NorTex 2018 Fall Newsletter

September 28, 2018 • NorTex

Fall 2018 1

THE NORTEX NEWSLETTER

NorTex Has Their First Combined Clinical and Community Advisory Board Meeting

Fall 2018 2NorTex is now guided by two advisory boards: a Community Advisory Board and a Clinical Advisory Board! We are excited to introduce the newly established Clinical Advisory Board and have our partners work together. The Clinical Advisory Board consists of physicians and medical professionals in the North Texas region. The vision for this advisory board is for members to collaborate and provide clinical advice on conducting innovative and meaningful research. They will work closely with the NorTex Community Advisory Board and internal advisors to help accomplish the overall goal of revolutionizing the way primary care and public health research is conducted, with NorTex being the interlocking key.

This past April, members from the Clinical Advisory Board and Community Advisory Board met with NorTex staff and our internal advisors for the first time to discuss the future of NorTex. This meeting was an opportunity to provide input on basic research needs, as well as collaborate with primary care researchers in the community. The focus of this meeting was to bring members together and overcome barriers between the different medical institutions and the community. New research opportunities were proposed and discussed, and NorTex collaborated on a grant based on these discussions. Our hope is that these boards will work together to help us address issues that are real threats to our community and improve the health of our citizens.Fall 2018 3

Our Clinical Advisory Board includes representation from the UNT Health Science Center Texas College of Osteopathic Medicine and College of Pharmacy, John Peter Smith Health Connection, UT Southwestern, Cook Children’s Medical Center, Texas FamiliCare Medical Group, and the North Texas Area Community Health Centers. Our Community Advisory Board includes representatives from Tarrant County Public Health, Oakmont Wellness Center, 2M Research, Parkland Health and Hospital System, and the community.

For more information about the NorTex Advisory Board members, please visit our website at https://www.unthsc.edu/research/nortex/board-members/.

NORTEX RESEARCH PROJECTS

Fall 2018 4FEATURED CURRENT NORTEX PROJECT

Lung Cancer Screening Practices Among Primary Care Physicians in NorTex

Lung cancer is a major public health concern in the United States. Although there have been advances in treatment and management, prognosis for lung cancer is still poor, and currently, most lung cancer cases are diagnosed at a late stage. Lung cancer screening with low-dose computed tomography (LDCT) in high-risk individuals is recommended by the U.S. Preventive Services Task Forces (USPSTF), and approved for the Affordable Care Act and Medicare beneficiaries. It was estimated that approximately 6.8 million smokers were eligible for LDCT screening in 2015, while very few eligible patients received lung cancer screening. NorTex is collaborating with Menghua Tao, MD, PhD on a research project titled “Lung Cancer Screening Practices among Primary Care Providers in NorTex”. For this project, we are conducting a survey about practices and perceptions of lung cancer screening among primary care providers in NorTex. The purpose of the study is to investigate utilization and perceptions of lung cancer screening among primary care physicians practicing in Texas, to identify their barriers to adherence to the USPSTF recommendations. The survey will be distributed electronically by NorTex.

PI: Menghua Tao, MD, PhD; Funding Source: Texas Academy of Family Physicians Foundation.

COMPLETED FEATURED NORTEX PROJECT

Bullying and Sexual Victimization as Predictors for Substance Abuse and Physical Fighting Among High School Students

Bullying and sexual violence have both been associated with negative health behavior outcomes in adolescent and youth populations. Traditionally, these topics have been researched separately; however, studies suggest that polyvictimization may increase the risk of experiencing negative health outcomes and behaviors. The objective of this study was to explore the association between having experienced both bullying and sexual victimization with substance abuse and physical fighting among American high school students. Data from the 2015 Youth Risk Behavior Surveillance System (YRBSS) for high school students were used. Logistic regression was used to examine the association of experiencing both bullying and sexual victimization with substance abuse and physical fighting. 15,624 students’ questionnaires were obtained. 15.5% of students reported being electronically bullied, and 20.2% reported being bullied at school. Additionally, 6.7% reported ever being physically forced to have sexual intercourse. The odds of ever smoking a cigarette, ever drinking alcohol, ever using marijuana,
ever using prescription drugs without a prescription, ever inhaling substances to get high, and ever getting into a physical fight were increased when an individual had been polyvictimized from both bullying and sexual victimization when compared to those who experienced no victimization. This was found in both simple and multiple regression models. In addition, findings showed that those who were ungraded, which indicated students who may be in alternative schools/ program, may be at an increased risk for ever using cigarettes, marijuana, and prescription drugs without a prescription. For every outcome, males also indicated higher risk, compared to females. Our results demonstrate polyvictimization indicates higher odds of negative outcomes when compared to those who have experienced no victimization.

Authors: Aliya Qureshi, MPH; Jessica De Hoyos, MPH; Kimberly Fulda, DrPH

PRISM HEALTH NORTH TEXAS

In 1986, amidst the crisis of the early years of the AIDS Epidemic, Prism Health North Texas (PHNTX) formed to provide hope, compassion, and care for people living with HIV/AIDS.

Prism Health North Texas expanded services over the years to better serve North Texans living with, or at risk for, HIV, with support from diverse federal/state/local grants and the community. As the largest community-based HIV/AIDS service organization in North Texas, PHNTX provides patient centered healthcare, psychosocial support, wellness, and prevention services to both insured and uninsured patients. Multiple locations in traditionally medically underserved areas of Dallas ensure access. Commitment to quality, dismantling stigma, and advocating for affordable healthcare for everyone are core values.Fall 2019 5 (2)

The key to illuminating healthy outcomes for those living with HIV is a comprehensive approach. PHNTX meets people where they are and acts as the patient’s health advocate, providing personalized expert healthcare through diverse interventions and nationally recognized care models. PHNTX is one of only a few community-based sites in the National Institutes of Health AIDS Clinic Trial Group (ACTG), an important research collaborative that enabled many of the discoveries in HIV medications that are now being used successfully today.

The integration of PHNTX’s Clinical Research team as an ACTG site within an AIDS Service organization provides access to participant pools and integrated care models for outcome success. Growing the clinical research trials at PHNTX supports the organization’s goal to advance the health of all North Texans.

NEW NORTHSIDE COMMUNITY HEALTH CENTER

Fall 2019 6 (2)This fall, North Texas Area Community Health Centers (NTACHC) will open its new Northside Community Health Center building at 2332 Beverly Hills Drive (the corner of Beverly Hills and Jacksboro Highway). The new $15.3 million, 33,000 square-foot-building replaces the current 12,000-square-foot building on North Main Street that the organization has leased since its inception in 2005. That building, which served more than 4,400 patients in 2006, now serves more than 10,000 patients and those numbers are now growing by 500 patients monthly. With the new building, patient exam rooms will be increased from 16 currently to 30. The new two-story space will accommodate the center’s current outpatient primary care services (family medicine, women’s health, pediatrics) with the new addition of an outpatient pharmacy, laboratory and behavioral health
services. Planned future additions include dental and vision services. With a focus on prevention, this one-stop neighborhood health center will meet the specific needs of the Northside population, including services for diabetes, cardiovascular disease, and prenatal and perinatal health. The Northside Community Health Center is the oldest of NTACHC’s three community clinics. Its other facilities are in Southeast Fort Worth and Arlington. Rep. Kay Granger has served as the Honorary Chair for the building’s capital campaign.

MEMBER HIGHLIGHT:

DIDI EBERT, DO, MPH, MS, FAAFP

Fall 2018 7Didi Ebert, DO, MPH, MS, FAAFP is an Assistant Professor at University of North Texas Health Science Center (UNTHSC) and board-certified family physician with UNT Health. She received her bachelor degree from Tarleton State University, then attended medical school at UNTHSC—Texas College of Osteopathic Medicine. While working on her Doctor of Osteopathy (DO) at UNTHSC, she also completed Master of Public Health (MPH) and Master of Science in Clinical Research and Education (MS) programs. Her medical training culminated at the McLennan County Medical Education and Research Foundation, a community-based program within a Federally Qualified Health Center. She began her career practicing broad-scope family medicine with obstetrics in a rural community and then followed her passion for teaching and service back to UNTHSC. The American Academy of Family Physicians recently awarded Dr. Ebert the Degree of Fellow, recognizing her as champion of family medicine for her early career achievements.

Dr. Ebert enjoys the excitement of participating in educational, clinical, and research initiatives that define the providers of the future and create solutions for a healthier Fort Worth community. She co-designed and co-course directs an innovative curriculum in which an inter-professional faculty team coaches medical students toward preparedness for clinic practice by applying the bio-psychosocial model to patient care while integrating resilience training via individualized and targeted growth of students’ emotional intelligence. She loves mentoring medical students in her roles as small group facilitator, advisor, and clinical preceptor. She is collaboratively developing a “value-add”, task-based curriculum to advance inter-professional education in practice. Her research activity grows as she hopes to publish educational research in the aforementioned areas and continue participating in clinical quality improvement projects and studies promoted by our primary care practice-based research network.

Outside of UNTHSC, Dr. Ebert loves living in Fort Worth, training for the annual Cowtown marathon, supporting local businesses, and spending time with friends and family. Though she has traveled, she considers herself a “Texas gal”, choosing to advance her education and training while never moving outside of an hour and a half of her hometown of Arlington, Texas.

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