Population Health

March 9, 2021

Initiative announces award of 2021 pilot research grants

Aerial view of Drumheller FountainEight different faculty-led teams have received have received pilot research grant awards from the University of Washington Population Health Initiative. These teams are composed of individuals representing seven different schools and colleges as well as external partners. Generous additional funding from school, college and departmental matching brought the total value of these awards to roughly $530,000.

“We’re delighted to support this year’s awardees in taking on pressing population health challenges ranging from COVID-19 to climate change to infant and child health,” shared Ali H. Mokdad, the university’s chief strategy officer for population health and professor of health metrics sciences. “It’s exciting to see the breadth of innovative ideas and interdisciplinary collaborations proposed in these projects, and we are particularly pleased at the number of community partners who are part of these project teams.”

The Population Health Initiative pilot research grant encourages new interdisciplinary collaborations among investigators for projects that address different challenges in population health. The awardees are:

Addressing Inequities in Speech-Language Pathology Services for Children with Communication Disorders

Sara Kover, Department of Speech and Hearing Sciences
Carly Roberts, College of Education
Natasha Arora

Project abstract
Disparities in access to services and quality of services for children with communication disorders from diverse racial, cultural and linguistic backgrounds have yet to be rectified in the field of speech-language pathology. As in other allied health fields, these inequities are the result of longstanding and deeply entrenched systems.

This study seeks to identify specific sources of those disparities by probing the perspectives of Washington speech-language pathologists (SLPs) and administrators. The aims are to identify their understanding of equitable service delivery, as well as barriers they experience, at both individual and systems levels, to implementing equitable SLP service delivery for children with communication disorders of diverse backgrounds.

This qualitative research will increase understanding of the multi-faceted sources of service delivery disparities through semi-structured interviews with SLPs and administrators in King County and Pierce County, in both early intervention and school settings. This work will allow dissemination of findings to clinicians, SLP graduate programs, decision-makers and other stakeholders across the State of Washington, with the ultimate goal of perturbing the systems that have created disparities in SLP services and outcomes.

This new, interdisciplinary collaboration between the Department of Speech and Hearing Sciences and the College of Education will provide the data and foundation necessary to secure external funding to launch a line of community-based participatory research to fully address the needs of children with communication disorders from diverse backgrounds, within and in spite of, the social, economic and systems that have led to disparities in speech language pathology services and outcomes.

Characterizing Risk Communication around Smoke Exposure in Rural and Tribal Communities in the Okanogan River Airshed Emphasis Area

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.

Ernesto Alvarado, School of Environmental and Forest Sciences
Savannah D’Evelyn, Department of Environmental & Occupational Health Sciences
Nicole Errett, Department of Environmental & Occupational Health Sciences
Cody Desautel, Confederated Tribes of the Colville Reservation

Project abstract
Wildfires across the western United States are increasing in frequency and severity. To lessen the negative impacts of high severity wildfires on both human and forest health, fuel management strategies such as prescribed fires (Rx fires) are being utilized. Use of Rx fires results in less severe wildfires and thus less severe smoke events. However, managing fire with fire increases the frequency of smoke exposure in rural communities outside of fire season.

To address this balance, we must start with effective risk communication for potentially affected populations. The goal of this project is to describe how tribal and non-tribal communities in the Okanogan River Airshed Emphasis Area (ORAEA) receive and communicate information about smoke exposure.

Through key informant interviews and focus groups, we aim to identify the community and cultural perceptions of smoke exposure and describe its impact on the community. We will partner with representatives from the Natural Resource Division for the Confederated Tribes of the Colville Reservation (CNRD), the Colville Environmental Trust Air Quality Program (CETAQP), and Washington Prescribed Fire Council (WPFC) to reach communities on and off the Colville reservation.

By working with these partners, we will describe perceived risk of smoke exposure, improve real-time culturally responsive risk communication, as well as advance and evaluate each community’s outreach goals. This work will set the stage for new and continued community-academic partnerships to develop effective and relevant resources and risk communication to enhance the resilience to, and reduce the disproportionate health risks of, smoke exposure.

Supporting Equitable Land Management Decisions Through the Characterization of Wildfire and Prescribe Smoke Exposure for At Risk Communities

Tania Busch Isaksen, Department of Environmental & Occupational Health Sciences
Julian Marshall, Department of Civil & Environmental Engineering
Claire Schollaert, Department of Environmental & Occupational Health Sciences

Project abstract
Wildfire activity in the western U.S. has increased in frequency, duration and intensity since the mid-1980s. In the United States, wildfire smoke (WFS) exposure has been associated with adverse respiratory and cardiovascular effects. Prescribed burning has been identified as one of the most effective methods to reduce fuel loads, mitigate future wildfire severity and facilitate forest restoration processes, all factors which could decrease future human exposure to smoke from wildfires.

However, prescribed burns also emit smoke and contribute to harmful air pollution exposures. Efforts to quantify the risk associated with prescribed burn smoke (PBS) events have been limited. To date, there has been no research on the relative contributions of WFS and PBS to population-level air pollution exposures. Additionally, it is unknown how these management activities have been targeted relative to the distribution of low income and communities of color, who may be at increased risk of wildfire impacts.

This lack of understanding is a barrier to developing safe and equitable land management strategies that fully appreciate the human health impacts. We will differentiate PM2.5 exposure from WFS and PBS events utilizing the GEOS-Chem atmospheric chemical transport model to simulate the contribution of WFS and PBS to surface PM2.5 concentrations and identify communities disproportionately impacted by these exposures in Washington and California. This knowledge can then be integrated into more holistic forest management planning that reduces high severity wildfire risk and promotes ecosystem restoration while simultaneously minimizing human exposures to hazardous pollutants.

A Collaboratory to Support Equitable and Just Climate Action

Jeremy Hess, Departments of Emergency Medicine, Environmental & Occupational Health Sciences, and Global Health
Jason Vogel, Climate Impacts Group
Julian Marshall, Department of Civil & Environmental Engineering
Sara Curran, Jackson School of International Studies and Department of Sociology
Kris Ebi, Departments of Environmental & Occupational Health Sciences and Global Health
Nicole Errett, Department of Environmental & Occupational Health Sciences
Andrew Dannenberg, Departments of Environmental & Occupational Health Sciences and Urban Design & Planning
Tania Busch Isaksen, Department of Environmental & Occupational Health Sciences
Esther Min, Front and Centered
Deric Gruen, Front and Centered
Tim Sheehan, Department of Environmental & Occupational Health Sciences

Project abstract
We propose to form a Collaboratory between the University of Washington (UW) and Front and Centered (F&C), a coalition of environmental justice organizations in Washington, to pursue just and equitable climate action in Washington State.

The Collaboratory will be built around three linked platforms: community engagement, led by F&C, that will solicit community priorities for climate action, including efforts to reduce greenhouse gas emissions and climate change adaptation; policy analysis, co-led by F&C and UW, that will translate engagement inputs into policy scenarios to use in health impact analyses (HIA); and web-based visualization, with baseline information on demographics, social determinants of health, environmental hazards, and climate, that will be coupled with scenarios to generate estimates of future health impacts along different action pathways.

The engagement platform will build on F&C’s experience with key informant interviews and focus groups. The policy analysis platform will build on F&C’s policy and advocacy activities and scenario-based HIA activities at UW’s Center for Health and the Global Environment (CHanGE). The visualization platform will incorporate prior work on environmental health disparities by F&C and the Department of Environmental & Occupational Health Sciences, climate projections done by the Climate Impacts Group, demographic projections done by the Center for Studies in Demography & Ecology, Julian Marshall’s work linking air pollution sources and receptors, and web visualization development led by CHanGE.

The Collaboratory will be an important tool for visualizing just climate action that, once developed, can be scaled to other geographies to facilitate risk management in other settings.

Addressing the Need for Culturally Responsive and Bidirectional Research Communication with the Latinx Community – The BRIDGE Project

Nathalia Jimenez, Department of Anesthesiology & Pain Medicine
Carmen Gonzalez, Department of Communication
Daniel Cabrera, Department of Medicine
Diana Maria Oliveros, Mexican Consulate in Seattle
Meg Gomez, School of Social Work
Aida Hidalgo, School of Public Health
Mikaela Freundlich Zubiaga, UW Latino Center for Health

Project abstract
Responding to the need for sustainable academic-community partnerships to address the burden of COVID-19 in Washington State Latinx communities, we propose developing an innovative bi-cultural, Bi-directional Research Digital Engagement (BRIDGE) Program.

BRIDGE is a new partnership between the Latino Center for Health, the UW Department of
Communications’ Center for Communication Difference and Equity (CCDE), UW School of Medicine’s Latinx Health Pathway (LHP) and the Mexican Consulate. BRIDGE aims to highlight community voices to address current COVID-19 needs and create a sustainable platform for future communication around Latinx health.

BRIDGE’s innovative approach leverages infrastructure from the Mexican consulate (Spanish radio programing and Facebook reach 20,000+ followers) and an interdisciplinary network of faculty in LHP, combined with CCDE’s storytelling experience, to create an interactive platform for in-time communication with Latinx communities.

Based on findings from LCH’s collaborative work around COVID-19 with the Washington Immigrant Solidarity Network and SeaMar Community Health Centers, and input from our community partner, the Mexican Consulate, BRIDGE proposes a stepwise pilot program that captures community needs through personal stories to understand gaps in care, education and outreach related to COVID-19 (e.g., mental health, school needs for Latinx children). It responds to outlined needs with in-time, culturally appropriate educational content (e.g., vaccinations) from bicultural/bilingual faculty and students to be disseminated through the Mexican Consulate’s outreach network.

Pilot data will inform future COVID-19 research efforts and a grant submission on the evaluation of social media as a tool for disseminating culturally appropriate health information to Latinx immigrant communities.

Rapid Community Partnered Mixed-Methods to Promote Vaccine Uptake in Diverse Communities

Theresa Hoeft, Department of Psychiatry & Behavioral Sciences
Bonnie Duran, School of Social Work
Diem Nguyen, Department of Psychiatry & Behavioral Sciences
Morhaf Al Achkar, Department of Family Medicine

Project abstract
U.S. communities of color are facing disproportionate levels of illness and death from COVID-19. COVID-19 vaccines can reduce health inequities if vaccines are trusted and accessible. Vaccine uptake can be improved through community partnered research. Rapid partnered mixed-methods need to be developed in order to help close health inequities during times of crisis including times of large-scale vaccine distribution tied to a global pandemic.

Over the course of the year, the University of Washington (UW) study team and community partners at the Vietnamese Health Board (VHB) will work with a Community Advisory Board (CAB) of diverse partners to develop a toolkit for partnered rapid mixed-methods research. UW and the VHB will also seek advice from a methods advisory group of experts in mixed-methods research, implementation science and community-based participatory research to support toolkit development.

The UW and VHB team will then develop and pilot a quantitative survey and qualitative interview guides to assess barriers and facilitators to vaccine uptake and accessing health care more generally. Findings from the pilot of these materials will inform refinement of the data collection tools and next grants.

Next steps with the VHB, CAB and methods advisory group include refining the toolkit as part of an R34 or R01 grant developing a community health worker intervention to reduce barriers to care more generally, including barriers to vaccine uptake. Community health workers for example can support patient education and offer motivational interviewing to support patient activation toward seeking care.

Co-Designing a Culturally-Responsive, Advanced Technology Intervention to Support the Health and Development of Young Children in King County

Julie Kientz, Department of Human Centered Design & Engineering
Kendra Liljenquist, Department of Pediatrics

Project abstract
King County’s 2018-2019 Community Needs Assessment identified that infants from racially and economically marginalized groups experience the highest rates of infant mortality and low birth weight than any other population. After implementing the Affordable Care Act (ACA), more families in King County used preventive health services (Albetta et al., 2019) like early childhood developmental milestone screening.

King County offers screening services through health providers and provides virtual information about early milestones, although a recent report revealed that health providers and caregivers/parents alike consider these tools inconsistent with cultural, social, and economic experiences. Environmental factors, like food and housing security, can constrain parent actions in supporting their child’s health, ultimately affecting a child’s outcomes (Bethell et al., 2011). Moreover, 92% of people aged 30-49 and 96% aged 18-29 in the US now own a smartphone (Pew Research Center, 2019).

Thus, there is an opportunity to engage in collaborative design efforts to develop more advanced smartphone-based interventions to provide culturally relevant activities and health recommendations, such as conversational or voice-based tools. To explore the feasibility of such tools, we aim to conduct community-driven co-design sessions with parents of children aged 0-5 in King County from racial and ethnic minority backgrounds.

During these sessions, parents will share stories about early childhood experiences, and ideate possible interventions that are compatible with their perceptions about culture and health. We will also develop a set of evaluation methods for assessing the usability and feasibility of these interventions.

This pilot research will provide the preliminary data needed to apply for funds to build and test a novel intervention with these communities to support the healthy development of children in King County and establish the foundation for longer-term solutions to reduce health disparities.

Community-Based Formative Research to Advance Reproductive Health Equity in Iñupiaq Alaska

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, including with sovereign tribal nations.

Elizabeth Harrington, Department of Obstetrics & Gynecology
P. Joshua Griffin, School of Marine and Environmental Affairs and Department of American Indian Studies
Dian Million, Department of American Indian Studies
Corina Kramer, Maniilaq Association
Lucas Trout, Maniilaq Association

Project abstract
Alaska Native women experience stark disparities in sexual and reproductive health (SRH) outcomes, including maternal morbidity/mortality, uptake of preconception and prenatal care and incidence of sexually transmitted infections. Many historical, socio-economic and geographic factors contribute to these disparities, from the ongoing structural violence of colonialism to the logistical challenges of providing health care to geographically-remote communities.

Maniilaq Association is a tribal health organization serving approximately 8,400 residents in 12 Iñupiaq villages across Northwest Alaska, ranging from 150 to 3,200 residents. This project will create a collaboration between the Maniilaq Social Medicine Program (SMP) and a team of UW faculty from the Departments of Obstetrics & Gynecology and American Indian Studies to advance SRH outcomes and equity in the Maniilaq service area.

Through community-based participatory research, we seek to understand the social, medical and place-based factors affecting women’s SRH in Northwest Alaska. Using interviews, process mapping and small group workshops, our team of UW and SMP co-investigators will highlight community-identified priorities for optimizing SRH care. We aim to gain insight into women’s, health providers’ and other stakeholders’ perspectives about culturally congruent approaches and interventions that will amplify community values, strengths and existing or emerging Maniilaq SRH programs.

By identifying innovative ways to mobilize clinical resources, training, technology and/or communication, this project will lay the groundwork for a long-term research and clinical partnership between the SMP and UW to benefit women’s health across Northwest Alaska.

The next funding call for population health pilot research grant applications will occur during winter quarter 2022.