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Item Analyzing Perceptions of Community-Engaged Health Research Partnerships Comprising Hispanic Groups and Academic Allies in Indiana(Indiana University, 2022-11-29) Gil, Cindy; Armenta, Karla; Espada, Camila; Ontiveros-Salinas, Leonel; Maupome, GerardoObjectives: To analyze perceptions about multiple community-engaged oral health research partnerships with various local Hispanic-serving institutions and community-based organizations occurring in Indiana from 2010 through 2020, via interviews with actors involved in those partnerships. Methods: We designed key informant interview questions based on a literature review to inform the approach at synthesizing perspectives from community partners and academic allies. Statements were categorized using thematic analysis and grounded theory. Lessons Learned: Forty percent of respondents stated that community-engaged research projects connect communities with educational information about dental care and low-cost resources. In terms of capacity building, about half of respondents felt these projects had a positive impact. Conclusions: Community partners defined positive impact as increasing access to dental care educational resources, helping to enhance communication networks through social media with community partners, and contributing to local Hispanic health education through TV, internet, and radio partnerships. The partnerships uniting Hispanic groups and academic allies appear to have helped set a foundation of trust to support current and future efforts in Indiana.Item Assessment of patient follow-up from student-run free eye clinic to county ophthalmology clinic(Springer Nature, 2022) Scheive, Melanie; Rowe, Lucas W.; Tso, Hanna L.; Wurster, Patrick; Kalafatis, Nicholas E.; Camp, David A.; Yung, Chi Wah Rudy; Ophthalmology, School of MedicineThe Ophthalmology Student Interest Group at Indiana University School of Medicine provides a free student-run eye screening clinic for an underserved community in Indianapolis. Patients with abnormal findings are referred to the ophthalmology service of the local county hospital for further evaluation. This retrospective chart review studied 180 patients referred from our free eye clinic to follow up at the ophthalmology service of a local county hospital from October 2013 to February 2020. This study investigated factors impacting follow-up of patients by analyzing demographics, medical history, insurance coverage, and final diagnoses at follow-up. Thirty-five (19.4%) of 180 patients successfully followed up at the local county hospital with an average time to follow-up of 14.4 (± 15.9) months. Mean patient age was 51 (± 13.6) with nearly equal numbers of males and females. The most common diagnoses at follow-up included refractive error (51.4%), cataract (45.7%), and glaucoma (28.6%). Patients with diabetes diagnoses or Healthy Indiana Plan insurance coverage had increased probability of follow-up. This study reveals gaps in timely follow-up to the local county hospital, demonstrating the current limitations of our free clinic in connecting patients to more definitive care and the need for an improved referral process.Item Association between sociodemographic factors and health beliefs related to breast cancer screening behavior among Northern Thai women: a hospital-based study(Springer Nature, 2024-03-31) Jiraniramai, Surin; Pinyopornpanish, Kanokporn; Wongpakaran, Nahathai; Angkurawaranon, Chaisiri; Champion, Victoria L.; Chitapanarux, Imjai; Jiraporncharoen, Wichuda; Wongpakaran, Tinakon; School of NursingEarly diagnosis of breast cancer is crucial for reducing mortality rates. The purpose of this study is to determine the impact of demographics/social determinants of health on beliefs about the practice of self-breast examination, using mammogram and ultrasound in the context of breast cancer screening among Thai women in a hospital-based setting for implying program planning and future research. A cross-sectional study was conducted in two health centers in Chiang Mai Province from August 2021 to December 2021, involving 130 Thai women ages 40 to 70 years. Data were collected by a survey using a questionnaire to gather sociodemographic information, and health beliefs about breast cancer and screening behavior utilizing the modified Thai version of Champion's Health Belief Model Scale (MT-CHBMS). Descriptive statistics, t-tests, ANOVA, and linear regression models were employed for examining association between sociodemographic factors and health beliefs about the practice of self-breast examination (BSE), using mammogram (MG) and ultrasound (UTS). Health insurance schemes were associated with Benefit-MG, Barrier-BSE, Barrier-MG and Barrier-UTS subscales. Additionally, monthly income was associated with Barrier-MG and Barrier-UTS subscales. The most common barriers reported were "embarrassment", "worry", and "takes too much time". To enhance breast cancer screening in Thailand, program planning and future research should focus on health insurance schemes, especially women with social security schemes, as they may be the most appropriate target group for intervention.Item Association of Maternal Age and Blood Markers for Metabolic Disease in Newborns(MDPI, 2023-12-20) Xie, Yuhan; Peng, Gang; Zhao, Hongyu; Scharfe, Curt; Medical and Molecular Genetics, School of MedicinePregnancy at an advanced maternal age is considered a risk factor for adverse maternal, fetal, and neonatal outcomes. Here we investigated whether maternal age could be associated with differences in the blood levels of newborn screening (NBS) markers for inborn metabolic disorders on the Recommended Universal Screening Panel (RUSP). Population-level NBS data from screen-negative singleton infants were examined, which included blood metabolic markers and covariates such as age at blood collection, birth weight, gestational age, infant sex, parent-reported ethnicity, and maternal age at delivery. Marker levels were compared between maternal age groups (age range: 1544 years) using effect size analyses, which controlled for differences in group sizes and potential confounding from other covariates. We found that 13% of the markers had maternal age-related differences, including newborn metabolites with either increased (Tetradecanoylcarnitine [C14], Palmitoylcarnitine [C16], Stearoylcarnitine [C18], Oleoylcarnitine [C18:1], Malonylcarnitine [C3DC]) or decreased (3-Hydroxyisovalerylcarnitine [C5OH]) levels at an advanced maternal age (≥35 years, absolute Cohen’s d > 0.2). The increased C3DC levels in this group correlated with a higher false-positive rate in newborn screening for malonic acidemia (p-value < 0.001), while no significant difference in screening performance was seen for the other markers. Maternal age is associated with inborn metabolic differences and should be considered together with other clinical variables in genetic disease screening.Item Cancer prevention, screening, and survivorship ECHO: A pilot experience with an educational telehealth program(Wiley, 2022) Severance, Tyler S.; Milgrom, Zheng; Carson, Anyé; Scanlon, Caitlin M.; O’Brien, Rishika Chauhan; Anderson, Brent; Robertson, Mary; Janota, Andrea; Coven, Scott L.; Mendonca, Eneida A.; Duwve, Joan; Vik, Terry A.; Pediatrics, School of MedicineIntroduction: The American Cancer Society, Inc. (ACS) estimates that 37,940 Indiana residents were diagnosed with cancer in 2020, which remains the leading cause of death in the state. Across the cancer continuum, national goals have been established targeting recommended benchmarks for states in prevention, screening, treatment, and survivorship. Indiana consistently falls below most goals for each of these targeted categories. Methods: To address these disparities, we implemented Project ECHO (Extension for Community Healthcare Outcomes) as a virtual telehealth educational platform targeted at local healthcare providers. ECHO programs utilize a novel tele-mentoring approach to the education of clinicians in a hub/spoke design. Sessions occurred twice monthly from September 2019 to September 2020 and consisted of a traditional didactic lecture and a case-based discussion led by participating providers. Results: During the pilot year there were a total of 22 ECHO sessions with 140 different participants. On average, 15.5 spokes attended each session with increasing participation at the end of the year. Post-session surveys suggested generally favorable perception with 72% of respondents finding the quality "excellent." Discussion: Given the increasing rate of recurrent participation toward the end of the pilot year in conjunction with the favorable survey responses following each session, it was felt that the program was overall successful and warranted continued implementation. Conclusion: The Project ECHO platform is a validated telehealth education platform that has the potential to impact cancer care at multiple points along the cancer continuum at the regional level.Item Chronic Lactation Insufficiency Is a Public Health Issue: Commentary on “We Need Patient-Centered Research in Breastfeeding Medicine” by Stuebe. Breastfeed Med 2021;16:349–350(Mary Ann Liebert, Inc., 2021) Shere, Helen; Weijer, Laurel; Dashnow, Harriet; Moreno, L. Elizabeth; Foxworthy Scott, Susanna; Baker, Helen; Medicine, School of MedicineItem Comparing Practices Used in Overdose Fatality Review Teams to Recommended Implementation Guidelines(Wolters Kluwer, 2022) Ray, Bradley; Bailey, Katie; Dunnigan, Megan; Aalsma, Matthew C.; Bell, Lauren; O’Brien, Mallory; Pediatrics, School of MedicineObjectives: Overdose fatality review teams are a public health and public safety collaboration that reviews fatality cases using a multidisciplinary team to provide recommendations for overdose prevention. No research exists on the case review practices currently being used in these programs. Design: We administered a cross-sectional survey measuring case review practices and perceptions to a convenience sample of overdose fatality review teams. Setting: We administered the online survey to participants at a national virtual forum on overdose fatality review. Participants: In this study, we examined 30 county-level overdose fatality review teams from 6 states who completed the survey. Main outcome measures: We developed measures of case review practices from an overdose fatality review implementation guide. We provided descriptive statistics on the survey items used to measure these practices and examined how practice uptake varied by overdose fatality review team characteristics. Results: Most overdose fatality review teams had adequate representation and membership, but none adhered to all of the practices measured from the implementation guide. The largest gap was in perceived effectiveness and implementation of case review recommendations. In addition, teams that had been reviewing cases for longer reported more adherence to recommended practices. Conclusions: Overdose fatality case review is a collaboration between local public health and public safety agencies that holds great promise. However, these teams will require additional training and technical assistance with local community support to ensure that recommendations are actionable.Item Confronting the ethics of pandemic influenza planning(2008-07-24T14:46:15Z) Monroe, Judith A.Item Confronting the ethics of pandemic influenza planning: communiqué from the 2008 Summit of the States(Indiana University Center for Bioethics, 2008-07)Recognizing the vital role that public health departments play in planning for an outbreak of pandemic influenza, this “Summit of the States” was convened on July 14-15, 2008, on the campus of Indiana University-Purdue University Indianapolis (IUPUI) by the Association of State and Territorial Health Officials, the Indiana State Department of Health and the Indiana University Center for Bioethics. Invitations were extended to all 50 states, 6 territories and the District of Columbia. More than 150 delegates from 35 jurisdictions accepted, making this one of the largest gatherings of senior leadership from state and territorial public health departments ever convened to discuss the ethical issues in pandemic influenza planning.Item Congenital Hypothyroidism Long-Term Follow-up Project: Navigating the Rough Waters of a Multi-Center, Multi-State Public Health Project(Springer International Publishing, 2015-06) Wintergerst, Kupper; Gembel, Gina; Kreipe, Tracey; Zeller, Patrick; Eugster, Erica; Young, Bill; Andruszewski, Karen; Kleyn, Mary; Cunningham, Troi; Fawbush, Sandy; Vanderburg, Nancy; Sockalosky, Joe; Menon, Ram; Linard, Sharon; Hoffman, Gary; Gorman, Lisa; Department of Pediatrics, IU School of MedicineThe Region 4 Midwest Genetics Collaborative, made up of seven regional states (Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, and Wisconsin), brought together pediatric endocrinologists, state laboratory experts, public health follow-up specialists, and parents of children with congenital hypothyroidism (CH) to identify the three-year follow-up management and education patterns of primary care clinicians and pediatric endocrinologists in the care of children diagnosed with CH by state newborn screening (NBS) programs. Among a number of challenges, each state had different NBS methods, data systems, public health laws, and institutional review board (IRB) requirements. Furthermore, the diagnosis of CH was complicated by the timing of the NBS sample, the gestational age, weight, and co-morbidities at delivery. There were 409 children with CH identified through NBS in 2007 in the seven state region. The clinician of record and the parents of these children were invited to participate in a voluntary survey. Approximately 64 % of clinician surveys were collected with responses to questions relating to treatment, monitoring practices, educational resources, genetic counseling, and services provided to children with confirmed CH and their families. Nearly one-quarter (24 %) of parents surveyed responded to questions relating to treatment, education, genetic counseling, resources, and services they received or would like to receive. De-identified data from six of the seven states were compiled for analysis, with one state being unable to obtain IRB approval within the study timeline. The data from this collaborative effort will improve state follow-up programs and aid in developing three-year follow-up guidelines for children diagnosed with CH. To aid in the facilitation of similar public health studies, this manuscript highlights the challenges faced, and focuses on the pathway to a successful multi-state public health endeavor.