Autumn 2025 pilot awardees report progress in their projects

Investigators
Lisa Manzer, Center for Women’s Welfare, School of Social Work
Sarah Brolliar, Center for Women’s Welfare, School of Social Work
Marisol Tapia Hopper, Workforce Development Council of Seattle-King County

Project update
This project expands the Self-Sufficiency Standard (SSS) to incorporate individual marketplace premiums and premium tax credits (PTCs), producing a more accurate measure of income adequacy and estimating the household impact of PTC expiration.

To date, work has focused on building the infrastructure required to support this modeling. The SSS production system has been fully transitioned from Excel to a reproducible, R-based workflow, with all components version-controlled in GitHub. A comprehensive federal and state tax calculation framework has been developed, enabling accurate modeling of tax liabilities and credits, including the structure needed to incorporate PTCs. The framework for integrating marketplace premiums into the SSS is established, and parameters for modeling PTCs under both current law and post-expiration scenarios are being finalized. The population modeling system is also complete: the R-based workflow for applying the SSS to American Community Survey (ACS) microdata is ready to generate household estimates under different policy scenarios.

The urgency of this work has increased: with Enhanced PTCs having expired at the end of 2025, the project is now positioned to document real-world impacts rather than projected ones, strengthening the policy relevance of findings.

Final policy outputs have not yet been produced, but the core systems required to generate them are in place. Remaining work is focused on completing integration, running simulations, and producing results.

Investigators
Lupita Santillan, Department of Psychiatry and Behavioral Sciences
Julia Mattson, Department of Pediatrics
Ana C. Hernandez, Seattle Children’s Hospital
Weili Yuan, Elson S. Floyd College of Medicine, Washington State University
Gulaiim Almatkyzy, Department of Oral Health Sciences
Brent Collett, Department of Pediatrics

Project update
Our project aims to design and pilot a mobile health intervention to improve oral health behaviors among young children through parent engagement. To date, we have obtained IRB approval from the University of Washington, as well as site approval from Seattle Children’s. We are currently awaiting Washington State University approval for one study team member who will support recruitment at our rural partner site (Joya Child and Family Development). Spanish translations of IRB-approved materials are in progress.

We have also expanded our recruitment network to include Seattle Children’s Early Childhood Clinic and the University of Washington Institute on Human Development and Disability’s Infant Development Follow-up Clinic. All English-language consent forms and questionnaires have been completed and programmed in REDCap. Additionally, our BOOST mobile application has been fully developed and tailored for the study in English. We are preparing to begin recruitment of English-speaking families within the next 1-2 weeks. Participant materials (e.g., tripods, toothbrushing kits) are in the process of being ordered.

Investigators
Sam Bernecker, Department of Psychiatry and Behavioral Sciences
Jennifer Turns, Department of Human Centered Design & Engineering
Patrick Raue, Department of Psychiatry and Behavioral Sciences

Project update
Psydkick is a digitally guided, reciprocal coaching tool designed to overcome common barriers to evidence-based psychosocial interventions (EBPIs). In Psydkick, pairs of users take turns delivering Problem-Solving Therapy (PST) to one another, guided by real-time prompts on a laptop, tablet, or phone.

The reciprocal, peer-delivered structure addresses both structural barriers (cost, provider scarcity, wait times) and attitudinal barriers (stigma, desire for self-reliance) that keep many people from receiving evidence-based mental health care. With Initiative funding, the team is conducting the discovery work needed to inform prototype development and support a follow-on pilot trial.

Progress to date includes the following:

• Refocused the project’s target population from rural-dwelling adults to community college (CC) students. CC students share the high unmet treatment need that motivated the original focus on rural adults—one large NIMH-funded study found that more than two-thirds of CC students screened positive for depression, anxiety, or PTSD, while only 11% had received psychotherapy in the past year—but they are more demographically diverse, more efficiently reached through institutional partners, and represent a large population (roughly half of working U.S. adults take at least one CC course). This refocus is expected to enhance the generalizability of findings.
• Established community college partnerships. The team secured letters of support from two Washington State community colleges (Highline College and Lake Washington Institute of Technology, with a combined enrollment of more than 20,000), including building relationships with one institution’s Executive Committee. Outreach is ongoing with several additional colleges.
• Developed study materials and submitted an IRB protocol for a mixed-methods user-needs study of community college students experiencing elevated depression and/or anxiety symptoms.
• Submitted an NIH K23 career development award proposal (PI: Bernecker) that builds directly on this work and proposes a pilot trial of Psydkick at community colleges. Initial review feedback is expected in the coming months.

Investigators
Dario Cvencek, Institute for Learning & Brain Sciences
Jessica C. Jones-Smith, Health Systems and Population Health

Project update
This project aims to investigate the development of children’s food attitudes and their associations with dietary habits and physical health outcomes. The study is guided by four primary objectives, and progress to date is summarized below.

Development of Assessment Measures. We have successfully developed and implemented a comprehensive battery of child- and parent-report measures within our data collection platform. These measures assess a broad range of factors related to children’s physical health, including home food availability (healthy and unhealthy), physical activity levels, presence and use of electronic devices and children’s food attitudes.

Demonstration of Project Feasibility. Data collection is well underway, with 78% of the target sample obtained to date. Recruitment and participation rates achieved within a relatively short timeframe indicate strong feasibility for a larger-scale longitudinal study. Both children and parents have demonstrated willingness and ability to complete the assessment battery in a remote (online) format.

Identification of Factors Associated with Food Attitudes. Although data collection is still in progress and analyses have not yet been conducted, successful administration of the full assessment battery supports our ability to carry out the planned analyses upon completion of data collection.

Examination of Links to Physical Health. Similarly, planned analyses examining associations between children’s food attitudes and physical health outcomes will be conducted once data collection is complete.

Investigators
Sebastian Tong, Department of Family Medicine
Peter Kahn, Department of Psychology & School of Environmental and Forest Sciences
Ashley Park, Department of Family Medicine
Hongfei Li, College of Built Environments

Project update
The Nature Engagement Project aims to translate Interaction Pattern Theory into clinical practice through the development of the Interaction Pattern Preference Inventory (IPPI), a patient- and provider-facing tool to support more specific, feasible and equity-informed nature prescriptions. Guided by the Health Equity Implementation Framework, the project focuses on understanding embodied interactions with nature and identifying barriers shaped by social and environmental contexts.

To date, the team has collaboratively developed core Tier 1 study materials, including a draft IPPI prototype, a survey instrument and three semi-structured interview guides tailored for patients, health care providers and community planners/practitioners. A recruitment plan has been implemented, healthcare providers have been successfully recruited, and qualitative interviews with providers are actively underway. An early conceptual version of the IPPI is being used within interviews to gather formative feedback on usability, feasibility and clinical relevance to inform future refinement. In addition, the project has supported the mentorship of an undergraduate student who is actively engaged in research activities and gaining applied experience in health equity–focused, practice-based research.

Investigators
Thanh P. Nguyen, Department of Pediatrics
Gabi Sepulveda, Department of Psychiatry & Behavioral Sciences
Matilda Sampson, Excelsior Wellness
Shayla Collins, UW Center for Child & Family Well-Being
Jim Mancini, Department of Pediatrics

Project update
This project works toward three interrelated aims to improve coordinated care for autistic youth with mental health needs and their families in Washington State.

For Aim 1, the team has initiated a multi-method data collection process to identify gaps, barriers and ideal practices in care coordination. A needs assessment survey has been developed and distributed to care coordinators and families of autistic youth, and data collection is currently underway. In parallel, the team is preparing for regional research World Café sessions—a qualitative approach designed to efficiently gather rich, practice-informed insights—including finalizing procedures, booking venues, and purchasing materials. Planning is also in progress for virtual focus groups that will engage diverse stakeholders such as caregivers, autistic individuals, coordinated care professionals and administrators.

Progress has also been made toward Aim 2, which focuses on developing a community-informed and vetted Care Coordination Training Curriculum (CCTC) manual. The team has drafted the training content and identified key topic areas for the manual. This draft will undergo iterative refinement through at least three rounds of stakeholder input gathered during the World Café sessions and the virtual focus groups.

For Aim 3, the team has engaged with several agencies across Washington State to explore alignment and potential interest in future collaboration related to a pilot study of the CCTC program. Ongoing data collection through the needs assessment survey, World Café sessions and virtual focus groups will continue to inform manual development and partnership building.

Investigators
Patience Binambiba Jaman, Department of Health Systems and Population Health
Kaboni Whitney Gondwe, Department of Child, Family, and Population Health Nursing
Rabi Yunusa, Department of Global Health
Mpiima Mugambe, Immigration Guide
Francis Abugbilla, Ghanaians in Seattle Association-GHASEA

Project update
This project seeks to understand the barriers and opportunities to equitable gestational hypertension care among Black immigrant women in Washington State through a community-partnered needs assessment. Using a mixed-methods and community-based participatory approach, the project aims to generate culturally informed insights to guide future interventions and policy-relevant recommendations. The project timeline includes preparation and recruitment (January–February 2026); data collection, including interviews (March–May 2026); data analysis and community validation (June–July 2026); and dissemination activities, including a stakeholder meeting (August 2026).

Progress to date reflects meaningful advancement toward these milestones, with several components completed as planned and others actively underway. The project has since focused on foundational activities essential to successful implementation. Institutional Review Board (IRB) approval for the study was obtained, and data collection tools, including surveys and interview guides, have been developed and refined with the help of our community partners and community advisory board.

Key partnerships have been established with community organizations serving Black immigrant populations, including Immigrant Guide and the Ghana Association of Greater Seattle (GHASEA). We have had five meetings with our community partners since the beginning of the study, where the research team has consistently provided progress updates and gathered feedback for improvement. They have actively engaged in shaping the study’s priorities and outreach strategies. The research team has also recruited and formed a Community Advisory Board (CAB) consisting of five community members to ensure cultural relevance and shared ownership of the research process. This board has met once to date, with a primary focus on addressing recruitment challenges.

Recruitment has started and is ongoing; flyers were shared at two Black community events, put at the Bantaba (African) restaurant, the Masjid, and the African Market in Lynnwood. Flyers have also been shared via email and on community platforms through the community partners. Despite these efforts, there are no confirmed participants among the targeted women at this stage. Participation has been slower than anticipated due to heightened fear and hesitancy among immigrant communities related to current immigration enforcement concerns, which has affected willingness to engage. Adaptive recruitment strategies are being implemented to address these challenges. Several strategies were discussed during the first CAB meeting to strengthen recruitment, including engaging a community recruiter to actively identify and approach potential participants. Additionally, we plan to advertise this study on social media at a cost.

This recruitment phase, scheduled for March to May 2026, will depend on the success of recruitment efforts over the next several weeks. If the recruitment strategies above prove effective, the project is expected to proceed as planned. Overall, the project is progressing as planned and is well-positioned to continue data collection and move into data analysis, with a strong foundation of trust, collaboration and community partnerships.

Investigators
Wanda Pratt, Information School
Yue Wu, Department of Ophthalmology
Mike Teodorescu, Information School
Kennedy Orwa, Information School

Project update
This project aims to lay the foundation for equitable, AI-enabled diabetic retinopathy (DR) screening by addressing limitations in generalizability of diagnostic AI systems across diverse populations and healthcare settings. The project is guided by two core objectives: (1) generating a rigorous, peer-review-ready evidence base on bias and generalizability in DR diagnostic AI, and (2) engaging multidisciplinary stakeholders to co-design pathways toward AI-ready health systems.

At mid-term, substantial progress has been achieved across both aims. The systematic literature review is complete, with a manuscript prepared for peer review. This work is synthesized through the Biomedical Informatics Generalizability (BIG) Framework, which conceptualizes generalizability as a systems-level property emerging from interactions across four interdependent layers: model, data, workflow and governance. The framework highlights how variability at any layer propagates across the system, shaping model performance and clinical outcomes.

In parallel, stakeholder engagement has progressed from initial mapping to active, context-grounded partnership development. A field mission to western Kenya was successfully conducted, involving site visits to multiple healthcare institutions and consultations with clinical and administrative stakeholders. This mission generated critical insights into infrastructure, workflow, and data ecosystem constraints, while also establishing strong institutional relationships and identifying partners for ongoing collaboration.