Initiative awards eight early-stage pilot grant to interdisciplinary UW research teams

Expanding the Self-Sufficiency Standard to Model Health Coverage Options

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 abstract
Affordable health insurance is essential to both population health and family economic security. Yet, the way affordability is measured often masks the challenges faced by working families. The Self-Sufficiency Standard (SSS) calculates the income needed for families to meet basic needs, but its health care cost component assumes employer-sponsored insurance—a scenario increasingly out of reach for many.

This project will update the SSS methodology by replacing employer-sponsored insurance costs with premiums from the individual marketplace and incorporating premium tax credit (PTC) calculations. By accounting for net health care costs under marketplace coverage, this new approach will produce a more accurate measure of family income adequacy.

The timing is critical: the Affordable Care Act’s Enhanced Premium Tax Credits are set to expire at the end of 2025. Without congressional action, families across the country will face substantial premium increases in 2026. Using the revised SSS combined with American Community Survey (ACS) data, we will estimate how many additional households will fall short of meeting their basic needs due to higher health insurance costs.

Findings will provide actionable insights for policymakers, workforce development councils, and public health leaders as they consider strategies to protect working families from being priced out of coverage. This pilot will demonstrate the feasibility and policy relevance of incorporating marketplace premiums and PTCs into the SSS, laying the groundwork for expanded state and national analyses.

Developing a Parent-Focused Intervention to Promote Toothbrushing

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 abstract
Early childhood oral health is a critical indicator of overall health and predicts long-term outcomes. Despite overall improvements in population-level oral health, dental caries remains the most common chronic disease in childhood. Significant disparities persist by socioeconomic status, race/ethnicity, geography (e.g., rural areas), and disability – leaving children with the greatest need underserved by current prevention and treatment efforts.

Parent-led toothbrushing with fluoridated toothpaste is a proven, modifiable behavior that improves oral health outcomes. However, even with widespread parent education, regular toothbrushing remains challenging for many families. When asked, parents cite child behavior problems as a primary barrier. Nevertheless, scalable interventions to address parents’ behavior management skills during toothbrushing are lacking.

As a first step, we will utilize remote observational data collection to identify common behavioral challenges during toothbrushing, thereby enhancing ecological validity and reducing participation barriers – particularly for rural and underserved families. Our interdisciplinary study team brings together experts in behavioral health, child development, oral health, and remote intervention delivery, along with dedicated experience in rural/underserved and Spanish-speaking populations.

We will partner with a rural community organization serving young children with developmental delays, who are at an elevated risk for poor oral health. Families experiencing toothbrushing refusal will be enrolled, and parents will co-design a brief, scalable behavioral intervention tailored to their needs. The results will lay the groundwork for a remotely delivered, parent-focused intervention to promote parent-led toothbrushing, to be tested in a subsequent randomized controlled trial.

Designing Psydkick, an EBPI implementation tool, to deliver problem-solving therapy to depressed and/or anxious rural-dwelling adults

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 abstract
Only half of those experiencing a mental illness receive treatment annually (SAMHSA, 2024), and most treatment that is delivered is not evidence-based (Harvey & Gumport, 2015). Treatment barriers are heightened in rural areas (Mack et al., 2022). Innovative solutions are needed to promote equitable access to evidence-based psychosocial interventions (EBPIs) in order to advance public mental health.

Our previous work demonstrated the appeal and feasibility (Bernecker et al., 2017, 2020) of training pairs of peers to take turns “coaching” each other using evidence-based problem solving skills. This reciprocal coaching approach has potential to overcome structural barriers to care, like cost and provider scarcity, and attitudinal barriers, like stigma and desire for self-reliance. In order to reduce training time and thus make the program more appealing and scalable, we are now developing Psydkick, a tool that provides real-time guidance in peer coaching from a digital app. We are piloting Psydkick to deliver problem-solving therapy (PST) for rural-dwelling adults with mild-to-moderate depression and/or anxiety symptoms. PST is transdiagnostic, acceptable, and intuitive, and depression and anxiety account for most rural mental illness burden (Breslau et al., 2014).

In this project, we will conduct essential discovery work, assessing user needs (Aim 1), and developing relationships with community partners and co-designing implementation strategies (Aim 2). This work will guide prototype development and will provide preliminary data to support a K award application for a pilot trial.

Children's Early Food Attitudes: Relations to Dietary Habits and Health Metrics

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

Project abstract
Obesity has become a national public health crisis, affecting 19% of U.S. children (Fryar et al., 2020). Previous research has indicated the age between 6–9 years as a crucial developmental period: Healthy food habits acquired at this age persist into adulthood (Skinner et al., 2002). Compared to other factors that may influence children’s food consumption (e.g., food access inside the home)—which are known to be impacted by socioeconomic factors—research with socioeconomically diverse samples has shown that attitudes towards food do not vary by SES (Brecic, Gorton, & Cvencek, 2022).

This raises an interesting question: If food attitudes do not differ by SES, but dietary habits do, then food attitudes may be outweighed by barriers to accessing healthy foods. Consequently, it would be important to show that food attitudes are associated with better dietary intake, regardless of SES. Understanding both types of attitudes in the same children—while accounting for household health environment—is therefore critical, because children’s early food attitudes may be a well-defined target for low-cost interventions to encourage healthy eating beyond home.

To better understand these relations, we hypothesize that children’s implicit and self-reported attitudes about food will be related to differences in dietary habits. The proposed grant will pilot (a) measures of dietary habits, along with (b) state-of-the-art online measurements of implicit and self-reported attitudes to uncover both automatic and conscious drivers of household food habits/environments, and (c) measures of children’s physical health to assess potential downstream impacts on children’s well-being.

Embodied Nature Engagement: Developing the Interaction Pattern Preference Inventory (IPPI) for Nature Prescriptions in Primary Care

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 abstract
Nature prescriptions are an emerging approach to support health by encouraging time in natural environments. Yet, many prescriptions remain overly generic (“spend 30 minutes outside”) and fail to reflect how people meaningfully engage with nature or the barriers that shape their ability to do so. Research shows that the benefits of nature stem not only from exposure alone, but also from embodied interactions, like resting under trees, engaging with water, or encountering wildlife.

Interaction Pattern Theory has described more than 1,000 such patterns highlighting their importance for restoration, presence, and resilience. This project will develop and pilot the “Interaction Pattern Preference Inventory (IPPI)”, a new patient and provider facing tool designed to translate Interaction Pattern theory into clinical practice. The process includes collaboration across three sectors: 1) patients for their lived experience and preference in interaction patterns; 2) care providers for clinical insight into prescribing needs and workflow integration; 3) community planners and practitioners for environmental factors.

Guided by the Health Equity Implementation Framework (HEIF), the IPPI will integrate patients’ lived experiences and SDOH-related barriers to ensure equity is embedded from the start. By mapping patient preferences within clinical and environmental contexts, the IPPI will help providers design prescriptions that are both practical and socially responsive. While this pilot will focus on chronic stress, the tool is adaptable to broader applications such as anxiety, trauma, attention difficulties, and burnout. Deliverables include a pilot-tested IPPI, a preliminary framework for equity-informed prescribing, and insights to guide Tier 2 testing and clinical translation.

A Community-Engaged Approach to Identifying Gaps and Creating Solutions in Care Coordination for Autistic Youth with Co-occurring Mental Health Needs

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 abstract
Autistic youth experience disproportionately high rates of mental health challenges, including anxiety, depression, suicidality, and self-injurious behaviors, often resulting in emergency department visits and psychiatric hospitalizations. These risks tend to increase with age and are further elevated among those with intellectual disabilities, language impairments, and lower adaptive functioning. While care coordination is a promising strategy for supporting youth with mental health challenges, current practices fall short for autistic youth with co-occurring conditions—leaving families without adequate support and burdened by financial and emotional strain.

This proposed research aims to address the critical knowledge gaps and delivery of effective care coordination for this population, and to develop a community-informed Care Coordination Training Curriculum (CCTC) for serving autistic youth with mental health needs and their families. Guided by an interdisciplinary team and community-engagement with stakeholders across Washington state, this mixed-methods study aims to: (1) identify gaps, barriers, and facilitators to effective care coordination for autistic youth with co-occurring mental health conditions—via implementation of needs assessment, research World Café sessions, and a virtual focus group; (2) produce a stakeholder-vetted CCTC manual through iterative feedback; and (3) recruit community partners and cohorts of care coordinators to participate in future pilot study using the finalized CCTC manual.

Findings from this research will generate foundational data on effective care coordination and inform the development of a scalable training intervention. Findings will also lay the groundwork for future implementation research and competitive funding opportunities.

Understanding Barriers and Opportunities for Equitable Gestational Hypertension Care Among Black Immigrant Women in Washington State: A Community-Partnered Needs Assessment

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 abstract
Gestational hypertension (GH) is a blood pressure more than or equal to 140/90 mmHg that typically starts after 20 weeks of pregnancy. GH happens in about 6% to 8% of pregnancies in the U.S. It increases the risk of fetal growth restriction and stillbirth, and in mothers may progress to preeclampsia, eclampsia, or death if untreated. Black women in the U.S. experience disproportionately high rates of GH and related complications, yet little is known about how nativity and immigrant status intersect with race to influence outcomes.

In Washington State, the experiences of Black immigrant women remain understudied, and state-level data rarely disaggregate by race and nativity. This mixed-methods project aims to lay the foundation for a future-proof-of-concept intervention by conducting a community-partnered needs assessment to understand barriers, facilitators, and priorities for equitable GH care. We will conduct individual in-depth interviews with 30 Black immigrant women (pregnant with GH or within two years postpartum who experienced GH), three focus group discussions, 6–8 key informant interviews with healthcare providers, and surveys to collect maternal demographic data.

Findings will be analyzed thematically, synthesized with WA and national data, and interpreted in partnership with a Community Advisory Board composed of community members, community leaders, and health professionals. Deliverables include a community-informed research agenda, findings, and recommendations for future interventions such as culturally tailored home blood pressure monitoring or improved postpartum follow-up strategies.

Building AI-Ready Health Systems for Equitable Diabetic Retinopathy Screening

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

Project abstract
Early detection is essential to preventing vision loss from diabetic retinopathy (DR), a leading cause of preventable blindness worldwide. Low-cost, AI-enabled imaging tools such as portable optical coherence tomography (OCT) and smartphone-based fundus cameras offer potential to expand screening access. However, their performance varies across populations remain underrepresented in training data used to develop embedded AI models. This limits generalizability of the AI systems and creates risks of inequitable diagnostic accuracy.
This Tier 1 pilot project will lay the foundation for equitable, AI-enabled DR screening by generating evidence, convening stakeholders, and strengthening institutional capacity for AI-ready health systems. Through interdisciplinary collaboration between the UW’s Information School, UW Medicine, ophthalmic providers in Washington State and Kenya, and partners including device manufacturers, and regulators, the project will:

• Synthesize evidence via a systematic literature review and meta-analysis on (a) data scarcity and bias in DR diagnostic AI, (b) the role of privacy regulations and data localization in shaping multi-site AI model training collaborations, and (c) institutional readiness for privacy-preserving AI approaches.
• Convene stakeholders in a collaborative forum to validate findings, share perspectives, and co-design strategies for building AI-ready data and governance practices that promote equity in DR screening.

The outcome will be a co-designed plan based on the literature review and collaborator co-design and engagement that positions the team for external funding to scale this work, advancing UW’s Population Health mission to improve equity and population health outcomes both locally and globally through earlier detection and prevention of vision impairment.