Population Health

June 9, 2022

Initiative announces awardees of spring quarter 2022 Tier 3 pilot research grants

Project team engaging with members of the communityThe Population Health Initiative has announced the award of five Tier 3 pilot grants to close out its grant funding for the 2021-22 academic year. The total value of these five awards is approximately $1.19 million, which included roughly $900,000 in funding from the initiative plus additional matching funds from different schools, colleges, departments and external partners.

The purpose of the Tier 3 pilot grant program is to support faculty and PI-eligible staff to create follow-on opportunities for impactful projects that have developed preliminary data or realized proof-of-concept and are seeking to scale their efforts and/or expand the scope of their work. This round of awards represented researchers from seven different UW schools and colleges – Arts & Sciences, Environment, Interdisciplinary Arts & Sciences (Bothell), Medicine, Pharmacy, Public Health and Social Work – as well as several community-based partners.

“We are delighted to fund these innovative, interdisciplinary projects that are seeking to address population health challenges ranging from health disparities in local populations to the impact of soil contamination in urban community gardens,” shared Ali H. Mokdad, the university’s chief strategy officer for population health and professor of health metrics sciences. “We also believe the research findings from each of projects will be poised for broad dissemination and adoption by others, which would dramatically expand the overall impact of the work of each of these teams.”

The awardees for this cycle are:

Community Pharmacist Epilepsy Services Program

Jennifer Bacci, Department of Pharmacy
Edward Novotny, Departments of Neurology and Pediatrics
H. Steve White, Department of Pharmacy
Andy Stergachis, Departments of Pharmacy and Global Health
Sabra Zaraa, Department of Pharmacy
Michelle Guignet, Department of Pharmacy
Kari VanderHouwen, Duvall Family Drugs and CPESN Washington
Grant Simic, UCB Pharma

Project abstract
Epilepsy is a complex spectrum of seizure disorders affecting approximately 3.4 million people nationwide, making it the fourth most common neurological disease after migraine, stroke, and Alzheimer’s disease. Antiseizure medicines (ASMs) are first-line treatment; however, 50% of people living with epilepsy (PWE) experience adverse drug effects, which negatively impact medication adherence and quality of life (QoL).

Community pharmacists are among the most accessible healthcare providers with extensive knowledge of pharmacotherapy yet are seldomly engaged in epilepsy care. Previous preliminary, proof-of-concept research led by this team and supported, in part, by the Population Health Initiative, developed and pretested a community pharmacist population health intervention for PWE. The intervention aims to improve human health and social and economic equity by positioning the community pharmacist as an accessible, trusted health partner with epilepsy expertise who can help close information and treatment gaps and disparities through frequent touch points, particularly for those patients who do not have easy access to a specialized epilepsy center.

The goal of this proposed Tier 3 study is to pilot the community pharmacist population health intervention for PWE in community pharmacies in Washington State. The aims are: (1) develop and evaluate a training program for community pharmacists’ population health intervention for PWE and (2) implement and evaluate the impact of the community pharmacist population health intervention on PWE’s QoL and health outcomes. This study will advance our efforts towards the long-term goal of scaling an effective intervention to improve the humanistic, clinical, and economic outcomes for PWE.

Amigas Latinas Motivando el Alma (ALMA): Addressing Mental Health Needs among Latina Immigrant Women in Yakima Valley

India Ornelas, Department of Health Systems and Population Health
Deepa Rao, Departments of Global Health and Psychiatry & Behavioral Sciences
Caty Padilla, Nuestra Casa
Magaly Solis, La Casa Hogar
Georgina Perez, Department of Health Systems and Population Health
Serena Maurer, Department of Health Systems and Population Health
Juan Gudino, Department of Health Systems and Population Health

Project abstract
Latina immigrant women living in rural areas are at increased risk of depression and anxiety symptoms, due to the many social and economic stressors they face, as well as significant barriers to accessing quality mental health care. In the past two years there has been the additional burden of COVID-19 on rural Latino communities, which has led to increased social isolation, family obligations and economic insecurity.

We propose to leverage existing expertise and community partnerships to pilot test the dissemination of the Amigas Latinas Motivando el Alma (ALMA) intervention to reduce depression and anxiety among Latina immigrant women living in the Yakima Valley. The aims of our pilot will be to: 1) Adapt the intervention to be delivered by local community health workers in the Yakima Valley; 2) Train and support local community health workers to deliver the intervention; and 3) Assess the potential effectiveness of the intervention when delivered by community health workers in a rural setting.

Community health workers at two community-based organizations, Nuestra Casa and La Casa Hogar, will be trained to deliver the ALMA intervention. Participants will be recruited through these organizations to participate in the intervention and complete surveys to assess changes in depression and anxiety. The study is a collaboration of an interdisciplinary research team that brings together expertise in public health, psychology, implementation science and community-based participatory research. Findings will be used to seek future funding to further evaluate the adapted intervention in a larger trial.

Healing Heart and Soul: Decreasing Maternal Racial/Ethnic Health Disparities through Home-Based Monitoring of Blood Pressure, Stress/Depression, and Safety

Rachel Chapman, Department of Anthropology
James Pfeiffer, Department of Global Health
Amelia Gavin, School of Social Work
Abril Harris, School of Social Work
Liza Perpuse, HealthPoint
Yvonne Griffin, Neighborcare Health
Tanya Sorensen, Swedish Medical Center
Katie Eastwood, Swedish Medical Center

Project abstract
The project team seeks to 1) decrease perinatal health disparities through homebased self-monitoring and self-reporting of blood pressure (BP), mental health (MH), and intimate-partner-violence/domestic violence (IPV/DV) during pregnancy, to improve care- providers’ response and treatment for elevated BP-MH-IPV/DV measures; and 2) center comfort, peace, safety and joy/pleasure as elements of healthy pregnancy.

During COVID, perinatal visits decreased. Anxiety, depression, IPV/DV, housing and food insecurity, pregnancy complications (gestational hypertension, diabetes, preeclampsia, fetal stunting) and maternal mortality spiked. Impoverished, racialized, especially Black women more often develop pre-eclampsia, suffer severe complications and fatalities, thus deepening already-persistent disparities. By increasing numbers of patients with BP cuffs (BPC) and a blood pressure, mental health, intimate-partner-violence/domestic violence and joy/pleasure screening tool, we increase home-monitoring and self-reporting. This operationalizes our main goal by 1) increasing provider-patient contacts; 2) facilitating patient reporting of elevated BP-MH-IPV/DV levels; and 3) improving provider-patient communication.

We propose supplying 500 pregnant patients with BPC and screener kits, and training providers and patients with the kits. “Bundling” BP, MH, IPV/DV, and joy/pleasure measurements potentially opens discussion of taboo subjects while normalizing joy/pleasure. Evaluation metrics include: 1) number of patients and providers receiving kits, training and doula check-ins; 2) patient uptake, reporting, results and satisfaction; 3) provider contacts, referrals and responses for elevated measures. Community-based doulas will conduct intake, midway and exit surveys with providers and patients in clinic systems serving under-served populations. Chart pulls will track tool utilization, home monitoring, patient reporting and provider follow-up. Policy implications address state-wide provision of BPC and screener to all pregnant people regardless of insurance status.

Equity Among American Indian, Alaska Native, Native Hawaiian, Pacific Islander communities under COVID-19 Telehealth Policy

Ashok Reddy, Department of Medicine
Edwin Wong, Department of Health Systems and Population Health
Joshua Liao, Department of Medicine

Project abstract
Washington implemented major Medicaid telehealth policy changes in response to COVID-19. These changes are particularly salient for American Indian/Alaska Native (AIAN) and Native Hawaiian/Pacific Islander (NHPI) populations, which have long suffered health inequity due to social determinants of health, such as poverty and language. COVID-19 has only exacerbated these disparities, with AI/AN and NHPI communities experiencing the highest death rates among all racial groups in the state.

Washington is home to one of the largest AIAN and NHPI populations in America. In view of both longstanding and COVID-specific inequities, it is critical to understand how telehealth policies have impacted these communities: whether telehealth reduces barriers to care in ways that disproportionately benefit them (e.g., obviating transportation), or create barriers that entrench or worsen disparities (e.g., requiring reliable broadband internet access). Problematically, little is known about these issues.

Our project addresses this major gap by using comprehensive Medicaid data to analyze telehealth use and disparities among AIAN and NHPI individuals. To ensure our work is informed by community perspectives, we will establish and incorporate input from a Community Board comprised of AI/AN and NHPI Medicaid beneficiaries, community-based organizations, clinicians, and policymakers. The Board will inform not just conceptual approach, project implications, and dissemination strategy; it will also help guide translation of project findings into future work. Ultimately, this project represents a vital step for addressing a major population health issue at the intersection of human health and social and economic equity.

Linking practice to policy change in urban community gardens

Melanie Malone, UW Bothell (School of Interdisciplinary Arts & Sciences)
Natalie Garcia, Department of Medicinal Chemistry
Brittany Johnson, School of Environmental and Forest Sciences
Ray Williams, Black Farmers Collective
Neli Jasuja, Young Women Empowered
Em Piro, Sustainable Seattle

Project abstract
Building off four years of research that confirmed contamination in urban community gardens (UCGs) is widespread throughout the Seattle metropolitan region, we aim to expand this research to center more community questions, and to impact policy and testing of UCGs. The study will first center a community question that asked us to compare grocery produce to what gardeners are growing in UCGs, and secondly will generate a framework that centers community feedback about risk, harm, and safety in UCGs.

During previous research, the lead PI found that soils and vegetables in all of the UCGs of this study exceeded health standards for a variety of contaminants, but that most people were unaware that they were encountering these contaminants and that they were encountering them at concentrations that had the potential to impact health. During this new phase of the project, we seek to understand what would make gardeners feel safe in their UCGs, and identify interventions on local and regulatory levels that centers community feedback, which could mitigate exposure to contaminants in UCGs.

In general, there is an absence of guidelines for UCGs, which makes it very difficult to make recommendations about what is safe. Moreover, guidelines that do exist have not considered community feedback. Legacies of environmental racism have resulted in limited choices for underserved gardeners who seek access to healthy food, and are already vulnerable to multiple environmental injustices. This project will address these issues in UCGs in order to improve their health.

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