Browsing by Author "Grischke, Tyra"

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    Empowering Youth: Examining Health Literacy Gains in High School Students
    (2024-04-26) Grischke, Tyra; Tannir, Shadia; Bohn, Camden; Hoffman, Leslie A.
    Research Statement/ResearchQuestion This study assesses the health literacy of high school students’ before and after an educational presentation about hypertension, a health condition more prevalent in underserved communities. Background Low health literacy is associated with worse health outcomes, particularly within underserved communities. Improving health literacy among high school students can empower them to take action to improve health and well-being within their communities. Methods In spring 2023, medical students from IUSM visited four high schools to educate students on health literacy and hypertension. Participants completed a 15-item test prior to and immediately following the presentation. Demographic data (grade level, race, ethnicity, and gender) was collected. Data was collected anonymously, using assigned codes to match pre- and post-tests. Data was analyzed using paired samples t-tests and ANOVA. Results A total of 104 high school students completed pre- and post-tests. There was a significant improvement in quiz scores from pre- (7.95±1.74) to post-test (9.41±2.01; p<.001). One-way ANOVA found significant differences in pre- and post-test performance based on race, with Black students scoring lower than White students on both pre-test (7.28±1.28 vs. 8.31±1.70; p<.05) and post-test (8.55±2.21 vs. 9.85±1.76; p<.05). There was also a significant interaction between students’ gender and their pre- and post-test scores with female students showing greater improvements in test scores than male students. Limitations This study was conducted in a single school district in a small midwestern city and may not be generalizable to larger urban or rural populations. The presentation was given during a science class and may have been biased by students’ prior knowledge. Differences among presenters may also impact students’ comprehension. Conclusion High school students’ health literacy improved after an educational presentation on hypertension. This study revealed racial disparities in health literacy, highlighting the need for more health education in schools that have more students from underserved racial and ethnic groups.
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    Relationship between Neighborhood-Level Socioeconomic Status and Relapsed Pediatric B-Acute Lymphoblastic Leukemia Treated with CAR-T19 Therapy in Indiana
    (2025-03-29) Ayub, Jinan; Walker, Alyssa; Grischke, Tyra; Garcia, Gloria; Skiles, Jodi; Spiegel, Courtney; Batra, Sandeep
    Background/Purpose: There is paucity of studies investigating the relationship between socioeconomic status and outcomes for patients receiving chimeric antigen receptor T-cell therapy (CART19) for refractory or relapsed B-ALL. Area Deprivation Index (ADI) serves as a measurement of socioeconomic disadvantage based on theoretical income, education, employment, and quality of housing. Methods: A retrospective chart review of 27 patients with relapsed B-ALL treated with CART19 at a non-profit children’s hospital from 2018-2024 was conducted. Using a public institution’s Neighborhood Atlas database, ADI scores (range 1-10) were recorded for each patient based on ZIP code of residence in Indiana. A low ADI score (0-5) indicates affluence and higher SES, while a high ADI score (6-10) indicates deprivation and a lower SES. Comparisons between groups were done using Chi-square tests for categorical variables. The Kaplan-Meier method was used to analyze relapse free survival (RFS) using the log rank test to compare groups. Results: The patients (age range 2-25 years) were stratified into two groups: low ADI or high SES (≤5, n = 10 (37%); 2.9 ± 1.4; range, 1-5)) and high ADI or low SES (>5, n = 17 (63%); 8.5 ± 1.5; range, 6-10). Seventeen identified as white (63%) and 10 (37%) as Hispanic. Three patients received CART19 infusions twice, and one patient received multiple CART19-directed products. In the high ADI group, 3-month, 6-month, and 1-year RFS post-CART therapy was 82%, 76%, 60% respectively compared to 100%, 71%, 57% in the low ADI group (p=0.9). Conclusion: Most patients who received CART therapy at our tertiary center resided in low SES areas but did not experience worse RFS compared to patients residing in more affluent areas. Further studies with larger sample sizes are needed to better understand the heath inequalities among patients with relapsed leukemia in Indiana and to identify challenges faced by patients from disadvantaged communities with limited resources.