School of Public Health

SPH news

Posted Date: January 10, 2018

By Sally Crocker

mChat-photoIn 2012, a group of UNTHSC faculty were approached with a unique opportunity. Millions of dollars had suddenly become available through Medicaid to fund innovative health care delivery projects for low-income and uninsured patients. The catch? Funding was performance-based, awarded as successful progress was proven. The Health Science Center could lose money if the projects did not meet their goals.

Dr. Scott Walters, UNTHSC Professor and Chair of Health Behavior and Health Systems in the School of Public Health, was asked to design a project focused on behavioral health.

“This was really unlike a traditional grant where the funder thinks you have a good idea and gives you money to conduct the project,” he said. “Not only did UNTHSC front millions of dollars, but it also had to take the risk that the projects would go well. Nobody had ever seen anything like this before.”

“I pay more attention to my health now. I stopped smoking and started exercising. Every morning, I would get a text reminder to take my medication and go for a walk, and that kept me motivated. I had been eating a lot of junk food at night, but the reminders made me think twice about reaching for cookies, so I would get a piece of fruit instead. Now I feel like I can continue on my own.”Sidney Taylor

In partnership with Dr. Emily Spence-Almaguer, UNTHSC School of Public Health Associate Professor and Associate Dean for Community Engagement and Health Equity, Dr. Walters’ team designed, a technology-assisted health coaching program for people residing in permanent supportive housing (PSH) in Fort Worth. About 75% of PSH residents have a chronic health condition; two thirds have active substance use, and more than half have active mental health symptoms. PSH residents tend to have substantially higher health care costs compared to the general population. mChat photoThe program matched PSH residents with a health coach, who met with them monthly over 18 months to set goals around diet, exercise, substance use, medication compliance and other areas. The program’s special software and system for reminders helped clients stay motivated and track progress along the way. The project enrolled 653 clients over four years. Most people chose to work on diet (62%) and exercise (60%). About 41% wanted to make changes in substance use, and 26% wanted to improve their level of social support. The pace of the project and performance-based reimbursement pushed the team to constantly adapt to new challenges. “In our first year, part of the funding was tied to enrolling 300 people fitting a certain profile. In a typical project, if you are meeting 80 or 90% of your goal, that’s a success. Under the Waiver mechanism, though, we were required to meet the full 100%,” Dr. Walters said.

“Being able to stop smoking has been my biggest accomplishment. I had tried to quit before but was struggling. My coach didn’t judge me. I was able to be very honest with him, and it helped to have someone to talk to. I worked on meal planning and lost weight, and the text messages reminded me to go walking twice a day. In the fall I started working on my associate’s degree online. I know I can do it now. Even if it gets hard, I don’t want to quit.” Sharon Simon

Despite many barriers to improving health, people who participated in showed substantial improvements: over 12 months, 23% increased their fruit and vegetable intake, 40% decreased sweet intake, and 49% decreased fat intake. People who set a goal to improve physical activity had far less sitting time and far more activity over 12 months, nearly doubling their number of active minutes per week. Depression scores went down by one-third, and more than one-third of substance abusers quit. “The unique impact of was in the way it addressed a broad range of behaviors affecting people’s health,” Dr. Walters said. “We demonstrated that people can improve their overall health, sometimes in more than one area, despite very difficult circumstances.” From a funding standpoint, the project was also a success, fully meeting its metrics each year. Projects like demonstrate UNTHSC’s ability to innovate quickly in response to a unique funding mechanism, resulting in win-win situations for the university and the community.

“Through different activities, I collected enough ‘Chat Bucks’ to buy things I couldn’t afford, like a mattress, groceries, laundry detergent. It makes you feel better about yourself and gives you something positive to look forward to”Pamela Wilson

Posted Date: January 3, 2018

By Sally Crocker

tornado pic car tornado pic 2

Through a CDC grant made possible by the American Planning Association-Texas and the Texas Public Health Association, a UNT Health Science Center instructor and students are leading an effort to help small and rural communities prepare for potential disaster situations.

With support from the UTA Urban Planning Department, the team, led by Dr. Melissa Oden from the UNTHSC School of Public Health, has developed a rural community disaster preparedness tool kit. The kit will be rolled out across the country in 2018 and will be available online for towns and cities this spring.

The project started in response to relief efforts for Van Zandt County, Texas, which was struck by a series of seven tornadoes in late April 2017. The National Weather Service classified two of the tornadoes as Category 3 and 4, ranging between 136 and 200 mph. One of the clusters, a mile wide in scope, was on the ground for 52 minutes.

tornado pic_Oden team“One of the important things learned from this tragedy is the need for rural communities to have disaster plans in place, to prepare for potential scenarios, outline immediate response and designate follow-up recovery efforts,” Dr. Oden said. “Large cities have plans, but rural communities often don’t. People need to know their roles and responsibilities in a disaster.  The tool kit that we’ve developed can be used for any situation, such as tornado, fire or flood.”

CDC’s goal with the grant was to build collaboration between county and city planners and public health professionals, to think “pre-disaster,” Dr. Oden said.

“In telling the story of Van Zandt, we hope to be able to help others in the future. A very bad thing happened to the good people of this community, and through focus groups and other data collection, they have given us valuable insight into what they wish they had known before the disaster and what they would tell others to help them prepare,” she said.

The team’s first site visit involved nearly four hours of surveying the damage, and the most recent visit was to share ideas for the toolkit and gain feedback from invitees across seven area counties.

tornado_roundtableThe toolkit will become part of the website where donations are currently being accepted to help Van Zandt County continue in its recovery efforts:

“The process of rebuilding has been slow, in part because the county’s damage threshold, while devastating, didn’t reach the measures for national disaster relief. Thanks to grassroots fundraising and partnerships between citizens, local government and outside agencies, the last family who had been forced to live in temporary housing for more than six months was finally able to move home before the holidays,” Dr. Oden said.

UNTHSC students Orji Okereke and Christian Chukwuma, both from the MPH program, worked alongside Dr. Oden, with student Kelsey Poole from UTA, who was responsible for social media on the project. Okereke and Poole will continue working on the project in the spring and will be joined by another interning UNTHSC public health student.

For other stories on this project, visit:

East Texas tornadoes case study to help rural communities prepare for and deal with disasters


Life after Tornadoes

Posted Date: December 11, 2017

By Sally Crocker

MHA Case Competition

The winning UNTHSC team with executive coach Paul Aslin from Wise Health System

A team of UNT Health Science Center MHA students has taken the top prize at this year’s American College of Healthcare Executives North Texas (ACHENTX) Case Competition.

Tasked with a real-world challenge, much like projects they will take on in their future careers as health care leaders, teams from UNTHSC and other North Texas universities went head to head on a case for “Humana’s Bold Goal: 20 Percent Healthier by 2020.”

The case focused on Humana’s plan to improve health in the communities it serves and make it easy for people to achieve their best health. Students were asked to develop and present a proposal for measuring the business performance and clinical progress along the way.

Members of the UNTHSC winning team were Crystal Bui, Liana Cherian, Monica Kovuri, Laci Sherman and Ela Vashishtha.

The team was coached by Paul Aslin, FACHE, Senior Vice President and Chief Population Officer with Wise Health System, who shared on LinkedIn, “For the second year in a row, I had the privilege of being the executive coach to the winning team of the North Texas ACHE Student Case Competition; for both years, the winners were from UNTHSC.”

Texas Institute for Surgery President David A Helfer FACHE, CMPE, ACC, BCC, who served as lead judge for the competition, was extremely complimentary of the students’ work.

“The initial written submission by UNTHSC’s winning team was exceptionally well crafted, organized and on point with the assignment.  As such, they were selected to move on to the live presentation round,” he said.

“As they launched their presentation, it became clear that they had quickly learned how to work with one another, and both the content and delivery were nearly flawless.  They were well prepared to answer the judges’ questions and even had back-up material that was not part of the main presentation, suggesting critical thinking and planning skills,” he said. “We understand that all the groups worked hard to reach the final round, but this team from UNTHSC stood out.”

The win has special significance for Ela Vashishtha, who has presented at three case competitions this year, regionally, statewide and nationally. In April, she was on the UNTHSC team that won for their “Transforming Galveston” proposal at the George McMillan Fleming Center for Healthcare Management’s annual student challenge event in Houston.

“This time, we were working on two case competitions at once; participating on a national level really helped improve our presentation skills and gave us a learning experience we could bring back to the North Texas competition,” she said. “The judges were impressed with the way we presented Humana’s Bold Goal in relation to a patient story. They also liked our approach, acting as consultants, and the way we developed proposal materials and business cards that visually aligned with Humana’s brand.”

MHA Case Competition

UNTHSC’s second competing team, with MHA Program Director Martin Ostensen and health care leadership expert Rulon Stacey, PhD (fourth and fifth from left, respectively)

This year, a second UNTHSC team was approved to join the North Texas competition as well, giving a group of first-year MHA students a chance to see how it works.

MHA Program Director Martin Ostensen, JD, MBA, MHA, called the opportunity “a great learning experience and a chance for the group to network with top-level health care executives from around the area.”

Members of the first-year team were Zachary Lueck, Aakshita Monga, Mark-David Onomeyovwe, Hector Rodriguez and Cassandra Umeh, coached by Bob Ellzey, FACHE, President of Texas Health Harris Methodist Hospital Azle.

“As first-year students, our team gained an invaluable experience, allowing us to recognize our strengths and use them in a proactive fashion,” Rodriguez said.  “We learned a few things about our individual shortcomings and how valuable it is to surround yourself with other people who are willing to help.  Every single team member was a leader at one point or another throughout the process, and whoever had a stronger background on a topic would take the lead whenever we hit a roadblock.”

With diverse backgrounds, each person brought different skills and perspectives to the table.

“My background is in non-profit management and health care policy. Cassie worked in a clinic and also has one year of medical school under her belt. Mark-David has an economic background and is an Army veteran. Aakshita graduated from dental school in India, and Zach previously worked as a scribe and, most recently, in the HR department of a major architectural firm,” Rodriguez said.

In addition to drawing on the unique talents and ideas of teammates, the students in both groups also sought guidance from UNTHSC faculty and executive leadership. Some of the university’s resident experts included Steve Sosland, Executive Vice President/Chief People and Performance Officer; Dr. Thomas Fairchild, Vice President for Organizational Excellence;  and Dr. Thomas W. Diller and Dr. Wonseok Choi, Associate Professors, Health Behavior and Health Systems.

Posted Date: November 16, 2017

By Sally Crocker

Ramphal Naley doctor bag
Thirty-eight years ago, Dr. Lilly Ramphal-Naley received a special gift on her medical school graduation day, and now she has passed it on to a UNTHSC public health graduate who will soon be caring for patients himself.

The gift- a doctor’s bag – is probably over 100 years old.

It was presented to Nnamdi Maduabum, who recently passed his medical board exams and is applying for a residency position.

Dr. Ramphal-Naley served as Maduabum’s faculty mentor while he was studying for his MPH in Environmental and Occupational Health Sciences at the UNTHSC School of Public Health (class of ’15).

After graduation, he went to work for Catholic Charities in Fort Worth as a Data and Research Specialist, and now he’s on to the next step in his career.

“This bag was given to me in 1979 by a 90-year-old doctor. He was barely standing. He brought it to my graduation. If was full of his thoughts, hopes and wishes for my future,” Dr. Ramphal-Naley said during the presentation. “I was young, but I knew it was a precious gift. So now I am passing this gift on to you.”

She advised Maduabum to “stay humble and grounded.”

“This bag is full of the voices of patients who have been cared for by a doctor before me, then by me, and now will be cared for by you,” she said. “Stay focused on them. Always apply your knowledge to do good for the most – to heal a village.”

The gift carries special meaning for Maduabum, who said, “I am honored to know that Dr. Ramphal-Naley thinks so highly of me and my desire to provide excellent medical care to the community.”

Posted Date: November 15, 2017

By Sally Crocker

When Dr. Thad Miller introduced a different kind of course project to his Health Insurance and Managed Care class, he knew it would be interesting, but he had no idea that it would result in one of the university’s largest and most collaborative Grand Rounds in many years.

How did a unique teaching experiment go so far and have such an impact?

“I know that when I’m personally learning new information or a new subject, it really comes alive for me if I have a chance to use the concepts in practice,” Dr. Miller said. “I wanted to give the class that kind of hands-on opportunity, to dig deeper into a very complex topic that would take them beyond the more traditional path of lectures and exams, so they could learn by doing.”

Dr. Miller challenged the class to engage across the UNTHSC campus, community and health care industry to plan and produce a Grand Rounds continuing education presentation for students, faculty, health professionals and others in the fields of medicine and public health.

In addition to a standing-room-only crowd on campus, an online audience from eight states tuned in to the webcast for Continuing Medical Education (CME) credit, viewing from Texas, California, Arizona, Utah, Alabama, Michigan, South Carolina and Pennsylvania.

Dr. Miller first connected the class with Leslie Herman, MLS, MBA, CHCP, Program Manager for INCEDO UNT Health Science Center, a nationally-accredited provider for continuing education activities and programs both live and online. The idea proposed was to explore the challenges of today’s health care environment with a panel of insurance and provider experts.

INCEDO liked the proposal for its educational value and because it fit accreditation guidelines for including students in the planning process.

“It was a valuable experience for the class to work with panelists from diverse health care business settings to examine how the payer/provider/regulatory sectors connect, and to gain a firsthand look ‘behind the curtain’ to see what goes into planning a continuing education activity where specific goals and desired outcomes align to inform a targeted audience,” Herman said. “This was the first time in my three years with UNTHSC that I’ve worked with students developing a Grand Rounds as part of a class project.”

Herman met regularly with the students, and Dr. Miller provided guidance along the way, connecting the class with leads on speakers and others within the university who could help.

“The Office of Brand Communication advised on messaging to present the story of ‘Insurance in a Dynamic Marketplace,’ and UNTHSC media spokesperson Jeff Carlton coached our moderators on effective panel interview techniques,” Dr. Miller said.

The School of Public Health agreed to underwrite costs for event, which was provided free to participants.

“The funding commitment from the Dean demonstrated confidence in what our students are doing. This is consistent with the mission of connecting our students with the community and the professional world,” Dr. Miller said.

The class broke into teams to start, electing an executive committee and sub-groups who would reach out to speakers, coordinate with INCEDO, develop questions for the panelists in line with CME guidelines, and plan hospitality and after-event follow up.

Dr. Miller’s active role minimized once the class took the lead. He advised the teams to avoid saying they were working on a class project, so they could take a higher-level approach in their conversations with speakers and others involved.

UNT Health’s Chief Medical Officer, Eric H. Beck, D.O., M.P.H., was recruited as a panelist, along with Paul Hain, MD, Blue Cross and Blue Shield of Texas, North Texas Market President, and William (Doug) Wallace, JD, Fraud Prosecutor with the Texas Department of Insurance, Fort Worth.

Student Laci Sherman (MHA candidate, class of ’18), who coordinated with Blue Cross Blue Shield as one of the class team leads, said the experience “brought the whole topic to light,” taking it a step beyond what’s presented in class.

“It gave us a great opportunity to network with professionals in the industry, learn more about the future of health care, and gain valuable project management and organizational skills that will help in our careers,” she said.

Dr. Miller said a big benefit to this teaching tool has been the new relationships formed with industry leaders, as well as increased awareness of what UNTHSC students can do.

Dr. Beck agreed, calling the event “a wonderful proof point for the value of One University and how UNTHSC is uniquely positioned as the producer of contemporary practitioners for the health care delivery system of the future – one focused on improving health for populations and communities.”

Posted Date: November 7, 2017

By Sally Crocker

Harleen SinghWithin two months of graduating from the UNTHSC School of Public Health (MHA ’16), Harleen Singh took on a highly selective administrative residency with Baylor Scott & White Health (BS&W), one of the largest not-for-profit health care systems in the United States.

This two-year postgraduate program – which helps prepare future health care leaders so they will be ready to assume a key management role within a complex health care organization – placed Singh with BS&W’s Health Texas Provider Network physicians group.

Her focus is on outpatient operations management, and the job takes her to different locations around Dallas-Fort Worth, where she spends several months in rotation learning about outpatient services, finance, human resources, physician-administrator relationships and other aspects of the business.

After completing her bachelor’s degree in Human Development and Family Sciences with a Business Certificate, Singh worked two years for Hilton Worldwide, where she was involved in revenue management and analysis for all of the company’s brands.

“It was during that time that I developed an interest in health care administration,” she said. “I have always had a passion for helping people, and being married to a physician, I was inspired to explore ways that I could apply my skills to the field and be able to serve others as well.”

She decided to pursue an MHA program where she could build on her revenue management background as a transition into health care leadership.

“I liked that the UNTHSC program is accredited by CAHME, the Commission on the Accreditation of Healthcare Management Education. This was very important to me when selecting my school, as it means that the program has met all the guidelines for having a robust and effective curriculum,” she said.

“Additionally, the program requires a 12-week, hands-on experiential internship where students are asked to incorporate, synthesize and apply their knowledge within both an operational and a community context. The program overall provided me with an excellent education and skillset to succeed in the health care industry,” she said.

As Singh took courses in health care finance, strategy, operations management and leadership development, she studied with health industry leaders who brought their real-world experiences into the classroom, “making it more relatable,” she said.

She also found a career mentor when she connected with Jack DuFon, her MHA internship preceptor at the VA Health Care System Dallas/Fort Worth, whose guidance helped Singh move toward her current administrative resident position.

“His advice helped me realize that practice management is a strong fit for my skills,” she said. “I believe it’s very important to connect with a mentor early on in your career, and in this field, organizations like the American College of Healthcare Executives (ACHE) are quite helpful with that process.”

Singh said she sees important work for outpatient health leadership in the future.

“As health care policies evolve and change, marketplace incentives are encouraging health systems to find ways of managing chronic disease care outside the traditional hospital setting. This signals a new trend for outpatient clinics, and it will be an important learning experience for me as I begin my career,” she said.

Posted Date: November 3, 2017

By Sally Crocker

Halloween Family Feud
UNT Health Science Center public health students celebrated Halloween 2017 in healthy style.

Halloween Blue ZonesAs part of a community-wide “Public Health in Action Series,” the School of Public Health was treated to a nutritious, tasty cooking demonstration courtesy of the Blue Zones Project Fort Worth.

Vahista Ussery, known locally as “Chef V,” boiled the pot to create a black bean and sweet potato Spooktacular Chili recipe and shared helpful tips on preparing vegetables, including her own techniques for chopping onions, peeling potatoes and slicing bell peppers.

A registered dietitian, Chef V is co-founder of the consulting and education company To Taste: A Culinary Nutrition Experience. To Taste works to help bridge the gap between medical advice, healthy eating and cooking.

“The chili was delicious, and Chef V received applause several times throughout the demonstration for her great kitchen tips and nutritional advice,” said Dr. Emily Spence-Almaguer, Associate Dean for Community Engagement and Health Equity.

SPH students in the Health Insurance and Managed Care class added a different touch to Halloween with their presentation for the weekly Tuesday Interlude cohort session.

Dr. Thad Miller’s classes have been involved in teaching others as a way to reinforce their own learning experience, so this semester’s group decided on a “Family Feud Halloween” theme for their program on Medicaid and Politics. The group was graded on their presentation, which was well received by the audience.

Halloween Blue Zones Halloween Blue Zones Halloween Blue Zones

Posted Date: October 24, 2017

ZoonoticUNTHSC students, faculty and staff are invited to the 2nd Annual Zoonotic Disease Fair from noon to 3 p.m. on November 21, to learn about some of the common diseases found in Texas that can be passed from animals to humans.

“It pays to be aware,” said public health student Emily Blankenship, who is helping to organize the event with fellow Environmental and Occupational Health classmates.

“Typhus, once considered almost eradicated in the U.S., is back on the rise in Texas. This potentially fatal disease transmitted by fleas joins the growing list of tropical infections impacting the state,” Blankenship said. “In August, a Texas dairy issued recalls on raw milk found to contain drug-resistant Brucella bacteria. And Listeria outbreaks in Texas food production have made news over the last several years. With climate change, we also expect to see more and different zoonotic disease threats moving in.”

The theme of the event is “In Our Backyard,” featuring games, food, prizes and brief presentations by speakers from the Tarrant County Public Health Department and UNTHSC School of Public Health.

ZoonoticUNTHSC Assistant Professor Katherine Fogelberg, DVM, PhD, will speak from noon to 12:20 p.m. on One Health, a global initiative recognizing the interconnectedness of the health of people, animals and the environment. One Health promotes an interdisciplinary approach to population health among veterinarians, physicians, public health officials and other health professions.

From 12:20 to 12:40 p.m., Dr. Vinny Taneja, Director, Tarrant County Public Health, will talk about Re-emerging Diseases from Developing Countries.

Russell W. Jones, MPH, Tarrant County Public Health Chief Epidemiologist, will speak on Brucellosis Exposure in Hospitals from 12:40 to 1 p.m.

Come-and-go games and activities are scheduled from 1 to 3 p.m.

The event will be held in MET 109-111.

For more information, contact Emily Blankenship at or 817-901-4040.

Posted Date: October 12, 2017
Livingston and Barnett

Lead author Melvin D. Livingston, PhD, with Tracey E. Barnett, PhD

UNT Health Science Center researchers and colleagues have released findings from a new study, published in the American Journal of Public Health, showing a reduction in opioid-related deaths following legalized recreational marijuana in Colorado.

Illegal and legally prescribed opioids now account for nearly 30,000 deaths a year in the United States, and the CDC says that 91 Americans die every day from an opioid overdose.

CDC data shows that opioid deaths from prescription drugs, heroin and synthetics like fentanyl have more than quadrupled since 1999.

In a July 31, 2017, interim report to the White House, the U.S. Commission on Combating Drug Addiction and the Opioid Crisis emphasized the severity of the problem, calling America “a nation in crisis.”

“As policy makers continue to grapple with both the growing opioid crisis and the rapidly changing landscape of marijuana laws in the U.S., scientific evidence is needed to help inform policy decisions to combat this disturbing upward trend in opioid-related deaths,” said Melvin D. Livingston, PhD, lead author of the study.

The researchers analyzed Colorado data covering a 15-year period from 2000 to 2015 to compare changes in the number of opioid-related deaths before and after recreational marijuana sale and use was legalized.

Findings showed that opioid deaths fell more than 6 percent in the following two years after the state’s marijuana legalization, reversing the previous upward trend.

“As of 2016, eight states and Washington DC have legalized recreational marijuana. While we found an apparent public health benefit in short-term reduction of opioid-related deaths following Colorado’s legalization, it’s important to note that expanded, legalized marijuana can also be associated with significant potential harms,” Dr. Livingston said.

“For policymakers to weigh decisions balancing potential beneficial and detrimental effects of these laws, researchers must continue to examine the full range of health outcomes through further study,” he said.

Dr. Livingston is Assistant Professor of Biostatistics and Epidemiology at the UNTHSC School of Public Health.

Co-authors of the study were Tracey E. Barnett, PhD, Associate Professor and Associate Dean for Academic Affairs, also with the UNTHSC School of Public Health; Chris Delcher, PhD, from the University of Florida; and Alex C. Wagenaar, PhD, from Emory University.

Posted Date: October 4, 2017

Helena SungHelena Sung, who received her MPH in Health Management and Policy from the UNTHSC School of Public Health in 2014, has been awarded the Benjamin B. Ferencz Fellowship in Human Rights and Law from the World Without Genocide organization at Mitchell Hamline School of Law in St. Paul, Minnesota.

Ferencz fellowships are named for one of the world’s leading advocates of human rights, justice and peace, who prosecuted and received convictions at the 1947 Nuremberg, Germany, trials.

The fellowships provide financial support through World Without Genocide for work on core areas of human rights, including research, policy development and action at local, state, national and international levels.

A second-year law student, Ms. Sung was selected as a reporter for the American NGO Coalition of the International Criminal Court and will attend the Court’s annual Assembly of State Parties at the United Nations in New York.

Dr. Rohit OjhaDr. Rohit Ojha, who received his DrPH from the UNTHSC School of Public Health in 2010, was published in the September 2017 issue of CANCER, a peer-reviewed journal of the American Cancer Society.

A team led by Washington University researchers in St. Louis and Dr. Ojha examined whether insurance status may affect survival rates of children diagnosed with cancer.

The team looked at data on cancers diagnosed among children under 15 years old for the time period 2007-2009. Among 8,219 childhood cancer patients (131 without insurance; 2,838 with Medicaid; and 4,297 with private insurance) who were followed for five years, the study found that children who were uninsured had a 26 percent higher risk of cancer death than those who were privately insured at diagnosis; the risk for those with Medicaid was similar to those with private insurance.

Dr. Ojha serves as Director for the JPS Health Network’s Center for Outcomes Research in Fort Worth, working toward improved patient outcomes in treatment and prevention of cancer, diabetes, infectious diseases like HIV and Hepatitis C, and maternal/child health.