NorTex 2017 Fall Newsletter

September 28, 2017 • NorTex

Fall 2017 1

The North Texas Primary Care Research Network


NorTex researchers are fortunate to work with students from all schools at the University of North Texas Health Science Center (UNTHSC). Fall 2017 3These students’ contributions are critical to the success of our projects! We not only employ student research assistants, but we also mentor students through their own projects. We aim to enhance their research skills and knowledge by providing them hands on experience.Fall 2017 2 Specifically, our student assistants/mentees are involved in all aspects of conducting research such as developing a research question, designing a project, collecting data, analyzing data, and working in teams. We also offer our students the opportunity to present their research at meetings such as the UNTHSC annual Research Appreciation Day (RAD). RAD serves as an opportunity for students from all schools at UNTHSC to show off their projects to our campus and community as well as compete against their peers for prizes. We are proud of how hard our students work, and we want to recognize their achievements to our NorTex collaborators! In 2016, Alex Espinoza, MPH; Etienne Jaime Hinojosa, MPH; and Alejandra Aguilar, MPH, won 3rd place in the RAD School of Public Health poster competition for their poster presentation titled “Exploring the Role of Protective Factors on Depressive Symptoms among Mexican American Children.” This year, Aliya Qureshi, MPH, and Jessica De Hoyos, MPH, won 2nd place in the School of Public Health poster competition for their research titled “Bullying and Sexual Victimization as Predictors for Substance Abuse and Fighting among High School Students.” We are proud of their hard work and are confident they will be successful researchers and public health practitioners!



Workforce Enhancement in Healthy Aging and Independent Living (WE-HAIL):

NorTex is collaborating with INCEDO (formerly known as the Office of Professional and Continuing Education) on part of the Workforce Enhancement in Healthy Aging and Independent Living (WE-HAIL) project. The purpose of the WE-HAIL project is to increase the number of healthcare workers in Tarrant County and surrounding rural counties with expertise to address and meet the needs of older adults at individual, community, and population levels. The project focuses on training healthcare professionals in geriatrics to take leadership roles in geriatric care. NorTex will be involved in distributing materials to practicing clinicians and offering maintenance of certification and quality improvement opportunities to our practices. NorTex is currently in the recruitment process for clinicians that are interested in participating in projects with a focus on dementia care. Participating physicians and physician assistants will be asked to complete a pre- and postsurvey. They will also be asked to conduct a review of medical records for 5 patients in their clinic at baseline, 3-6 months after the intervention, and again 3-6 months after the second medical records abstraction. The 5 charts can be any combination of patients who presented to their clinic with potential signs of memory concern and patients with an existing diagnosis of dementia or Alzheimer’s disease. A continuing education opportunity specific to each clinician will be provided after the first survey and set of chart reviews. For more information about this study or any other NorTex project, please contact Dr. Kim Fulda, Director, at or; or Anna Espinoza, Assistant Director, at Dr. Janice Knebl, DO is the Principal Investigator for WE-HAIL.


Association Between Healthcare Provider Type and Intent to Breastfeed Among Expectant Mothers

Elizabeth Balyakina, Kimberly G. Fulda, Susan F. Franks, Kathryn M. Cardarelli, Kollier Hinkle

Background: The primary purpose of this study was to determine the association between type of health care provider delivering prenatal care and intent to exclusively breastfeed.

Methods: A self-report survey was administered to 455 expectant mothers. Logistic regression was performed to determine the association between prenatal care provider type [obstetrician; other primary care physician (family doctor/ general practitioner/internist/or other physician); midwife/nurse midwife; more than one provider; and other] with intent to breastfeed (exclusive/non-exclusive).

Results: Having a midwife/nurse midwife as a prenatal care provider was associated with intent to breastfeed compared to having an obstetrician (OR 2.544, 95 % CI 1.385–4.675). There was no difference in intent between women with another primary care physician and an obstetrician. Women with another type of health care provider, no prenatal care from a health professional, or no knowledge of who is providing prenatal care were less likely to intend to breastfeed (OR 0.228, CI 0.068–0.766) as compared to those with an obstetrician.

Discussion/Conclusions: Provider type is associated with intent to breastfeed among pregnant women. Women’s intent t0 breastfeed is an important predictor of breastfeeding initiation, continuation, and duration that may be assessed by healthcare providers during the prenatal period. A consideration of what features of provider care are associated with improved breastfeeding outcomes and characteristics of women seeking prenatal care with midwives may serve to formulate future prenatal care policies and education during prenatal care visits. Maternal Child Health Journal. May;20(5):993-1000.


Fall 2017 4Fall 2017 5

Tarrant County Public Health (TCPH) offers a four week evidence-based Tobacco Cessation Program, Live Tobacco Free, in English, Spanish and Vietnamese. The program, developed by the American Lung Association, is based on proven addiction and behavior change models and addresses the physical, mental and social aspects of nicotine use. The program offers a structured, systematic approach to quitting, which includes three phases: preparation, quitting and maintenance. It has a positive, interactive focus, with an emphasis on the vast benefits of better health. Because no single cessation technique is effective for all smokers, the step by step individualized program includes a comprehensive, variety of evidence-based cessation techniques. The program incorporates five key issues: managing stress, nicotine withdrawal, coping strategies, weight control and long-term strategies for maintaining cessation. For individuals that are unable to attend in-person classes, TCPH also offers the program online. Classes are offered on an ongoing basis throughout Tarrant County at five area locations. Potential participants and interested professionals can learn additional information at 817-321-4976 or


One of the benefits of being a part of NorTex is the opportunity to participate in CME activities through INCEDO at UNTHSC. Information about these opportunities can be found at Take advantage of these upcoming CME opportunities:

  •  September 20, 2017
    • 2017 Grand Rounds: Differences in Sexual Differentiation
      (DSD) UNT Health Science Center –LIB 110; Fort Worth, TX
  • September 27, 2017
    • 2017 Grand Rounds: What the Skinny?
      An Update on Medications for Weight Management
      UNT Health Science Center –LIB 110; Fort Worth, TX
  • September 28, 2017
    • 16th Annual Infant Health Summit:
      Making Health Equitable for all Females
      Colleyville Center; Colleyville, TX
  • October 4, 2017
    • 2017 Grand Rounds: Harnessing Defects in DNA Repair
      as a Therapeutic Approach for BRCA1 and BRCA2 Related
      UNT Health Science Center –LIB 110; Fort Worth, TX
  •  October 13, 2017
    • 7th Annual JPS Trauma Symposium
      Tarrant County College Trinity River Campus; Fort Worth, TX
  • March 21, 2018
    • Advanced Wilderness Life Support Course
      Cleburne State Park; Cleburne, TX

To access previous NorTex Newsletters



Fall 2017 6Al Faigin, D.O., was born in Detroit Michigan and received his bachelor degree from Wayne State University. He completed medical school at Kansas City College of Osteopathic Medicine, and he has practiced as a family medicine doctor in Fort Worth for over 40 years. He is affiliated with Baylor All Saints Medical Center in Fort Worth, Baylor Surgicare, Baylor Surgical Hospital, Cook Children’s Medical Center, and Texas Health Huguley Hospital Fort Worth South. He is also licensed to practice medicine in Wyoming, Vermont and Michigan.
Dr. Faigin’s practice includes a wide range of patients, from newborns to the elderly. He enjoys a hands- practice, which includes: delivering babies, taking care of newborns in the hospital nursery, and caring for seniors and end-of life-issues. Dr. Faigin performs multiple minor surgical procedures such as removal of lumps, vasectomies, sigmoidoscopies, colposcopies, D&Cs, and he assists in surgeries for patients, with the surgeon’s permission. Currently, Dr. Faigin assists an orthopedic surgeon with knee, hip, and shoulder procedures one day a week.
Dr. Faigin has served on multiple hospital committees and has been a delegate from TOMA (Texas Osteopathic Medical Association) District 2 to the State of Texas Hospital Delegates for close to 30 years. He has also been a delegate from TOMA through the AOA House of Delegates for over 20 years, representing other DOs from Tarrant County in the state of Texas.
Outside of medicine, Dr. Faigin loves camping, playing golf (handicap ranges from 9 to 14), and before injuring his knees, running marathons and playing softball. Snow skiing and scuba diving with his daughters has been a pleasure. He is active in his community, serving on multiple boards of directors for religious institutions, schools, and nonprofits. Dr. Faigin has also been president of a community center and a Synagogue.
A saying of Dr. Faigin’s which he advises new, young, doctors starting in practice, is “Zachor” – which means “remember.” He explains this as, “Do unto others…Treat your patients like you would like your parents and their children to be treated. Treat your patients with the respect they deserve. They are allowing you into their lives and putting their life in your hands for many years and trust in you to take good care of them.”

Spring 2013 8