Population Health

March 14, 2019

Initiative announces award of 2019 pilot research grants

Shot of the roses in the Rose Garden by the Drumheller Fountain in Rainier Vista.The University of Washington Population Health Initiative announced the award of approximately $280,000 in pilot research grant funding to six faculty-led teams. These teams include members from seven different schools and colleges, plus representatives of both UW Bothell and Tacoma. Funding was partially matched by additional school, college and departmental funds, bringing the total value of these awards to roughly $850,000.

“We were impressed by the number of innovative project ideas and the range of interdisciplinary collaborations represented in this year’s round of applications,” said Ali H. Mokdad, the university’s chief strategy officer for population health and professor of health metrics sciences. “We are delighted to be able to support each of the awardees in their efforts to improve the population health of communities here and around the world.”

The Population Health Initiative pilot research grant encourages new interdisciplinary collaborations among investigators for projects that address critical components of different grand challenges the UW seeks to address in population health. This year’s awardees were selected from a pool of 29 applications from faculty investigators representing the UW Bothell and UW Tacoma campuses as well as nearly every school and college on the Seattle Campus. The awardees are:

CocoBot - Tailored Self-Management Program for Caregivers of Children with Chronic Conditions

Weichao Yuwen, Nursing & Healthcare Leadership, UW Tacoma
Dong Si, Computing and Software Systems, UW Bothell
Sunny Chieh Cheng, Nursing & Healthcare Leadership, UW Tacoma
Teresa Ward, Psychosocial & Community Health

Project abstract
In the United States, 10 million family caregivers care for children with chronic health conditions. The stress of caregiving, particularly for the underserved is so significant that it negatively impacts caregivers’ physical and mental health and wellbeing. Existing health self-management interventions have primarily focused on caregivers of adults with dementia, pediatric cancer, and in samples with moderate to high socioeconomic status. Less is known about family caregivers who reside in underserved communities and care for children with chronic conditions. These caregivers are often isolated and reside in high-poverty communities with limited access to healthcare.

Promoting caregiver health in underserved communities has local and national implications. In considering the multiple needs of these caregivers in underserved communities, we propose to develop and pilot test the usability and feasibility of CocoBot, a theory-based self-management intervention that uses artificial intelligence (AI) “chatbot” technology to provide family caregivers of children with chronic asthma and arthritis with on-demand and interactive self-management skill development to reduce physical and mental health symptoms. The application of AI chatbot technology enables us to develop an accessible and cost-effective self-management intervention tailored to underserved family caregivers’ specific needs and preferences.

CocoBot will be developed and refined through family caregivers’ direct input and expert reviews using user-centered participatory design and iterative usability testing approaches. Findings regarding intervention feasibility and acceptability will guide future intervention optimization, and estimation of intervention efficacy will provide essential information and power calculations for a future definitive trial of the intervention.

Community Pharmacist Integrated Population Health Management of People Living with Epilepsy

Jennifer Bacci, Pharmacy
H. Steve White, Pharmacy
Sabra Zarâa, Pharmacy
John Miller, Neurology and Neurological Surgery
Edward Novotny, Pediatrics and Neurology
Bryan Weiner, Global Health and Health Services

Project abstract
Epilepsy is a complex spectrum of seizure disorders, affecting approximately 3.4 million people nationally and 75,000 people in Washington State; and the number is increasing. It affects quality of life and leads to significant health and socioeconomic disparities. The experiences of a person with epilepsy involves managing multiple co-existing health conditions and taking anti-seizure drugs, the mainstay of treatment that are often accompanied by significant adverse effects. Yet, healthcare and community services are often fragmented and uncoordinated.

Community pharmacists are among the most accessible and trustworthy healthcare providers with extensive knowledge of drug therapy, yet are seldom leveraged to fill the gaps in epilepsy care or many other non-communicable diseases. Community pharmacists educate patients about their disease, ensure dosing accuracy, monitor for side effects and drug interactions, and encourage medication adherence. At a population level, community pharmacists collaborate with other healthcare providers and assess medication use patterns and patient outcomes data to ensure medications are used effectively, safely, and in a cost-effective manner. No models exist for engaging community pharmacists in population health approaches to epilepsy care.

This project seeks to develop a community pharmacist integrated population health intervention for people living with epilepsy by (1) identifying best practices to address the needs of persons living with epilepsy and their caregivers; (2) develop an intervention using a stakeholder driven and consensus building approach; and (3) evaluate the acceptability, appropriateness, and feasibility of the intervention. The intervention developed from this project will be piloted and evaluated for effectiveness in future research.

Creating Climate Resilient Agricultural Communities in the Tropics through Natural Climate Solutions

Half of the funding for this award came via a partnership with the UW Office of Global Affairs, which seeks to enhance the UW’s global engagement and reach.

June Spector, Environmental and Occupational Health Sciences
David Battisti, Atmospheric Sciences

Project abstract
Natural climate solutions (NCS) are land stewardship practices that can contribute to climate change mitigation and provide ecosystem services essential for addressing all three pillars of population health threatened by climate change. In this project, we focus on quantifying how NCS can help communities residing near tropical forests adapt to the health and resilience challenges of a changing environment.

It is well-known that tropical forests sequester more carbon than any other habitat, but less well-known is that tropical deforestation events can immediately and substantially increase local temperatures. Because current climatic conditions in many tropical countries already approach levels that may be unsafe for humans, deforestation is an imminent threat to human health and resilience. Yet, in many tropical areas, deforestation continues to accelerate. Despite the potential benefits of NCS, decision-makers still lack information on how much and where NCS can best address climate, health, and resilience goals.

This project will examine how potential future climate and land use scenarios (i.e., deforestation patterns) affect heat exposure, health, and productivity in agricultural communities in industrializing tropical countries. The ultimate goal is to identify NCS portfolios that maximize community resilience and capacity. We propose a new inter-disciplinary team of atmospheric sciences, public health, and economics experts from the UW and The Nature Conservancy (TNC) to implement this effort. We will leverage TNC’s policy community ties to integrate project results into climate change mitigation and adaptation decision-making processes. This project has the potential for future funding and transferability to other areas of the world.

Does access to federally qualified health centers with high levels of behavioral health integration impact ED and hospital use among Medicaid beneficiaries?

Amber Sabbatini, Emergency Medicine
Theresa Hoeft, Psychiatry & Behavioral Sciences
Herbert Duber, Emergency Medicine

Project abstract
The proposed project leverages a new academic-public partnership to evaluate the effects of behavioral health integration on outcomes for Medicaid beneficiaries. Behavioral health integration with primary care is an expanding strategy for improving the quality of care for patients with mental illness and is a core component of Washington State’s Medicaid Transformation Program (MTP), a contract with the Centers for Medicare and Medicaid Services that provides up to $1.5 billion of federal investment for regional health system transformation projects. Yet, to date, there exists a limited body of research evaluating the characteristics and benefits of integrated care, especially within the context of large-scale policy efforts.

Our study reflects a collaborative effort between the UW investigator team, Public Health – Seattle King County, and HealthierHere, the regional Accountable Community of Health responsible to the state for improving outcomes and shepherding delivery system transformation in King County. Using organizational data collected from provider surveys linked to Medicaid claims we aim to 1) describe the landscape of services integration across federally qualified health centers in King county, 2) determine the patient and organizational factors associated with greater implementation of integrated services, including the populations that have (or lack) access to integrated care and 3) determine whether access to highly integrated care reduces ED and hospital use. Findings from this work will provide timely and actionable data to inform ongoing policy initiatives within the state, and yield important preliminary data for a larger grant application focused on understanding the effects of integrated care on a broad array of health and socioeconomic outcomes.

Ethnoforestry: Applying Traditional Ecological Knowledge for Ecosystem Sustainability on the Olympic Peninsula

Half of the funding for this award came via a partnership with UW’s EarthLab, which works in partnership with others to co-produce and catalyze actionable science.

Bernard Bormann, Environmental and Forest Sciences
Marc Miller, Marine and Environmental Affairs
Courtney Bobsin, Environmental and Forest Sciences

Project abstract
Across the Olympic Peninsula, widespread changes in forest management policy have altered rural communities over the last several decades. Many rural communities were hit hard by a decrease in available jobs due to a decline in timber supply from over-harvesting and spotted owl protections as well as mill modernization. Tribes have since suffered from a decline of some cultural keystone species adapted to early seral conditions precluded by efficient tree regeneration and late-seral reserves. In the aftermath of this, rural communities are left to rebuild with their primary sources of work and culture degraded.

We believe a key way to build community resilience and health is through ethnoforestry: using traditional ecological knowledge of local people and applying it to forest management on public lands. Applied ethnoforestry can put the space in between regenerating conifers over the first 15 years after harvest to work. Species that are culturally valuable to nearby communities will be planted, tended, and then harvested for personal or semi-commercial use. If successful, ethnoforestry will add new small businesses and jobs and boost the local economy.

Through this grant, we will work will tribal and non-tribal communities on the Washington Coast to determine what plant species they would like to see us bring back in nearby ecosystems. We will develop a research proposal to test the growth and success of these species in permanent plots. This interdisciplinary approach will not only enhance the resilience and health of the local community, it will also benefit the local ecosystem.

Supporting Latinx Parents of Young Children with Tools for Parenting, Stress-Management and Legal Education

Elizabeth Dawson-Hahn, Pediatrics
Liliana Lengua, Psychology
Nora Coronado, Center for Health Equity, Diversity and Inclusion
Brian Johnston, Pediatrics
Gino Aisenberg, Social Work

Project abstract
There are ~4.5 million Latinx citizen children in mixed immigration status families in the US, and vulnerable immigration status is associated with poor health, development and social service access. Despite the potential negative impact of immigration stress on child health, responsive parenting plays an important buffering role for children affected by adversity and promotes resilience.

Since positive parenting and immigration status both impact the health of children and families, we aim to adapt a brief, responsive parenting behavioral skills intervention — Social, Emotional and Academic Competence for Children and Parents (SEACAP) and pair it with immigration law and policy education and resources. Initially we will conduct qualitative interviews with Latinx parents of young children with vulnerable immigration status to identify their strengths and stressors around parenting, and expressed needs related to immigration law. We will then utilize the themes identified in the qualitative interviews to adapt the SEACAP program to SEACAP+Legal (SEACAP+L). We anticipate developing SEACAP+L will involve enhancing the cultural relevance of the SEACAP curriculum, and adding an immigration law component to the content –including safety planning and know your rights training. Then finally we will pilot test the SEACAP+L program in a single arm trial for feasibility and acceptability.

This work will be realized through a new collaboration among faculty members from Pediatrics, Psychology, Social Work, the Center for Health Equity, Diversity and Inclusion, members of the medical-legal partnership with advising from UW School of Law, and community partner organizations.

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