On July 21st, the CHC Center of Excellence hosted a closing ceremony to recognize twenty-five (25) high school students for their successful completion of the STARS and STRIPES. Summer Enrichment program. The 13 Student Training for Academic Reinforcement in the Sciences (STARS), and the 12 Special Training to Raise Interest and Prepare for Entry into the Sciences (STRIPES) participants included students from 7 local high schools.
Dr. Errol D. Crook, Director and Principal Investigator of the Center of Excellence, opened the program by giving a brief overview of the program, welcoming all in attendance and congratulating the students on a successful summer. He then recognized Dr. Hattie M. Myles, retired Co-cor
e Director of Community Outreach, for her outstanding legacy of service to the Center, the University of South Alabama and the community. Dr. Myles presented the Keynote in which she provided a heartfelt, “real talk” message of perseverance, dedication, and hard work. Finally, four former STRIPES graduates who participated in 2017 CHC Undergraduate Research Program, spoke on their undertaking of various research projects and gave the student participants a glimpse into college life.
Funded as a part of the NIMHD Center for Excellence, the STARS and STRIPES program activities include:
Academic enrichment sessions during the summer
Participation in community service activities and health advocacy
An eight-week internship in a health care provision site or a medical research facility upon high school graduation
This June, five Community Health Advocates(CHAs), submitted applications to the Center for Healthy Communities to implement short term, limited scope community projects addressing nutrition, health literacy, family health, and mental health. These projects are:
Nutrition through Gardening: CHA Lead, Sheena Billingsley Starting in July, Sheena and her partners planned four health and nutrition awareness events at community gardens in the area. These events focused on educating community members on healthy eating and healthy living. Each consisted of
Hands on gardening activities
Healthy cooking demonstrations
Sustainable gardening techniques
Conversations with volunteer health professionals
As an incentive for participation, participants received personal growing space in the community garden located in their zip code.
Community Garden at Ridge Manor: CHA Lead, Frewin Osteen The goal of this project is to increase and enhance home-based and community centered gardening though the construction of a Hoop House to demonstrate the feasibility of a new gardening method suited to small, protected areas.
Smart Grocery Shopping Workshop: CHA Lead, Barbara Hodnett Through this workshop which was held in June, Ms. Hodnett offered an educational program designed to help participants develop shopping skills to save money while buying healthy foods. The workshop topics included:
Learning the typical layout of a grocery store
Arranging your pantry and food storage areas to maximize healthy choices
Reading labels to determine whether a product is a sound nutritional choice
Creating a healthy weekly meal plan
Workshop participants also participated in a walking field trip to practice applying the information they had learned.
Hearts to HEAL (Health Education and Literacy): CHA Lead, Porsche Blount This five-day summer enrichment program aims to improve the health knowledge and literacy, reduce associated stigmas, improve self-self esteem, and help to create a positive self-image among adolescent girls aged 12 to 18. The topics addressed in the program are
A pre/post test design will be used to measure the knowledge gained by participants in the program. Also, the final day of the enrichment experience will be an opportunity for the girls to give presentations about what they have learned.
Black Mental Health Matters: CHA Lead, Zionne Williams Through this two part project, Zionne and her partners hope to “break the stigma associated with mental health in minority communities and to bring much-needed awareness to the issues associated with mental health.” Part one of the project consists of a family-friendly community event to raise awareness of the importance of recognizing when someone may need help and how to connect those in need with the correct resource. The event included fun kid’s activities, food and entertainment, and presentations from mental health professionals.
The second part of the project is the development of a mental health awareness campaign through an online platform to promote health literacy, create an open dialogue with the community, and encourage potentially affected individuals to seek and complete treatment. To accomplish the goal, individuals will be invited to share their personal stories through visual, written and audio documentation that will be shared online.
These CHA led projects provide an important mechanism for the Center for Healthy Communities to support the CHAs in applying the knowledge they gain through CHC supported trainings to target health issues that are of greatest concern to them. Through these projects they provide information in culturally relevant formats to improve the health of their neighbors.
The Sentinel Surveillance to Monitor Progress toward Health Equity project of the CHC’s Center for Excellence aims “to develop and implement a surveillance system to capture the information necessary to monitor progress towards health equity for health disparate populations.” Members of the Community Advisory Board (CAB) are community leaders who work in the research focus areas target by the project. Since the inception of the project in 2011, CAB members have provided the research team with important insight for choosing data collection sites and guidance in interpreting and understanding the collected data. The CAB members include:
On July 28, 2017, participants in the Medical Student Summer Research program presented on their projects. Among the eight oral and 55 poster presentations, five students were participants in the Center for Healthy Communities Undergraduate Research Program and two were undergraduate medical students who have multi-year connections to the CHC.
Ms. Destini Smith, a second year USA Medical student, gave an oral presentation entitled “Access to Employer Provided Health Insurance in Low Income Communities.” Her work was sponsored by Dr. Kenneth Hudson of the Department of Sociology, Anthropology, and Social’ Work, and Dr. Errol Crook, Abraham A. Mitchell Chair and Professor Department of Internal Medicine and Director-Principal Investigator of the Center for Healthy Communities.
The poster presentations included:
Treatment of Hepatitis C Infection in HIV Infected Patients in Inner City Clinics, presented by Verlisa Kennedy, a first year USA medical student was sponsored by Dr. Eduardo Calderon, Division of Infectious Disease.
Health Policy and Child Poverty: An Illustration of the Social Determinants of Health presented by Aryne Hudson, a junior at Montevallo University was sponsored by Dr. Errol Crook, and Shannon M. Shelley-Tremblay, from the Center for Healthy Communities
Access to Employer Provided Health Insurance in Low Income Communities presented by Jasmine Mabry, sponsored by Dr. Kenneth Hudson of the Department of Sociology, Anthropology, and Social’ Work, and Dr. Errol Crook, Abraham A. Mitchell Chair and Professor Department of Internal Medicine and Director-Principal Investigator of the Center for Healthy Communities.
CASPASE-1 Levels are Elevated in Diabetic Patients Residing in Health Care Disparity Areas of Mobile County presented by Andrew Spriggs, a sophomore at UAB was sponsored by Diego Alvarez, M.D., Ph.D., Department of Physiology and Cell Biology, Center for Lung Biology and Center for Healthy Communities, University of South Alabama College of Medicine, Mobile, AL.
Telehealth Enhanced Education for Patients Living with Diabetes in Rural Alabama, presented by Elizabeth Torrance, sponsored by Jessica Hardy of the Alabama Public Health Department in Montgomery and Dr. Alethea Hill of the College of Nursing.
A Mouse Model To Test The Cytotoxic Immune Response To Intracellular Antigens presented by Raven Walker, sponsored by Dr. Victor Solodushko and Dr. Brian Fouty, Departments of Pharmacology and Internal Medicine in the College of Medicine.
College Student Obesity Prevention Program: Pilot Study, presented by Christen Carter, Sponsored by Sharon Fruh, Ph.D., RN, FNP-BC, Rebecca J. Graves, Ph.D., Heather Hall, Ph.D., Debra Swanzy, DNP, Theresa Wright, DNP, College of Nursing.
The summer program included 9-weeks of hands on research and a seminar program focused on various scientific and clinical topics.
The Center for Healthy Communities is pleased at the news that Dr. Bobbie Holt-Ragler, a long-serving Community Health Advocate (CHA), will receive the Lillian B. Smith Award at the Annual Convention of the Alabama State Nurses Association (ASNA) in October. Named for a long serving executive director of the ASNA, the Lillian B. Smith Award recognizes association members demonstrating long-term commitment both by service in the organization and in their communities.
Dr. Holt-Ragler received her Doctorate in Nursing Practice in 2007 and served for 30 years in the University of South Alabama hospital system. She also worked as a worked as a nurse educator at Mobile Infirmary Hospital. Now retired and a CHA, Dr. Holt-Ragler uses her knowledge and expertise in helping people gain important information about disease, disease prevention, and how to access medical assistance.
The Sentinel Surveillance to Monitor Progress toward Health Equity project aims to develop and implement a surveillance system to capture the information necessary to monitor progress towards health equity for health disparate populations. One key element of this project is the engagement of community members through a Community Advisory Board (CAB). Recently, Reverend Michael Johnson, pastor of Faith Lutheran Church in Mobile, shared a little about his experiences with the CAB.
Tell us a little bit about yourself and your background.
I was born in Mobile and attended local public schools. After high school, I attended Bishop State Community College and, then, the University of South Alabama where I studied Civil and Structural Engineering. I completed my Master of Divinity at Concordia Theological Seminary in Fort Wayne, IN. Before my pastorate here in Mobile, I pastored churches in Detroit, Birmingham, Memphis, and Baltimore.
How did you become involved with the Community Advisory Board for the Sentinel Surveillance Project?
I became involved by request of a previous [research office] employee, Andrea Hudson. She was aware of my years of community activism and involvement in providing initiatives for change.
Why did you decide to become part of the CAB?
We need to address the health disparities that cause much brokenness in our communities. Participation in the CAB offers an opportunity to participate in important research that helps us understand these disparities and help mend the brokenness in our community.
Give us a few highlights of your time as a CAB member. Is there any one memory that stands out?
I appreciate the meetings, brainstorming ideas for effective health change, workshops and collaborating with others of the interest. If I had to identify a single memory/experience that has piqued my interest the most, that would be my recommendation and participation in the Bayou Health Disparity Fellows Program, of which I graduated May 9, 2017.
What community needs are you most concerned about?
Health Disparity change, diabetes, hypertension, obesity, drugs and alcohol addictions.
How do you see the sentinel surveillance project addressing these issues in the community?
Specifically, Dr. Arrieta’s sharing of information discovered through the research and community experience helps to educate also. Because of her personal interactions, it allows us to build relationships that are loving and caring for one another.
Have you ever been involved in research before, if so how is this similar or different?
I have been involved with research before on the data collection side. I desire to extend my interest is collaborating in academic, clinical trials and community samples through education and photovoice.
What have you learned about research through this process?
I learned that there are many causes of Health Disparity. There are also, needs and means for change, including policy change that would dissolve determinants causes.
Has the experience changed the way you consider or approach research in other areas of your life?
Yes, my viewpoint has changed tremendously. I am better educated and more motivated to be involved in the partnership and seeking means for health change for self and community.
Would you encourage others people in your life to participate in or be a part of leading/shaping research projects as a result of your involvement with Sentinel Surveillance?”
Yes, would definitely as I am encouraging others to get involved, get educated, participate and share in the movement of better health – better life.
A recent study published in Preventive Medicine Reportsexplored the effect of health insurance coverage and doctor-patient relationships on the likelihood that an individual would receive diagnostic tests for diabetes and cardiovascular disease. Using data collected from 230 participants in the Labor Market Health Care Survey(LMHCS), the study examined three questions:
How does health insurance affect the likelihood of having a regular health care provider?
How does health insurance coverage affect the likelihood of receiving tests for cardiovascular disease?
To what extent does having a regular health care health care provider mediate the effect of health insurance coverage on receiving the diagnostic tests?
The research team, led by Dr. Kenneth Hudson, the LMHCS was a multi-wave longitudinal study of adults 18 and older living in nine high-poverty census tracts in a county of approximately 400,000 residents. For the study, high poverty census tracts were defined as those where 50% of the households have incomes below the poverty threshold. Interview participants were selected through a two-stage random sample. To be included in the study, an individual had to be over 18 years of age. While data collection began in 2006, about 90% of the data in this study were collected since 2013. The research team interviewed participants every 2 to 3 years when they could be located. During interviews, participants provide information on their household composition, employment history, health status, health care utilization and income. Of the 230 participants in the study, about half were under the age of 40.
Analysis of the data included 3 dependent variables:
Whether or not participants have health insurance from any source
Whether or not the participant has a regular health care provider and knows their doctor’s name
Whether or not participants receive diagnostic tests for blood pressure, cholesterol levels and blood sugar levels.
In terms of health insurance coverage, only 12% of participants reported having coverage through an employer, 7% purchased coverage from the private market, and 5% had coverage through a family member. About ⅓ of participants had coverage through Medicare or Medicaid. The final ⅓ did not have any type of insurance coverage.
In relation to health care utilization, 45% of participants reported not having a regular provider. 17% reported having a regular health care provider but did not know their doctor’s name. The remaining 38% had a regular provider and could report the doctor’s name. Around half of the participants reported having cholesterol, blood sugar and blood pressure tests in the last 2 years.
Through the analysis, Dr. Hudson and his team found that participants with health insurance coverage were more likely to have had recent tests for diabetes and cardiovascular disease than those without coverage. However, they also found that having a regular health care provider mediates the effects of insurance coverage, especially when the participant could report the name of their doctor.
The 2017 STARS and STRIPES program launched on June 12th with an orientation session introducing students and parents to program instructors and staff. Ms. Mary Williams, Center for Healthy Communities (CHC) community outreach coordinator, opened the event and provided an overview of what all participants could expect over the summer and introduced the instructors and program assistants for the 2017 session.
In welcoming the students, Dr.Errol Crook, Director and Principal Investigator for the CHC, encouraged the young people to take advantage of the opportunities ahead of them and support each other through the program and future challenges as they move on to college and into careers in the medical sciences. He stressed that the CHC focuses on health disparities and sees education and knowledge building as a key component of helping communities to develop their own capacity to advocate for equity and improvement.
Drawing on her experiences as an immigrant to the United States, Dr. Martha Arrieta, Director of Research Core, continued the theme of encouraging the STARS and STRIPES participants to take their futures into their own hands and to make the most of their participation in the program. She also challenged the group to remain curious; explaining that curiosity is the foundational principle of research. In asking the questions — specifically what, when, where, who, and why — researchers move forward in identifying problems and finding solutions.
Mary Williams welcoming the STARS and STRIPES students.
After the greetings, Ms. Williams introduced the program assistants and instructors who in turn explained the program of study for the summer: