Initiative awards eight Tier 1 pilot grants to interdisciplinary research teams

Investigators
Hyun-Jun Kim, research assistant professor, School of Social Work
Jennifer Stuber, associate professor, School of Social Work
JanRose Ottaway Martin, executive director, North Sound BH-ASO
Joe Avalos, executive director, Thurston-Mason BH-ASO

Project abstract
Behavioral health crises, including suicidal thoughts, psychosis, and overdose, are a growing population health concern in Washington. While the state has invested in a crisis care continuum that includes crisis lines, mobile response teams, stabilization services, and follow-up care, these resources are fragmented across agencies and organizations. As a result, providers, individuals in crisis, and their families may struggle to identify appropriate services and often rely on emergency departments, law enforcement, or go without care altogether.

This project will lay the foundation for a statewide tool that helps connect people with behavioral health crisis services by providing a single source of information on available resources, who they serve, when they operate, and how they can be accessed. The research team will define the scope of services to be included, integrate data from statewide surveys and administrative sources, and identify information gaps. They will then build a working prototype that allows users to identify available crisis response resources based on location.

The team will partner with approximately 200 service providers, as well as individuals with lived experience and caregivers, to verify information and provide feedback on the prototype. Deliverables will include an integrated statewide database, a data acquisition and maintenance plan, and an analysis of geographic access gaps. Findings will provide the foundation for future testing and statewide implementation of a tool designed to improve access to crisis services and advance behavioral health equity across Washington.

Investigators
Amanda Phipps, associate professor and associate chair, Department of Epidemiology
Gary Stobbe, clinical professor, Departments of Neurology and Psychiatry & Behavioral Sciences
Benjamin Mako Hill, associate professor, Department of Communication
Kate West, associate teaching professor, Department of Health Systems and Population Health
Marwa Abdalla, PhD candidate, Department of Epidemiology

Project abstract
People with intellectual and developmental disabilities (IDD) and autism are disproportionately represented in the criminal legal system. Competency-to-stand-trial determinations rely on written forensic evaluations that, in Washington state, also influence whether an individual is connected to disability services, remains in jail, or is admitted to a state hospital. Despite the significant consequences of these evaluations, little is known about how evaluators reach their conclusions or how consistently those conclusions are applied.

This project brings together expertise in epidemiology, computational text analysis, qualitative research, and clinical neuropsychiatry to examine competency evaluation reports completed between 2022 and 2024. Using both artificial intelligence-based text analysis and qualitative coding methods, the team will identify the reasoning evaluators use when making competency determinations and assess variation across evaluators and counties. The project will also compare findings from human and AI analyses to better understand the strengths and limitations of each approach.

By examining consistency and transparency in competency evaluations, the project addresses equity for a population with disabilities while exploring how critical legal decisions affect access to health and social services. Findings will lay the groundwork for future efforts to improve evaluation practices, including potential reporting templates, training protocols, and larger externally funded studies.

Investigators
Stipica Mudrazija, assistant professor, Department of Health Systems and Population Health
Robert Penfold, senior investigator, Kaiser Permanente Washington Health Research Institute
Tracy Mroz, professor, Department of Rehabilitation Medicine
Melissa Knox, teaching professor, Department of Economics

Project abstract
As growing numbers of working-age adults provide care for older family members, states are increasingly turning to paid family leave programs to support caregivers. Washington’s Paid Family & Medical Leave (PFML) program is among the nation’s most established, yet little evidence exists regarding its impact on the health and well-being of older adults and their caregivers. A key challenge is the lack of data connecting caregiving responsibilities, health needs, and leave utilization.

This project will evaluate whether Kaiser Permanente Washington data can support a future large-scale study of PFML’s effects on health and economic outcomes. The research team will develop and validate methods for identifying family-care leave certification requests within electronic health records, with a particular focus on chronic conditions such as dementia. They will also assess data quality, characterize the population of leave applicants, and conduct preliminary analyses needed to support a future federal grant application.

Working in partnership with Kaiser Permanente Washington, the Washington Employment Security Department, and University of Washington collaborators, the project will also explore pathways for securely linking administrative and health data. Deliverables will include a validated cohort-identification approach, a descriptive profile of leave applicants, and a feasibility report that positions the team to pursue larger studies of paid caregiving leave and its population health impacts.

Investigators
John Y. Choe, associate professor, Department of Industrial & Systems Engineering
Nicole A. Errett, associate professor, Department of Environmental & Occupational Health Sciences

Project abstract
Investments in wildfire mitigation can substantially reduce future losses and strengthen community resilience, yet the benefits of those investments often remain invisible to insurers, infrastructure operators, public agencies, and philanthropic funders. This disconnect can limit incentives for communities to undertake mitigation efforts and reduce opportunities for additional investment in resilience.

This project will explore how verified wildfire mitigation activities can be more effectively connected to organizations that could reward, support, or build upon those efforts. Through a landscape scan, stakeholder interviews, and a statewide roundtable, the research team will identify the data, verification, governance, and trust barriers that currently prevent mitigation efforts from being recognized in decision-making processes. Particular attention will be paid to concerns that mitigation information could be misused and to opportunities for ensuring equitable outcomes for rural, Tribal, and other underserved communities.

The project will produce a partner-and-evidence map, identify data requirements and public-interest safeguards, and develop a prioritized roadmap for future demonstration projects. These deliverables will position the team to pursue larger proof-of-concept efforts aimed at strengthening wildfire resilience, improving health outcomes associated with wildfire impacts, and advancing environmental and social equity across Washington State.

Investigators
Elizabeth McNeilly, T32 postdoctoral fellow, Department of Pediatrics
Molly Adrian, professor, Department of Psychiatry & Behavioral Sciences
Jessica Jenness, associate professor, Department of Psychiatry & Behavioral Sciences

Project abstract
Suicide is the second leading cause of death among adolescents, and social experiences often play a central role in suicide risk. At the same time, young people increasingly interact through social media platforms, creating opportunities to better understand behavioral indicators that may signal periods of elevated risk. However, little is known about whether adolescents at high risk for suicide are willing and able to share social media data for research purposes.

This pilot project will test the feasibility and acceptability of social media data donation among adolescents ages 11–17 who have experienced a suicidal crisis and participated in an ongoing clinical trial. Using an open-source tool, participants will voluntarily contribute selected, de-identified information from platforms such as Instagram and TikTok. The study will examine participation rates, technical barriers, privacy concerns, and willingness to participate in similar research in the future. Researchers will also explore whether patterns of social media use are associated with changes in suicide risk over time.

The project addresses both human health and social equity by evaluating an innovative approach to understanding adolescent suicide risk while ensuring that participation is feasible across diverse populations. Findings will provide critical groundwork for future studies aimed at identifying digital markers of suicide risk and informing real-time intervention strategies.

Investigators
Jason Castaneda, fellow physician, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine
Thomas Fitzpatrick, acting instructor, Department of Medicine, Division of Allergy and Infectious Diseases
M. Kennedy Hall, associate professor and director of data science and informatics, Department of Emergency Medicine
Lauren K. Whiteside, associate professor and section head, Population Health, Department of Emergency Medicine
Tessa Steel, assistant professor, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine

Project abstract
The use of smoked opioids and stimulants has increased dramatically in Washington and across the western United States, yet the respiratory health consequences of this shift remain poorly understood. While reduced injection drug use may lower rates of infections such as HIV and infective endocarditis, inhalational drug use may present new and underrecognized risks for acute and chronic lung disease.

This project will establish the foundation for future research on the respiratory health impacts of changing drug-use patterns. The research team will conduct a retrospective analysis of electronic health record data from adults with opioid- and stimulant-related diagnoses receiving care within UW Medicine, examining trends in respiratory illnesses, respiratory-related health care utilization, and injection-associated infections. To better understand routes of drug use, the team will also evaluate the feasibility of using large language models to extract information from clinical documentation and compare those findings with patient-reported data.

Community members and people with lived experience will play an active role in interpreting study findings and identifying priorities for future research. Results will provide critical preliminary data for larger studies examining the relationship between routes of drug use and pulmonary health outcomes, while helping inform future patient-centered interventions and care strategies.

Investigators
Cristal Resto, graduate student, School of Public Health, Food Systems, Nutrition & Health
Barbara Baquero, professor, Department of Health Systems & Population Health
Christian Primack Metcalfe, associate teaching professor, Department of Management and Organization
KeliAnne Hara-Hubbard, community research manager, Department of Health Systems & Population Health
Lea Draven, member, Food Research and Equity Collaborative

Project abstract
Eastern Washington is one of the nation’s most productive agricultural regions, yet Latino families in the area continue to experience disproportionately high rates of food insecurity and limited access to affordable, nutritious, and culturally relevant foods. Tiendas, small independent grocers that serve many rural Latino communities, are among the most accessible food retailers in these areas. However, because they lack the purchasing power of large grocery chains, tiendas often face higher costs for fresh produce, limiting their ability to provide affordable fruits and vegetables to community members.

This project will explore whether a collective produce purchasing model could serve as a viable strategy for increasing tiendas’ purchasing power and improving access to affordable produce. Building on existing partnerships with the Food Research Equity Collaborative (FrEsCo), the project will establish a working group of tienda managers, produce distributors, and community leaders to assess the feasibility and value of collective purchasing. The team will also examine current purchasing practices, distribution costs, gross margins, and produce spoilage to evaluate the financial viability of a shared purchasing approach.

Using findings from these activities, stakeholders will co-develop a collective purchasing model for future pilot testing. The project will generate foundational evidence on whether collective purchasing can strengthen rural food systems and improve healthy food access in Latino communities, while positioning the team to pursue larger implementation and intervention grants.

Investigators
Tania Busch Isaksen, teaching professor, Department of Environmental & Occupational Health Sciences
Sarah Bliss Matousek, assistant professor, Gonzaga University School of Health Sciences
Elena Austin, associate professor, Department of Environmental & Occupational Health Sciences
Brian G. Henning, director, Institute for Climate, Water, and the Environment and Professor of Philosophy and Environmental Studies & Sciences, Gonzaga University
Kaitelin Teigen, PhD candidate, Department of Environmental & Occupational Health Sciences

Project abstract
The 2026 Spokane Complex Fires destroyed homes and buildings across Spokane County, creating concerns about exposure to wildfire smoke, contaminated ash, and other pollutants generated when structures burn. Although outdoor air quality is monitored in the region, little is known about the quality of air people breathe inside their homes during recovery and rebuilding efforts or how cleanup activities may affect exposure.

This project will establish a community-hosted network of 30 to 50 households across Spokane County that will monitor indoor and outdoor air quality using paired sensors. Priority enrollment will be given to households directly affected by the fires or located near burned areas. Participants will complete surveys about housing characteristics, ventilation and cleaning practices, and perceived physical and mental health impacts associated with post-fire conditions. Households will receive individualized summaries of their results, while de-identified data will be shared with public health agencies and the broader community through an open-access repository.

The study will evaluate the feasibility of a community-based air quality monitoring network while generating critical data on post-wildfire exposures, household protective behaviors, and health perceptions. Findings will inform future interventions aimed at reducing exposure to harmful pollutants during wildfire recovery and support larger funding proposals focused on wildfire resilience, environmental health, and community recovery.