SPH news

Posted Date: May 22, 2017
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The prescription bottle said, “Take one tablet as needed,” so the patient did – repeatedly – going far beyond the recommended daily dosage.

health_literacy

Left to right, Dr. Wagner with State Senator Diana Arevalo and Chris Yanas, Director of Governmental Affairs, Methodist Healthcare Ministries of South Texas

A health information pamphlet for teens titled “Adolescent Transitional Care Policy” became much clearer when given the new headline, “You’re Becoming an Adult!”

In another example, plain language, photos and illustrations were found to better communicate how to take and store strong oral chemotherapy medicines that depend on closely following the directions.

“Every day across the U.S., patients are confused by or misinterpret healthcare instructions, sometimes leading to very dangerous results,” said Teresa Wagner, DrPH, MS, CPH, RD/LD, health literacy advocate and Adjunct Assistant Professor with the UNT Health Science Center School of Public Health.

“With health forms and instructions written well above the average adult reading level, it’s no wonder most Americans find health information complicated and confusing,” she said.

Concurring with Dr. Wagner are findings from the Institute of Medicine, reporting that more than 90 million adults today have limited skills in reading and math, considered necessary tools for understanding and following basic health information.

Health literacy, simply defined, is being able to obtain, use, understand and navigate health information, instructions and resources.

For quite some time, Dr. Wagner has been working to increase health literacy awareness across Texas, speaking earlier this year at a Medicaid conference, providing trainings across the state, and most recently, speaking to legislators in Austin on behalf of a bill she championed to improve health literacy, access to care and patient outcomes.

“If passed, House Bill 3682 would be the first document to legally recognize the issue of health literacy in the state, and the long-term effect could improve the health of citizens and potentially save Texas millions of dollars in healthcare costs,” she said.

Sponsor of the bill is State Representative Diana Arevalo from San Antonio, with support from Methodist Healthcare Ministries of South Texas and the Texas Dental Association.

“Low income families, the elderly and new immigrants are most likely to suffer from health literacy challenges,” Dr. Wagner said, “greatly impacting prevention and control of health conditions. Language and cultural differences can also change interpretation and translations, giving different meanings than what may be intended.”

“It’s important to find ways to bridge communication gaps among the healthcare system, providers, patients, their families and caregivers,” she said.

A registered dietitian, Dr. Wagner works directly with patients and consults with health providers to empower individuals to take an active role in their personal wellness plan. Health literacy, she says, is key in this process.

“When the doctor’s advice is for a patient to ‘eat healthier,’ what does that mean? Patients need a good understanding of how to shop for and prepare healthy foods, and how to make the best choices, as well as how to talk with doctors, nurses and others about their conditions, questions and concerns,” she said. “Those providers can then refer inter-professionally, so that experts in each area can address patient needs in a health literate manner.”

“I have seen so many patients unsure of how to be proactive in their own care by simply asking questions, people who have stopped taking their medicines because they didn’t feel comfortable talking to the pharmacist, or who didn’t understand health or nutrition instructions but were afraid to ask.”

“Even making a doctor’s appointment can be a challenge when it comes to navigating websites and completing forms online,” she said.

Dr. Wagner was first drawn to health literacy while pursuing her DrPH at the UNTHSC School of Public Health, when she began working as a graduate assistant on a health literacy research project for the United Way of Tarrant County.

She then chose to complete her doctoral residency at the University of Texas Center for Health Communication and the Literacy Coalition of Central Texas (LCCT). She was subsequently hired as the LCCT’s Director of Health Literacy, leading to her work that continues in this area today.

This fall, part of her appointment will be with the UNTHSC Institute for Patient Safety, leading health literacy efforts. These efforts will address general health and wellness information, as well as emphasize health literacy as a factor in patient safety.

Posted Date: May 12, 2017

ORJI OKEREKEUNTHSC School of Public Health student Orji Okereke has been named as this year’s recipient of the 2017-18 American Industrial Hygiene Foundation (AIHF) Kyle B. Dotson Scholarship.

The scholarship program was established by the Dotson family in 2007, to give back to the profession and serve as a model for other professionals to contribute toward the future and viability of the industrial hygiene profession.

Mr. Dotson – who currently serves as an independent management consultant and expert in the areas of occupational safety, industrial hygiene and indoor environmental quality – is a Fellow of the American Industrial Hygiene Association and has served on the organization’s board of directors.

Okereke is pursuing the MPH in Environmental and Occupational Health.

 

Posted Date: May 9, 2017

ShlesmaUNTHSC School of Public Health student Shlesma Chhetri is no newcomer to making award-winning oral presentations, and this year she won her second Texas Public Health Association (TPHA) honor.

Chhetri recently came in first at the TPHA Annual Education Conference’s student oral presentation competition for her talk on “Getting on the same page for breast health knowledge and prevention.”

The presentation was based on results of a breast cancer screening day evaluation project sponsored by a Susan G. Komen Greater Fort Worth community grant, supporting efforts of the Tarrant County Cancer Disparities Coalition.

“Shlesma is an exceptionally great presenter and won this top TPHA award in 2015 as well,” said faculty mentor Emily Spence-Almaguer, PhD, MSW, who serves as SPH Associate Dean for Community Engagement and Health Equity and as Community Outreach Core Director for the Texas Center for Health Disparities.

“For her 2015 award, Shlesma presented on ‘Sex Trade: Survival Strategy Among Homeless Women,’ as explored in a study UNTHSC managed for the Tarrant County Homeless Coalition,” Dr. Spence-Almaguer said.

Chhetri, a public health PhD candidate, reported this year on ways that the Komen community grant for Greater Mount Tabor Christian Center in Fort Worth was able to evaluate the level of breast health awareness among Tarrant County women through data from screening day and community breast health educator trainings.

Primarily Hispanic screening participants in the 40-49 year age group with a high school or GED education level were able to evaluate their risk factors for breast cancer and understanding of symptoms, to help program researchers gain information on how reading levels correlate with knowledge, awareness and prevention efforts.

“While the study reflected a lack of knowledge regarding breast cancer risk and symptoms among participants, the brief training offered information that helped improve their awareness,” Chhetri said. “We also learned that this information should be presented at reading levels appropriate for known high-risk populations.”

Posted Date: May 5, 2017

Austin trip 2017
Nine SPH students, accompanied by faculty members Dr. Kris Lykens and Dr. Alisa Rich, spent their 2017 spring break visiting the State Capitol in Austin.

The trip was coordinated with students from the Austin College undergraduate public health program in Sherman, Texas, taught by Dr. Mathias Akuoka, a PhD graduate of the UNTHSC School of Public Health.

“Students from both our SPH and Austin College enjoyed the collaboration and would like to continue working together in future legislative sessions,” Dr. Lykens said.  “In fact, some of our students are Austin College alumni, so the two groups had a lot in common.”

One highlight of the trip was a welcome and public introduction of both classes to the March 13 House of Representatives full session.

The students also had an opportunity to observe the Senate Floor debate on Senate Bill 6 (SB 6) – Texas Privacy Act “Transgender Bathroom Bill or Potty Bill,” relating to Regulations and Policies for Using a Bathroom or Changing Facility.

The two classes also attended the State Affairs Committee Hearing on Senate Bill 31 (SB 31) on texting while driving.

“Personal testimony from citizens who have lost family members in texting-related accidents was presented, and the most compelling moment came when two children testified with their uncle about the loss of both of their parents and their brother’s permanent paralysis in a fatal accident from texting,” Dr. Lykens said.

Students met individually with staff of legislators whose bills they had selected, researched and followed, and they were granted access to a special Capitol conference room for daily debriefings with the professors, thanks to arrangements by Danny Jensen, UNTHSC Vice-President for Governmental Affairs

SPH students participating in this year’s trip were Megan Bhatti, Carolyn Bradley-Guidry, Kirsteen Edereka Great, Patrick Li, Gabrielle Logan, Michael McClure, Soha Mayurkumar Patel, Laura Phipps and Courtney Searles.

pictured at top: SPH students and Dr. Kris Lykens at the State Capitol with Texas Representative Larry Philips (Rep) from Sherman

Posted Date: May 3, 2017

At this year’s Texas Public Health Association (TPHA) annual conference, co-hosted by the UNTHSC School of Public Health, hundreds of students, researchers and public health professionals from around the state gathered in Fort Worth for a chance to share ideas, network and gain new perspectives in the field.

A highlight of the week, and a new event for 2017, was the “TPHA Hack-A-Thon,” modeled after an idea from computer software experts, where the goal is to explore new solutions to a problem during a concentrated, “marathon” time period.

For the TPHA exercise, roundtable teams of students – paired with organization members and community leaders – were tasked with creating an intervention or program to address adolescent suicide, a serious public health concern in Texas.

UNTHSC School of Public Health student Shanalyn Gosh, who is pursuing her MPH in Maternal and Child Health, attended the event as the school’s reporter. Here she shares her notes:

 

What is a hack-a-thon?

TPHA Hack a Thon

“So … what exactly is a hack-a-thon?” one of my classmates whispers, as I walk into the Hilton Hotel and push past a crowd to get to the registration desk.

“No idea,” I say, wondering that same question myself.

A volunteer hands me my packet and I make my way to the designated room, running into other classmates along the way.

We finally reach the room and we see many of the community partners are already there, munching on breakfast and mingling. I take a seat at my assigned table and smile tentatively at the community members already seated, feeling a little out of place.

I quickly realize that this is unfounded. Talking to the community members is much easier than I had anticipated.

It’s often very easy to be intimidated by those who are well regarded and experienced. But I find that the community leaders are eager to share advice and experiences just as much as we are eager to listen.

As the talking dies down, Dr. Melissa Oden (UNTHSC faculty member and 2016-17 TPHA President) gives us a quick run-down of the rules.

She gives us a sheet of paper with a problem and the demographics of a population that needs help. We are given an hour or so to come up with an intervention or program that addresses teen suicide, and then we’ll present our results to a panel of judges.

When Dr. Oden finishes, everyone sets to work.

As I walk around observing the different groups, I’m surprised by how quickly the students have risen to the occasion of getting their ideas out without hesitancy, and how the community partners listen with a certain attention that I think is often rare between students and mentors. The mutual respect is obvious.

The hour passes and it’s time to present.

Offering solutions … lessons learned

There are seven groups, and I’m a struck by the innovation in their ideas, the creativity even in the names of these theoretical programs that they are proposing.

There is a group called “Suicide Squad” that wants to create teen suicide awareness by involving the whole community in a pep rally; they want to name it “Life Rally.”

Another team, “Affluenza Texas,” wants to address what they see as a communications gap around mental health issues. Among other ideas, they recommend creating a phone app called “What’s Up With You,” where users could Skype, FaceTime or text to reach out to others when they need to talk.

Soon it’s time for the judges’ deliberation, and Dr. Oden leads a quick discussion about what each of the community partners does for a living and their thoughts on public health.

As they go around the room, I am surprised at how many professions are influenced by public health, such as police work, insurance, lobbying, teaching and many others.

I think about how diverse my cohort class is, and I am glad that we are reflected in the community in that way.

As we continue talking about issues in the youth population, Dr. Oden says something that strikes a cord in me. She says, “What happens to you and when is incredibly important.”

It makes me think of what we learn in class and why all of us are here in public health. And why it matters why that we’re here.

The group that ends up winning is “Little Phoenix.”

Their case study involves a community with higher suicide rates than most, combined with lower than average household incomes. They deem it a “community in decline” that has “lost its identity.”

They believe that an infusion of new jobs and programs to cultivate technical skills could be a turning point for residents. They recommend starting with high-level community leader involvement to implement immediate short-term goals and then follow up with longer-term, sustainable programs.

The team is awarded coffee mugs for their winning solution, and we have all learned a lot from the experience.

What’s most interesting at the end is to find out that our case studies are based on real communities and real problems, which I think is truly the best learning experience for students who aren’t yet actively out in the field. It also gives community leaders insight into how students would approach their work outside the classroom.

Dr. Oden gives a quick thank you to the community partners and students.

As we’re leaving, she says almost as an afterthought, “It’s called a hack-a-thon because you all hack at a problem within a short time period. The idea of the hack-a-thon is originally for computer programmers.”

It seems a little silly, but it works.

 

 

Posted Date: April 26, 2017
Case Competition Winners2017

SPH Dean Dennis Thombs (left) and MHA Program Director Martin Ostensen with Case Competition winners Sayali Ethape, Amruta Sakhalkar and Ela Vashishtha

The mission was to “Transform Galveston” with strategies for improving chronic disease prevention and care among Galveston County Medicaid patients.

Accepting the challenge was a team of three MHA students from the UNTHSC School of Public Health: Amruta Sakhalkar, Ela Vashishtha and Sayali Ethape.

At the recent George McMillan Fleming Center for Healthcare Management’s 6th Annual Case Competition in Houston, the UNTHSC team’s presentation took first place for solutions addressing poor nutrition.

In the U.S., chronic diseases like obesity, cancer, heart disease, stroke and diabetes are among the leading causes of death and disability and are responsible for major limitations in daily living for almost one out of 10 Americans.

Although chronic diseases are among the most common and costly health problems, they are also the most preventable, by adopting healthy behaviors such as eating nutritious foods, being physically active and avoiding tobacco use and exposure.

Assuming the role of a Medicaid managed care organization, student teams were charged with developing proposals for a five-year plan to improve health outcomes for enrollees, lower costs and outline funding sustainability for five years and beyond.

Students were asked to consider barriers that might impact participants’ success in adopting healthier behaviors, including economic, social, education and community/neighborhood/food accessibility conditions.

“Our plan outlined methods to screen enrollees for malnutrition and hunger and to distribute food packets to those in need,” said UNTHSC team member Ela Vashishtha. “We also recommended drive-through food distribution centers for more remote areas of the community where healthy foods are not easily accessible.”

The team also proposed partnering with a local non-profit farmers market.

“Right now, Galveston’s farmers market operates two daytime locations on Thursdays and Sundays. Expanding to later weeknight hours could enable more people could visit the market without compromising their work schedules,” Vashishtha said.

Community gardens and backyard food cultivating initiatives were also suggested, as well as alliances connecting local farmers directly to schools and businesses through monthly food ordering programs.

“The most important feedback we gained from the healthcare leaders evaluating our proposal was to link the nutritional initiatives with physical activities. Diet and exercise together will produce better outcomes,” Vashishtha said.

Posted Date: April 25, 2017
Food Bank 1Food Bank 2Food Bank 3

 

 

 

 

 

 

 

 

Nearly 60 School of Public Health volunteers recently spent a day with the Tarrant Area Food Bank, where they helped provide over 18,000 meals for hungry children, families and seniors across North Texas.

SPH students, faculty and staff took on morning and afternoon shifts at the Food Bank’s Fort Worth distribution center near the UNT Health Science Center campus, where donations from local grocery stores and community members are received and processed through quality control. Foods passing inspection are organized, packed and sent to food pantries around the North Texas area.

In just three hours, SPH morning shift volunteers worked through 12,557 pounds of food products, helping to provide more than 10,464 meals for community members in need.

Afternoon volunteers worked with 9,582 pounds of foods, providing for nearly 8,000 meals.

“I am proud of the SPH efforts to feed families in our local 13-county region,” said Dr. Dennis Thombs, Dean. “All of those who took the time to work a shift on our designated volunteer day deserve a big thank you. It was both fun and interesting to learn about the Food Bank’s operations and to support their efforts, and we look forward to doing this again in the future.”

In thanking the SPH team, Linda Smith, Food Bank Director of Volunteer Services, said, “We would not be able to do what we do without the help of so many wonderful volunteers. Hunger is not a challenge that is going away anytime soon, and as long as there are food donations and volunteers, we will continue to feed those in need.”

The Tarrant Area Food Bank assists more than 50,000 individuals in a typical week and more than 53,000 households per month.

Posted Date: April 13, 2017

2017 end of year celebration
The UNT Health Science Center School of Public Health (SPH) recently celebrated National Public Health Week by recognizing 2016-17 academic year student, faculty and staff accomplishments at its annual End of Year Celebration.

MHA student Chelsea Kleen was presented with the Richard S. Kurz Award, given to an outstanding public health graduate exemplifying the leadership, accomplishments and visionary qualities of the school’s Dean Emeritus, who led the SPH from 2007 to 2015. This award was established in 2012 by the school’s faculty leadership.

At the ceremony, two SPH students were admitted into the Alpha Sigma Chapter of Delta Omega public health national honor society: Chelsea Kleen (MHA program) and Heidi Threadgill-Honza (MPH Professional Option). These two students, as presented by faculty member Dr. Brad Cannell, were selected for their “demonstrated academic excellence, leadership, activity and commitment to and in the field of public health and ensuring the health of all people.”

Alumni inductees into Delta Omega were Dr. Diana Cervantes, Chief Epidemiologist with the Texas Health Department of State Health Services (DSHS) Region 2/3, and Sophia Anyatonwu, Epidemiologist II/Regional FLU Surveillance Coordinator with DSHS Region 7.

Dr. Katherine Fogelberg from the SPH faculty was also inducted into Delta Omega, as was an honorary community recipient, Jon Wilcox. Wilcox was introduced by Fort Worth community leader Libby Watson, who was named to Delta Omega by the UNTHSC School of Public Health in 2014. Wilcox has long been involved in volunteerism and leadership for non-profit organizations and public health-related programs and activities on both a local level and with a national/international scope.

Students named to the SPH Dean’s List were Amy Board, Clara Ramirez, Erica Stockbridge, Heidi Honza, Chelsea Kleen, Ruchi Shah, Rasheedat Sadiq-Onilenia, Kristyn Mathewson, Thomas Gans, Fanni Mandy, Jennifer Liou, Sarah Abdelhadi, Ashnia Taher and Gopi Vinjamuri.

This year’s Leon Brachman Award was presented to Fanni Mandy (MPH – Epidemiology). The award is given annually to a public health student in the MPH or MHA program demonstrating exemplary academic achievement in his or her graduate course of study. The award is named in honor of the community leader and philanthropist who helped establish the UNTHSC School of Public Health in 1999.

The 2017 Kenneth Cooper Award winner was Victoria Kwentua (MPH – Maternal and Child Health). This award – presented to an outstanding MPH or MHA student demonstrating excellence and quality in the application of research methods in preparation for the thesis or other research activities – is named for best-selling author and internationally known health/wellness guru Dr. Kenneth H. Cooper, who started the Cooper Aerobics Center in Dallas in 1970 and pioneered the concept of preventive medicine and healthy lifestyle.

Pooja Mehta (MPH – Epidemiology) was presented with the Bob Crow Award, named for the former executive director of the Texas charitable Amon G. Carter Foundation and past member of the school’s Steering Committee, recognizing an outstanding MPH or MHA student with exemplary leadership and service to the school and community.

Amy Board (MPH Professional Option) was presented with the Dean’s Award for Scholarly Excellence in Academics, and Erica Stockbridge (PhD – Health Services and Policy Research) received the Dean’s Award for Scholarly Excellence in Research.

The UNTHSC Public Health Student Government Association also presented honors, highlighting faculty and staff members for going above and beyond in support of SPH students.

Recognized were Dr. Subhash Aryal for Outstanding Faculty in Teaching; Dr. Tania Lopez for Outstanding Faculty in Online Teaching; Dr. Katherine Fogelberg, Outstanding Faculty Advisor; and Elizabeth Heyerdahl as Outstanding Public Health Staff Member.

Posted Date: March 30, 2017
Thad Miller Mexico

Dr. Miller (seated left, foreground) and volunteers help patients in the clinic

As the sun rises over Eagle Pass, just across the U.S. border into Mexico, a small caravan of trucks and cargo trailers slowly makes its way toward the State of Coahuila in the country’s northwestern region.

The travelers are doctors, nurses and other volunteers who for more than 30 years have been the main source of medical care for isolated desert villages that would otherwise go without.
For the last 10 years, Dr. Thad Miller and his family have been a part of this group. A UNT Health Science Center public health professor, Dr. Miller recently spent his spring break on one of the trips, visiting three villages.

“The closest town is six hours away from some of these remote communities, across rugged desert terrain. There is scant infrastructure and few resources,” he said. “These families have so little—no electricity, running water, stores or routine communication with the outside. And without us, they would have no medical care.”

Thad Miller Mexico 2

Dr. Miller and his nephew on one of the Mision de Candelilla Mexico trips

Volunteers help however they can, and the situations vary. This trip, Dr. Miller managed the visiting clinic’s pharmacy, dispensing patient medications. He leads trips, and even helped a community build a water well during one visit. Along the way, he has also worked on vehicle repairs and changed a few flat tires as needed.

“It’s challenging under the best circumstances, and a lot can go wrong. But experience is a great teacher,” Dr. Miller said.

“The roads are so bad into these remote areas that we always risk car trouble. One year, a trailer simply broke apart hours from the nearest town,” he said.

Dr. Miller speaks enough conversational Spanish to get by, and over the years, he and his family have forged friendships that go beyond words. His wife is a pediatrician, his sister is a registered dietitian, and his brother-in-law is a firefighter and paramedic. All of their children have come along on trips, as well as Dr. Miller’s 74-year-old mother.

“Our kids have grown up being a part of the medical mission trips, since my oldest daughter, who is now entering college, was about eight years old,” he said. “Our children used to play with the local kids while their parents were at the clinic, and now, each time we return, it’s like a family reunion.”

Dr. Miller serves on the Board of Mision de Candelilla, the Fredericksburg, Texas, non-profit organization that has coordinated the trips since 1986.

When first he joined as a volunteer, Dr. Miller was looking for a meaningful way to help people and to give his children an understanding of the world and the values of service.

“I had been on medical mission trips to other countries before where the health problems were more than visiting volunteers could take on,” he said. “Good health care in a resource poor region requires consistency, relationships and continuity. It takes years, and single visits by well-meaning medical teams really can’t do much.”

“The ongoing relationships we have built with these little villages in Mexico are enabling us to address health issues typical of those in any primary practice–diabetes, high blood pressure, the need for antibiotics and conditions that can be helped by a wellness visit or minor surgical procedure, “ he said.

Mision de Candelilla cares for 12 Mexican villages overall, visiting each community on its “route” at regular six-month intervals. By providing a 180-day supply of necessary routine medications, the organization is able to effectively manage a great majority of the medical needs seen.

Dr. Miller estimates that Mision de Candelilla provides more than 2,000 patient encounters and distributes medication with a retail prescription value of more than $1 million each year, all of which comes through donations, fundraising and volunteer efforts, never at a cost to the people it serves.

Mision de Candelilla takes its name from the candelilla desert plant that grows in Mexico, which is harvested for wax used in candles, cosmetics and other beauty products. The name is symbolic of bringing light to others in a region where the stark challenges of daily living mirror the long, labor-intensive process villagers use to extract and prepare the wax for sale.

“Being a part of something like this really helps you get your perspective,” Dr. Miller said. “You put your own needs on the shelf and spend the week serving others first. We gain as much from the friendships and experience as the people we care for.”

“While we can’t fix every problem, we help where we can. It’s just good folks doing the things that need to be done.”

Posted Date: March 14, 2017
Livingston_research

A new study published in The American Journal of Public Health provides recommendations for community-based and individual level prevention strategies to reduce alcohol use among American Indian and white teens living in multicultural rural communities.

UNT Health Science Center researcher Melvin Livingston, PhD, led the statistical design and analysis of the study, which was supported by the National Institute on Alcohol Abuse and Alcoholism (NIAA), part of the National Institutes of Health, and the National Institute on Drug Abuse. Dr. Livingston is Assistant Professor of Biostatistics and Epidemiology at the UNTHSC School of Public Health.

“This study is one of the largest alcohol prevention trials ever conducted with an American Indian population, and the first to demonstrate the effectiveness of screening and brief counseling
intervention in significantly reducing youth alcohol use at a community level,” said NIAAA Director George F. Koob, PhD.

American Indian teens and other rural youth initiate alcohol use at younger ages and have higher rates of alcohol-related problems than other groups. Early prevention is critical in these populations, but both American Indians and rural communities have been underrepresented in studies aimed at finding effective solutions for underage drinking.

To address this gap, a team of researchers led by Kelli A. Komro, PhD, of Emory University, worked with students in the Cherokee Nation, northeastern Oklahoma, to evaluate the effects of two strategies that previous research has indicated may be beneficial.

The first strategy, Communities Mobilizing for Change on Alcohol (CMCA), is a citizen-led community-organizing effort that holds local officials responsible for taking action to reduce alcohol access, use and consequences among underage youth.

The second strategy, called CONNECT, is a school-based, one-on-one health screening and brief intervention in which trained health coaches meet with students each semester to motivate healthy behaviors related to alcohol consumption.

High school students in six communities were randomly assigned to treatment or control conditions over a three-year period. Two communities received both intervention strategies, while students in two other communities received neither intervention strategy. Another community received only CMCA, and one received only CONNECT.

Results showed that alcohol use in the past 30 days, including any consumption and heavy drinking episodes (five or more drinks on at least one occasion), was significantly reduced among students receiving either or both of the interventions.

“The two distinct interventions alone and in combination resulted in similar patterns of effect across time,” said Dr. Komro, “but, interestingly, we found no evidence that the two interventions combined had significantly greater effects than either alone.”

“We found that community and school support and engagement in prevention is critical to shaping a more healthful environment for teens. Strategies such as ones conducted in this study should be further investigated with a focus on sustainability,” she said.