Population Health

April 7, 2022

Initiative announces award of eight winter quarter 2022 Tier 2 pilot research grants

UW team conducting research on a boatThe University of Washington Population Health Initiative announced the award of eight Tier 2 pilot grants to teams representing researchers from seven different UW schools and colleges and several community-based partners. The total value of these awards was roughly $677,000, which included $463,000 in funding from the initiative plus additional matching funds from different schools, colleges and departments.

“We are excited to support these eight innovative, interdisciplinary and largely community-based projects to test hypotheses, methods and interventions as they take on different grand challenges we face in population health,” said Ali H. Mokdad, the university’s chief strategy officer for population health and professor of health metrics sciences.

The initiative’s Tier 2 pilot grant program supports researchers in developing preliminary data or the proof-of-concept needed to pursue follow-on funding to scale one’s efforts. The awardees for this cycle are:

Development of a Vaccine for Valley Fever

Deborah Fuller, Department of Microbiology
Michael Gale, Department of Immunology
Jesse Erasmus, Department of Microbiology
Bridget Barker, Department of Biological Sciences, Northern Arizona University
Erik Settles, Department of Biological Sciences, Northern Arizona University

Project abstract
Valley Fever (VF) is caused by a fungal (Coccidioides) infection. VF resembles COVID-19 symptoms and causes an estimated 15-30% of community-acquired pneumonias in endemic regions (South-West United States). VF is spreading rapidly into the soils of the Pacific Northwest due to climate change, wildfires and the expansion of human populations that disrupt the soil. To date, there is no safe and effective vaccine to protect against the threat of future VF epidemics.

We have developed novel DNA and mRNA vaccine platforms that induce robust immune responses against infectious diseases including robust antibody and T cell responses that have been shown to play a role in protection from VF reinfection in naturally infected patients. Here, we will employ our DNA and RNA vaccine technologies to investigate the feasibility of using these platforms to as a strategy to develop an effective VF vaccine. We will construct DNA and RNA vaccines expressing well-defined VF immunogens and compare the immunogenicity of these vaccines in mice.

In collaboration with VF experts at Northern Arizona University, we will then evaluate the most potent vaccines for protective efficacy in a mouse model of VF infection. If successful, this pilot study will provide valuable preliminary data to support advancing this approach to develop a novel nucleic acid vaccine for Valley Fever.

Assessing National Public Housing Authority Disaster Preparedness, Response and Recovery of Place-based Subsidized Housing Units

Nicole A Errett, Department of Environmental & Occupational Health Sciences
Rebecca Walter, Department of Real Estate
Andrew Aurand, National Low Income Housing Coalition
Jamie Vickery, Department of Environmental & Occupational Health Sciences
Amber S Khan, Department of Environmental & Occupational Health Sciences

Project abstract
America is experiencing a shortage of seven million affordable homes for low-income renters. At the same time, climate change is contributing to a rapid increase in frequency and intensity of disasters, which damage and destroy substantial housing stock, displacing populations and leaving many exposed to environmental hazards. This leads to adverse mental and physical health outcomes, especially among low-income tenants, who already experience limited affordable housing.

Public Housing Authorities (PHAs) own and manage housing units (i.e., Place Based Subsidized Housing, or PBSH) that they rent to low-income tenants. As tenants in PBSH have historically been in precarious housing situations following disasters, PHA disaster preparedness is of paramount public health importance, yet it remains unknown if and how PHAs are planning for disasters.

The goal of this project is to assess PHA engagement in disaster preparedness, response and recovery activities. We first aim to identify PHA responsibilities through a content analysis of state-level disaster plans. Next, we will conduct key informant interviews to describe strategies being undertaken by PHAs before, during and after disasters, and to identify opportunities to enhance PHA engagement in disaster preparedness, recovery and response.

Partnering with the National Low Income Housing Coalition (NLIHC) to reach stakeholders, we will improve understanding around implementation of PHA disaster strategies and advance current knowledge of housing gaps in state-level disaster planning decisions. This work will build a strong community-academic partnership, provide preliminary data on implementation of PHA strategies and foster future research on equitable disaster housing strategies for low-income renters.

Parent Behavior Management Training for Foster Caregivers

Kari Gillenwater, Department of Pediatrics, Harborview Medical Center Foster Care Center of Excellence
Erin Schoenfelder Gonzalez, Department of Psychiatry and Behavioral Sciences, Department of Pediatrics
Elana Feldman, Department of Pediatrics
Molly Cevasco, Clinical Psychologist, Seattle Children’s Hospital
Emma Whitmyre, General Child Psychology Resident
Aleksandra Bacewicz, Child and Adolescent Psychiatry Fellow

Project abstract
Foster children are a vulnerable population, at risk for worse health, educational and developmental outcomes than the general population. Children of color are overrepresented in the child welfare system along with those who come from low-income households. These children share histories of adversity and trauma, which contribute to behavior problems and can further lead to placement disruptions. Many foster parents report feeling inadequately prepared to meet the behavioral and emotional needs of foster children. Evidence-based treatments for mental health and behavioral concerns are often difficult to access, time-intensive and expensive.

First Approach Skills Training for Disruptive Behavior (FAST-B) is an evidence-based behavioral parent training program to address behavior problems in children ages 4-11 including oppositional behavior, parent-child relationship and adjustment problems. Histories of maltreatment and multiple placements in the foster care population, among other characteristics, add further nuance to behavioral issues not specifically addressed with FAST-B.

This project brings together members from the departments of Pediatrics, Psychology and Psychiatry at University of Washington, Seattle Children’s Hospital and Harborview Primary Care (Foster Care Center of Excellence), to adapt and pilot the FAST-B curriculum for caregivers of foster children. The project adapts the FAST-B program to foster caregivers and evaluates its feasibility through an iterative quality improvement process. Additionally, the effects of the program on parenting practices, caregiver strain, caregiver/child relationship and child behavior are evaluated. As a proof-of-concept study, participants will provide feedback on the program, structure and material, with the goal of optimizing these variables to provide enhanced foster caregiver guidance and support.

Innovating Better Methods to Enumerate Individuals Experiencing Homelessness

Amy Hagopian, Departments of Global Health and Health Systems & Population Health
Owen Kajfasz, Acting Chief Community Impact Officer with the King County Regional Homelessness Authority
Bo Zhao, Department of Geography
Paul Hebert, Department of Health Systems & Population Health and Veterans Administration Health Services Research & Development
Zack Almquist, Department of Sociology
Gang Luo, Department of Biomedical Informatics and Medical Education
Adrian Dobra, Department of Statistics

Project abstract
Homelessness is not new in Seattle history, but the problem has mushroomed since plentiful cheap housing has dwindled. In November 2015, the city’s then-mayor declared a homelessness state of emergency, after which visible homelessness only multiplied. Counting the number of people in outdoor and sheltered homeless situations is the responsibility of a nationwide network of HUD “Continuum of Care” agencies. The “one night” census approach to counting unhoused populations has been soundly critiqued, but enumeration strategies have been limited by lack of innovation. Counting is important because we cannot solve problems we cannot describe.

We have formed a partnership with King County’s new Regional Homelessness Authority to innovate the “Point in Time” count, bringing modern methods: respondent driven sampling, multiple list (aka capture/recapture), anonymous cell phone signal counts from encampments and tracking those swept from open air encampments. We are, in essence, establishing a UW multidisciplinary Homelessness Research Lab with faculty from public health, geography, sociology, statistics and informatics. With proof of concept of these enumeration methods, we are poised to apply for larger grants to develop this field. We are working in a collaborative way with other west coast universities, where U.S. homelessness is concentrated.

Human Health and Well-being Implications of Pervasive Navy Aircraft Noise Pollution

Edmund Seto, Department of Environmental & Occupational Health Sciences
Julian D. Olden, School of Aquatic and Fishery Sciences
Anne Harvey, President, Sound Defense Alliance
Bob Wilbur, President, Citizens of Ebey’s Reserve
Taylor Hendricksen, Environmental & Occupational Health Sciences

Project abstract
Impacts of noise on human health and well-being are pervasive, yet considerable knowledge, regulatory and policy gaps remain. Military activity over western Washington has increased dramatically over the past decade due to national consolidation to Naval Air Station Whidbey Island. Although naval flights have been operating in the area for decades, the transition from Prowler to Growler aircraft and expanded operations has increased the noise experienced by residents, visitors and wildlife. However, lack of federal environmental noise legislation (i.e., comparable to Clean Water or Clean Air Acts) has led to insufficient research attention and limited data to guide evaluation and mitigation actions.

Since 2013, community groups, tribes and agencies have sponsored their own research, lobbied legislators for relief, negotiated with the Navy and taken legal actions. However, there is an urgent need for corresponding advances in understanding how noise affects people, communities and the environment.

Our community partners initiated and developed this research to bolster their longstanding advocacy around this issue. We will analyze a robust archive of raw data collected over the past decade to quantify noise levels, duration and frequency of events across the study region. Population health risks will be estimated using quantitative exposure-response relationships for noise and health impacts, which include hearing loss, increased blood pressure, sleep disturbance, stress and annoyance and childhood learning. We will produce spatial estimates of noise levels and health burden to inform mitigations in impacted communities. This project leverages each partner’s strengths to co-produce findings that will lead to policy solutions.

Population-Based Administrative Data to Understand Child Maltreatment and the Pandemic – The Risk of Death and Serious Injury Study (RODIS)

Melissa L. Martinson, School of Social Work
Kushang V. Patel, Department of Anesthesiology and Pain Medicine
Benjamin de Haan, Director of the Center for Social Sector Analytics & Technology (CSSAT), School of Social Work
Emily Brown, Department of Pediatrics
Peter Pecora, Casey Family Programs
Rebecca Rebbe, School of Social Work, University of Southern California

Project abstract
Research has demonstrated that child maltreatment has both immediate and long-term detrimental impacts on physical, developmental, and mental health. It is also a common problem and the agency designed to respond to it in Washington State, child protective services (CPS), received 111,983 reports of child maltreatment in 2019 alone. The COVID-19 pandemic has impacted most facets of health and well-being in the United States, and early signals suggest an impact on child maltreatment.

With schools and daycare facilities closed and higher unemployment rates due to the COVID-19 pandemic in 2020, experts have worried not only that the incidence of child maltreatment has increased, but that that new or recurrent cases of maltreatment have gone undetected. Yet, empirical evidence and data regarding whether these concerns are founded are limited.

This project will be a collaboration between the School of Social Work, the Harborview Injury Prevention & Research Center, the School of Medicine and Casey Family Programs to construct a novel linked administrative dataset that includes population-level information on births, hospitalizations, deaths and CPS records for Washington State 2010- 2021. It will enable us to generate data-informed knowledge on if and how the COVID-19 pandemic has impacted the incidence and severity of child maltreatment, if these impacts are different by poverty status and race/ethnicity and if and how medical professionals are responding to concerns of maltreatment in order to potentially improve child safety outcomes.

Addressing COVID-19 Vaccine Hesitancy in Pregnancy Within U.S. Black Communities

Kristina Adams Waldorf, Department of Obstetrics and Gynecology
Alex Stonehill, Department of Communication
Evelyn Botwe, National Black Leadership Commission on Health
Lauren Marcell, School of Medicine
Ekta Dokania, Department of Communication
Maria Jose Soto Monteverde, Department of Communication
Kolina Koltai, Information School, Center for an Informed Public
Judy Fordjuoh, National Black Leadership Commission on Health
Bibi Natosha, National Black Leadership Commission on Health

Project abstract
Although pregnant people tend to be young and healthy, they are a highly vulnerable group to the coronavirus disease 2019 (COVID-19) and experience a more severe illness and higher rates of maternal death, preterm birth and stillbirth. Public health messaging to pregnant people in the U.S. has been confusing and insufficient, which has led to the spread of misinformation regarding the effect of vaccination on pregnancy outcomes, menstrual periods and fertility. Low vaccination rates in pregnant individuals are striking compared to the general population (all races/ethnicities 41.5%; Black Non-Hispanic 25.5%) and reflect a failure in public health messaging.

In this proposal, we will partner with the National Black Leadership Commission on Health (NBLCH) to investigate vaccine hesitancy in Black and Afro-Latinx pregnant individuals living in the urban East and rural South to inform the design of social media content. We hypothesize that vaccine hesitancy in Black pregnant individuals is based in mistrust of the medical system due to systemic racism and that faith- and family-based messaging will increase vaccine confidence.

Our study design will involve mixed methods to explore reasons for vaccine hesitancy and reaction to digital content through surveys, focus groups and direct interviews. Qualitative data will be analyzed thematically to inform design of social media test ads that will be tested on Facebook, Instagram and Tiktok. Completion of this project will enable an R01 proposal to explore vaccine hesitancy and test and refine social media messaging to promote vaccine uptake in Black pregnant individuals.

STIM A SPU’US (“What’s in Your Heart”): A Culturally Adapted, Trauma Informed Parenting Intervention for the Colville Tribes

A portion 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.

Myra Parker, Department of Psychiatry & Behavioral Sciences
Teresa Evans-Campbell, School of Social Work
Alvina Marris, Department of Behavioral Health, Confederated Tribes of the Colville Indian Reservation
Sara Waters, Department of Human Development, Washington State University

Project abstract
American Indian (AI) communities have experienced and continue to experience family disruption due to contacts with the foster care system, parental substance use and untreated trauma response. Moreover, historical trauma, intergenerational trauma and individual trauma remain prevalent, yet few parenting skills curricula address these issues in a culturally congruent manner.

Parents’ ability to understand children’s cognition and emotions plays an integral role in attachment, and without efforts to support healing, parent-child attachment will remain disrupted due to the effects of historical trauma and intergenerational trauma within AI communities. Because our relationship with our caregivers serves as a critical predictor of social-emotional development and overall mental health, this disruption represents a core public health problem in AI communities.

The overall aim of this study is to implement a pilot test of a culturally congruent, trauma informed, parenting skills curriculum that provides critical parenting support to Colville families. The curriculum provides instrumental trauma support and parenting skills with the goal of promoting loving, caring relationships among parents and children.

Our first aim is to test curriculum feasibility and preliminary efficacy in the Colville community by examining pre and post assessment scores on parenting knowledge, reflective functioning, and cultural connectedness, and tracking participation and engagement across sessions. Our next goal is to assess the quality of the curriculum and the overall fit through curriculum satisfaction. This feedback, along with data on pre and post assessments, will provide support for a future randomized controlled trial submission to test the efficacy of the intervention across the community.

More information about the Population Health Initiative pilot grant program, tiering and upcoming deadlines can be found by visiting our funding page.