Spring 2024 Tier 3 pilot awardees report midpoint project updates

Community-driven Enumeration and Needs Assessment of People Experiencing Homelessness: A high-frequency method for enumeration and needs assessment of the unsheltered population of people experiencing homelessness

Investigators
Zack W. Almquist, Department of Sociology
Amy Hagopian, Department of Health Systems and Population Health
Paul Hebert, Department of Health Systems and Population Health and VA Health Services Research and Development
Tyler McCormick, Departments of Sociology and Statistics
Junhe Yang, Center for Studies in Demography & Ecology and eScience Institute
Owen Kajfasz, King County Regional Homelessness Authority
Janelle Rothfolk, King County Regional Homelessness Authority
Cathea Carey, King County Regional Homelessness Authority

Project update
We have put together a team of scholars to measure and model change in the population of people experiencing homelessness across King County, WA, with an emphasis on designing a program of evaluation that will allow for broad adoption of the our respondent-driven sampling (RDS) method and expand its use to more frequently estimate the change in the homeless population. We have increased UW’s institutional capacity to help resolve our region’s most stubborn social and economic problem, while engaging students at multiple levels. We are well on our way to delivering on what we promised with the large growth in the UW Homelessness Research Working group (UW-HRWG) with faculty, graduate students and postdocs from public health, geography, sociology, statistics, the international school, and informatics, and those associated with the VA, and community members from King County, Snohomish, Pierce Counties and Bellevue City.

HUD homeless count: Our work on the homeless population count has been published in the American Journal of Epidemiology with a policy report jointly with King County Regional Homelessness Authority to come out in May 2025. We are currently working on improving the method with focus on bringing in data from the Homeless Management Information System (HMIS) database. We have also held IRB-approved focus groups with people who participated in the count to learn more about the how the experience of being counted is felt.

Assessing encampments: We are further developing our relationship with Evergreen Treatment Services (aka REACH) to study its remarkably detailed data set of encounters between outreach workers and people living on the street over an eight-year period. We are working to answer our research question, “What can REACH’s outreach worker encounter data tell us about what happens to people who have been displaced from their encampment locations in the city of Seattle by ‘sweeps’ conducted by city workers, aimed at removing unsheltered individuals from the landscape?” This was a follow on to a 2021 study that traced those who were displaced from the under-the-freeway “jungle” encampment in 2016. We obtained IRB approval and negotiated Data User Agreements with REACH, paving the way for future research.

The REACH data also detailed the locations of almost 1,000 encampments over a ten-year period in Seattle, which we geocoded and compared to data sets on amenities (libraries, social service offices) and dis-amenities (air pollution, industrial zoning). We have three activities directly in development: (1) We’re working to map very specific spatial and temporal air pollution measures to encampment sites; (2) map the locations where individuals choose to locate tent encampments compared to renters and emergency shelters, and (3) network modeling of the displacement and return of people

Evictions: We worked extensively with Berkeley’s Eviction Research Network team to develop research to clarify the relationship between evictions, homelessness and health. We also included the VA in this work and are working with the Veterans Health Administration Office of Primary Care to ingest data from the Eviction Research Network on names and addresses of evictees in King and Pierce County in 2017 and merge them to VHA health and housing records. We found that compared to non-evicted veterans, evicted veterans were more than 3 times as likely to be Black, and more than twice as likely to use mental health services and have a diagnosis of substance use disorder.

Setbacks in our timing for more frequently repeat RDS counts: We had pledged to work with KCRHA to repeat the Point in Time homelessness count (PIT) up to four times a year. We aim to run PIT counts in Fall 2025 and January 2026, and ideally one more in spring 2026 at the end of the grant. We have an active weekly meeting with KCRHA (every Thursday) for planning the Fall, Winter and Spring PIT counts. Additionally, we are working to provide an ethical low-identification strategy to identify individuals found repeatedly across the counts, without using Social Security Numbers or other sensitive data.

Living with Water: Co-developing strategies to protect health while adapting to sea level rise in the Duwamish Valley

Investigators
Nicole Errett, Department of Environmental & Occupational Health Sciences
Maja Jeranko, Department of Environmental & Occupational Health Sciences
BJ Cummings, Department of Environmental & Occupational Health Sciences
Katelin Teigen, Department of Environmental & Occupational Health Sciences
Juliette Randazza, Department of Environmental & Occupational Health Sciences
Paulina López, Duwamish River Community Coalition
Robin Schwartz, Duwamish River Community Coalition
Celina Balderas Guzman, Department of Landscape Architecture
Bethany Gordon, Department of Civil & Environmental Engineering
Sameer H. Shah, School of Environmental and Forest Sciences
Amir Sheikh, The Burke Museum / Quaternary Research Center

Project update
The Living With Water (LWW) project was collaboratively developed in response to a request from the Duwamish River Community Coalition (DRCC) to create a comprehensive, community-led vision for flood adaptation.

Our aims are to:

1. Identify and assess flood adaptation strategies for inclusion in the Duwamish Valley planning efforts, ensuring they align with the community’s values and priorities. This involves:
   • Engaging South Park residents including youth through interviews and focus groups to better understand their core values and priorities in relation to flood adaptation.
   • Conducting an integrative literature review to compile a broad range of flood adaptation strategies.
   • Evaluating the strategies identified in the literature against the values and priorities expressed by the community to determine which are the most compatible.
2. Co-develop conceptual flood adaptation strategies that reflect and uphold community values and support health and well-being, through participatory multilingual workshops and visioning sessions.
3. Analyze the equity implications of our process and outcomes to help inform more just and inclusive climate adaptation research and planning in the future.

Overall, the project aims to build community capacity for climate resilience planning and support ongoing flood adaptation efforts in the Duwamish Valley.

To date, we have conducted 25 open-ended interviews with South Park residents to gain a deeper understanding of their experiences with the 2022 flooding, priorities and concerns for the future, and understanding of possible flood adaptation solutions (Aim 1a).

Interview findings informed the design of a “Community Conversation” event focused on participatory mapping, and a subsequent Design Workshop, both co-developed and co-facilitated with DRCC (Aim 1b). We reached a wide audience of people living in or near the flood zone, with about 30 community members participating in each event. All materials and sessions were offered in English and Spanish to ensure language justice and accessibility.

We anticipate that our process has strengthened a foundation for future collaboration by facilitating relationships between community members, researchers, and local decision-makers.

We are still completing our integrative literature review (Aim 1c). We have reviewed paper titles and abstracts against inclusion criteria and are currently reviewing and extracting information from those that have advanced to full-paper review.

Next, we will complete the literature review, finalize the community-informed flood adaptation strategies, and work with DRCC to disseminate findings through public-facing formats, including community briefings and visual communication materials. We also plan to explore opportunities for policy impact by engaging local agencies and other partners.

Aim 3 is to evaluate our project through an equity lens. At the start of the project, we used a framework to guide our approach to systemic equity (Bozeman et al. 2022), adapting it to the context of the project and South Park.

We then conducted interviews with project team members so that they could describe and self-reflect on the equity considerations embedded in the design, implementation, and product development for each of the project aims.

In addition, we developed and deployed tools at the Design Workshop to collect community members’ perspectives on the event’s content and design processes (Aim 2) and evaluate its reach within the community. The research team generated the evaluation tools based on feedback from community partners throughout the project design process and from information collected during other aim activities.

Sensing the impacts of climate change on frontline workers in Thailand

Investigators
Kurtis Heimerl, Paul G. Allen School of Computer Science & Engineering
Jason Young, Information School
Adisorn Lertsinsrubtavee, Asia Institute of Technology
Weenarin Lulitanonda, Thailand Clean Air Network

Project update
The goal of the project is to explore the impacts of pollution on at-risk frontline populations in Thailand. Thailand has some of the worst air quality in the world, with regular burns in nearby Burma causing regular events spiking to over 150 AQI. Working with the Asia Institute of Technology (AIT), we have been developing and deploying air quality sensors among motorcycle taxi drivers to better understand the impact of these pollution events in Bangkok and Chiang-Mai. We are currently in the midst of our primary study exploring cognitive impacts by leveraging our sensors and psychomotor vigilance tests.

At the beginning of the study, we had an existing “personal impacts of pollution” study that was ongoing; that has been completed and a Work-in-progress accepted for presentation at ACM COMPASS. We’re planning for a more in-depth publication for ACM CHI in the fall.

As far as our new research agendas, our primary focus has been on exploring the acute cognitive impacts of air pollution on drivers based on a recent nature study (Acute particulate matter exposure diminishes executive cognitive functioning after four hours regardless of inhalation pathway) that found that exposure to relatively small amounts of particulate matter (~100 AQI) can have significant cognitive effects in a lab setting.

We’ve deployed sensors with drivers and have them performing similar tests (notably psychomotor vigilance tests) while driving throughout the day over a series of days, creating a within-subjects in situ evaluation of air quality impacts. We have focused the study on Chiang-Mai, given its much higher air quality variability, which has raised costs slightly. After piloting the sensors and PVTs in Chiang-Mai in the spring, the study is currently on hold for the rainy season (as AQI is good then).

Online Assessment and Monitoring of Memory Health in Rural Communities Through Personalized Computational Modeling

Investigators
Andrea Stocco, Department of Psychology
Thomas Grabowski, Department of Radiology; Alzheimer’s Disease Research Center
Nancy Spurgeon, Central Washington Area Health Education Center

Project update
The goal of the project was to test and validate a new approach to population-level monitoring of memory function in rural communities. Specifically, we proposed developing and testing a novel software for accurate and adaptive memory assessment, as well as enrolling approximately ~500 individuals from Douglas and Chelan counties in a longitudinal study.

The primary achievement to date has been the development and refinement of the adaptive memory testing software. The software’s reliability and diagnostic sensitivity have undergone rigorous evaluation in a series of lab studies; these experimental results are detailed in four scientific papers, currently under review. In preparation for unsupervised deployment in rural areas, we piloted the software at two public events: Douglas County (October 2024) and King County (May 2024). Both events were successful, although they also revealed areas for improvement in the user experience and the way results are returned.

These concerns have since been addressed. As of now, we are finally ready to start the deployment phase.

Improving data to understand the well-being of small and excluded populations

Investigators
Jennie Romich, School of Social Work
Sofia G. Ayala, Center for Studies in Demography & Ecology
Santino Camacho, School of Social Work
Isaac Sederbaum, Evans School of Public Policy & Governance
Scott Allard, Evans School of Public Policy & Governance
Max Halvorson, School of Social Work
Youngjun Choe, Department of Industrial & Systems Engineering
Arjee Restar, Department of Epidemiology

Project update
This project sought to establish community-informed methods and practices for identifying small populations (i.e., transgender people and Native Hawaiians and Pacific Islanders) within Washington State administrative data. Our first three quarters have been productive. Below are accomplishments aligned with each of our project aims.

AIM 1: Document the presence of transgender people and Native Hawaiian and Pacific Islander (NH/PI) peoples within extant data, specifically the Washington Merged Longitudinal Administrative Data.

Key accomplishments:

• Completed the first draft of a memo quantifying the NH/PI population in Washington State as observed in merged administrative data.
• Enabled disaggregation by NH/PI subgroups (e.g., Native Hawaiian, Samoan, Guamanian or Chamorro, Marshallese, Micronesian, Tongan, Fijian, Palauan, Chuukese, and others).
• Memo includes:
  • In-depth description of the sources of data used.
  • Quantification of NH/PI population by source and merged data, showing agreement/disagreement across sources.
  • Analysis of employment characteristics (e.g., number of workers, average/median wages and hours worked).
  • Discussion of possible extensions to the analyses.

Remaining work: Drafted an initial version of the Trans memo; considering supplementary analyses before sharing with Trans community advisors.

AIM 2: Work with leaders from trans and NH/PI communities to develop principles for best describing their populations.

Community-Engagement Trainings:

A team member designed and held trainings for the WashPop team to prepare for engagement with NH/PI and Trans communities. Topics included:

• Participatory Research Ethics and Methodologies:
  • Indigenist Collaborative Research
  • Community Based Participatory Research
  • Decolonizing Methodologies
• Introductory information on Washington’s NH/PI communities
• NH/PI histories of settler colonialism and contemporary social/policy issues:
  • Data disaggregation, data justice, and data sovereignty (Washington State and National)
  • U.S. Imperialism, Militarization, and Militourism in Oceania
  • Scientific Racism in Oceania, including the Castle-Bravo Nuclear tests

Trainings are ongoing, and development is underway for a training focused on working with Transgender communities in Washington State.

NH/PI CAB Recruitment and First Meeting. We recruited our NH/PI Community Advisory Board (CAB) through connections with the Pacific Islander Community Association of Washington (PICA WA) and the United Territories of Pacific Islanders Alliance of Washington (UTOPIA WA), two statewide non-profit organizations providing NH/PI communities with social service, health, and other human services. Our partners at these organizations then made recommendations for 3 additional board members who are engaged in community research, state policy, and social service provision. Together these 5 CAB members represent regions of Washington that have high concentrations of NH/PI communities such as Spokane, Vancouver, and the greater Puget Sound Area.

In April, we held our first meeting with our NH/PI CAB to review our first draft of our NH/PI memo. In this meeting we discussed challenges with the data and received recommendations for improving the memo and further analyses needed to understand these challenges more clearly.

Transgender CAB Progress: We conducted outreach to potential Trans CAB members, thus far we have confirmed three CAB members participation and intend to recruit 2-3 more before the first draft of our memo is finalized.

AIM 3: Develop a set of practices and methods for identifying trans and NH/PI persons within future administrative data resources within and beyond Washington State.

Though we have begun to identify some of the challenges with our data we have not yet began to work towards this aim yet as we are deliberately spending time doing the necessary community learning and partnership building to ensure ethical and strong collaborative relationships with our partner community organizations.