, Daniel B. Horton

Phase 1

Introduction: Chronic musculoskeletal (MSK) pain has been associated with chronic illnesses and high rates of pain medication use, often in referral centers, European populations, or studies focused on single drug classes. We aimed to characterize patterns of comorbidities and treatments associated with chronic MSK pain in a nationally-representative sample of US youth.

Methods: We used the National Ambulatory Medical Care Survey (2002-2015) and National Hospital Ambulatory Medical Care Survey (2002-2011), which contain cross-sectional data for US outpatient visits. The study included all visits for youth age 8-24, excluding those with malignancy or sickle cell disease. We compared comorbidities and drugs …

Design Thinking For Community-Provider Collaboration: Designing A Culture- And User-Friendly Refugee Wellness Center, Ellen Solomon, Oluwatoni Okuboyejo, Shandon Coffman, Brandon Joa, Bon Ku, Md, Mpp

Phase 1

Background: Designing South Philadelphia’s first permanent healthcare facility dedicated to refugee health presents a unique opportunity to integrate cultural sensitivity with principles of community health. Design thinking (human-centered design) is a promising strategy to address health and social justice concerns through the development of innovative products and services that prioritize population needs. This project utilized design thinking to inform suggestions to the design of Hansjörg Wyss Wellness Center that promote a culturally sensitive and welcoming environment in order to improve healthcare outcomes for the refugee population in Philadelphia.

Methods: Standard qualitative data gathering methods were used to gather insight into …

Applying Design Thinking For Community-Provider Collaboration: Designing A Culture- And User-Friendly Refugee Wellness Center, Brandon Joa, Ellen Solomon, Oluwatoni Okuboyejo, Shandon Coffman, Bon Ku, Md, Mpp

Phase 1

Purpose: This case study demonstrates the application of design thinking to the process of building a culturally sensitive health center for refugees and immigrants.

Background: Refugee communities present a growing underserved population. Designing South Philadelphia’s first permanent healthcare facility dedicated to immigrant and refugee health presents a unique opportunity to integrate cultural sensitivity with principles of community health. Design thinking is a promising yet underutilized strategy for addressing health and social justice concerns in an efficient way that improves both provider and patient satisfaction. A project was conducted to utilize design thinking to make suggestions to the design of Hansjörg …

Design Thinking For Community-Provider Collaboration: Designing A Culture- And User-Friendly Refugee Wellness Center, Shandon Coffman, Oluwatoni Okuboyejo, Ellen Solomon, Brandon Joa, Bon Ku, Md, Mpp

Phase 1

Background: South Philadelphia has a growing immigrant and refugee population, increasing the need for a healthcare facility dedicated to refugee health that integrates cultural sensitivity with principles of community health. Design thinking (human-centered design) is a promising strategy to address health and social justice concerns through the development of innovative products and services that prioritize population needs. This project utilized design thinking to inform suggestions to the design of Hansjörg Wyss Wellness Center that promote a culturally sensitive and welcoming environment in order to improve healthcare outcomes for the refugee population in Philadelphia.

Methods: Standard qualitative data gathering methods were …

Medical Student Knowledge Of Narcolepsy, Alyssa Sinko, Karl Doghramji, Md

Phase 1

Background: Narcolepsy is a sleep disorder, whose main symptoms include daytime sleepiness, cataplexy, sleep paralysis, disturbed sleep, and hypnagogic hallucinations. The disorder is poorly identified in medical settings. We hypothesized that lack of knowledge of narcolepsy and its hallmark symptoms are a cause for the low levels of identification of this disorder. This was a pilot study into medical student knowledge of narcolepsy at Sidney Kimmel Medical College of Thomas Jefferson University (SKMC).

Methods: Two groups of SKMC students, years 1 and 2 (before sleep medicine education) and years 3 and 4 (after sleep medicine education) were the subjects of …

Veteran Employment: A Study Into Barriers In Healthcare Industry Positions, Javier Saldana, Debby Derricks

Phase 1

Introduction: While there are many challenges veterans face while making the transition to the civilian lifestyle, undoubtedly one of the more frustrating factors is finding employment. While the veteran unemployment rate has dropped in recent years, it currently sits at ~3.4%. Therefore, an estimated 323, 000 veterans are currently unemployed. Given these statistics, what are the common barriers veterans face when seeking employment, specifically in healthcare industry positions?

Methods: Two (30 minute) interviews will be conducted with individuals heavily involved in veteran employment at Jefferson Hospitals. The questions asked the interviewee’s opinions on factors that make veterans successful in gaining …

Effect Of Sustained Attention On Early Start Denver Model Outcomes, Katherine Mcleod, Giacomo Vivanti, Phd

Phase 1

Introduction: There is very little research on the use of sustained attention as an outcome predictor for the Early Start Denver Model (ESDM). We hypothesized that a child’s level of sustained attention prior to therapy will correlate with positive ESDM outcomes.

Methods: 10 pre-preschool age children with a diagnosis of autism spectrum disorder received one year of ESDM therapy. A novel coding scheme was developed to evaluate each child’s pre-treatment level of sustained attention. Mullen Scales of Early Learning were evaluated prior to and after one year of ESDM. Pre-treatment levels of sustained attention were compared to pre-and post-treatment Mullen …

Identifying The Health Needs Of Latino Youth In East North Philadelphia Through Photovoice, John Mckeegan, Maria Arisi, Vincent Pepe, Caleb Dafilou, Mph, Rickie Brawer, Mph, Phd, Mches

Phase 1

Introduction: The Hispanic population in East North Philadelphia is abounding with risk factors for poor health. These structural risk factors adversely affect the Hispanic adolescents in the area – a demographic that has historically had little say in the research that is done to contextualize the self identified health needs in the community.

Objective: The purpose for this project is to identify the factors that are both helping and preventing healthy development and living of Hispanic adolescents in East North Philadelphia, as well as beginning to find avenues of support for the prioritized self identified needs.

Methods: A Photovoice project …

Predictors Of Negative Outcomes And Causes Of Loss To Follow Up Among Breast Cancer Patients In Port-Au-Prince, Haiti, A. Johnson, R. R. Henderson, G. Jones, Y. Fujii, P. Haley, J. Bernard, V. Degennaro

Phase 1

Objective: To determine predictors of negative outcomes and causes of loss to follow-up (LTFU) in patients with breast cancer in Haiti.

Design and Methods: Patients seen by Innovating Health International’s (IHI) cancer program were designated as LTFU after at least six months of non-contact (n=606). A cohort of LTFU breast cancer patients (n=101) was compared to the larger population of breast cancer patients (n=939), and a regression model constructed in order to identify risks for death and LTFU. Multiple calls were made to contact LTFU patients, and reasons for LTFU were recorded.

Results: Death and LTFU status were associated with …

Characteristics Of A Food Insecure Population In North Philadelphia, Galicano Kai Inguito, James Gardner, Laura Layer, Karen Fritz

Phase 1

Introduction: A 2018 report by Hunger Free America showed that food insecurity increased in Philadelphia by 22%, even though it decreased nationally. The objectives of this study were to perform food insecurity screens, and to describe the demographic characteristics in terms of age, gender, primary language, body mass index (BMI), and zip code. We hypothesized that older, overweight, Hispanic females would be more likely to be food insecure.

Methods: After obtaining consent, the validated Hunger Vital Sign screening tool was used in the Summer of 2019 in North Philadelphia by teams of trained students in the Summer Medical Institute program. …

Increasing Food Access: Evaluation Of A Food Buying Club In Philadelphia, Kimberly Hoover, Rickie Brawer, Mph, Phd, Mches

Phase 1

Introduction: Children living in food insecure homes are at higher risk of developing a variety of negative health outcomes, including cardiovascular disease, obesity, and cognitive, emotional and behavioral problems. In order to combat these outcomes, Mercy Neighborhood Ministries of Philadelphia (MNMOP) established a Food Buying Club to increase accessibility and affordability of fresh produce. However, the satisfaction with this program among participants needs to be determined in order to strengthen the program.

Objective: The objective of this quality improvement study was to evaluate parental satisfaction with the MNMOP program, specifically regarding produce options, cost, and variety.

Methods: An online survey …

War On The Wards: The Collapse Of Health Care Infrastructure Resulting From Violent Conflict, Nathan Hersh, Amy Hagopian, Barry Levy

Phase 1

Introduction: While utilizing satellite images to verify reports of hospital damage resulting from armed conflict allows for remote assessment, the use of private satellites to gain access to images prohibits widespread use. The questions this study sought to answer were: Is it possible to replicate the findings of previous reports of hospital damage that used the services of private satellite imagery using open source software, such as Google Earth? What variations exist among the different sites where damage to hospitals is visible, and what gradation is possible? Is this methodology applicable to other examples of armed conflict?

Methods: Using the …

Examining The Associations Between Addiction Severity And Prior Adverse Childhood Experiences In Pregnant Women Receiving Treatment For Opioid Addiction, Julia Gong, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Opioid use during pregnancy poses risk to both the mother and fetus, including fetal loss and pre-term birth. Prior research suggests that adverse childhood experiences (ACEs) are a plausible antecedent to opioid abuse. However, there is insufficient understanding of the association between prior ACEs, familial history of substance use, and treatment outcomes in pregnant women receiving treatment for opioid addiction.

Methods: A retrospective chart review will be used to review data from 167 MATER patients who entered treatment between 1997 and 2017. Descriptive statistics will be utilized to characterize the study population. Regression and chi-square analyses will be conducted …

The Effect Of Intrapartum Glycemic Control On The Incidence Of Neonatal Hypoglycemia, Signe Caksa, Amanda Roman, Md

Phase 1

Introduction: 1-2% and 6-9% of pregnancies are complicated by type I/II and gestational diabetes mellitus (DM), respectively, leading to increased risk of adverse neonatal outcomes. Women with DM require glucose monitoring and glycemic control at the time of delivery; however, it remains unclear how variations in intrapartum glucose impact neonatal hypoglycemia.

Methods: This is a retrospective cohort study of women with singleton pregnancies, diagnosed with DM, who delivered >36 weeks gestation after attempting induction of labor at Thomas Jefferson University Hospital between 01/01/2017 and 01/01/2018. Intrapartum DM management included hourly capillary glucose (CG) monitoring until delivery, insulin drip with CG …

Analyzing The Attitudes, Beliefs, And Practices Of Breastfeeding Women At Maternity Care Coalition, Angela Heysel, Conor Bradley, Naima Black, Galissa Jones

Phase 1

Introduction: Breastfeeding is essential for health and bonding within the mother-child dyad. Most guidelines, therefore, suggest women continue breastfeeding up to twelve months post-partum. Discrepancies in achieving this exist across zip codes and race in Philadelphia, despite high overall rates of breastfeeding. Our research goal is to understand these discrepancies and the relationship between attitudes and practices of breastfeeding Philadelphian women, in order to target them with breastfeeding resource.

Methods: General population data was collected via an online survey taken by residents of Philadelphia and the surrounding counties, whereas the focus group survey was taken in-person by Maternity Care Coalition …

Perceptions Of Centering Pregnancy At Jefferson’S Maternal Addiction Treatment, Education & Research (Mater) Program, Lindsay Caldarone, Ms, Vanessa Short, Phd, Mph

Phase 1

Introduction: Opioid use and misuse, including during pregnancy, is prevalent across the United States. Many women with opioid use disorder (OUD) face multiple barriers to care, including prenatal care. Group prenatal care, as compared to individual prenatal care, may lead to beneficial outcomes such as reduced odds of preterm birth.

Objective: This study aimed to assess the perceptions of Centering Pregnancy (CP), a group prenatal care program, among women in treatment for OUD.

Methods: The target population included women who participated in the CP program at MATER. Participants (N=6) completed a survey after the last CP session. Survey questions assessed …

Building Connections: Skmc – Ces Medellín International Exchange Program Development, Elias Borne, Kaitlin Demarest, Rosemary Frasso, Phd, Andres Fernandez, Md, Msed

Phase 1

Introduction: To date, there has been no formal evaluation of the exchange program that sends medical students from Sydney Kimmel Medical College (SKMC) to CES University, Colombia. While many medical schools have international exchange partnerships, little is known about what makes a successful global training experience. This project aims to evaluate the SKMC-CES student exchange program with the goal of improving collaboration between the two universities and creating a logic model backbone for the program going forward.

Methods: Surveys and interviews were done with program participants from the 2018 and 2019 academic years (6 students interviewed and 4 surveyed) exploring …

Health Outcomes In Pathways To Housing Clients, Kimberly Alfonso, Lara Weinstein, Md

Phase 1

Introduction: Homelessness is widespread throughout the United States, with homeless individuals accounting for over half a million of the country’s population. In addition, chronic mental, behavioral, and medical issues are overly expressed in this population. Therefore, the purpose of this project was to determine if the Housing First Model, represented by Pathways to Housing PA, would alleviate these chronic conditions over the course of stay.

Methods: The target population of the study was the homeless population, specifically within the city of Philadelphia. Data was collected via the SAMHSA (Substance Abuse and Mental Health Services Administration) NOMs (National Outcome Measures) survey. …

Thomas Jefferson Health System Medical Legal Partnership, Theresa Clark Rihn, Ema, Jd, Martha Romney, Rn, Ms, Jd, Mph, Rickie Brawer, Mph, Phd, Mches, Jennifer Roman, Bsn, Rn, Ccm

Phase 1

Introduction: Medical-legal partnerships (MLPs) provide civil legal services in concert with healthcare services to mitigate complex social conditions with health-harming effects. Currently, there are 333 MLPs in 46 states. Thomas Jefferson Health System (TJHS) does not have a systemwide MLP. (Magee Rehabilitation Hospital does have an MLP used by qualifying Magee patients). This project sought to identify the core components of an MLP and to demonstrate the value an MLP would provide TJHS.

Methods: Assessed existing literature. Interviewed an existing MLP director. Patients from the Jefferson Hospital Ambulatory Practice (JHAP) clinic completed a written survey regarding health-harming social-legal …