By Sally Crocker

Groups of UNTHSC students, faculty and staff are being organized by the School of Public Health to assist with this year’s Tarrant County Homeless Count on January 24.

Dr. Emily Spence-Almaguer, SPH Associate Dean for Community Engagement and Health Equity, makes this volunteer endeavor part of her public health classes each year, giving students an opportunity to opt out of a quiz by joining in this effort to locate, count and survey individuals spending the night on local streets or in places that aren’t meant for sleeping and living.

Over the years, many others from UNTHSC have joined in to help as well.

The local efforts are part of a larger national initiative that includes police departments, government officials, church and neighborhood groups, nonprofit organizations, universities and other invested citizens across the U.S. who help gather data used to analyze and address the changing trends, extent and nature of homeless across the country.

Information gathered is used each year to measure the progress being made in the community and on a national scale to end homelessness.

According to U.S. Department of Housing and Urban Development data from the 2018 national count, about 553,000 people in the United States experienced homelessness on a single night last year.

About 65% were staying in emergency shelters or transitional housing programs, and the rest were in unsheltered locations, on the streets, in or behind abandoned buildings, under bridges or living in other places not suitable for human habitation.

“Our community saw the Tarrant and Parker county numbers increase by 5% in 2018. On the night of the count, we found 2,015 individuals, as compared to the approximately 1,924 persons counted on the 2017 night,” said Tammy McGhee, Executive Director of the Tarrant County Homeless Coalition.

The numbers are even more staggering, McGhee said, when taking into account the thousands of others in North Texas who are without a stable home, living in week-to-week motels, doubled up with friends or families, or in other precarious and unpredictable living situations.

UNTHSC has long been a partner with the Tarrant County Homeless Coalition, to help address this issue and meet the needs of this population.

“Everyone deserves a safe and adequate place to call home,” Dr. Spence-Almaguer said. “Through the Tarrant County Homeless Coalition and its many partners in healthcare, mental health, education, first response, faith and community services, local government and other areas, thousands are able to access resources each year to help get back on their feet.”

The needs are varied and many.

Mental and physical health, and having necessary prescription medicines available with a place to store them, can sometimes mean the difference between life and death.

For those living on the street in winter or during other extreme weather conditions, McGhee said, there are options available for a warm, safe and dry place to sleep, from temporary shelters and transitional housing to longer-term programs.

Through the Tarrant County Homeless Coalition, individuals can also connect with resources for employment, transportation, family assistance, counseling and other services.

“Housing is one of the most important factors,” McGhee said. “Finding a place to live is the first start.”

UNTHSC has long been involved as an active community partner in various ways, through research and educational programs, planning and advisement, School of Public Health student internships and broad volunteerism.

“Being a part of the homeless count each year helps us learn more about what these individuals need and how we as a community can best help,” Dr. Spence-Almaguer said.

To learn more and be a part of this year’s January 24 Tarrant County Homeless Count effort, visit http://ahomewithhope.org.

More than 500 volunteers are needed to help in Tarrant and Parker counties.

By Sally Crocker

Dr. Teresa Wagner at right

Every day, approximately 830 women around the world die from pregnancy or childbirth-related complications.

The number of maternal deaths in the U.S. has more than doubled in the last 30 years, and Texas data is especially concerning, with about 14.6 deaths for every 100,000 births.

Through a new study funded by the National Institute on Minority Health and Health Disparities, UNT Health Science Center researcher Dr. Teresa Wagner aims to evaluate the impact of health literacy on this problem.

“Few studies to date have looked at the effect of health literacy on obstetric outcomes,” Dr. Wagner said. “There is a vast amount of medical instruction provided when leaving the hospital, which begs the question, ‘Are women understanding how to evaluate if symptoms after childbirth are normal, abnormal or requiring urgent medical attention?’”

Dr. Wagner, Assistant Professor in the UNTHSC School of Public Health and Senior Fellow for Health Literacy with SaferCare Texas, formerly known as the UNTHSC Institute for Patient Safety, has spent much of her career working to bring about change in the ways people navigate and understand the complex healthcare environment.

Her recommendations for improved health literacy in Texas have received support across the state and are slated for review in the 2019 legislative session.

“There is so much to process when new mothers leave the hospital and head home that it may be challenging to get a good grasp on all the discharge paperwork and homecare instructions,” she said. “Along with the responsibilities of caring for a newborn, new moms may also be facing sleep deprivation and physical and emotional changes. It’s important that women have a clear understanding of warning signs or complications indicating they should call a healthcare provider or go to the nearest emergency department.”

African American and low-income mothers, as well as women at extremes of the standard maternal age and those from rural areas, are most at risk, Dr. Wagner said.

“Readability, understandability and cultural sensitivity are all important in the way that health information is provided and will be assessed in this new study,” she said.

The project will partner with the UNTHSC Healthy Start program; Family Circle of Care in Tyler, Texas; and the Harris College of Nursing and Health Sciences at TCU, to evaluate current postpartum education and information through national standards assessment models and personal interviews with both urban and rural patients though community programs affiliated with large Texas hospital systems serving low-income patients as part of their demographic mix.

“The innovative aspect of this study is that we will be including women’s own personal perceptions with standard health literacy assessments, to gain firsthand advice and make recommendations on how communications and instructions can be improved as new mothers leave the hospital,” Dr. Wagner said. “The information and opinions they share will be important in helping to improve standards of care for hospitals and keeping mothers safe from preventable harm.”

Research reported in this publication was supported by the National Institute On Minority Health And Health Disparities of the National Institutes of Health under Award Number U54MD006882. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

By Sally Crocker

Dr. Jaime González

Growing up, Dr. Jaime González thought he might one day become a priest.

Life, however, had other plans, taking him on a different path of serving others, through public health and health-related services.

As Chief Business Development Officer for the Health Plan Alliance, a national trade organization that brings health plans, hospitals and physicians together to address patient health and wellness, he is passionate about doing all he can to make healthcare better for all.

“It really started with my family,” Dr. González said. “Growing up as the seventh of eight children, with an even larger extended family of 60-plus cousins on my father’s side and 36 on my mother’s, I learned the lessons of giving and sharing at a very early age.”

Both parents were strongly committed to church and community, and Dr. González’ mother was often the first to visit the sick or lend a hand when someone needed help.

“My dad moved here from Mexico to start a life and a family in Texas, and his commitment to making things better, not just for us, but for others around him, was truly inspiring,” Dr. González said. “Being part of something bigger, of supporting and taking care of each other – our family, friends, neighbors, church and community – showed me what a difference can be made and impacted how I wanted to approach the world in both my career and personal life.”

When Dr. González started working on his DrPH in Health Management and Policy at the UNTHSC School of Public Health, he had already completed a master’s degree in clinical social work and another in health administration.

He had directed clinical case management services related to pediatric intensive care and children’s cardiovascular surgery.

He had worked in the health insurance industry, and had experience with public policy and regulatory affairs.

He was serving in a top leadership role for UnitedHealthcare’s Latino Health Solutions division, developing projects, programs and partnerships to improve health services and healthcare access for the U.S. Latino market nationwide, when he was encouraged by a longtime friend, mentor and UNTHSC professor at that time, Dr. Adela González, to “connect the dots” in his educational experience by adding public health to his professional background and perspective.

“Public health is the ideal standard for serving the community and doing the most good for all,” he said. “Working in the health plan industry, being able to deliver services and resources from a broad, population health view, keeps the focus on what is most important, the patient.”

Today, in his role with the Health Plan Alliance, he oversees multicultural/healthcare equity programming and partners with members across the country on educational opportunities and sharing of subject matter expertise and best practices.

“My job touches on public health every day, whether it involves the social determinants of health, member/patient engagement, health literacy, health education, wellness, or the financial side of serving members efficiently and at a better cost through group purchasing and other programs,” he said.

“If I can help our members improve patient care outcomes, and connect people to information and people to people, then I know that I am doing what I believe in and helping others in the way that my parents taught me growing up,” he said. “My mother used to say that God has a way for everything; this is my way.”

By Sally Crocker

UNTHSC School of Public Health (SPH) students, faculty and alumni participated in a variety of educational workshops and had opportunity to network at dinners and other events as part of this year’s American Public Health Association (APHA) Annual Meeting and Expo in San Diego.

More than 13,000 public health professionals from across the country took part in this four-day conference, held November 11-14, focused on the theme of “Creating the Healthiest Nation: Health Equity Now.”

Breakout sessions covered topics including chronic disease management; infectious disease prevention; environment and food safety; health reform; maternal and child health, with a special focus on the role of fathers and partners; and other key determinants of building a healthier population.

UNTHSC Public Health Student Government Association (PHSGA) President Luvleen Dharni and PHSGA Vice President Sarah Matthes were selected to represent the SPH at the Student Leadership Institute (SLI) led during the conference by the Association of Schools and Programs of Public Health (ASPPH). The SLI is a skill-building and networking opportunity for student leaders at ASPPH-member institutions.

Other UNTHSC students attended the APHA conference as well, with travel scholarships provided by the SPH and PHSGA.

“Attending this conference gave me a great opportunity to network and learn more about the importance of advocacy in the field of public health,” Dharni said. “I was surrounded by people who value public health and understand the impact we make at the population level. I looked forward to returning to campus to work with the student body in taking small steps to help build the healthiest Tarrant County community.”

During the trip, Dharni and other participants were also involved in two Public Health Service Day volunteer events, to help clean up San Diego’s Embarcadero Beach and Promenade, and to give time to a non-profit agency’s thrift boutique dedicated to child abuse prevention and building family resilience.

The most memorable breakout session for Dharni featured a panel presentation on “Dying Too Soon,” looking into critical issues surrounding the premature deaths of women in the U.S.

For Matthes, the opportunity to take part in SLI, to learn from experts on cultural humility and writing as a public health tool, and to interact with student leaders from other universities and programs was especially important.

“I came away from APHA having met inspiring individuals and having learned novel approaches for addressing public health concerns,” Matthes said.

Dr. Dennis Thombs, SPH Dean, said this year’s annual meeting also gave faculty and alumni a chance to reconnect, as well as to participate in various breakout sessions and presentations, gain new insight and collaborate with other schools, researchers and industry leaders.

“It’s an important experience for our students and a great way to join with our colleagues on a national level in exploring new solutions to some of public health’s greatest challenges,” he said.

The 2019 APHA Annual Meeting is scheduled for November 2-6 in Philadelphia, with the theme of “Creating the Healthiest Nation: For Science. For Action. For Health.”

By Sally Crocker

Thought leaders from around the country recently joined forces at UNT Health Science Center to brainstorm on new approaches for controlling an ages old health risk.

“A century ago, my grandmother lost her sister, mother and grandfather to tuberculosis,” said Dr. Thaddeus Miller, UNTHSC School of Public Health (SPH) Associate Professor and Principal Investigator of the North Texas Tuberculosis Epidemiologic Studies Consortium (TBESC), one of the CDC’s 10 such selected TB research sites in the U.S. “Through rigorous domestic public health programs, including a focus on latent TB cases, the United States has been largely protected in recent decades. But this protection, as well as new and emerging threats, shouldn’t be taken for granted until we are able to see TB only in our past and not our future.”

Leaders from the CDC’s Division of Tuberculosis Elimination came together with partners from across the U.S. for a Systems Thinking Symposium with the goal of more effectively leveraging the U.S. commercial healthcare sector against the persistent threat of TB.  The day was an example of the power of interprofessional collaboration.

More than 30 participants brought perspectives representing academia and research, healthcare, state and federal health agency oversight, private and public provider organizations, the managed care industry and others.

Dr. Miller and colleague Dr. Erica Stockbridge, UNTHSC SPH Assistant Professor, led much of the event’s development and organization, with a much larger team from around the UNTHSC campus and beyond playing supporting roles.

Led by MHA student Kaitlyn McKinley, UNTHSC teams of public health, TCOM and pharmacy students provided hospitality and recorded the discussions.

Dr. Crystal Howell, School of Pharmacy Assistant Professor, contributed to the event’s development, and was among the several UNTHSC faculty who took a direct part in the day’s discussions.

Tarleton State University’s College of Health Science and Human Services also participated, contributing a team of faculty volunteers, led by associate Dean Dr. Julie Merriman, to moderate the discussions.

The topic of latent TB infection (LTBI) was of special interest at the event.  People can carry LTBI and not even know it, with the infection lying dormant for years or even decades.

During this latent stage, TB is not infectious, has no symptoms and can’t be passed on to others, but it is estimated that anywhere from five to 10 percent of people with LTBI will develop active TB at some point in their lifetime, Dr. Miller said.  “This is especially concerning given CDC estimates that as many as 13 million people in the U.S. have LTBI,” he said. On a larger scale, about one-fourth of the world’s population has LTBI.

LTBI is more prevalent in certain countries, and states in the U.S. with high populations of foreign-born individuals, like Texas, California, New York and Florida, may be at higher risk for the potential of active TB among residents. Foreign-born populations account for nearly 70 percent of active TB cases in the U.S., and the LTBI prevalence is about 13 times higher among these groups.

“LTBI is treatable and can usually stop the development of active tuberculosis,” Dr. Miller said. “Public health officials and the CDC agree that to solve this problem, private sector health providers and influencers must be engaged, to work side by side with the public health system in testing and treatment.”

“The public health system does not have the capacity to address this alone,” said Dr. Thomas R. Navin, Chief of the CDC’s TB Surveillance, Epidemiology and Outbreak Investigations Branch, who opened the symposium at UNTHSC.

“TB-related care, including testing and treatment for LTBI, has historically been provided by local public health agencies,” Dr. Navin said, “but to more effectively address the slowing progress in TB elimination across the country, a new and expanded approach is needed to look beyond what public health, working on its own, can provide.”

The goal of the symposium was to engage participants in multifaceted thinking, to look at new ways of addressing this major health challenge together on a broader scale, Dr. Miller said, and to identify both long-term and more immediate actions that can be taken now.

“By enlisting help from other stakeholders who impact care, insurance, regulatory and quality compliance, medical testing, bottom-line coding and billing, research and policy, we stand a better chance of stopping TB,” Dr. Miller said.   “Without taking new action to finish the job we’ve begun, we run the risk of a future as ravaged by TB as was our past. I’m proud to be part an organization with the partnerships and expertise to see this fight to the end.”

By Sally Crocker

Dr. Teresa Wagner, right

Dr. Teresa Wagner’s own experiences as a mother trying to help her daughters through two life-threatening health scares, misdiagnosis and providers’ failure to recognize critical symptoms ignited her passion to lead the charge for improved patient health literacy and better communication between physicians and patients across Texas.

In recognition of her efforts to bring about change in the ways people navigate and understand today’s complex healthcare environment, Dr. Wagner has been named as the 2018 Health Literacy Hero by the Health Literacy Collaborative, a network of healthcare professionals, educators, businesses and community members working for improvement and increased awareness of health literacy.

The award was presented at the partnership’s 14^th Annual Texas Health Literacy Conference in San Antonio.

Dr. Wagner is Assistant Professor of Health Behavior and Health Systems at the UNT Health Science Center School of Public Health and serves as Senior Fellow for Health Literacy at the UNTHSC Institute for Patient Safety.

She remembers the struggles her older daughter, then in college and living away from home, went through before it was finally discovered that she had appendicitis.

“The symptoms were getting worse; my daughter knew that what she was feeling wasn’t right, yet the physician continued to say it was something else, not that serious,” Dr. Wagner said. “Years later, at 27, she went through a similar situation with diverticulitis.”

Dr. Wagner’s younger daughter sought care for a different problem but ended up silently suffering in pain from an undiagnosed hormonal syndrome, after deciding not to go back to the physician who had told her the only thing wrong was that she needed to lose weight.

“When someone feels shamed, or that they are just not being listened to, they can end up living with symptoms that are often debilitating or even deadly,” Dr. Wagner said.

Age-related disparities can have a profound impact on health literacy, she said, with the most vulnerable populations being young people just learning to live on their own, roughly ages 18 to 23, and senior adults, who may be too frail or too ill to speak up for their own care.

Solutions point to a give-and-take relationship and clear, open, two-way communications between patients and their health providers, both in person and in the directions and medications provided.

“There are many facets to health literacy,” Dr. Wagner said. “Consider the pages and pages of discharge paperwork that patients receive when leaving the hospital. If patients have trouble understanding what they should do when they get home, the repercussions could be critical. Prescriptions, as well as recommendations sent home after a clinic or physician’s office visit, represent other good examples where instructions might be confusing. Revising these types of materials into plain language can make a real difference.”

As the result of a policy brief Dr. Wagner developed for the State Health Committee and her testimony during  the 2017 Texas legislative session, state leaders will be reviewing recommendations for improved health literacy actions in the 2019 legislative session.

“Five other states now have legislation, and others have centers dedicated to health literacy. The hope is that Texas will move forward in this direction as well,” she said.

Dr. Wagner’s current research interviewing administrators and leaders representing up to 80 different healthcare organizations across North Texas is giving her a unique opportunity to examine the health literacy challenges that exist in hospitals today, based on the National Academy of Medicine’s model for Attributes of a Health Literate Organization.

Through the study, each participating hospital will receive a report on the strengths and opportunities of their organization, as well as recommendations, training options and areas for collaborative health literacy efforts across healthcare systems.

Dr. Wagner is also involved in research related to the impact of health literacy on maternal health, birth outcomes and postnatal care.

“As a mom who has been there, my hope is that no patient has to go through what my daughters have endured. The push for greater awareness and improvements in health literacy has the power to change and save lives,” she said.

By Sally Crocker

Dr. Dana Litt

What happens in the first semester of college can profoundly impact students’ alcohol use and future drinking behaviors, especially during the first six weeks, says UNTHSC Associate Professor Dana M. Litt, PhD, who is leading a new study on ways to reach freshmen when they are most impressionable.

This three-year project is funded by a $600,000 grant from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), one of 27 institutes and centers comprising the National Institutes of Health (NIH).

“An extensive amount of research to date has focused on problems and prevention related to heavy drinking in college, but significantly, we see that about 25% of students who were previously non-drinkers or light drinkers often begin drinking or progress to heavy alcohol use during their freshman year,” Dr. Litt said. “Timing interventions during the first six weeks of college, the critical ‘red zone’ period, could provide an opportunity to reach these freshmen during their highest time of vulnerability for either beginning or escalating drinking.”

Dr. Litt and UNTHSC Professor Melissa A. Lewis, PhD, Co-Investigator on the study, will conduct focus groups of incoming North Texas-area college freshmen who are either non-drinkers or light drinkers to learn about their opinions and personal experiences with alcohol, and to measure the importance of friend/peer influences, personal goals and alcohol-free events and activities on campus.

Focus groups will also be asked to evaluate proposed content and delivery methods for text messaging interventions, which will then be tested with different follow-up groups of new freshmen the next year, from their first day on campus throughout the entire first two semesters.

Significantly, students themselves will be helping to create the ways to reach future freshmen down the road.

“In phase one, we want to learn what type of information these target freshmen would like to receive via text, how often, which days of the week and which times of day,” Dr. Litt said. “During phase two, as we actually follow the next groups of students from their first day forward, the value of the messaging will be assessed after the first six weeks of college, then at three, six and nine months afterward, to evaluate if they have been influenced to drink less or not to start drinking at all.”

Typically, non-drinking or light-drinking college students are considered as relatively low risk in research studies, but negative consequences measure higher among these groups if they begin or escalate alcohol use during their freshman year.

“Most freshmen are entering into a new social environment with much less parental oversight. You want to meet people and go to parties, have fun and be a part of it all, but for kids without experience, drinking can be especially risky,” Dr. Litt said. “Our goal is to support their decisions to not drink or to drink lightly, in part by correcting the belief that everyone is doing it, by reinforcing goals that don’t involve alcohol, and by encouraging these students to find non-drinking activities they enjoy where they can meet like-minded friends.”

By Sally Crocker

Dr. Scott Walters

When the U.S. Surgeon General published a recent health advisory – the first such alert in the last decade – asking for the public’s assistance in tackling the nation’s growing opioid epidemic, Dr. Scott Walters from the UNTHSC School of Public Health made plans to do his part.

“Be prepared. Get naloxone. Save a Life,” the Surgeon General said. “For patients currently taking high doses of opioids as prescribed for pain, individuals misusing prescription opioids and individuals using illicit opioids such as heroin or fentanyl, health care practitioners, family and friends of people who have an opioid use disorder, and community members who come into contact with people at risk for opioid overdose, knowing how to use naloxone and keeping it within reach can save a life.”

As a behavioral health professor and researcher at the UNTHSC School of Public Health, Dr. Walters has worked with people who are homeless, on probation and at risk of interpersonal violence. His research takes him to community shelters, institutional settings and out to the streets.

“Being able to react quickly when an overdose is suspected could mean the difference between life and death,” Dr. Walters said. “If there is a chance I could help someone in an emergency, I want to be ready. Not many people, though, know where or how to get naloxone, or realize that it’s available through their insurance without questions or a prescription.”

Naloxone, sometimes referred to by the brand name Narcan, is a safe antidote for overdose that has been used in hospitals and among emergency medical personnel for years, Dr. Walters said. It is available in injection form or as a nasal spray.

“There are no side effects,” he said. “The only result is to reverse the deadly threat of an overdose.”

Over the last 15 years, individuals, families and communities across the U.S. have been tragically affected by the opioid crisis, with the number of deaths from prescription and illicit opioids doubling from 21,089 in 2010 to 42,249 in 2016.

“The problem is real, and unfortunately, it is still growing,” Dr. Walters said. “We can all help by understanding the signs of opioid abuse and knowing what to do in an emergency.”

Obtaining naloxone was initially challenging for Dr. Walters.

The first pharmacy he tried was hesitant and not familiar with the new guidelines. To bill his insurance, they suggested he needed a doctor’s prescription.

A call to his doctor didn’t help either, as the physician wasn’t comfortable with moving away from typical protocol for prescribing a medication. Because it would be used for someone else, the doctor didn’t feel able to assist.

As Dr. Walters pursued it further with the Texas Pharmacy Association, he discovered that a standing naloxone prescription order exists for all Texas citizens and is now applicable in most other states.

A visit to a second pharmacy with this new information yielded a better outcome. The medication was provided without a personal prescription, at a cost of his usual insurance copay.

Texas Society of Addiction Medicine President Dr. Carlos F. Tirado, who signed the state’s standing order more than one year ago, said, “This medication has been available to the public for quite a while. We still have a lot of work to do in educating and informing pharmacists, physicians and citizens on how to obtain naloxone and the power we all have to save someone’s life. Anyone who has a concern about someone they know, or someone close to them, can get this medication at any pharmacy.”

People who keep opiates or painkillers at home or who have curious teenagers might be wise to have this antidote on hand, Dr. Walters recommends.

“Many colleges, in fact, keep naloxone available in case of emergency,” Dr. Walters said. “People who work in healthcare, public health or other fields where they encounter vulnerable populations, or anyone who suspects they might be around someone who could be abusing drugs, may also benefit.”

By Sally Crocker

Dr. Melissa Lewis

Two UNT Health Science Center public health researchers plan to get inside the minds of teens and young adults to learn what influences them to drink, and when they are most apt to use alcohol, through a new $2.6 million, five-year study funded by the National Institute on Alcohol Abuse and Alcoholism through the National Institutes of Health (NIH).

Dr. Melissa A. Lewis, UNTHSC Professor of Health Behavior and Health Systems, is leading the study, along with Dr. Dana M. Litt, UNTHSC Associate Professor, Health Behavior and Health Systems, and colleagues from the University of Washington.

The researchers will connect with volunteer participants ages 15-25 through smartphone technology to study situations, influences and state of mind that may lead to drinking.

“Some theories suggest drinking is intentional, while others believe it may not be so planned,” Dr. Lewis said. “We want to know more about that, by looking at how young people think and engage with others throughout the day, and how influences, situations and timing may affect their urge to drink. We also want to learn what may be different for a high school student, someone of college age, and a person who is slightly older, to see how factors and motivations may change over time or according to different stages of maturity.”

This NIH-funded project will examine decision-making multiple times throughout a day related to high-risk alcohol use among the 15- to 25-year age group, and is both significant and innovative in the way it will study drinking behaviors at both the daily level and developmentally over time, according to age and experience.

Volunteers enrolled in the study will receive random text surveys in quarterly “burst” segments over a one-year period. During each cycle, participants will be texted twice a day, three days a week, for three weeks. The aim is to collect data across three weekdays and three weekends per quarter.

Dr. Dana Litt

Rolling recruitment will continue to enroll new participants on an ongoing basis, using social media, peer referrals, ads and other methods of promotion. The goal is to gather data from more than 1,000 teens and young adults over five years in order to develop alcohol interventions tailored specifically to this demographic.

“Through this research, we plan to assess the best timing for alcohol interventions, by understanding what matters to teens and young adults and how their day-to-day thinking fluctuates depending on the time, influences and what is happening throughout their day,” Dr. Lewis said. “If you wake up not thinking about drinking or planning to, what changes that or triggers a willingness later on?”

The surveys delivered by smartphone technology will gather information on how individuals feel and what they are thinking to start their day, whether they drank or used substances the day before, how much they drank, whether they had planned to drink, where they drank and whether it was alone or with others.

Questions will gauge how friends and social environments may have impacted drinking decisions and determine how drinking made respondents feel physically and emotionally (got sick or hurt, felt bad, couldn’t remember things); whether drinking ended up getting them in trouble (skipped school or homework, got in fights or arguments); or if it made them regret something, or feel embarrassed or guilty.

“Alcohol use continues to be a growing problem among young adults and is a leading risk factor for disease, premature death and behaviors that lead to other serious consequences,” Dr. Litt said. “Through this study, we hope to better understand the motivators and influences to develop prevention and intervention recommendations for reaching young adults when they are most apt to make risky drinking decisions.”

By Sally Crocker

Dr. Scott Walters

For nearly 20 years, Dr. Scott Walters has served others in extraordinary ways through research, teaching, scholarship, community service and contributions to the public good.

In recognition of his work and its impact, the UNT System Board of Regents has awarded Dr. Walters with a rare academic distinction as Regents Professor.

Dr. Walters, who joined UNTHSC in 2011, serves as Professor and Chair for the Department of Health Behavior and Health Systems in the School of Public Health.

He is the only SPH professor to receive this honor in the school’s nearly 20-year history.

As a behavioral health researcher seeking solutions to critical public health issues, Dr. Walters focuses on developing better ways to talk with people about making positive changes.

His research has developed new ways of using smartphones and computers to understand people’s motivation for substance use and other risky behaviors, in order to personalize ways to help them with recovery and other goals.

He and a colleague were recently awarded a major, $650,000 grant from the National Institutes of Health (NIH) to develop and test a unique smartphone-based alcohol treatment for homeless adults, using geolocation and self-reporting in real time to better identify factors that lead people to drink.

Dr. Walters has also created online solutions to help court-ordered probationers meet their substance abuse recovery goals through a unique program called MAPIT. The responsive, self-guided software program addresses a critical need in the criminal justice system, where more than half of the country’s 3.5 million probationers struggle with completing required treatment.

His work has also developed ways to address heavy drinking in hospital settings, vocational success for veterans with a criminal history, alcohol interventions for young adults, community-based health navigation and health advocacy for people at risk of interpersonal violence. In total, he has secured more than $10 million in research funding.

In addition to publishing more than 100 articles and book chapters and five books, Dr. Walters has been recognized for his teaching at UNTHSC and other universities.

“Dr. Walters is a highly sought teacher as well as an internationally renowned researcher and scholar,” said Dr. Mary Marden Velasquez, Director, Health Behavior Research and Training Institute and Centennial Professor in Leadership for Community, Professional and Corporate Excellence at The University of Texas at Austin, in a recommendation letter offered to the UNT System Board of Regents. “In my many years in higher education, I have not encountered a more outstanding teacher and mentor to students, faculty and colleagues.”

As a nationally recognized expert in Motivational Interviewing, a behavior change strategy that has been applied in a wide range of settings, Dr. Walters is frequently consulted by news media and invited to conduct trainings for criminal justice workers, counselors and healthcare professionals. In the last 15 years, he has conducted more than 200 trainings across the country.