Population Health

May 16, 2023

Initiative awards nine spring quarter 2023 Tier 1 pilot grants to UW research teams

Research project team engaged in discussionThe Population Health Initiative announced the award of nine Tier 1 pilot grants to interdisciplinary research teams representing 10 of the University of Washington’s schools and colleges. The total award value of these grants is nearly $210,000, which includes school, department and unit matching funds.

“We were extremely pleased with the range of challenges these awards will work to address,” said Ali H. Mokdad, the UW’s chief strategy officer for population health and professor of health metrics sciences. “It was also quite inspiring to see the number of different academic disciplines that came together to develop these projects.”

The purpose of Population Health Initiative Tier 1 pilot grants is to support researchers in laying an interdisciplinary foundation for a future project to generate proof-of-concept. The nine awardees for this cycle are:

Documenting the Impact of Abortion Myths on Healthcare Providers and Advocates

Anna Lee Swan, Information School
Amanda Lock Swarr, Department of Gender, Women, and Sexuality Studies
Rachel Moran, Information School
Taylor Agajanian, Information School
Izzi Grasso, Information School
Andrew Beers, Department of Human-Centered Design & Engineering
Emma Spiro, Information School

Project abstract
Abortion is a common and safe medical procedure with a long history of practice within the U.S. Yet, inaccurate and misleading information around abortion persists including falsehoods about the accessibility and legality of abortion related healthcare, myths around long-term physical and mental impacts, and misleading descriptions of abortion procedures. The prevalence of inaccuracies has been exacerbated by the politicization of abortion and the patchwork of state laws governing access to abortion in the wake of the overturning of Roe v Wade in May 2022.

Despite extensive documentation of abortion-related misinformation in online and offline spaces, and calls of concern from healthcare practitioners about such content [24], little academic research exists documenting and examining how misleading abortion information impacts the everyday work of healthcare providers and others working within abortion healthcare. Accordingly, this research project looks to address current gaps to properly document the impacts of misleading information on healthcare providers. These potential impacts include, but are not limited to, how persistent abortion myths–especially those amplified on social media–emerge in patient-provider interactions, affect patient-provider relationships, and influence patients’ reception of and trust in accurate abortion-related information as communicated by healthcare professionals.

Through in-depth interviews with regional abortion healthcare providers and professionals working with abortion-related care, we will conduct a needs assessment to identify perceived public gaps in knowledge, understand barriers to providing abortion and related care, and document the impact of misleading abortion information on patients’ understanding of abortion as a safe healthcare intervention based on the experiences of providers and advocates to inform future interventions.

Assessing for Violence Exposure and Other Health-Related Social Needs in Children by Pediatric Health Care Providers

Anna Bender, Department of Pediatrics
Frederick Rivara, Department of Pediatrics
Anjum Hajat, Department of Epidemiology
Megan Moore, School of Social Work
Beth Ebel, Department of Pediatrics
Brian Johnston, Department of Pediatrics
Monica Vavilala, Department of Anesthesiology & Pain Medicine

Project abstract
Many children across the U.S. are exposed to physical assault, sexual assault, property crime, and/or witness violence. Effects of injury and violence exposure on child biopsychosocial well-being are profound and enduring. Social determinants of health (SDoH) and related health-related social needs (HRSN) can significantly predictive of CEV, and can also condition or transmit the effect of CEV on biopsychosocial outcomes. HRSN (e.g., housing insecurity, personal safety from violence exposure) are potentially malleable factors to reduce childhood exposure to violence (CEV), prevent negative outcomes and reduce health disparities.

This study will explore existing approaches for HRSN assessments conducted by pediatric health care providers in Washington state. This project is well-aligned with the Joint Commission’s 2023 mandate to reduce health disparities by assessing for HRSN across health care settings. In-depth interviews will be conducted with pediatric health care providers/staff and systems-level administrators across Washington to understand (1) current processes for HRSN assessments; (2) facilitators of and barriers to such assessments; (3) follow-up care for identified HRSNs; and (4) innovative solutions for HRSN assessment and follow-up in pediatric health care settings.

A Qualitative Study of the Psychological Costs of Citizen-State Interactions for Trans People

Isaac Sederbaum, Evans School of Public Policy & Governance
Arjee Restar, Departments of Epidemiology and Health Systems and Population Health
Karin Martin, Evans School of Public Policy & Governance
Rachel Fyall, Evans School of Public Policy & Governance

Project abstract
Despite high levels of need, trans people face unique barriers when seeking to access government safety-net services. One of these barriers is administrative burden, which refers to the costs associated with interacting with government, especially when seeking benefits or services. Prior research confirms that administrative burden not only prevents individuals from receiving important assistance (such as food stamps); it can also create psychological costs, such as stress and stigma. While trans people are routinely construed as liars, frauds, and deviants deserving of punishment, there are no studies that examine the administrative burdens of citizen-state interactions for trans people specifically. This project explores how administrative burdens, specifically psychological costs, impact service-seeking behavior and service receipt of safety-net programs among trans people.

The goal of this study is to develop a detailed portrait of how stigma, stress, and loss of autonomy impact trans people and investigate whether these impacts have later-term outcomes that affect overall wellbeing. To achieve this goal, we will conduct semi-structured interviews with 50 trans people who have previously consented to contact following a related survey. Utilizing the aid of a participatory advisory board to help analyze findings, this study will expand existing administrative burden theory to both include trans people as well as investigate how burdens impact well-being long-term.

Working Towards Prevention: Identifying Early Predictors of Risk for Schizophrenia in Diverse Youth

Mahnoor Hyat, Department of Psychology
Jennifer Forsyth, Department of Psychology
Alison Fohner, Department of Epidemiology
Katherine Foster, Departments of Psychology and Global Health

Project abstract
Schizophrenia (SCZ) is a debilitating and costly disorder associated with high unemployment rates, social disability, and suicide. Current diagnostic criteria depend on fully-formed psychotic symptoms, leading to treatments being introduced only after severe symptom expression and suboptimal outcomes for most patients. However, growing evidence suggests that early cognitive and behavioral signs may precede future psychopathology in those who develop SCZ. Importantly, the success of recent genome-wide association studies (GWAS) of SCZ now allows for computation of summary-level polygenic risk scores, which provide a cumulative measure of an individual’s genetic risk level for SCZ. However, the majority of research on SCZ genetic risk factors and early behavioral signs has relied on predominantly white, European ancestry samples. Given differences in exposure to environmental stressors, SCZ diagnosis rates, and allele frequencies across genetic ancestry groups, there is a substantial need for research on SCZ risk markers in diverse groups.

The current project aims to identify early behavioral markers of genetic risk for SCZ across individuals with African, Latinx, and European ancestry, using data from the Adolescent Brain and Cognitive Development study. It will examine whether genetic risk for SCZ is linked to cognitive, behavioral and/or emotional functioning in childhood, and if molecularly-defined genetic risk provides information beyond what is garnered through family history of SCZ. The overarching goal is to improve screening for elevated SCZ risk across diverse youth in healthcare settings and to develop a team that is well poised to conduct population-health research and work towards equitable application of genetics in mental health.

Improving Public Health Surveillance and Communication for Freshwater Harmful Algal Blooms in Washington State: A Pilot Study using Drone Technology

Joey Teresi, Department of Environmental & Occupational Health Sciences
Tania M. Busch Isaksen, Department of Environmental & Occupational Health Sciences
Scott Meschke, Department of Environmental & Occupational Health Sciences
Gordon Holtgrieve, School of Aquatic and Fishery Sciences

Project abstract
As climate change warms the planet, freshwater harmful algal blooms (HABs) will continue to increase and threaten access to drinking and recreational waters, leading to adverse public health outcomes. Freshwater HABs are mainly caused by photosynthetic microorganisms called cyanobacteria, or “blue-green algae,” that accumulate in excessive amounts and impair freshwater ecosystem services, including potable drinking water, recreation, and subsistence-based and sport fishing. According to the Centers for Disease Control, exposure to cyanotoxins can result in negative health outcomes including dermatologic, gastrointestinal, respiratory, or neurologic symptoms. In Washington State, freshwater HABs are a growing public health concern to residents, pets, livestock, and other animals as blooms increase in frequency and severity.

Remotely piloted drones can be an effective tool for environmental monitoring of smaller-scale freshwater bodies. Drones with high-resolution cameras offer a more comprehensive visual assessment of a HAB’s spatial extent and migration over time, as opposed to a limited view from the shoreline or boat. Additionally, drones can be outfitted to facilitate quicker and more frequent water sample collection, enabling additional data collection to understand bloom dynamics. This pilot study aims to develop a protocol for drone-based water sampling of lake cyanotoxins and aerial photo collection, specific to the needs of Washington State local environmental resource management and health agencies. We posit that drone technology will improve local jurisdiction’s ability to characterize HAB health risks and communicate risk to the public. This multidisciplinary study will result in a standard operating and sampling procedure document to be adopted by health agencies.

Public Health Camp: Public Health Educators and Practitioners Partnering to Strengthen and Expand the Workforce

Jenna van Draanen, Departments of Child, Family, and Population Health Nursing and Health Systems and Population Health
Shayla Holcomb, Public Health – Seattle & King County

Project abstract
The U.S. Public Health workforce needs at least 80,000 full-time equivalent positions for state and local health departments to be able to protect and promote the health of all people in all communities. A collaboration between public health educators and practitioners to diversify the educational pipeline through upstream capacity-building is a viable solution to recruiting and sustaining a fully staffed workforce.

To do this, the project team will plan, implement, and evaluate a Public Health Camp to develop an academic-to-practice pipeline by engaging high school students in a 3-day program to increase their likelihood of pursuing involvement and leadership in public health practice. The inspiration for PH Camp is from the UW Nurse Camp which has maintained annual sustainability for over a decade to promote an academic-to-practice pipeline for nursing. PH Camp aims to provide the same for careers in public health.

An Assessment of Caregiver and Provider Level Barriers to the Implementation of National Sickle Cell Disease Clinical Guidelines

Patricia Pavlinac, Department of Global Health
Alison Wiyeh, Department of Epidemiology
Arjee Restar, Departments of Epidemiology and Health Systems and Population Health

Project abstract
Over 80% of the 240,000 children born with sickle cell disease (SCD) in sub-Sahara Africa each year die before their fifth birthday. Despite the existence of evidence-informed guidelines around the use of disease modifying interventions necessary for the management of SCD, achieving high treatment coverage and fidelity to recommended treatment remains a challenge.

There is evidence suggesting that when guideline implementation interventions are tailored to address potential barriers to guideline use, this leads to improved professional practice when compared to the dissemination of guidelines alone. We propose to carry out a project that will identify and unpack caregiver and provider level factors that act as barriers to the implementation of the national SCD management guidelines in Kenya. We will review existing literature on SCD guideline implementation. The evidence from this review will be used to inform the designing and conduct of a mixed methods study consisting of a survey of healthcare workers, focus group discussions with caregivers of children living with SCD, and key informant interviews with policy makers aimed at elucidating barriers in SCD guideline implementation. The evidence generated from this Tier 1 project will lay the foundation for more robust clinical trials that will examine different novel implementation strategies to address key barriers preventing families from accessing evidence-based interventions for children affected by SCD.

Incorporating Youth Perspectives to Improve Disaster Planning: Piloting Drone-Based Photovoice to Explore Cultural Assets

Matias Korfmacher, Department of Environmental & Occupational Health Sciences, Urban Design and Planning
Nicole Errett, Department of Environmental & Occupational Health Sciences
Daniel Abramson, Department of Urban Design and Planning
Resham Patel, Department of Environmental & Occupational Health Sciences

Project abstract
Disasters frequently damage the built and natural environment and disrupt a sense of place, leading to long-term psychosocial health impacts, particularly among younger individuals. Cultural assets — places, spaces, programs, and structures — help young community members build self-identity. Youth are thus especially vulnerable to place-based disruptions. At the same time, strong place attachment can contribute to pre-disaster resilience and creating new ties can facilitate post-disaster recovery. Despite heightened youth vulnerability, youth perspectives are often underrepresented in disaster literature and in community disaster planning.

This project pilots a novel photovoice methodology that uses drones to empower youth perspectives and align these perspectives with existing disaster planning. Westport, Washington, was selected as a study site due to its high exposure to tsunami hazards, established partnerships committed to developing youth capacity, and existing capacity related to drone-based data collection and other technology-focused approaches to community asset mapping. With guidance from the research team, the Ocosta Junior-Senior High School STEAM club will use drone imagery to identify Westport’s key cultural assets. The research team will use this data to help the community create a youth-centric geonarrative. Outputs from this project will contribute to the literature on youth engagement through photovoice and help Westport identify gaps in its disaster planning by integrating youth perspectives. Additionally, the aerial photovoice protocol developed during this project has vast future potential to build new partnerships and support integration of other under-represented voices in disaster planning.

A World Worth Living In: Exploring the Impact of Social Policies on Mental Health of BIPOC and LGBTQ+ Individuals

Sarah Porter, School of Social Work
Zeruiah Buchanan, Department of Epidemiology
Megan Moore, School of Social Work
Anne Massey, Department of Epidemiology
Kelsey M Conrick, School of Social Work
Taylor Riley, Department of Epidemiology

Project abstract
The mental health crisis care system in Washington state experienced significant strain during the COVID-19 pandemic, with increased needs arising among historically marginalized communities. Preexisting mental health disparities among Black, Indigenous, people of color (BIPoC), and Queer (LGBTQ+) communities are being met with increasing environmental stressors such as rising housing and food prices. Although Washington and other states are implementing mental health crisis legislation (e.g., 9-8-8) to bolster emergency services, these policies do not address forms of systemic oppression (e.g., transphobia) that can increase risk of a mental health crisis.

A promising wraparound service approach to supporting BIPoC and LGBTQ+ community members before and during a mental health crisis are peer-run community mental health organizations. These organizations are funded by state and/or private grants to provide services such as respite homes, low-cost or free nonclinical group therapy, meal services, and more. As these organizations continue to grow to address community mental health disparities, it is imperative to understand what social policies are facilitating or hindering mental health needs in their state. Our specific aims are to: Aim 1. Identify social policy priorities of peer-run mental health organizations in Washington and four other states, and Aim 2. Develop a pilot policy database of laws related to the policy area that was rated most highly by community experts in Aim 1. The coded policies will be compiled to create a publicly available database and be used to prepare for future efforts to develop a comprehensive social policy database.

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