SPH News Brief: Dr. Doug Livingston’s abstract related to community efforts for reducing adolescent alcohol use and access was selected as an “Abstract of Distinction” by the Society for Prevention Research (SPR) and was recognized at the organization’s 25 Annual Meeting in Washington, D.C., held May 30-June 2, 2017. This year’s meeting focused on the theme of Prevention and Public Systems of Care: Research, Policy and Practice. This was the first year that SPR conferred this honor. More information on Dr. Livingston’s research can be found here: https://www.unthsc.edu/school-of-public-health/study-finds-alcohol-prevention-strategies-effective-american-indian-teens-rural-youth/.
Dr. Livingston is Assistant Professor of Biostatistics and Epidemiology at the UNTHSC School of Public Health.Dr. Livingston was also published in the May 2017 issue of the American Journal of Public Health. With colleagues from the University of Florida, he reported research showing that federal regulation of precursor chemicals can positively reduce cocaine availability in the United States and can be correlated to a decline in maternal and neonatal hospital stays. Earlier this year, Dr. Livingston spoke with White House officials on these findings.
SPH News Brief: Recently, SPH students Amy Board (DrPH ‘17) and Erica Stockbridge (PhD ’17) made Centers for Disease Control and Prevention (CDC) presentations in Atlanta related to national research consortium efforts on tuberculosis prevention and monitoring. During their doctoral studies, both students have worked with SPH professor Dr. Thad Miller, Principal Investigator, on the CDC-funded Tuberculosis Epidemiologic Studies Consortium (TBESC). Also attending in Atlanta was UNTHSC MPH student Armando Moreno. Dr. Miller is Associate Professor, Department of Health Behavior and Health Systems, at the UNTHSC School of Public Health.
- SPH News Brief: Dr. David Sterling, Professor of Biostatistics and Epidemiology, at the UNTHSC School of Public Health, was recently recognized as one of five finalists for the UNT Health Science Center’s new honor, the Faculty Achievement Award. Honorees were chosen by a committee of their peers, led by the Faculty Senate. As a finalist, Dr. Sterling was recognized for demonstrating excellence in teaching, scholarship, service and leadership. Dr. Sterling has been with the UNTHSC School of Public Health since 2008 and has most recently been in the news for his work with children’s asthma management in the Fort Worth Independent School District, through the “Asthma 411” program. He is a long-time panel reviewer for the National Institutes of Health, EPA and other agencies, and maintains an active research program. Among his funders have been the Centers for Disease Control and Prevention, National Institutes of Health, the Environmental Protection Agency, Texas State Department of Health Services and various not-for-profit foundations. This June, he was recognized as a Fellow in the American Industrial Hygiene Association (AIHA). According to the organization, only five percent of AIHA membership can qualify for the Fellow Award, presented as a high recognition to those who have made significant contributions to the field of industrial hygiene.
Nineteen UNT Health Science Center MHA students have found their 2017 summer internships, thanks to a “speed interview” event on campus with potential healthcare employers.
In quick rotations, students were able to meet with representatives from 11 local healthcare organizations to showcase their talents, interests and resumes.
Participating organizations included JPS Health Network, Children’s Health Dallas, Children’s Health Plano, UNTHSC, Lake Granbury Medical Center, Kane Hall Berry Neurology, North Central Surgical Center Hospital, Southwest Sports and Spine Center, Texas Health Resources, Weatherford Regional Medical Center and Wise Regional Health System.
“The MHA speed interview event is a great way to connect students with internship opportunities,” said Martin Ostensen, MHA Program Director. “All of the students who interviewed in the timed sessions presented well and impressed the visiting organizations with their polish and professionalism.”
Students will be working on a variety of projects and healthcare assignments this summer. One such project is the design and implementation of an emergency operations plan to meet new Centers for Medicare and Medicaid Services (CMS) guidelines. Another project will involve development of a model and criteria for patient room improvements.
She promised not to cry, but there were still some emotional moments as Dr. Christine A. Moranetz presented her Last Lecture to students, faculty, community colleagues and close friends.
For nine years, Dr. Moranetz has served in a variety of leadership positions for the UNT Health Science Center School of Public Health, and as Associate Professor preparing for retirement, she had a lifetime of reflections, stories, learning examples and advice to share.
The tradition of The Last Lecture, initiated by the UNTHSC Public Health Student Government Association, provides students a chance to hear closing thoughts and gain inspiration from professors they have studied with over the years.
“I’ve been working on this presentation for quite a while, and I’ve prepared 180 slides for our three-hour workshop today,” Dr. Moranetz joked, opening her talk. “Seriously, I have so much to tell you, but I think you’ll be glad to know that I’ve condensed it into a one-hour presentation focused on my top ten words of advice.”
SPH graduate research assistant Md Abdullah Al Mamun, who has been mentored in his PhD studies by Dr. Moranetz, described her in opening introductions as “a professor who shares compassion with each of her students, who nurtures us and lets us thrive.”
Dr. Dennis Thombs, Dean, echoed those thoughts in his remarks, saying, “She always puts students first.”
Former student Allen Applegate, DrPH, MPH, CPH, traveled to Fort Worth from San Francisco to attend the presentation, saying, “Dr. Moranetz had such a positive impact on me as a student and on my career. It was an honor to be part of her final lecture as she reflected on her meaningful career and those who helped her achieve success. The wisdom she shared was heartfelt and inspiring.”
Applegate, who now serves as Lieutenant Commander for the US Public Health Service Commissioned Corps, US Department of Health and Human Services, worked with Dr. Moranetz during his UNTHSC doctoral studies.
Between reflections on her long career in both health promotion/disease prevention and academics, Dr. Moranetz shared some of her interesting hobbies, favorite quotes and very personal, touching stories.
In David Letterman style, she offered her “Top 10 Countdown,” noting that, “While this is particularly directed to the students, I hope that some of what I share speaks to everyone in the room.”
She offered this inspiring list of advice:
- #10: Dream big. Dr. Moranetz challenged students to “do one thing that scares you,” and to think in new and creative ways.
- #9: Be courageous. After a long battle with cancer and now four years in remission, Dr. Moranetz advised that sometimes there will be things that seem insurmountable, when you feel that you “just can’t do it,” but with courage and the help of friends and family, the impossible can be achieved.
- #8: Develop compassion and empathy. Dr. Moranetz illustrated this advice with a story of her mother’s career as an honored World War II Army nurse who served two tours of duty in the Pacific before returning home to continue her professional career stateside.
- #7: Serve others. “That’s what we do if you’re in public health, that’s what we are about,” Dr. Moranetz said. She encouraged working with populations most in need of public health students’ time and talents.
- #6: Leave a legacy. In describing one of her proudest career achievements – a dramatic educational theater project she co-developed on AIDS/HIV prevention that has continued for 24 years – Dr. Moranetz encouraged students to create their own legacy, professionally and personally.
- #5: Strive for equality and social justice. She challenged the audience to embrace diversity and advocate for gender equality.
- # 4: Cultivate friendships. “Live, laugh, play,” Dr. Moranetz said. “I’m a loyal friend and my friends have been loyal to me; we’ve been through a lot together.” She shared stories of professional colleagues who have remained friends for decades.
- #3: Stand by your faith and convictions. In advising students to “be honest and true,” Dr. Moranetz reflected on the example her father set in his military service and commitments to veterans and the community. Quoting a Native American Cherokee proverb, she said, “Live your life so that when you die, the world cries and you rejoice.”
- #2: Live in the moment. “Keep a journal, reflect, make time to be grateful for what you have, don’t let worry and tension keep you from enjoying life,” she said. ”You might not know this, but I enjoyed learning to ballroom dance. I took lessons for 12 years and competed in professional-amateur competitions for seven years. What dancing taught me is how important it is to ‘follow’ – you don’t have to lead all the time. Life is a dance, enjoy it.”
- #1: Get out of your head and into your heart. In closing, Dr. Moranetz shared a number of thoughts, including the famous Helen Keller quote, “The best and most beautiful things in the world cannot be seen or even touched – they must be felt with the heart.”
“It’s been said that great teachers inspire, and I hope, from the bottom of my heart, that I’ve been an inspiration to you, as you have been to me,” Dr. Moranetz said.
Dr. Moranetz has served as Associate Dean for Academic Affairs, DrPH Program Director, PhD Program Director and Chair of the Department of Public Health Education in the School of Public Health. On mentoring her last doctoral students, she will retire from UNT Health Science Center this summer.
The prescription bottle said, “Take one tablet as needed,” so the patient did – repeatedly – going far beyond the recommended daily dosage.
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.
UNTHSC 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.
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.”
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
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?
“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.
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.
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.