When we sit down to plan each newsletter, we often look for a theme – maybe it’s on our wonderful trainees, or our contributions to policy, or a specific subject. If this issue were a dinner, it might be what we call “international night” in my house (which sounds so much fancier than “leftovers”). There are pieces on subjects with a long history at Sheps and new areas of interest our colleagues are exploring. We hear from researchers who have been here for decades, some who are long-standing Tar Heels but relatively new to Sheps, and some who are just starting their careers. Some stories cover award-winning publications and others focus on policy engagement. And maybe that’s the point -- we stumbled accidentally into our theme for this issue: the Sheps Center offers a “big tent” of health services research. We can be the proverbial elephant in the cave – while some describe an elephant by its trunk, others by its tusks, and still others by its feet, Sheps likewise has a multifaceted reputation. While some may view this lack of a sole identity as a weakness, I am proud that the Center is known for different strengths across different stakeholders. This is a strength, where we can pull from other disciplines, experiences, and fields to export approaches to new applications. These newsletters are intended to help with just that – to share some of the great work happening across the Center with your colleagues.
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Dr. Orr is a general pediatrician and health services researcher at the University of North Carolina at Chapel Hill. After residency, Dr. Orr was interested in complementing his clinical skills and knowledge with research methods and completed a T32 Primary Care Research Fellowship at the Cecil G. Sheps Center for Health Services Research and obtained an MPH from the University of North Carolina Gillings School of Global Public Health. Dr. Orr joined the UNC Department of Pediatrics in 2019 as an Assistant Professor. Since joining the faculty, Dr. Orr has focused his research efforts on examining how the social determinants of health, specifically food insecurity, influence the growth and health of infants and children. Dr. Orr is also interested in health equity and studying how interventions can be adapted to the most impact on communities. Dr. Orr has received multiple awards for his research and has obtained grant funding to support his research agenda. Dr. Orr joined the Sheps Center's leadership team as a Deputy Director in Spring 2023. |
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Mark Holmes addresses US Senate Subcommittee on Rural Access to Care
Mark Holmes, PhD, Director of the Sheps Center, testified before the Senate Finance Committee’s Subcommittee on Health Care on May 17th, 2023. The hearing was titled “Improving Health Care Access in Rural Communities: Obstacles and Opportunities”.
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Health Workforce Research Centers present at HRSA summit and AAMC Conference
The Program on Health Workforce Research & Policy gave a number of presentations this spring. On May 26th, Drs. Brianna Lombardi and Lisa de Saxe Zerden gave a keynote, titled "The State of the Behavioral Health Workforce and Promising Practices", which was part of a broader one-day summit on Extending the Ladder: The New Behavioral Health Workforce Landscape in Newton, MA at William James College, in collaboration with HRSA's Office of Intergovernmental and External Affairs.
Earlier in May, at the AAMC Workforce Research Conference in Washington DC, the Behavioral Health Workforce Research Center team presented "Are Behavioral Health Providers Located in Areas of Deprivation?", and the Carolina Health Workforce Research Center team presented the following two projects: "Are DEA Waivered Prescribers Co-located With Behavioral Health Clinicians?" and "Understanding Available Data Sources to Estimate the Size and Distribution of Community Health Workers in the United States."
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Sheps Center presence at NRHA
In May, six Shepsters (3 PIs and 3 students) traveled to San Diego for the National Rural Health Association's Annual Rural Health Conference. They participated in three presentations, presented two posters, learned from collaborators new and longstanding, and came back energized for more rural health research!
Emily Hawes, PharmD; Erin Fraher, PhD, MPP; Mukesh Adhikari, MPH, MPA presented on their work on “Graduate Medical Education (GME) Status of Rural Hospitals under new regulation” (available on demand until August 16, 2023, for a virtual registration fee here). Mark Holmes, PhD co-presented with colleagues from other research institutions, technical assistance centers, and the Federal Office of Rural Health Policy, “Implementation of the New Rural Emergency Hospital Model” (available on demand here). PhD candidate Hannah Friedman presented work on Travel Times to NICUs in Rural Areas as part of a session of contributed papers in Maternal/Child Health. Hannah also presented a poster on “Differences in HealthCare Utilization by Rural Residence.” Susie Gurzenda, MS presented a poster entitled: “Estimating Eligibility: Rural Marketplace Insurance Rates Continue to Lag in North Carolina.”
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AcademyHealth ARM 2023
AcademyHealth's Annual Research Meeting was held this year in Seattle, WA from June 24-27. Several Sheps researchers gave podium presentations covering COVID trends, substance use, women's health, and health workforce. There were also many posters from Sheps and UNC that were presented by trainees, faculty, and students addressing a variety of topics including women's health, data analytics, Medicaid, end of life care, health workforce, and health disparities. The Sheps Center and the Department of Health Policy and Management co-hosted a reception on Monday June 26th for UNC alumni and friends.
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North Carolinian Caregivers – Who Cares? |
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Nearly 1 in 5 North Carolinians, about 1.3 million people, are family caregivers and provide essential support to their family members and friends with serious health problems, illnesses, and disabilities. This care is unpaid, but valued at about $13 billion dollars. Caregivers in NC face many challenges. A recent analysis led by alum Dr. Kate Miller in Milbank Quarterly of caregiver-friendly policies ranked North Carolina in the bottom 10% of states. In addition, a report that HPM graduate student and Sheps researcher Hannah Friedman contributed to on rural caregivers in North Carolina demonstrates high access barriers. Rural areas are growing older but have fewer job prospects to maintain a workforce able to tend to the growing number of older adults who need support.
Sheps research fellow Erin Kent, PhD and colleagues recently led a commentary in the North Carolina Medical Journal March/April Issue caregiving across the lifecourse, to call for a unified perspective on caregiving and an explicit focus on caregivers themselves to help strengthen supports for this essential population. These issues were also presented as part of the NC Caregiving Policy Summit, held on May 10-11.
State investment in caregiving may be increasing, as evident in the recent release of NC Executive Order 280 to shore up the state’s commitment to building an age-friendly state. As part of this effort, the NC Division of Health and Human Services is leading a multisector plan for aging called “All Ages, All Stages NC” which will provide a strategic framework and guidelines for promote equitable access to services and strengthen community engagement.
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Creativity Hub will use machine learning to improve children's mental health in NC |
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North Carolina has the highest prevalence of untreated mental health (MH) diagnoses among children in the United States. The COVID-19 pandemic has worsened this crisis and exposed the shortcomings of the state's MH system. Only 20% of children with MH disorders receive treatment from a MH provider, despite nearly one in five children nationally being affected by such disorders. To address this issue, a project led by Samantha Schilling, MD, MSHP and Paul Lanier, PhD, MSW aims to leverage existing data and data science methods to improve the efficiency and effectiveness of the state's MH system. Machine learning techniques will be applied to enhance modeling efficiency and identify patterns from large administrative datasets. The goal is to create a platform that allows data scientists to collaborate directly with policymakers, public health leaders, clinical providers, community members, and experts from various scientific disciplines to design systems to improve the mental health of children in North Carolina.
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Betsy Sleath and team create substance use and vaping resources for teenagers in Western NC |
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Betsy Sleath, PhD received funding from the Dogwood Health Trust to develop educational materials to prevent substance use and vaping among teenagers in Western North Carolina. A research team from the UNC Eshelman School of Pharmacy (led by Sleath) is collaborating with community partners in Western North Carolina and two teen advisory boards to design 11 videos on substance use and vaping, which will be housed on the website “Information for the evolving teenager” (iuveo.org). The videos will also be disseminated through other methods in Western NC. Information for the evolving teenager is a new health information website for teens, co-designed by teens. The process of the website’s development is explained in a recently published manuscript at PEC Innovation: “Co-designing a website with and for youth, so they can better manage their health” (Wright et al., 2023).
Additionally, the team will expand the content on the substance use and vaping sections of the website and will create more question prompt lists on substance use. Teenagers can use these question prompt lists to communicate with their health care providers and other adults they trust by asking questions they might have about substance use and vaping.
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Wright M, Thomas KC, Carpenter D, Lee C, Coyne I, Garcia N, Adjei A, Sleath B. Co-designing a website with and for youth, so they can better manage their health. PEC Innovation. 2023;2:100164. doi: https://doi.org/10.1016/j.pecinn.2023.100164.
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Dr. Saif Khairat Receives the 2023 APIC-AJIC Award for Publication Excellence |
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Saif Khairat, PhD, MPH, has been awarded the prestigious "2023 APIC-AJIC Award for Publication Excellence" from the Association for Professionals in Infection Control and Epidemiology (APIC). This award recognizes an author who has published an article in the American Journal of Infection Control (AJIC) that was widely read and cited during the previous year, and has the potential to make a significant impact on the practice of infection prevention and control.
Dr. Khairat's award-winning publication, titled "Factors and reasons associated with low COVID-19 vaccine uptake among highly hesitant communities in the US", discussed the factors that influenced individuals' COVID-19 vaccine hesitancy in the US. The study reported that low education levels are a major contributor to vaccine hesitancy and ultimately vaccination levels.
The publication was co-authored with Dr. Julia Adler-Milstein, UCSF Professor and the 2023 Gordon H. DeFriese Distinguished Lecturer, and Dr. Baiming Zou associate professor at the Gilling’s School of Global Public Health. We congratulate Dr. Khairat and his co-authors on their outstanding achievement and their contribution to the field of infection control and epidemiology.
Dr. Khairat also recently received funding on a multi-million dollar grant from NIH/NCATS to establish the Center for Virtual Care Value and Equity (ViVE). ViVE will be the first-of-its-kind center to promote translational research in virtual care. The goal is to lay a strong foundation for the future adoption and dissemination of virtual care research capabilities. Chris Shea, PhD will be a Co-Investigator and Mark Holmes, PhD will sit on the internal advisory board of the Center.
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NRSA Postdoc quoted in CNN and receives CATCH grant |
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NRSA Primary Care Research Fellow and Pediatrician Brittany Raffa, MD, MPH authored a recent JAMA publication on the increased ingestion of illicit substances by children during the pandemic. This was picked up by CNN and Dr. Raffa is quoted in that story. She also published the article, "Immigration Policy and the Health of Latina Mothers and Their Infants", in the Journal of Immigrant and Minority Health in April.
Dr. Raffa received a Community Access to Child Health (CATCH) grant, funded by the American Academy of Pediatrics. With this funding, she will explore the experiences of Latino caregivers with accessing care when one child has health insurance and the second child is uninsured. Her team will focus on how to improve the current processes in place to access care for all children, and how not having insurance for one child affects the whole family unit. They will also speak with Spanish-speaking Community Health Workers who support Latino families navigating services and care.
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NEW FACES AT THE SHEPS CENTER |
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Larissa Jennings
Mayo-Wilson, PhD, MHS
Sheps Research Fellow
Dr. Jennings Mayo-Wilson is an Associate Professor in the Department of Health Behavior and Department of Maternal and Child Health at the University of North Carolina Gillings School of Global Public Health. She is a sexual and reproductive health behavioral scientist with methodological skills in epidemiology, biostatistics, randomized behavioral clinical trials, and qualitative research. Her work focuses on design and evaluation of micro-economic interventions to mitigate disparities in sexual and reproductive health (including HIV) in clinical and community settings.
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Alejandro "Ale" Madrid
Medicaid Waiver Evaluation
Ale joined Sheps in March 2020. Recently, she made an exciting transition into a Project Management role within the Medicaid Evaluation team. When she is not working, she loves diving into books as part of her local book club. Spending time with her 19-month-old son is incredibly precious to her, and she also enjoys the thrill of exploring new places through travel.
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Maria Gaiser, MPH
Health Workforce Research and Policy
Maria is a Research Associate/Project Manager with the Behavioral Health Workforce Research Center. She holds 11 years of professional experience in the public health and behavioral health fields, with a primary focus on cross-disciplinary training on addressing health disparities created by social, political, and physical factors. Maria joins Sheps after four years with the University of Michigan Behavioral Health Workforce Research Center, where she specialized in workforce distribution, peer support provider certification and training, and workforce training program evaluation. Originally hailing from San Francisco, she currently lives in Boulder, Colorado where she enjoys running, hiking, and adventures in the great outdoors.
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David Elliott, PhD
Aging, Chronic Illness, and
Long-Term Care
Dr. Elliott joined Sheps as a Senior Analyst in January 2023. Previously, he served as Research Associate at the Diversity Institute at Cleveland State University where he performed mixed methods program evaluation research focused on diversity, equity, and inclusion for clients both within CSU and in the Cleveland community. He is excited to be applying and expanding his data analysis and data science skills in data cleaning and preparation, statistical sampling and modeling, computational text analysis, and social network analysis. He enjoys walking, listening to audiobooks, political podcasts, and lectures, seeing films at the Chelsea or streamed via Kanopy, and reading.
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EXTERNAL PARTNER SHOUTOUT |
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North Carolina Integrated Care for Kids (NC InCK) is a CMS-funded collaboration between NC DHHS, Duke Health, and UNC Health with a common goal to improve the health and well-being of children in central North Carolina. NC InCK champions built a coalition of child health leaders from across the NC InCK region and state, and this coalition designed a model to address the root causes of poor child health outcomes.
The recently awarded UNC Research Creativity Hub project "Systems Science Hub: Youth Mental Health" will leverage an ongoing partnership with NC InCK to gain family, community, and stakeholder input and for translation of findings into real-time changes to improve the mental health of children in North Carolina.
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Kids under 6 were increasingly treated for illicit...
Some research suggests drug and alcohol use increased in adults after the start of the pandemic, and now new research shows that kids under 6 years old have been ingesting some of these substances as well. Experts share what we need to do about it.
Read more
edition.cnn.com
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Rooted: Laura Hanson - UNC Research
Laura Hanson is the medical director of the Department of Medicine's Palliative Care and Hospice Program. She has been contributing to research at Carolina for 31 years.
Read more
research.unc.edu
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'Silver tsunami' requires aging expertise - The Well
Penny Gordon-Larsen is the Carla Smith Chamblee Distinguished Professor of Global Nutrition at the Gillings School of Global Public Health and Carolina's interim vice chancellor for research. According to the World Health Organization, every...
Read more
thewell.unc.edu
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UNC Pembroke exploring optometry program
UNC Pembroke was recently granted permission by the University of North Carolina System to move forward with a proposal to establish the state's first school of optometry. If approved by the UNC System Board of Governors, the school would be the...
Read more
www.uncp.edu
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Disparate Issues Shape Rural Health | Triangle NewsHub
By Jaymie Baxley Many of North Carolina's so-called rural counties bear little resemblance to the pastoral hamlets that people tend to picture when they think of rural living. In reality, the 78 counties that fall under the common statistical...
Read more
trianglenewshub.com
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3 Keys to Addressing the Rural Maternal Health Crisis | AHA
Rural hospitals, which deliver about one in 10 babies nationally each year, have been closing in significant numbers. Despite the challenging environment, rural hospitals and health systems are taking traditional and innovative approaches to...
Read more
www.aha.org
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A Beauty Treatment Promised to Zap Fat. For Some, It...
CoolSculpting is among the most popular fixes for unwanted bulges. But the risk of a serious side effect appears to be higher than previously known. Send any friend a story As a subscriber, you have 10 gift articles to give each month. Anyone can ...
Read more
www.nytimes.com
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Fractured: The effectiveness of psychiatric residential...
Paul Lanier, MSW, Ph.D. works to develop prevention programs in child welfare, mental health and early childhood systems. Lanier explains psychiatric residential treatment facilities.
Read more
www.wfae.org
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NRSA predoctoral trainee and Pharmaceutical Outcomes and Policy PhD candidate, Phillip Hughes, MS, has an article in press with Professional Psychology: Research and Practice titled "Examining Psychologist Prescriptive Authority as a Cost-Effective Strategy for Reducing Suicide Rates."
This cost-effectiveness study simulates the 20-year impact of granting prescriptive authority to psychologists as it relates to suicide deaths and suicide attempts. We demonstrated that the policy was associated with nearly 850 fewer suicide deaths, 800 suicide attempts, and a societal savings of over $268 million dollars. This is the first study to examine economic outcomes associated with prescriptive authority for psychologists and will be a critical piece of evidence for the nearly 15 states where similar bills are currently under consideration.
A full list of Sheps Center publications from March 2023 - July 2023 can be found here.
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Subscribe to and read other Sheps Center newsletters:
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THE CECIL G. SHEPS CENTER
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Have feedback on this newsletter or suggested content for future newsletters? Contact Lindsay McCall.
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