Fall 2019/Winter 2020
It's an understatement to say that we've experienced some big changes over the past year. As most know by now, we were not refunded by the CDC for this 5-year cycle. It was clearly disappointing as we felt we submitted a strong application, but it was not to be. So, we move forward. We are grateful for the past 10 years of funding by the CDC as it provided us the infrastructure support to establish, with our community partners, a strong, community-focused research center we believe will be around for a long time. This is in part due to the unwavering support from Dr. Jonathan Haines and the School of Medicine, as well as our continued research funding from other grant sources that allow us to continue our collective work under the umbrella of a mission-driven center.
However, none of this would be possible
without the unwavering support and collaboration of you, our community partners and advisors.
As many of you may remember, we decided very early in the establishment of the PRCHN, when we merged the staff and projects of two previous centers (Center for Health Promotion Research and the Center for Adolescent Health), we would forever be known as the
Prevention Research Center for Healthy Neighborhoods - and so it is. Our funding may change but our name is not changing, nor is our mission or the passion we have for finding effective strategies for improving health in low-income and under-resourced neighborhoods like ours here in Cleveland. If anything, the changes we have experienced in the past year have helped us to re-evaluate, re-focus and re-energize.
But we do want to take a moment to reflect on our accomplishments as a Center. Here's a quick summary of the accomplishments of our PRCHN over just the past five years:
- Actively engaged over 150 community partners in one or more of our projects or center activities.
- Secured over $18.4 million in total funding (direct and indirect) in local, state, and federal grants and contracts.
- Published 121 peer-reviewed manuscripts, and 4 book chapters.
- Developed and disseminated 88 data, research, and policy briefs, toolkits, and technical reports.
- Developed 11 data collection tools (6 survey-based data collection tools; 4 environmental audit tools; community engagement assessments).
- Presented 103 national peer-reviewed presentations.
- Provided 17 trainings and national webinars; 37 videos; 94 state, regional, and local presentations; 55 research seminars and symposia (2014 - Apr 2019).
- Trained 341 students and 60 community ambassadors.
As we look forward, we are excited about the new projects and challenges that lie before us. While we remain steadfast in our commitment to healthy food access, we are turning our focus slightly to put more of our effort into reducing tobacco use in Cleveland, with hopes to learn and disseminate new strategies for tackling this significant heath issue. As many of you know, the rate of tobacco use in Cleveland is one of the highest in the country, with over 38% of adults reporting the current use one or more type of combustible tobacco products (cigarettes, little cigars, pipes, etc) -
that is twice the national rate. As the number one preventable contributor to disease and mortality we feel we need to do what we can to move the needle on tobacco use in our community. Building on a substantial foundation of research by Associate Director Dr. Erika Trapl, our growing collaborations within the Case Comprehensive Cancer Center, and the arrival of our new faculty member, Dr. Jin Kim-Mozeleski in January, we are well prepared to work with community and health care partners to offer effective approaches to reducing the rate of tobacco across Cleveland. Stay tuned on these new developments!
As we have reflected over the past year, we continue to be reminded of the invaluable contributions of those with whom we have shared our journey. I would like to take this time to thank each and every one of you who has contributed to the building of the PRCHN.
We are strong and committed because of you.
And together, we will continue to work to address the health and wellness needs of our community by identifying and developing strategies, approaches and partnerships that lead to real population level health improvement.
Elaine A. Borawski, Ph.D., FAAHB
Director, Prevention Research Center for Healthy Neighborhoods
Angela Bowen Williamson Professor of Community Nutrition
Departments of Population and Quantitative Health Sciences and Nutrition
PRCHN Director Dr. Elaine A. Borawski and Associate Director Dr. Erika Trapl received a $100k award from the Case Comprehensive Cancer Center to conduct pilot work needed to develop an evidence-based, comprehensive action plan for reducing adult tobacco use across the city, which involves a new approach to providing referrals for local cessation support through the United Way's 2-1-1 Helpline.
Together with co-investigators Dr. Sarah Koopman-Gonzalez (PRCHN), Dr. Monica Webb Hooper (Case Cancer Center), Persis Sosiak, MPH, RN (Cleveland Department of Public Health) and Matthew Finley, CRS, CIRS (United Way 2-1-1), and members of the Healthy Cleveland's BreatheFree Committee, the team will conduct two projects:
- Conduct interviews with 75 Cleveland smokers (or recent quitters) with the goal of filling in the gaps we currently have in understanding the barriers to and facilitators of intentions and quit attempt experiences of low-income Cleveland smokers.
- Examine the capacity of United Way 2-1-1 to administer cessation referrals by documenting their implementation process and conducting a qualitative study of call experiences using in-depth interviews and a systematic audit of calls for cessation referrals.
In addition, the group will establish a Steering Committee with academic, clinical and community representation that will guide the projects and help to develop the comprehensive plan (with timeline and milestones) to be implemented over the next 5-10 years, with the goal of reducing adult tobacco use in Cleveland through improved implementation strategies, tailored marketing, and coordinated cessation services.
Interested in participating in this initiative or
serving on the Steering Committee?
Please contact Elizabeth Frost at email@example.com
Trapl Lands $1.4M NIH Grant
To Study Flavored
Cigarillos remain a preferred product among youth and young adults, and flav
ored products predominate in this type of tobacco product. The vast majority of youth and young adults report that their first ever tobacco product was flavored. Marketing strategies promote flavored cigarillos such as grape and chocolate through advertisements featuring musical artists popular with youth and young adults in print and social media. And, product packaging for cigarillos conveys the diversity of product flavors using colors and imagery known to attract interest and attention from younger users.
PRCHN Associate Director Erika Trapl (PI) is joined by Drs. Amanda Quisenberry (Roswell Park Comprehensive Cancer Center) and Elizabeth Klein (Ohio State University College of Public Health) to establish FLASH
(cigarillo Flavor and abuse Liability, Attention, and Substitution in youtH), a 3-year study funded by the National Institute on Drug Abuse (NIDA) to examine cigarillo use among youth. The goal of FLASH is to better understand the appeal of cigarillos, and the purchasing and risk perceptions youth have about cigarillo products. FLASH will also examine the impact of flavored cigarillo product advertising on visual attention and risk perceptions among youth and young adult cigarillo users and nonusers.
This collaborative study will utilize a novel behavioral economic method, the Experimental Tobacco Marketplace, a digital storefront in which participants can purchase tobacco products using an account balance that reflects their typical tobacco product purchasing. The investigators will explore abuse liability - the potential of a product to become addicting - of flavored versus unflavored cigarillos while also looking at substitutability of flavored versus unflavored e-cigarette products.
Live Community Forum
On July 31, more than 180 community members participated in a
live community forum and taping
entitled "from risk to resilience: Understanding and Supporting Local Teens."
in partnership with PRCHN, was held
to raise awareness of the scope and prevalence of health risk behaviors by Cuyahoga County middle school students, provide a snapshot of the safety net already at work in Cuyahoga County to address these issues, and reinforce the protective factors that can be provided by parents and teachers to lower the potential harm these ri
sk behaviors generate.
The data presented was derived from the 2018 Youth Risk Behavior Surv
ey (YRBS, an annual survey conducted by the PRCHN, under the direction of Dr. Erika Trapl, Ms. Jean Frank and the small army of dedicated staff and volunteers that support the effort, including Catherine Osborn, Marisa Hollinshead, and Audrey Kinsella (shown right, with Jean Frank, seated).
Exploring the Mental Health Needs of the Adolescent Latinx/Hispanic Community
New Schubert Center Seed Grant
Through regular, thoughtful examination of annual local
Youth Risk Behavior Survey (YRBS) findings
PRCHN's YRBS Advisory Committee helps identify areas of concern for elevation to increase community awareness. Over the past few years,
Latinx/Hispanic students have reported an alarming prevalence of depressive symptoms.
With an award from the
Schubert Center Seed Grant Competition for Child and Adolescent Research,
Dr. Erika Trapl is leading a team of collaborators including Hispanic UMADAOP of Cleveland, Esperanza,Cleveland Clinic Lerner College of Medicine, and members of the PRCHN Adolescent Surveillance and Evaluationinterdisciplinary team led by Marisa Hollinshead BS, MD Candidate, with Sarah Koopman-Gonzalez PhD, Jean Frank MPH, and Heather Baily MA
to identify specific mental health needs of this unique Latinx/Hispanic adolescent population. Along with CC-YRBS data, the team will conduct focus groups and semi-structured interviews with 14-18-year-old Latinx/Hispanic adolescents. Insights gained through this project may eventually lead to development of new evidence-based interventions and research-informed best practices.
The PRCHN has administered the
Youth Risk Behavior Survey (YRBS)
to middle and high school students in Cuyahoga County for 15 years. This cross-sectional tool, developed by the Centers for Disease Control and Prevention and adapted for our local needs, tracks adolescent risk behavior over time.
- The YRBS team conducted its first-ever fall survey administration in 2018, visiting 94 middle schools in Cuyahoga County and all middle and high schools in Summit County. Click here to view Summit County reports.
- With considerable effort and coordination, the YRBS team has also been able to move more schools to online administration rather than paper and pencil, saving time and money.
results of the 2018 Cuyahoga County YRBS
have attracted a great deal of media attention
, in part due to a challenging picture for middle schools teachers, principals, and parents, with an unacceptable percentage of Cuyahoga County middle school students engaging in risk behaviors that could have serious near and long-term health consequences, such as
and a growing number of students reporting
However, the survey data also provide a snapshot of
such as the importance of parents talking with their teens about school or feeling valued in the community, which are linked to fewer risky behaviors.
- YRBS Director of Adolescent Surveillance and Evaluation, Jean Frank, MPH, was interviewed for the Fall issue of THINK: The Magazine of Case Western Reserve University. In the article, "The Private Lives of Youth," Ms. Frank discusses the value of YRBS data, noting "the insights gained can help inform anything from what schools discuss with parents and students to local laws detailing age restrictions for vaping...and the survey also documents the magnitude of problems."
Be sure to follow
on Twitter for updated briefs, infographics, statistics, and relevant news.
No Cost, High Impact Means of Improving Population Health
is a national campaign to raise the tobacco sales age from 18 to 21 years of age. Currently, over 475 cities and 18 states including Ohio have already raised the age to 21. Ohio's new law,
which included raising the legal age to purchase vaping and tobacco products to 21 statewide,
took effect on October 17, 2019. More information can be found on the Ohio Department of Health website
DYK: Cleveland was the first major city in Ohio to pass Tobacco21 legislation. And the PRCHN and local Youth Risk Behavior Survey had an important part in that legislation! We are excited to have a new Healthy Cleveland infographic and rack cards depicting the journey.
Want to read more about Tobacco21 in Cleveland?
FreshLink Ambassadors are community champions
who provide their neighbors with a social connection to local resources to raise awareness of healthy food options and Supplemental Nutrition Assistance Program (SNAP) incentive programs.
How can these resident ambassadors help connect these customers to local farmers' markets? That's one of the questions PRCHN's core research project,
, set out to understand.
The FreshLink Ambassador model is a peer-based intervention tested as part of a 5-year research project of the PRCHN. The overall goal was to increase access for low-income neighborhoods to nutritious food, specifically at local farmers' markets. During Year 1, we recruited community leaders and hired them as FreshLink Ambassadors (FLA) to work with the FreshLink team at the PRCHN. With the vision of the program to "bridge residents to resources to foster healthy communities," we worked to educate residents about local programs such as Produce Perks, and support the local food economy in Cleveland.
The FreshLink model builds from the existing networks of each ambassador and engages communities by utilizing the leadership from within. FLAs raise awareness of healthy food options and SNAP incentive programs through outreach at community events, and encourage new customers to shop at farmers' markets. Year 2 was pilot testing and, incorporating what was learned, in Year 3 we worked with 3 different farmers' markets/farm stands: Gateway 105, Good Earth Farmstand, North Union Farmers' Market at University Hospitals and 8 ambassadors. Year 4 expanded the reach by adding Coit Road Farmers Market, North Union Farmers' Market at Shaker Square, and The Village Market in Slavic Village and hiring 4 new Ambassadors. The final year focused on spreading the model nationally through trainings, presentations, journal articles, and toolkits.
All told, the project depended upon 67 partners and 12 Ambassadors to develop a successful, evidence-based model and produce 21 presentations, 11 publications, 4 trainings, and a set of toolkits and outreach materials.
We extend our sincere appreciation to all of our partners and the dedicated Freshlink Ambassadors - we couldn't do it without you!!
Watch the FreshLink video
PRCHN's core research project,
, has shared its
evidence-based community ambassador model
through 4 training sessions: a national webinar and in-person trainings in Columbus, Tucson, and Cleveland.
Combined, more than 125 health professionals, community and organizational representatives from across the country have participated in these sessions, representing 8 states, 97 organizations, and more than 9 sectors.
The trainings take participants through the steps necessary for organizations to create their own ambassador program and facilitate increased SNAP use at local farmers' markets. B
ased on lessons learned through development and implementation by the PRHCN between 2014 and 2019, the FLA model may also be adapted for other outreach or community health worker applications.
Now, the full complement of training materials is available online as a
to assist other communities and organizations interested in implementing similar programs.
The FreshLink Ambassador (FLA) toolkit is designed to support the implementation of the FreshLink Ambassador model in diverse community settings. The Toolkit includes four components designed to be used together:
eshLink Facilitator Manual
FLA Training Curriculum
FLA Workbook, and
FLA Employment Handbook
. In addition to the toolkit, outreach materials and PowerPoint presentations are available online.
REI Groundwater Training
PRCHN was proud to co-host the
Racial Equity & Inclusion (REI) Groundwater Training
on Sept. 18 with Case Comprehensive Cancer Center's Office of Cancer Disparities Research (OCDR). This 3-hour learning journey was attended by 100+ public health professionals, community partners, faculty, researchers, clinicians, and students who came together to increase a shared understanding of racial inequities that impact health and begin a discussion of strategies to promote a more equitable society. The workshop was presented by members of the
Racial Equity Institute
"Through our continued efforts to deepen our understanding of our history, the outcomes of unequal systems, and the language needed to describe with specificity how systemic racism impacts every facet of American life (including our work), we move one step closer to creating a more equitable society."
PRCHN Faculty and Staff Provide Leadership to CTSC Community and Collaboration Core
Cleveland Clinical and Translational Science Collaborative
, funded by the National Institutes of Health, is part of a national network of 60 medical research institutions - called Hubs - that "work together to improve the efficiency, quality and impact of the process for turning observations in the laboratory, clinic and community into interventions that improve the health of individuals and the public" (NCAT, 2019). Our CTSC provides research support to investigators at CWRU, MetroHealth, University Hospitals, Cleveland Clinic and the Cleveland VA.
Within each Hub is a Community and Collaboration (C&C) Core that is responsible for promoting collaboration through inter-disciplinary team science and intentional stakeholder engagement across the institutions. Stakeholders are defined as an independent, engaged, individual or group that has a stake in the outcomes of the research and whose input could greatly enhance the research endeavor. Stakeholders partner with researchers to help translate scientific observations into interventions as well as taking some responsible for moving the translational product into wider use in the community. Stakeholders thus come from a wide range of places from industry to health care to the community (organizational and citizens).
In this 5-year funding cycle, Dr. Elaine Borawski, PRCHN Director, was asked to serve as Faculty Lead for the C&C Component and is supported by a PRCHN-based team lead by Anna Matos, Dr. Meredith Goodwin, Briana McIntosh and Rachel Gardenhire. The C&C team also includes PRCHN Affiliated Faculty members Drs. Shirley Moore, Darcy Freedman, Kurt Stange, Heidi Gullett and Jim Werner. The goals of the C&C are:
- Develop a pipeline of collaborative teams (interdisciplinary teams with engaged stakeholders) to form and produce novel and relevant translational research;
- Increase awareness and capacity of STAKEHOLDERS to engage in team science research;
- Increase awareness and capacity of INVESTIGATORS (faculty, staff and trainees) on importance of team science with stakeholder engagement;
- Cultivate team science with stakeholder engagement as a valued institutional norm.
Welcome New Staff & Students
Say hello to the most recent additions to our PRCHN team!
Teen Pregnancy Prevention Program
Tanisha Velez Heart Smarts Project Associate
Wyndi Moore, Ronneta Stallworth, and
FARE Outreach Associates
We were saddened to say goodbye to two faculty in the last year -
Susan A. Flocke, PhD and
Darcy Freedman, PhD, MPH
. Both served as Associate Directors of the Center.
locke (left), with the Center at its inception, last year
w position as a Professor in the Department of Family Medicine at Oregon Health & Science University.
Dr. Freedman accepted the directorshi
p of the Mary Ann Swetland Center for Environmental Health here at CWRU
While missed, we are excited about their new opportunities. Both remain as friends, collaborators, and Affiliated Faculty of the PRCHN. We wish our colleagues
all the best as they continue their professional journeys.
Erika Trapl, PhD
, was selected as a program co-leader for the Cancer Prevention Control and Population Research at Case Comprehensive Cancer Center and chosen as a trainee in the highly selective NCI Training Institute in Dissemination and Implementation Research in Cancer.
Jean Frank, MPH, Director of Adolescent Surveillance & Evaluation, received the Connected Learning Award as part of the Cleveland Metropolitan School District/Alliance for a Healthier Generation "Wellies" Awards on May 1, 2019. The Healthy Schools Wellness Award Celebration recognizes and shows appreciation for Cleveland school wellness leaders and their accomplishments in creating healthier school environments.
PRCHN Community Health Ambassador
was named a National Association of Community Health Workers (NACHW) Ambassador, one of 20 individuals selected nationwide. Ambassadors will act as liaisons between the NACHW and local, state, and regional community health worker networks and associations. This honor recognizes Ms. Collins' commitment to improving the health of citizens in disproportionately affected neighborhoods and is reflective of her relationship with the PRCHN.
The PRCHN received the 2019
Ohio Academy of Nutrition and Dietetics
Outstanding Contribution Award. This award is issued to a non-member who has shown stellar support for the dietetic profession in providing tools for optimal health and nutrition well being in the state. The PRCHN was recognized both for its numerous nutrition-related interventions (such as FreshLink, REACH, FARE, resident Community Health Ambassadors, and IMPACT) and for its training of public health professionals focused on nutrition. To date, the PRCHN has provided training for 48 nutrition students, including 37 from the CWRU Master of Science in Public Health and Nutrition program.
Erika Trapl, PhD and Morgan Taggart, MA accepted the award during the Ohio Academy of Nutrition and Dietetics' (OAND) 2019 Annual Conference, May 2-3 in Cincinnati, Ohio.
We are grateful to Jennifer Kerner and Laura Moore of the Recognition Committee of the Greater Cleveland Academy of Nutrition and Dietetics, who nominated the PRCHN for this award.
Tiggs BB, Miller D, Dudding KM, Balls-Berry JE,
, Dave G, Hafer NS, Kimminau KS, Kost RG, Littlefield K, Shannon J, Menon U, and The Measures of Collaboration Workgroup of the Collaboration and Engagement Domain Task Force, National Center for Advancing Translational Sciences,National Institutes of Health.
Measuring quality and outcomes of research collaborations: An integrative review.
Journal of Clinical and Translational Science, page 1 of 29. doi: 10.1017/cts.2019.402
V. Schlosser, PhD, MSW, Samantha Smith, MA, *Kakul Joshi, PhD Candidate, MPH, Anna Thornton, MPH, Erika S. Trapl, PhD, and Shari Bolen, MD, MPH. "You Guys Really Care About Me...": a Qualitative Exploration of a Produce Prescription Program in Safety NetClinics. J Gen Internal Med. 2019 Sept 11;p1-8;
Moore SM, Borawski EA, Love TE, Jones S, Casey T, McAleer S,Thomas C, Adegbite-Adeniyi C, Uli NK, Hardin HK, Trapl ES, Plow M, Stevens J, Truesdale KP, Pratt CA, Long M, Nevar A. Two Family Interventions to Reduce BMI in Low-Income Urban Youth: A Randomized Trial. Pediatrics. 2019 Jun;143(6). pii: e20182185. doi: 10.1542/peds.2018-2185.
Director Elaine Borawski presented a recent manuscript in Prague, Czech Republic in June: Gardenhire, R*, Jones, S*,
Personal, Social and Program Factors Linked to Recruitment and Retention of Overweight and Obese Youth in a School-Based Fitness Program.
2019 International Society for Behavioral Nutrition and Physical Activity. Prague, Czech Republic. June 2019.
ABSTRACTS & POSTER PRESENTATIONS
Briana Mcintosh, MPH, Anna Thornton, MPH,
Erika S. Trapl, PhD
, Delores Collins, Erika Hood, M.Ed, Michele Benko, MS, RD, LD, Kakul Joshi, MPH*, and
Elaine A. Borawski, PhD
. Creating Greater Destinies: Results of a Resident-led Approach to Health Equity in Greater Cleveland. American Clinical and Translational Science Conference. Washington DC. Mar 2019.
School-Based Retail Environment Exposures and Youth Cigarette, Cigar, and e-Cigarette Use. 2019 Society for Research on Nicotine & Tobacco Annual Meeting. San Francisco, CA. Feb 2019.
Borawski EA, Goodwin M, and Matos A.
The Advancement of Team Science and the Role of Stakeholders in Clinical and Translational Science. Invited Presentation Center for Health Care Research & Policy, MetroHealth Medical Center, Cleveland OH, Sept. 20, 2019
. Presentation: Tobacco 21. Case Comprehensive Cancer Center Retreat. Warrensville Hts., OH. July 26,2019.
TECHNICAL REPORTS, DATA BRIEFS, TOOLKITS
Du A, Kinsella A, Osborn C, Frank JL,
, (Sept 2019). Infographic: Electronic Vapor Product Use: Survey Results for Students in Cuyahoga County. Cleveland, OH: Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University.
Kinsella A, Osborn C, Frank JL, Trapl ES, (August 2019). Youth Data Brief: Electronic Vapor Use in Cuyahoga County. Cleveland, OH: Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University.
Osborn C, Frank J, Kinsella A, Koopman Gonzalez S, Trapl ES (August 2019). Youth Data Brief: Sexual Risk Behaviors and Academic Achievement in Cuyahoga County. Case Western Reserve University, Prevention Research Center for Healthy Neighborhoods. Cleveland, OH
Fahoum J, Frank J, Kinsella A, Osborn C, and Trapl ES. (June 2019). Youth Data Brief: Protective Factors in Cuyahoga County. Case Western Reserve University, Prevention Research Center for Healthy Neighborhoods. Cleveland, OH
Osborn C, Frank, J, Trapl E, and YRBS team. (June 2019) Depressive Symptoms among LGB Youth Survey Results for Students in Cuyahoga County. Infographic. Cleveland, OH: Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University.
Sommer, R., Vargo, L., Martinez, R*., Bilkert, K. and Freedman, D.A. (2019). FreshLink Training Curriculum (including 6 PowerPoint Presentations). Case Western Reserve University, Prevention Research Center for Healthy Neighborhoods; Cleveland: OH.
Sommer, R Vargo, L., Martinez, R.*, Bilkert, K. and Freedman, D.A. (2019). FreshLink Ambassador Workbook. Case Western Reserve University, Prevention Research Center for Healthy Neighborhoods; Cleveland: OH.
Sommer, R Vargo, L., Martinez, R.*, Bilkert, K. and Freedman, D.A. (2019). FreshLink Ambassador Toolkit: Facilitator Guide. Case Western Reserve University, Prevention Research Center for Healthy Neighborhoods; Cleveland: OH.
Sommer, R Vargo, L., Martinez, R.*, Bilkert, K. and Freedman, D.A. (2019). FreshLink Ambassador Toolkit: Ambassador Employment Manual. Case Western Reserve University, Prevention Research Center for Healthy Neighborhoods; Cleveland: OH.
December 12, 2019
PRCHN's Neighborhood Environmental Assessment Project (NEAP) Food Retail Report
Elaine A. Borawski, PhD and Rachel Gardenhire, PRCHN
January 8, 2020
How visual attention informs health decisions: Eye tracking research in tobacco control.
Liz Klein, PhD, MPH, The Ohio State University College of Public Health
Copyright © 2014. All Rights Reserved.
This e-newsletter is supported by Cooperative Agreement Number 1-U48-DP-001930 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Centers for Disease Control and Prevention.
A proud member of the National PRC Network, funded by the Centers for Disease Control and Prevention