Browsing by Author "Savaiano, Dennis A."

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    A mixed-methods evaluation using effectiveness perception surveys, social network analysis, and county-level health statistics: A pilot study of eight rural Indiana community health coalitions
    (Elsevier, 2019-12) Ken-Opurum, Jennifer; Lynch, Krystal; Vandergraff, Donna; Miller, Douglas K.; Savaiano, Dennis A.; Surgery, School of Medicine
    Community health coalitions (CHCs) are a promising approach for addressing disparities in rural health statistics. However, their effectiveness has been variable, and evaluation methods have been insufficient and inconsistent. Thus, we propose a mixed-methods evaluation framework and discuss pilot study findings. CHCs in our pilot study partnered with Purdue Extension. Extension links communities and land grant universities, providing programming and support for community-engaged research. We conducted social network analysis and effectiveness perception surveys in CHCs in 8 rural Indiana counties during summer 2017 and accessed county-level health statistics from 2015-16. We compared calculated variables (i.e., effectiveness survey k-means clusters, network measures, health status/outcomes) using Pearson’s correlations. CHC members’ positive perceptions of their leadership and functioning correlated with interconnectedness in their partnership networks, while more centralized partnership networks correlated with CHC members reporting problems in their coalitions. CHCs with highly rated leadership and functioning developed in counties with poor infant/maternal health and opioid outcomes. Likewise, CHCs reporting fewer problems for participation developed in counties with poor infant/maternal health, poor opioid outcomes, and more people without healthcare coverage. This pilot study provides a framework for iterative CHC evaluation. As the evidence grows, we will make recommendations for best practices that optimize CHC partnerships to improve local health in rural areas.
  • Thumbnail Image
    Item
    Promotion and tenure for community-engaged research: An examination of promotion and tenure support for community-engaged research at three universities collaborating through a Clinical and Translational Science Award
    (http://dx.doi.org/10.1111/cts.12061, 2013-06-06) Marrero, David G.; Hardwick, Emily J.; Staten, Lisa K.; Savaiano, Dennis A.; Odell, Jere D.; Frederickson, Karen; Saha, Chandan
    Introduction. Community engaged health research, an approach to research which includes the participation of communities, promotes the translation of research to address and improve social determinants of health. As a way to encourage community engaged research, the National Institutes of Health required applicants to the Clinical and Translational Science Award (CTSA) to include a community engagement component. Although grant-funding may support an increase in community engaged research, faculty also respond to the rewards and demands of university promotion and tenure standards. This paper measures faculty perception of how three institutions funded by a CTSA support community engaged research in the promotion and tenure process. Methods: At three institutions funded by a CTSA, tenure track and non-tenure track faculty responded to a survey regarding perceptions of how promotion and tenure committees value community engaged research. Results: Faculty view support for community engaged research with some reserve. Only 36% agree that community engaged research is valued in the promotion and tenure process. Discussion: Encouraging community engaged scholarship requires changing the culture and values behind promotion and tenure decisions. Institutions will increase community engaged research and more faculty will adopt its principles, when it is rewarded by promotion and tenure committees.
  • Thumbnail Image
    Item
    The Purdue Extension and Indiana CTSI's Community Health Partnerships collaboration: An innovative, generalizable, state-wide model to help communities build a culture of health
    (Cambridge University Press, 2017-10) Savaiano, Dennis A.; Lynch, Krystal H.; Vandergraff, Donna J.; Wiehe, Sarah E.; Staten, Lisa K.; Miller, Douglas K.; Pediatrics, School of Medicine
    The Indiana Clinical and Translational Sciences Institute's Community Engagement Partners-Purdue Extension collaborative model demonstrates tremendous potential for creating state-wide programmatic efforts and improvements in both the health culture and status of Indiana residents across the state. It can serve as a prototype not only for others interested in pursuing wide geographic health improvements through Clinical and Translational Sciences Award-Cooperative Extension partnerships but also for broader collaborations among United States Department of Agriculture, National Institutes of Health, Centers for Disease Control and Prevention, state and local health departments, and health foundation efforts to improve population health.
  • Thumbnail Image
    Item
    Relationships of Intestinal Lactase and the Small Intestinal Microbiome with Symptoms of Lactose Intolerance and Intake in Adults
    (Springer, 2022) Jansson-Knodell, Claire L.; Krajicek, Edward J.; Ramakrishnan, Monica; Rogers, Nicholas A.; Siwiec, Robert; Bohm, Matt; Nowak, Thomas; Wo, John; Lockett, Carolyn; Xu, Huiping; Savaiano, Dennis A.; Shin, Andrea; Medicine, School of Medicine
    Background: Approximately two-thirds of adults are genetically predisposed to decreased lactase activity after weaning, putting them at risk of lactose intolerance. However, symptoms are a poor marker of lactose maldigestion. Aims: We assessed association between self-reported lactose intolerance and intestinal lactase, lactose intake, and the small intestinal microbiome. Methods: Patients 18-75 years presenting for upper endoscopy were recruited prospectively. Observational study participants completed a lactose intolerance symptom questionnaire and reported lactose intake. Post-bulbar biopsies were obtained to measure lactase activity and assess the small intestinal mucosal microbiome. We compared intestinal lactase between patients with and without lactose intolerance. We assessed associations between lactose intolerance symptoms and lactase and lactose intake. We examined associations of small bowel microbial composition with self-reported lactose intolerance and symptoms. Results: Among 34 patients, 23 (68%) reported lactose intolerance. Those with lactose intolerance had higher total symptom scores, more frequent bowel urgency, and more bowel movements after consuming dairy. The proportion of individuals with abnormal lactase activity did not differ by lactose intolerance status. Median lactase levels were correlated with total lactose intolerance symptom scores (p = 0.038) and frequency of bowel urgency (p = 0.012). Daily lactose intake did not differ between groups. In 19 patients, we observed significant associations of small intestinal microbiome beta diversity with stool consistency after consuming dairy (p = 0.03). Conclusions: Intestinal lactase is associated with lactose intolerance symptoms and bowel urgency in adults but does not distinguish the clinical phenotype entirely. Studying other contributing factors (microbiota, diet) may further clarify the pathophysiology of lactose intolerance.