Public Health Commons^™

The Utility Of Performing Cervical Length Follow-Up In Lower Risk Singleton, Varsha Kripalu, Rupsa Boelig, Md

Phase 1

Introduction: Short cervical length (<25 mm) during pregnancy is known to be an increased risk factor for preterm birth (<37 weeks). While interventions exist for women who have had prior preterm births, it is important to investigate the cost effectiveness of screening low risk women with an intermediate cervical length (26-29 mm).

Objective: To quantify the association between change in cervical length on follow up and the incidence of preterm birth in otherwise low risk women with an initial intermediate cervical length.

Methods: A retrospective cohort study was conducted, reviewing 108 charts of women who had an initial screening between 26 and 29 mm. Charts were reviewed for whether or not a follow-up ultrasound was recommended, whether or not the follow-up was performed, and the outcome of their deliveries.

Results: 93.5% (N=101) of women were recommended to get a follow-up ultrasound and 84% (N=85) completed their follow-up. …

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. …

Advocating For Protective Measures Against Childhood Lead-Poisoning In Philadelphia Rental Homes, Claire Miller, Colleen Mccauley

Phase 1

Introduction: Lead exposure has been linked to delays in development and behavioral problems in children. Over 1,500 children are poisoned by lead each year in Philadelphia; the majority (62%) in rental homes.

Objective: The purpose of this project was to understand the impact of lead poisoning on children in Philadelphia, the current policies in place to protect children and the ways in which various stakeholders can advocate for policy changes that will better protect children.

Methods: A mixed-methods approach was utilized including meetings with councilmembers, stakeholder interviews and data analysis, visualization and presentation. This information was used to gain councilmembers’ …

Development Of An Emergency Room Identification Tool To Aid In The Identification Of Victims Of Sex Trafficking, Misha Yakobi, Amy Leader

Phase 1

Despite the reality that the majority of victims of sex trafficking interact with the healthcare system, there is no uniformly implemented or agreed upon screening tool utilized by emergency departments to identify members of this population. In addition, there is no easily accessible composite of resources available to be distributed if these victims of sex trafficking are identified. This study aims to aid in the design and dissemination of such a screening tool and to create a composite of local and national resources that serve this population.

Using an interview guide, conversations were held with policy experts and healthcare professionals. …

High Retention In An Fqhc Moud Program Despite Substantial Vulnerabilities In Population, Qais Iqbal, Lara Weinstein, Md, Mph, Drph

Phase 1

Background: Seventy-thousand people in Philadelphia use heroin, and another 50,000 misuse prescription opioids. Philadelphia has increased its capacity for medication for opioid use disorder (MOUD) with buprenorphine from 100 slots in 2017 to 2,906 as of December 2018, but clearly there is still a need for thousands of more treatment slots. Additionally, recent evaluations reveal people from vulnerable populations, including homeless, non-white, and those with chronic medical diseases, have compounded difficulty accessing MOUD, even if there is sufficient capacity. Our objective was to describe and report initial outcomes of a low-threshold MOUD program at our Federally Qualified Health Center (FQHC) …

Efficacy Of Existing Interventions For Health Care Provider Stress & Implications For Low-Resource Health Care Settings: A Systematic Review, Ann Marie Kelly, Ms, Patience Afulani, Mbchb, Mph, Phd

Phase 1

Introduction: There is a demand for interventions that may help providers cope with inevitably high levels of stress, but there is a paucity of data on the efficacy/feasibility of interventions for provider stress/burnout—particularly in low-resource settings. This study examined existing interventions and their effectiveness in combatting stress and burnout among providers.

Methods: The traditional format of a systematic review was employed utilizing PubMed, PsycInfo, and SCOPUS to examine stress and burnout interventions offered to health care providers. Primary outcomes of stress/burnout were analyzed through the use of validated resilience scores. This study initially identified 1,720 records; twelve studies were included …

Obesity And Cardiovascular Health Differences Between Urban And Suburban Philadelphia High School Athletes, Peri Levey, Kyle Prochno, Prashant Rao, Md, David Shipon, Md, Facc, Facp, Jeremy Close, Md

Phase 1

Introduction: The strongest risk factor for primary hypertension in children is obesity, and concern for pediatric hypertension rises with the rising prevalence of obesity in American children. Specifically, in urban Philadelphia schools from 2009 to 2012, preparticipation physical evaluations (PPEs) demonstrated a positive correlation between blood pressure measurements demonstrating stage 1 or 2 hypertension and elevated body mass index (P < 0.00001).

Objective: The purpose was to identify potential differences in cardiovascular health and prevalence of obesity between adolescents in the urban and suburban Philadelphia areas.

Methods: Data from PPEs administered to urban Philadelphia high school athletes in 2018 by the Athlete …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Ilana Porges, Vaishali Mehta, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: Delays in management of high risk pregnancies can result in significant morbidity for women seeking obstetric care. A trend of high incidence of pregnancy complications has been observed among women with non-communicable diseases (NCDs) receiving care at the University Teaching Hospital of Kigali (CHUK), which may suggest the need for more consistent screening of NCDs among pregnant women, and more streamlined care for those identified to be at highest risk for complications.

Methods: This study utilized a mixed method design to assess the need for screening of NCDs among pregnant women (n=255) who received obstetric care at CHUK between …

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

Phase 1

Introduction: It is recommended that women breastfeed for twelve months because breastfeeding is an important part of infant development and maternal bonding. Research shows that despite high overall breastfeeding rates, discrepancies exist in breastfeeding rates across zip codes and race in Philadelphia. The research goal is to develop a community resource to promote breastfeeding in Philadelphia and to understand the impact race and zip code have on breastfeeding attitudes and practices.

Methods: Data was collected from residents of Philadelphia and neighboring counties through an online general population survey and focus group survey. Both surveys addressed demographics and the women’s attitudes …

Obesity And Cardiovascular Health Differences Between Urban And Suburban Philadelphia High School Athletes, Kyle W. Prochno, Peri Levey, Prashant Rao, Md, David M. Shipon, Md, Facc, Facp, Jeremy D. Close, Md

Phase 1

Introduction: Limited data exist regarding hypertension and obesity levels of Philadelphia-area high school student-athletes. We aim to assess their prevalence in an urban population, investigate whether they are correlated with demographic factors, and determine whether urban student-athletes differ in these outcomes compared to their suburban/non-urban counterparts.

Methods: Demographic and physical data were extracted from Athlete Health Organization (AHO) 2018 pre-participation physical exams. Adiposity classifications were made from body mass index (BMI) calculations applied to appropriate Centers for Disease Control and Prevention (CDC) growth charts, while systolic/diastolic measurements were used to classify students’ blood pressure according to current American Academy of …

The Effects Of Centering Pregnancy On Attitudes Towards Breastfeeding Among Women With Opioid Use Disorder, Francesca Mancuso, Vanessa Short, Phd, Mph

Phase 1

Introduction: Breastfeeding has been found to decrease severity of neonatal abstinence syndrome (NAS), however, breastfeeding rates among women with opioid use disorder (OUD) are significantly lower than national averages. CenteringPregnancy, a group prenatal care model, increases exposure to education regarding breastfeeding, making it more likely that patients breastfeed in traditional populations.

Objective: This project’s purpose was to identify and understand current infant feeding attitudes among mothers with OUD and explore whether participation in the CenteringPregnancy “Breastfeeding Session” positively impacted knowledge and attitudes towards breastfeeding.

Methods: Data were collected from 12 women in treatment for OUD who participated in CenteringPregnancy. A …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Vaishali Mehta, Ilana Porges, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: There has been a recent trend of women experiencing delays in management for high-risk pregnancies in Kigali, Rwanda. Physicians at the University Teaching Hospital of Kigali (CHUK) have observed a high incidence of women receiving obstetric care that were not screened appropriately. This points to an inconsistent screening method for non-communicable diseases (NCDs) prior to delivery and lack of streamlined care. The objective of this study is to assess the need for more robust screening of maternal NCDs.

Methods: This study, between June 2018-19, is a needs-assessment for the screening of NCDs among pregnant women (n=255) at CHUK. It …

Medication Adherence In A Housing First Model, Lily Segal, Sharon Lyles

Phase 1

Introduction: Mental illness and chronic medical conditions are prevalent among those experiencing homelessness. Medication adherence has been very poor due to a variety of barriers, one of those being housing. For those who have previously experienced homelessness, does a Housing First model have a positive impact on medication adherence?

Methods: The target population was individuals on Team 1 at Pathways to Housing, PA. Medication adherence was measured through the use of blister packs, which contained 1 weeks’ worth of medication, therefore at the end of the month 4-empty blister packs should have been returned. Medication adherence, specifically for …

Systems Analysis Of The Community Elder Caregiver Program At The Spirit Lake Nation, Morgan Ferrell, Robert Motley, Md, Mhcds, Christine Burd, Phd, Rn

Phase 1

Native Americans (NA) disproportionately reside in areas with significantly more social, economic, and health disparities than any other population, and have the lowest employment rates nationally. Additionally, the NA Baby Boomer generation is aging, with senior citizen services largely unavailable on reservations. The Community Elder Caregiver (CEC) Program at Spirit Lake was developed with two aims: 1) to meet the needs of unemployed natives and 2) to develop a competent workforce to help elders safely “age in place”. In the initial pilot, seventeen individuals started the initial (NECC) training, with three completing the Qualified Service Provider (QSP) training. We analyzed …

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

Phase 1

Introduction: The East North Philadelphia community contains the city’s largest Latino population, most of whom are of Puerto Rican and Dominican descent. This community in particular has unique health needs compared to the rest of the city of Philadelphia, with rates of diabetes (22.9%), asthma (28.6%), and poverty (45.5%) exceeding the national and city averages. Documenting the perceived needs of the children living here regarding their built environment will provide insight into the problems onto which the community at large needs to focus. This study aims to determine the priority needs of the community and to empower the youth …

Patient Engagement And Opinions Of A Medication Assisted Treatment Program For Opioid Use Disorder: A Qualitative Assessment, Sarah Wagoner, Lara Weinstein, Md

Phase 1

Introduction: Opioid use disorder is widely regarded as a national health epidemic. Stephen Klein Wellness Center 6as started a Medication-Assisted Treatment (MAT) program to help combat this epidemic- a program that is unique in that it does not require sustained abstinence for continued participation in the program.

Objective: The objective of this study is to better understand the beliefs and attitudes of patients towards a substance use treatment program that does not require sustained abstinence.

Methods: Five focus groups, totaling 31 participants, were assembled from patients who are current participants in Stephen Klein’s MAT program. The content of the interviews …

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 …

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 …

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 …

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 …