Community Health and Preventive Medicine Commons^™

How To Develop A Qualitative Evaluation Plan For A Complex National Intervention: Key Steps And Reflections From The Radx-Up Program, Shelly A. Maras, Josephine Mckelvy, Kelley Milligan, Allyson Kelley, Valerie A. Lucas, Tara Carr, Abisola Osinuga, Leah Frerichs, Gaurav Dave

The Qualitative Report

This article describes the formative process of developing and implementing a Qualitative Evaluation Plan (QEP) for a large-scale, National Institute of Health (NIH) supported program: Rapid Acceleration of Diagnostics — Underserved Populations (RADx-UP). RADx-UP includes over 137 projects in the United States that aim to ensure that all Americans have access to timely, accurate diagnostics for COVID-19, with a specific focus on populations the pandemic disproportionately affects. As part of a comprehensive, mixed-methods strategic evaluation plan, our team developed the QEP. We employed qualitative methods to understand RADx-UP academic and community partners’ experiences implementing community-engaged research strategies, and to understand …

Addressing Barriers To Black Americans Participation In Clinical Trials: A Faith-Based Community Survey, Alexandra Stone, Lydell Lettsome Md, Brian A. Stone Md, Clinical Diversity Solutions

Medical Student Research Symposium

Background: The underrepresentation of high-risk minority groups in clinical trials remains a crisis in American healthcare. Despite pressures from the NIH to increase Black-American participation in trials, recruitment and retention in this group rarely match population demographics. Our company launched an opinion survey polling 260 Blacks regarding their thoughts and awareness about clinical trial participation.

Methods: We created a web-based survey consisting of 38 items and subdivided it into three main sections: (1) cultural affinity, (2) trust, and (3) background information. The survey was conducted using Jotform, a HIPAAcompliant web-based application. Our target population was Black Americans in central Alabama. …

Natural Spaces, A Social Determinant Of Health, And Self-Rated Health Among Medical Students, Josiah P. Stryd, Anil N. F. Aranha

Medical Student Research Symposium

Background and Purpose: Natural spaces are areas which have a majority of natural ground cover such as vegetation or water. These spaces have positive effects on both physical and mental health. The purpose of this study was to investigate whether medical students who have greater accessibility and use of natural spaces have better self-rated health.

Methods: M2-M4 students from Wayne State University School of Medicine received an email link to the Qualtrics-based study. Variables evaluated included: sociodemographics, residence zip code, natural spaces access frequency, distance, and transportation method. Self-rated physical and mental health was measured using the Healthy Days measure …

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 …

Histories, Cultural Contexts, Health Status, Wildlife Contact Characteristics, And Perception Towards Covid-19 Of The Urak Lawoi Ethnic Group In Koh Lanta District, Krabi Province Of Thailand: A Qualitative Study, Kanokwan Suwannarong, Paisit Boonyakawee, Thanomsin Ponlap, Kannika Thammasutti, Phitsanuruk Kanthawee, Nisachon Bubpa, Chularat Boonyakawee, Vittaya Pulkird, Junsri Changnum

Journal of Health Research

Background: The Urak Lawoi ethnic group is an indigenous community residing in the Andaman Sea of southern Thailand and are engaged in various activities related to wild animals. This qualitative study was conducted from November 2022 to February 2023 to collect information on wildlife contact characteristics and determine the level of awareness and understanding of zoonotic diseases and COVID-19 risks among this ethnic group in Koh Lanta district, Krabi province.

Methods: This qualitative study collected data through key informant interviews (KIIs) and focus group discussions (FGDs). The study respondents included 29 Urak Lawoi village health volunteers (VHVs), To Mo …

Assessing Oral Health-Related Quality Of Life And The Application Of Silver Diamine Fluoride (Sdf) In Arresting Caries Among Older Adults, Palinee Detsomboonrat, Panatcha Weerapol, Sirinan Tangyusuk

Journal of Health Research

Background: This study aimed to evaluate the impact of oral health problems on oral health-related quality of life (OHRQoL) and assess the effectiveness of the application of 38% silver diamine fluoride (SDF) solution in arresting dental surface caries among the older adults.

Methods: This study assessed the oral impact on daily performance (OIDP) scores and evaluated the percentage of arrested caries and patient satisfaction levels before and after receiving SDF treatment among older, community-dwelling adults attending the Diabetes Mellitus Clinic under the care of Bangkok Public Health Center 5.

Results: In total, 42.9% of 49 participants encountered a minimum of …

Finding A Good Fit: Tips On Hiring Rural Personal Assistants, Rayna A. Sage, Krys Standley

Health and Wellness

Living in rural areas means being part of close communities. For people with disabilities in these areas, Personal Assistance Services (PAS) help them live on their own. But finding good PAS workers in rural places can be hard. To help you pick the right PAS worker, we explored what traits make them a good fit.

“No Matter How Hot It Is, You Just Have To Do The Work”: Examining Farmworkers’ Experiences With Heat And Climate Change In Idaho, Carly Hyland, Delmy Flores, Grace Augusto, Irene Ruiz, Marielena Vega, Rulon Wood

Public and Population Health Faculty Publications and Presentations

Introduction: Farmworkers are one of the populations most vulnerable to climate change. In addition to disproportionate exposure to climate-intensified hazards such as extreme heat and wildfire smoke, many farmworkers face situational and psychosocial stressors that also impact their health.

Methods: We conducted open-ended interviews with 16 farmworkers in Southcentral Idaho during June-August 2023 as part of a digital storytelling project in partnership with the Idaho Organization of Resource Councils (IORC). Interviews assessed participants’ experiences with climate change, perceived impacts on their health, and strategies and barriers to protecting themselves. Bilingual (English/Spanish) study staff translated and transcribed all video recordings verbatim, …

Why I Chose To Practice In Rural Michigan, Lisenia M. Collazo Dmd, Mph

The Journal of the Michigan Dental Association

This article explores the motivations behind dentists choosing rural practice, focusing on personal experiences and factors influencing career decisions. The narrative outlines the author’s journey from Pennsylvania to the Upper Peninsula of Michigan, emphasizing a commitment to addressing oral health disparities in underserved communities. The discussion covers training experiences, financial considerations, community engagement, and the challenges of rural health care. The author also highlights the role of mentorship and advocates for building relationships with mentors in the profession, especially in rural settings. The essay underscores rural practice’s unique advantages, including professional growth, lower living costs, and a supportive community.

Washington’S Ride Program: A Model Providing Rural Practitioners, Mary K. Smith Dds, Mba

The Journal of the Michigan Dental Association

The University of Washington School of Dentistry Regional Initiatives in Dental Education (RIDE) program is an award-winning dental education model that trains dentists to practice in rural and underserved areas. Its first cohort of students graduated in 2012. To date, there have been 96 graduates. More than 80% of RIDE graduates in practice are in rural and underserved areas, including those seeking specialty training. RIDE is successful because it collaborates with multiple universities, community health centers, local dental associations, and community leaders in the area where the students are located.

News You Need, David Foe Ma

The Journal of the Michigan Dental Association

The 2024 MDA Annual Session promises a range of valuable events and courses, including a free keynote by Joe Johnson, PhD, addressing career fulfillment. Additional highlights include the Gordon Christensen session, new dentist track, leadership courses, and an expansive exhibit hall. Meanwhile, the MDA House of Delegates Nominating Committee announced its candidate slate for the upcoming administrative year. The MDA also offers a free webinar on suicide prevention and celebrates communities awarded for water fluoridation quality. Additionally, ADA news covers a clinical guideline on managing dental pain, the ADA Academy's teaching program, and World Oral Health Day initiatives. Lastly, local …

J Mich Dent Assoc March 2024

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association provides news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It stands as the primary publication reaching Michigan dentists.

In the March 2024 issue, the Journal focuses on the landscape of practicing in rural settings. Original content includes:

• A cover story discussing "Market Realities for Rural and Small-Town Practices"

• A feature commentary from a new dentist in the Upper Peninsula on "Why I Chose to Practice in Rural Michigan"

• A feature article highlighting a dental education initiative, "Washington’s RIDE Program: A Model …

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Mda Foundation: Mission Of Mercy Volunteer Registration Is Open!, Anne Berquist

The Journal of the Michigan Dental Association

The MDA Foundation announces the reopening of volunteer registration for the Mission of Mercy free dental clinic in Flint, Michigan, from June 13-17. The clinic seeks dental professionals and laypeople alike to provide essential dental care to around 2,000 needy individuals. Volunteers can contribute clinical or non-clinical assistance, with opportunities for short-term or extended commitments. COVID-19 precautions are in place, and volunteers receive continuing education credits while profoundly impacting patients' lives.

Market Realities For Rural And Small-Town Practices, W. E. Rupprecht Dds

The Journal of the Michigan Dental Association

This article explores the challenges rural dental practitioners face in Michigan, highlighting the struggle to find successors for practice continuity and the impact on patient care. Examining sales data and demographic trends reveals disparities in successful practice transitions, emphasizing the difficulty in attracting buyers to rural areas. The reluctance of potential buyers, influenced by family and professional considerations, underscores the need for strategic solutions. Initiatives by the Michigan Dental Association and innovative approaches such as mentorship and financial incentives aim to address these challenges. The article concludes by urging practitioners to act as stewards and plan for successful transitions in …

Dietary Adherence And Cognitive Performance In Older Adults By Nativity Status: Results From The National Health And Nutrition Examination Survey (Nhanes), 2011–2014, Md Towfiqul Alam, Elizabeth Vásquez, Jennifer L. Etnier, Sandra Echeverria

Department of Health Sciences - Faculty Scholarship

Although adherence to dietary guidelines is associated with better cognitive performance, there may be differences by nativity status. This study aimed to investigate the association between adherence to the healthy eating index (HEI) and cognitive performance (CP) among United States (US)-born and foreign-born older adults (60+ years). Data were obtained from the 2011–2014 NHANES (n = 3065). Dietary adherence was assessed with HEI quintiles. CP (adequate vs. low) was examined using word listing (CERAD), animal naming (AFT), and the digit symbol substitution test (DSST). Weighted multivariable logistic regressions were used to examine associations. The US-born participants in higher dietary quintiles …

Ocular Syphilis: A Case Report And Public Health Discussion, Andrew L. Fine, Hope V. Daskalakis, Rutwik Pradeep Sharma M.D., Mirna Ogeilat M.D.

Advances in Clinical Medical Research and Healthcare Delivery

Ocular Syphilis describes a localized manifestation of a systemic treponema pallidum infection. It most commonly presents with decreased visual acuity due to uveitis and can occur at any time throughout the disease course. This report describes a case of undiagnosed syphilis that was serendipitously diagnosed with blood product screening. This case highlights the need for better public education and outreach pertaining to sexually transmitted infections. This report will detail this patient's clinical course and discuss how healthcare providers can aid in early disease detection to improve both patient outcomes and overall public health.

A Pharmacist’S Central Role In Improving Hormonal Contraceptive Access, Aleese Smith, Urvi Patel, Alexandra Arledge, Josie Young, Erin Johanson

Annual Research Symposium

In 2019, the roles of Utah pharmacists grew with the implementation of a statewide standing order allowing prescribing abilities for hormonal contraceptives. With the rates of unplanned pregnancies in Utah up to 1 in every 5; pharmacists have a new role in birth control distribution. Pharmacists and pharmacy interns across the state of Utah are able to prescribe self-administered hormonal contraceptive medications including: oral pills, vaginal insertion medications, and birth control patches. Pharmacists are entrusted with the responsibility to evaluate the patient and their needs to ensure all women receiving birth control are educated about the risks and side effects …

The National Status Of Pharmacists’ Ability To Prescribe Hormonal Contraceptives, Aleese Smith, Urvi Patel, Alexandra Arledge, Josie Young, Erin Johanson

Annual Research Symposium

The scope of practice for pharmacists first expanded in California and Oregon with the ability to prescribe hormonal contraceptives to patients in their communities. Since 2016, over 33 states now allow for pharmacist prescribing of birth control in their pharmacy practice laws.

90% of Americans live within 5 miles of a retail pharmacy, making community pharmacies an accessible resource who may otherwise be unable to access contraceptives. The gap in care experienced by certain patient populations is now being filled by pharmacists with their ability to prescribe birth control.

Patient Education On Naloxone And Fentanyl Testing, Monika Baranek, Kyra Dockstader

Annual Research Symposium

To educate patients on the importance of naloxone use to prevent unintended opioid overdoses and deaths. To provide community resources for fentanyl testing and destigmatize their use.

Double-Blinded Randomized Control Trial Investigating The Efficacy Of Probiotic Mouth Rinse In Enhancing Oral Health, Sudeep C B Prof. Dr., Sunil P M Prof. Dr.

Annual Research Symposium

The efficacy of probiotic mouth rinse in enhancing oral health was investigated through a double-blinded randomized controlled trial involving 45 children aged 12 to 15 over a two-week period. Comparing probiotic mouth rinse, chlorhexidine mouth rinse, and a control group, plaque and gingival accumulation were assessed using established indices. Results indicated both probiotic and chlorhexidine groups exhibited reduced plaque compared to the control, with the probiotic group showing superior reduction in gingival inflammation. These findings suggest the potential of probiotic mouth rinse in improving oral hygiene and overall oral health.

Evaluating The Oral Health-Related Quality Of Life Among Dental Patients In South India - A Descriptive Study, Dheekshitha P K, Sudeep C B Dr., Sunil P M Dr., Suji M Dr.

Annual Research Symposium

This study aims to evaluate the oral health-related quality of life among dental patients in South India.

Investigating The "Sex Paradox" In Pulmonary Arterial Hypertension: Results From The Pulmonary Hypertension Association Registry (Phar), Jacqueline T. Desjardin, Noah Kime, Nicholas A. Kolaitis, Richard A. Kronmal, Matthew R. Lammi, Stephen C. Mathai, Corey E. Ventetuolo, Teresa De Marco

School of Medicine Faculty Publications

BACKGROUND: Female sex is a significant risk factor for pulmonary arterial hypertension (PAH), yet males with PAH have worse survival - a phenomenon referred to as the "sex paradox" in PAH. METHODS: All adult PAH patients in the Pulmonary Hypertension Association Registry (PHAR) with congruent sex and gender were included. Baseline differences in demographics, hemodynamics, functional parameters, and quality of life were assessed by sex. Kaplan-Meier survival analysis was used to evaluate survival by sex. Mediation analysis was conducted with Cox proportional hazards regression by comparing the unadjusted hazard ratios for sex before and after adjustment for covariates. The plausibility …

Unsatisfactory Fecal Immunochemical Tests For Colorectal Cancer Screening: Prevalence, Reasons, And Subsequent Testing, Po-Hong Liu, Rasmi G Nair, Celette Sugg Skinner, Caitlin C Murphy, Eric J Kim, Cynthia Ortiz, Lei Wang, Ellen Hu, Jacquelyn M Lykken, Theodore R Levin, Beverly B Green, Erin E Hahn, Noel Santini, Ethan A Halm

Faculty, Staff and Student Publications

BACKGROUND: Fecal immunochemical test (FIT) is an effective colorectal cancer screening modality. Little is known about prevalence, reasons, and testing after unsatisfactory FIT, or a FIT that cannot be processed by the laboratory due to inadequate stool specimen or incomplete labeling.

METHODS: Our retrospective cohort study examined unsatisfactory FIT among average-risk individuals aged 50-74 years in a large, integrated, safety-net health system who completed an index FIT from 2010 to 2019. We determined prevalence of unsatisfactory FIT and categorized reasons hierarchically. We used multivariable logistic regression models to identify factors associated with: (i) unsatisfactory FIT; and (ii) subsequent testing within …

Neighborhood Environment And Poor Maternal Glycemic Control-Associated Complications Of Gestational Diabetes Mellitus, Leela V. Thomas, Claudine T. Jurkovitz, Zugui Zhang, Mitchell R. Fawcett, M. James Lenhard

Department of Medicine Faculty Papers

INTRODUCTION: Risk of complications due to gestational diabetes mellitus is increasing in the U.S., particularly among individuals from racial minorities. Research has focused largely on clinical interventions to prevent complications, rarely on individuals' residential environments. This retrospective cohort study aims to examine the association between individuals' neighborhoods and complications of gestational diabetes mellitus.

METHODS: Demographic and clinical data were extracted from electronic health records and linked to American Community Survey data from the U.S. Census Bureau for 2,047 individuals who had 2,164 deliveries in 2014-2018. Data were analyzed in 2021-2022 using Wilcoxon rank sum test and chi-square test for bivariate …

Acceptability Of Personalized Lung Cancer Screening Program Among Primary Care Providers, Paul J Resong, Jiangong Niu, Gabrielle F Duhon, Lewis E Foxhall, Sanjay Shete, Robert J Volk, Iakovos Toumazis

Faculty, Staff and Student Publications

Current lung cancer screening (LCS) guidelines rely on age and smoking history. Despite its benefit, only 5%-15% of eligible patients receive LCS. Personalized screening strategies select individuals based on their lung cancer risk and may increase LCS's effectiveness. We assess current LCS practices and the acceptability of personalized LCS among primary care providers (PCP) in Texas. We surveyed 32,983 Texas-based PCPs on an existing network (Protocol 2019-1257; PI: Dr. Shete) and 300 attendees of the 2022 Texas Academy of Family Physicians (TAFP) conference. We analyzed the responses by subgroups of interest. Using nonparametric bootstrap, we derived an enriched dataset to …

"I Live My Best Life In The Garden": Project Dig Summary Report, Tracy Boehm Barrett, University Of Montana Rural Institute

Health and Wellness

People with intellectual and developmental disabilities (IDD) are commonly overlooked in society because of a combination of social, economic, political, and cultural barriers. Due to such constraints, they also experience a wide range of health and community disparities that result in negative impact on their quality of life and well-being (Mpofu et al., 2020; Akyurek & Bumin, 2017). While many community-based organizations provide a variety of supports for people with disabilities, far less common are those providing therapeutic horticulture (TH) programs within the scope of their services. This report provides information about and recommendations for TH as an increased practice …

Assessment Of Salivary Cadmium Levels And Breast Density In The Marin Women's Study, Michaela F. George, Shayne Paff, Jenyse Rojo, Mark Powell, Christopher Benz, Karl Pope, Karla Kerlikowske, John Shepard, Matthew Willis, Rochelle Ereman, Leeann Prebil

Global Public Health | Faculty Scholarship

Background: We aimed to determine if salivary cadmium (Cd) levels had any association with breast density, hoping to establish a less invasive cost-effective method of stratifying Cd burden as an environmental breast cancer risk factor.

Methods: Salivary Cd levels were quantified from the Marin Women's Study, a Marin County, California population composite. Volumetric compositional breast density (BDsxa) data were measured by single x-ray absorptiometry techniques. Digital screening mammography was performed by the San Francisco Mammography Registry. Radiologists reviewed mammograms and assigned a Breast Imaging-Reporting and Data System score. Early morning salivary Cd samples were assayed. Association analyses were then …

Association Between Community Social Vulnerability And Preventable Hospitalizations, Rachel Hogg-Graham, Joseph A. Benitez, Mary E. Lacy, Joshua Bush, Juan Lang, Haritomane Nikolaou, Emily R. Clear, J. M. Mccullough, Teresa M. Waters

Public and Population Health Faculty Publications and Presentations

Preventable hospitalizations are common and costly events that burden patients and our health care system. While research suggests that these events are strongly linked to ambulatory care access, emerging evidence suggests they may also be sensitive to a patient’s social, environmental, and economic conditions. This study examines the association between variations in social vulnerability and preventable hospitalization rates. We conducted a cross-sectional analysis of county-level preventable hospitalization rates for 33 states linked with data from the 2020 Social Vulnerability Index (SVI). Preventable hospitalizations were 40% higher in the most vulnerable counties compared with the least vulnerable. Adjusted regression results confirm …

Pandemic-Related Changes In Incidence And Mortality Rates Of Gastrointestinal Cancers During 2020, Caitlin C Murphy, Anna Tavakkoli, Sachin Wani, Amit G Singal

Faculty, Staff and Student Publications

INTRODUCTION: Coronavirus Disease 2019 disrupted cancer-related care in early 2020.

METHODS: We used population-based cancer registry data to estimate incidence and mortality rates of gastrointestinal cancers between 2016 and 2020.

RESULTS: Incidence rates were unchanged from 2016 to 2019 but decreased in 2020, with the largest declines for colorectal cancer (rate ratio [RR] 0.88; 95% confidence interval [CI] 0.87-0.90) and hepatocellular carcinoma (RR 0.85; 95% CI 0.82-0.88). Mortality rates of colorectal cancer (RR 1.06; 95% CI 1.04-1.08) and esophageal adenocarcinoma (RR 1.06; 95% CI 1.00-1.13) increased in 2020.

DISCUSSION: Incidence and mortality rates of gastrointestinal cancers may increase in the …

Mda Foundation: What A Difference A Smile Makes, Anne Berquist

The Journal of the Michigan Dental Association

The 2023 round of scholarships awarded by the MDA Foundation totaled $31,000, more than twice the amount awarded in 2022. As a recipient of the MDA Foundation's Dr. George L. Bletsas Scholarship, Maya Scott, now a dental student, is dedicated to advocating for underserved minorities. Scott's journey into dentistry was shaped by her personal experiences with dental care and her desire to address health disparities. Growing up in challenging circumstances, orthodontic treatment transformed her smile and ignited her interest in dentistry. Her scholarship facilitates participation in dental missions and eases living expenses. With aspirations for general dentistry in underserved areas, …