Population Health

February 14, 2019

Inaugural pilot research grant awardees close out their yearlong projects

Image of the front of Suzzallo libraryThe Population Health Initiative pilot research grant encourages new interdisciplinary collaborations among investigators for projects that address critical components of different grand challenges the University of Washington seeks to address in population health.

The initiative funded an inaugural round of five pilot research grants to faculty-led teams from 10 different UW schools and colleges in October 2017. Those five teams have now finished their yearlong projects, with highlights of their work including:

Connecting fishery and health policies for diet-specific solutions for vulnerable populations

Edward H. Allison, School of Marine and Environmental Affairs
John Zachary Koehn, School of Aquatic and Fishery Sciences
Jennifer Otten, School of Public Health (Nutrition)
Christopher M. Anderson, School of Aquatic and Fishery Sciences
Ray Hilborn, School of Aquatic and Fishery Sciences
Emilee Quinn, Department of Environmental and Occupational Health Sciences

Final project summary
On the U.S. West Coast, rich and underutilized fishery resources exist alongside poor and malnourished people. This pilot project aimed to examine the scope and mechanisms for improved utilization of available food sources to improve diets and reduce incidence of non-communicable disease burdens in poor and marginalized coastal communities. Specific goals included identifying nutritionally-vulnerable U.S. West Coast communities who may benefit from improved fish access, and quantifying the extent of underutilized fish species in U.S. West Coast fisheries.

To meet these objectives, we collected and visualized spatially-explicit quantitative secondary data on fish catches, vessel permits, food environment, harbor infrastructure and socioeconomic conditions. We then organized the data into an analytical framework that identified nutritionally-vulnerable communities and linked them to offshore underutilized fish. Our initial findings indicate that harvest of many managed stocks with strong scientific harvest guidelines co-occur in areas with indicators that are high both in food need and capacity to access these fishery resources.

Our findings also included descriptive case studies of existing efforts that successfully directed underutilized fish to consumers and nutritionally vulnerable populations along the west coast. We also assessed the need for and feasibility of implementing additional systems and partnerships in regions where the quantitative data indicate that fish availability and food need exist.

The eventual goal of this pilot project is to make the case for proposing a much larger, strategic intervention to better connect fisheries production with the U.S. food system and with attempts to make that food system healthier for low-income consumers.

InterACTION Labs: Piloting an interdisciplinary built environment community health program with an informal settlement in the Peruvian Amazon

Joseph R. Zunt, Global Health, Neurology, Epidemiology, Medicine (Infectious Diseases)
Sarah Gimbel, Family and Child Nursing
Rebecca Neumann, Civil and Environmental Engineering
Peter Rabinowitz, Environmental and Occupational Health Sciences
Ana Lucia Seminario, Dentistry
Ben Spencer, Landscape Architecture

Final project summary
The InterACTION Labs is a transdisciplinary action research and service-learning program that responds to locally driven priorities to develop, implement and assess built environment projects and their capacity to improve human and ecological health in impoverished communities. The InterACTION Labs launched in a pilot in Iquitos, Peru with support from the Population Health Initiative funds and matching funds from seven UW departments/schools, two UW research centers, the Center for Technological, Biomedical and Environmental Research (CITBM) in Peru and the 100,000 Strong in the Americas Innovation Fund.

This pilot project took place in the informal floating community of Claverito where we paired interventions in the built environment designed to improve health and well-being with microbiome testing and conventional health assessment tools as a means of learning about the intertwined relationships between health and the environment. We involved 90 students, faculty and professionals from both the UW and Peru representing eight research centers and 26 disciplines, and worked alongside 221 residents who collaborated in the study.

We collected pre- and post-intervention health and microbiome measurements and, using a community participatory approach, constructed a built environment intervention designed to reduce exposure to harmful microbiome and increase exposure to helpful microbiome. The intervention consisted of a community park with improved stairs and household gardens that incorporated more than 1,500 local plants for medicine, food, beautification and improved habitat.

The pilot study sequenced the DNA of more than 3,500 different species found the oral, gastrointestinal and environmental microbiome and collected health measures including mental health, oral health, chronic disease risk, self reported symptoms, environmental exposures, nutrition and food security, parasites and demographics. The pilot has resulted in a rich database of community health measures, preliminary results to act as proof-of-concept for this transdisciplinary action research approach to apply for further funds, and improved environmental conditions in an urban slum.

Prepare for the IT workplace program (PREP for IT)

Hala Annabi, Information School
Jill Locke, Speech and Hearing Sciences
Gary Stobbe, Neurology

Final project summary
The PREP for IT initiative aims to empower young adults with autism who are pursuing IT careers to define their professional path and develop the tools to excel in the IT workplace. Over the course of this pilot project, we designed and deployed a workforce preparation program to empower post-secondary education students with autism at the University of Washington who are pursuing IT careers to secure, persist and advance in employment in the IT workplace.

The program uses an individual, strength-based approach for career planning and skill development that emphasizes community and collaboration with IT professionals. During their participation, students engaged in a series of workshops, mentoring engagements, shadowing experiences, company visits and coaching.

The funded pilot project produced an evidence-based curriculum model and materials transferrable to other post-secondary education settings to prepare students with autism for the IT workplace nationwide. We also developed research instruments to measure students’ work-readiness, self-efficacy and self-advocacy. Finally, we established the baseline measure for the current cohort and will assess student progress over time.

Islamic trauma healing: Somalia feasibility study

Lori A. Zoellner, Psychology
Debra Kaysen, Psychiatry & Behavioral Sciences
Michele Bedard-Gilligan, Psychiatry & Behavioral Sciences
Hamza Zafer, Near Eastern Languages and Civilization
Shannon Dorsey, Psychology

Final project summary
Rates of PTSD are considerably higher in war-torn regions like Somalia, known for sexual violence and other human rights violations (WHO, 2016). In the aftermath of substantial war- and refugee-related trauma, there is a clear need for research addressing the significant, under-addressed mental health needs of Somalis and the broader Muslim community. Although efficacious PTSD treatments exist, such treatments typically require extensive training of providers. Furthermore, there are significant barriers to dissemination due to Islamic and cultural beliefs that may inhibit mental health help seeking, language and cultural differences and limited access to care.

No existing trauma-focused treatments have an Islamic focus, despite almost a quarter of the world’s population practicing this religion. Islamic Trauma Healing is a brief, group-based, lay-led intervention specifically targeting healing of the mental wounds of trauma and community reconciliation within mosques. The six-session intervention combines principles of empirically-supported treatment with Islamic principles central to spiritual, social, family, and work life. Core components include cognitive restructuring through Prophet narratives and exposure to trauma memories through turning to Allah in dua [prayer]. Tea, snacks and supplications are included to promote a sense of community and spirituality.

We tested initial feasibility of implementing the program outside of the U.S. by conducting a small (N = 28) pre- to post-feasibility study in Somalia, providing critical pilot data for a later overseas randomized controlled trial. Based on both quantitative and qualitative data, the Islamic Trauma Healing program showed strong potential to provide a low-cost, self-sustaining model of a faith-based intervention that can address the psychological wounds of trauma and promote community reconciliation. If effective, Islamic Trauma Healing can be easily scaled-up through mosques, community centers and refugee programs.

Behavioral health workforce development

Patricia Areán, Psychiatry & Behavioral Sciences
Patrick Raue, Psychiatry & Behavioral Sciences
Amelia Gavin, School of Social Work
Zoran Popovic, Computer Science and Engineering
Shannon Dorsey, Psychology
Deborah Cowley, Psychiatry & Behavioral Sciences
Anna Ratzliff, Psychiatry & Behavioral Sciences

Final project summary
This project was intended to address the shortage of a mental health workforce trained to deliver evidence-based psychosocial interventions (EBPIs) by developing a training model for non-experts. This “task-sharing” approach has demonstrated effectiveness in low- and middle-income countries by teaching lay counselors with little or no prior experience to deliver EBPIs.

The current project used Population Health Initiative funds to develop such a training model and supplement it with a prototype of an intelligent tutoring system (ITS; a computerized training program developed by colleagues in Computer Science and Engineering). This training was delivered to 11 undergraduate students from psychology and social work as a course over the summer 2018 quarter (PSYCH 448b).

By the end of the course (nine class sessions), 81.81% (nine students) were rated as competent in delivering the intervention. Students reported a statistically significant improvement in their self-reported competence delivering this intervention by the end of the course. A few of the participating students who were trained in the intervention in PSYCH 448b will deliver the intervention to adults with depression in a pilot study during fall 2018/winter 2019. This study will provide preliminary feasibility and acceptability data on this intervention as delivered by non-expert behavioral health technicians. We will collect patient outcome data to support the efficacy of this intervention.

The next funding call for population health pilot research grant applications will occur during winter quarter 2020.