Category Archives: MPH students & alums

MPH Student Travel Blog: HIV/AIDS Advocacy in Botswana

Another one of our stellar MPH students, Jasmine Jones, is interning at a non-governmental organization in Botswana focusing on HIV/AIDS advocacy and support for youth and vulnerable populations. Check out her travel blog here!

Nkaikela Youth Group

Nkaikela Youth Group, Botswana

Travel Blog: Summer 2015 Public Health Work in Chicuque, Mozambique

Check out the Travel Blog of our amazing MPH/MSN student, Joshua Littlejohn.  He is working in Mozambique with Y-Center, a social innovation company that operates in Mozambique and India, for 12 weeks during the summer of 2015. The larger project that he is a part of is called Connect The Dots and is an SMS text-based system for disease reporting and supply inventory designed to connect community health workers (CHWs) with the central Ministry of Health. Josh’s project will be to work with the CHWs and local resources to create new visual media for use in education campaigns. These materials should be low-cost, easily reproducible, low-tech, and locally relevant.

He just uploaded his 2nd post: Map to Nowhere


 

First, I’ll give the basic run down of my week and then we’ll talk about some of the more existential stuff, that’s the fun part anyway. My week is pretty structured for not having a formal schedule or anything. Since I can’t sleep with all this friggin sunlight (hey, I’ve almost only ever worked night shifts, even before I was a nurse) I get up between 6 something and 7 something every morning, even without an alarm clock. My bucket bath in the morning is a great eye-opener and by the time I’m done with that I *almost* don’t need coffee… almost…

This week was the first actual week of work since Dr. Arlindo (the director of CoH) was back from Maputo (the capital) and the three missionaries were in the office. Actually, I think only two of them, Rose and Elfie, are missionaries and the third woman, Pastor Marcia, is local and works for Dr. Arlindo. Elfie is a nurse and Rose did a degree in health sciences and management. They are with the Methodist Church and Rose does the accounting and such for projects while Elfie works on developing the health projects that CoH conducts.

They get here between 7:30 and 8:30 and we have a small breakfast together usually. I’ve most likely had two cups of coffee by that point. Dhairya and I take our stuff into the work room down the hall on the work-side of CoH and make camp for the day at the collection of tables down there. I’ve been working on prototypes of the materials and gathering information about the area, thinking about the realities of life here, and how best to integrate what little information I have collected so far into some sort of meaningful messages.

UNISAF Y Center Banner

UNISAF Y Center Banner. The inside of the University. It is basically a giant O shape/square

Maria, who works at CoH in a general-help kind of position, usually puts out a small lunch of bread and cheese, tea, and maybe some boiled eggs. We eat together and chat a bit, then back to work and maybe a meeting with either Dr. Arlindo or the public health team (PHT – Elfie, Rose, and Pastor Marcia) The official work day ends about 3:00 and they actually kick us out of the work-side of CoH so that Manuel (Maria’s counterpart) can lock everything up. Sometimes he’s a bit over zealous and locks things up like the silverware … or dishes… lol.

I’m most likely not done doing whatever it was that I was working on, so I move back to my room and use the desk in there to work some more. I’ve thoroughly spread myself out over the entire room and used every surface that I could. In fact, I’d probably go crazy if there was another person in here with me to share the space… it’s been a long time since those undergrad years when I actually had to share a *room* with someone (not just an apartment).

UNISAF Y Center Banner1

UNISAF Y Center Banner1 UNISAF. The University in Maxixe that we work with sometimes.

I’ve taken a few afternoon trips

 

Arrest on the Run: How a Penn MPH Student Saved a Life Using CPR

On Sunday, May 3, 2015, Kelsey Sheak, a 2015 Master of Public Health Candidate at the University of Pennsylvania, woke up and prepared to run the 10K Broad Street Run.  Shortly after starting the race, she noticed a crowd gathering around a collapsed man. Upon arriving at his side, Kelsey immediately put her CPR training into action.  Kelsey was one of the many bystanders who helped this fallen runner survive from his cardiac arrest.  Read her full story below.


 

Kelsey Sheak, 2015 MPH Candidate

Kelsey Sheak, 2015 MPH Candidate

CPHI: We heard you performed a life-saving procedure at the Broad Street Run on Sunday, May 3, 2015.

Kelsey Sheak: I did!  I was running and between miles 2 and 3 I saw a crowd of people. There was a gentleman in the center of the crowd and he was clearly having a medical emergency.  Shortly after I arrived, he lost his pulse.  Once he lost his pulse, a group of bystanders and I started administering cardiopulmonary resuscitation (CPR).  We communally performed CPR – one person would start, another person would step in, and so on.  After about ten minutes in, the Philadelphia Police Department came with an automated external defibrillator (AED). The police are trained on how to use AEDs and to provide emergency medical care. They took over for all the bystanders and the patient was shocked and taken to the hospital.  We were sent on our way and told to continue running. It was a little weird!

CPHI: Let’s back up for a minute. You are a Master of Public Health (MPH) student, but clearly you are well trained in CPR. What is your background?

KS: It’s crazy because 40,000 people ran the Broad Street Run and for me to come upon this is just mind-blowing – really serendipitous.  My background is in cardiac arrest research and education.  By profession I spend my days learning as much as I can about CPR and ways to improve it, ways to disseminate it, and ways to make survival much better.  To come across this situation where I needed to use it was crazy.

CPHI: Who were other bystanders?

KS: Most of the people that were helping the collapsed runner had medical backgrounds: nurses, a physician, and me.  The most important take-home message is that he didn’t need a medical professional; he just needed someone to recognize that he was in cardiac arrest and that he needed CPR.  Anyone who is trained can do that.  If you’re not trained in CPR, you should be!

CPHI: How was it meeting the collapsed runner the next day in the hospital?

KS: I went to the hospital after he arrested and I was able to meet his family.  They were very nice and very thankful.  I’m happy to know that he will go back to having a normal life.

CPHI: I want to take a moment to address a common misconception: many people think a heart attack is the same as a cardiac arrest. Can you help clear up this confusion?

KS: A cardiac arrest is when your heart stops and blood flow stops to the entire body.  With a heart attack, your heart doesn’t stop; rather, there is a blockage. Generally, people who have a heart attack have chest pain, they go to the hospital, and they can recover.  Cardiac arrest generally happens with little to no warning and people are generally healthy when it happens.  It can happen for a lot of different reasons and everyone’s reason is different.

CPHI: Is there a most common reason why cardiac arrest happens?

KS: There isn’t a most common reason – but there are situations that are most savable.  The gentleman at the race had a savable arrest because he had a shockable arrest.  This means that his heart was in a rhythm that a defibrillator could recognize and turn into a healthy heart rhythm.  Places like airports, casinos, and races are places where lots of cardiac arrest victims do well – there are numerous educated people around and these places are heavily watched. But there are also places where people don’t do well – like low-income neighborhoods, which are less likely to receive bystander CPR.

CPHI: After you helped save a fellow racer, did you continue running?

KS: Yes, I finished the race!


 

For more information about CPR and cardiac arrest, please visit the Penn Medicine Center for Resuscitation Science website.

Make Penn Your Gym!

Make Penn Your Gym table on Locust Walk

Make Penn Your Gym table on Locust Walk

 

We recently celebrated National Public Health Week (April 6-10) – with a twist! The Center for Public Health Initiatives (CPHI), Penn HR, Student Health Services (SHS), and the Penn Public Health Society (PPHS) collaborated to present “Make Penn Your Gym” to Penn’s campus. This pilot campaign was based on “Make NYC Your Gym”, a program dedicated to showing New  Yorkers how they can take advantage of the surrounding built environment, get in their necessary exercise, and fit daily activities into busy schedules. Added bonus: it’s free! No gym membership required.  For “Make Penn Your Gym”, SHS identified various jogging routes (1-, 2-, and 3-miles) throughout Penn’s campus and University City. PPHS and CPHI then designed and printed trifold maps of these routes, which were distributed from a table on Locust Walk between April 6th and April 10th. The table also featured some public health “swag” – travel hand sanitizers, SPF 23 lip balm, granola bars – as well as a simple survey for those interested (for example, “How could YOU make Penn your gym?”). Going forward, those survey responses will help shape the future of “Make Penn Your Gym”. Thank you to those who participated and stay tuned for more opportunities to “Make Penn Your Gym”!

Written by: Matthew Kearney, MPH Candidate 2016

Fieldwork in Bosquet, Cameroon

Meagan Rubel & research participant

Meagan Rubel & research participant

In the week that I have been doing field work in remote rainforest village of Bosquet in east Cameroon, I have become extremely proficient at asking people if they are able to give a fecal sample. I recognize that this is a strange thing to be “proficient” at, but me and the team that I am working with will have to do this hundreds of times to get enough samples as part of my and the Tishkoff Lab’s research. Walking people discreetly to a side of the school we are using for “base operations” this week, I ask them in my fledgling French, “Vous pouvez faire des selles?” (Can you make stool?). For people who agree, I hand them a new, sterile plastic container with a lid and provide them with toilet paper. After this, we will freeze a portion of the sample in liquid nitrogen for analysis and use another portion to do fecal microscopy directly in the field to identify any infectious agents present in the stool, which can then be treated by a physician working with our collaborators at the University of Yaounde 1.

Sunset with the Baka in the village of Bosquet, Cameroon.

Sunset with the Baka in the village of Bosquet, Cameroon.

I’m here for two months with eight other team members- one, Dr. Alessia Ranciaro, is a senior research scientist in my lab, and our other colleagues are from Cameroon. We are conducting research as part of Dr. Sarah Tishkoff’s investigations into phenotypic (what you see when you look at someone) and genotypic (a person’s genetic makeup) variation in diverse Cameroonian populations. I’m also collecting fecal samples for my PhD research on the gut microbiomes (the microorganisms in your gut including bacteria, fungi, and archaea that have functions in many aspects of our physiology, including immunity and digestion) of Cameroonians practicing different kinds of subsistence, with a focus on how infectious gut parasites, including various soil transmitted helminths and schistosomes endemic to the region may have a role in shaping the composition and diversity of the gut microbiome. This fieldwork will also be part of the required field experience for the MPH degree at Penn.

A Baka woman balances a bucket of water on her head, retrieved from the local covered well.

A Baka woman balances a bucket of water on her head, retrieved from the local covered well.

Cameroon is a country of immense cultural, linguistic, and environmental diversity, with populations that practice pastoralist, agriculturalist, and hunter-gatherer subsistence and have diverse diets. The people of Bosquet are Baka, a recently settled hunting and gathering group of approximately 2,000 people. Their ethnic group, along with those of other equatorial African rainforest hunter gatherers, are more commonly known as pygmies due to their short stature, although this term is considered pejorative by many Baka. Nowadays, the Baka live primarily in mud brick huts with dirt floors, and have very limited access to electricity. While many of them have small gardening plots to cultivate yams, cassava, plantains, and bananas, and they no longer travel in small, mobile bands through the forest, they still rely heavily on the forest to hunt bushmeat such as antelope, giant forest rats, and monkeys, in addition to providing various wild fruits and honey, and several traditional medicines to treat common (and potentially life threatening) ailments such as malaria and diarrheal disease. The Baka of Bosquet have access to a covered well, which provides them with a source of clean water for drinking and bathing, although streams are often used, too.

Cassava (manioc), a dietary staple of the Baka, being harvested and prepared.

Cassava (manioc), a dietary staple of the Baka, being harvested and prepared.

All of these dietary changes we are observing in indigenous groups are important to understanding the structure of the gut microbiome; some groups may possess certain kinds of bacteria that have allowed them to better digest particular kinds of foods as an example of adaptation to local environments. As their diets and health change, we can hypothesize about the kinds of shifts we may see in the microbiome, and consider the downstream implications for disease. For instance- as groups like the Baka become more settled, and potentially rely less on foraging in the rainforest and increasingly eat processed foods, will their gut microbiomes start to look like those of neighboring Bantu agriculturalist groups? This has implications for the kinds of chronic diseases we may begin to see in many of these groups.

Presently, some of the greatest threats to Baka health are issues like food scarcity, access to clean water, infection with intestinal worms, malaria, hernias, HIV, and tuberculosis. The nearest major hospital is over an hour away in the town of Lomie, so the team has brought a doctor to help treat the Baka, who can elect to receive free medical treatment regardless of whether or not they partake in our research. Cameroon has a national deworming campaign that provides periodic, free deworming agents, but populations like the Baka, who live far from major cities in dense rainforests traversable primarily by rough dirt roads, are often logistically hard to treat. The medications provided to the community of Bosquet will be able to alleviate some of their ailments; hopefully, the downstream results of our research can provide evolutionary and health clues as to not only why some groups get more sick than others, but what we might be able to do to help these groups in the future, and to be aware of how rapidly shifting cultural and subsistence practices could affect the health of groups like the Baka.

Labwork in the field: Stool samples in white containers awaiting fecal microscopy screening.

Labwork in the field: Stool samples in white containers awaiting fecal microscopy screening.

Written by: Meagan Rubel, MPH, Rubel@sas.upenn.edu

Health Equity- A Dream or an Achievable Goal?

Source: Saskatoon Health Region Advancing Health Equity

Source: Saskatoon Health Region Advancing Health Equity

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”  – Dr. Martin Luther King Jr.

Nearly half a century after Dr. King’s observation, the Affordable Care Act made tremendous strides towards equality of access in health care. Equality promotes fairness, however it’s only effective if everyone starts from the same place and has the same needs.  When it comes to breaking the barriers to health care equity—we still have a long road.

Dr. David Satcher was the keynote speaker for the Perelman School of Medicine Health Equity Symposium, held at the University of Pennsylvania in January. He was the first African American Surgeon General of the United States and is the current director of The Satcher Leadership Institute at the Morehouse School of Medicine. “In order to eliminate disparities we need leaders who care enough, know enough, will do enough, and are persistent enough,” he said. He encouraged attendees to delve deeper into the realities of health inequity in America.  The symposium provided a glimpse into some of these inequities.

According to the CDC Health Disparities & Inequalities 2013 Report, Non-Hispanic Black adults are 50% more likely to die of heart disease or stroke prematurely than Caucasians.  Until recently, scant efforts in organizational quality improvement were made in health care to address racial disparities. This was evident in the health care inequities of our Veterans population.

Said Ibrahim, co-director of the U.S. Department of Veterans Affairs Center of Health Equity Research, posed the following question at the Symposium,

“How do we make sure the equality of opportunity translates to the equality of health outcomes?”

According to the Department of Veteran Affairs Health Service Research & Development Services, minority veterans are receiving less and lower quality health care, despite needing more and higher quality care (suggesting a form of “regressive” healthcare delivery).

Another population that is currently experiencing health care inequities are Asian Americans. They are currently the fastest growing minority group with a growth rate increase of 46% from 2000 to 2010.  Ironically, this group receives little attention in the statistical analyses of health and health care inequities. The labeling of the “model minority” for Asian Americans is quite paradoxical —simultaneously successful and marginal. The notion has often led to the tuning out of the hardships of prejudices, health disparities, and health care inequities, Asian Americans face.

pic 2

Although the Affordable Care Act benefited Asian Americans in increasing health care access, cultural competence and community engagement is necessary to successfully eliminate the gaps in health care equity.   A concerted effort by public health professionals on local, state, and national levels will help bridge the gap in health care access in the Asian American & Pacific Islander communities.

The LGBT community  faces health care inequity as well. Risk of psychiatric disorders, substance abuse, and suicide are elevated as a result of social stigma and discrimination, calling for a need for culturally competent medical care.

SOURCE: Center for American Progress, 2009

SOURCE: Center for American Progress, 2009

Increasing coverage promotes greater access to care but it won’t translate to equity of health outcomes. Quality improvements in health care delivery must place emphasis on social determinants of health and culturally competent care.  Our health care approach should not be one size fits all, but rather it must be modified to fit the specific needs of vulnerable populations.

Written by: Amy Rajan, RN, MSN/MPH Candidate, Class of 2016

Revisiting The Opioid Epidemic and its Unintentional Consequences

drug overdose death rates in US

Source: Centers for Disease Control and Prevention

PHILADELPHIA—Americans represent 4.6% of the world’s population, yet we consume more than 97% of all the hydrocodone produced worldwide. In 2012, the CDC reported health care providers wrote 259 million prescriptions for painkillers, which is enough for every American adult to have a bottle of pills.

The Center for Public Health Initiatives dedicated a week in November to focus on the opioid epidemic and how to reduce the level of prescribing these drugs. In her talk, “From the Streets to the ER,” Dr. Jeanmarie Perrone from the University of Pennsylvania’s Department of Emergency Medicine proposed that health care providers should begin to focus on patient education, “It takes 30 seconds to prescribe and 30 minutes to educate.” So which one is a more viable option?

The fine line between compassionate pain management and encouraging addiction is often hard to distinguish when prescribing opioid medications. Larger patient loads and shorter doctor-patient visits (average, 7-9 minutes) may encourage physicians to prescribe chronic non-cancer patients opioids instead of spending time to educate them on alternative options.

Is the solution to the opioid epidemic as simple as a half hour of education? A team approach to patient education has consistently worked well. Dr. Perrone and her colleagues conducted a study involving two urban emergency departments in Philadelphia and investigated the use of a multidisciplinary team approach to decrease the amount of opioid packs dispensed at discharge. The interventions included educating a multidisciplinary team of nurses, residents, nurse practitioners, and attending physicians. The number of opioids dispensed at discharge for individuals who were at risk for opioid dependence decreased significantly from 21.8% to 13.9% in the primary ER investigated.

Studies involving a multidisciplinary approach and state regulations implementing prescription drug monitoring programs led to a successful reduction in rates of opioid abuse.

State Successes After Implementing Prescription Drug Monitoring Programs

Sources: NY, TN: DMP Center of Excellence at Brandeis University, 2014. FL: Vital Signs Morbidity and Mortality Weekly Report, July 1, 2014.

Sources: NY, TN: DMP Center of Excellence at Brandeis University, 2014. FL: Vital Signs Morbidity and Mortality Weekly Report, July 1, 2014.

Unintentional Consequences

With strong policies that have made it more difficult to obtain prescription pills, some argue that these regulations have only shifted the type of opioids being used.

Emerging research shows that the increased opioid regulations may be linked to the increase in heroin use. Over the past three years, opioid related fatalities in New York City have leveled off, while deaths involving heroin use have increased by 44%.

unintentional overdose deaths

As opioid regulations increase across the nation, public health practitioners should pay close attention to an unintended rise in heroin use, particularly in areas where heroin is readily accessible.

Written by: Amy Rajan, RN, MSN/MPH Candidate, Class of 2016

Penn’s Dominating MPH Presence at APHA’s 142nd Annual Meeting & Expo

The University of Pennsylvania’s Master of Public Health Program made a strong showing at this year’s APHA meeting in New Orleans. This year’s conference theme was “Healthography: How Where You Live Affects Your Health and Well-Being.” Six alumni, four current students, and many faculty presented their work. The Penn MPH booth at the Public Health Expo was also very popular!APHA_2014_Annual_Meeting


Alumni:

Noel Harbist, MD, MPH

Primary care pediatricians identify barriers to recommended care

With the establishment of the Children’s Health Insurance Program Reauthorization Act (CHIPRA) Pediatric Quality Measures Program (PQMP), there is increased attention to the measurement and delivery of recommended care. Primary care pediatricians identify time, payment issues, and family issues to be significant barriers to delivery of recommended care.  Enhancements in QI processes, such as the design of electronic medical records, may improve the documentation of care, but may not alleviate the obstacles pediatricians identified in the delivery of recommended care. QI strategies for delivery of recommended care should consider pediatricians’ perspectives and the possible role public health initiatives.

Jordan Price, MPH

Barriers and facilitators influencing inconsistent condom use in young adults in Philadelphia

Rates of chlamydia and gonorrhea in Philadelphia are three to four times higher the national rates, respectively, and clients served by Planned Parenthood of Southeastern Pennsylvania (PPSP) have the highest rates in the city. Though it is well known that condoms are one of the most effective ways to prevent sexually transmitted infections (STIs), reasons behind inconsistent condom use are not fully understood. This study aims to identify the barriers and facilitators that influence

Jane Seymour, MPH

Literacy and fertility: Lifecourse evidence from the National Longitudinal Survey of Youth (NLSY)

Literacy is associated with many health outcomes among US adults, but little is known about its relationship with reproductive outcomes. This study assessed the link between literacy and fertility outcomes for US women.

Elizabeth Stelson, LSW, MSW, MPH

Reentry and reunification: Investigating the influence of children in the reentry experience of mothers released from short-term jail stay

The incarceration rate of women has increased 800% in the last 30 years, and 80% of incarcerated women are mothers of children (<18 years of age). Research on community reentry for mothers released from prison has shed light on how social determinates of health—such as social support, housing, and employment—relate to successful reunification with children. Successful prison reentry has been linked to improved health and social outcomes for both the mother and child. However, little is known about maternal reentry following release from jail, which is markedly different from prison, characterized by a shorter stay, uncertainty awaiting sentence, and access to fewer resources.

Resources for reentry: Investigating the biopsychosocial needs of mothers of young children released from jail

The vast majority of incarcerated women (80%) are mothers of children (<18 years). Research on community reentry for mothers released from prison has identified significant barriers to health care services (HCS) and unmet social health needs. However, little is known about the reentry barriers experienced by mothers released from jail, characterized by shorter stays and fewer HCS compared to prison.

Samantha Gross, JD, MPH

Medical legal partnership education: A survey of existing programs and recommendations for national curriculum

Medical-Legal Partnership (MLP) is an integrative and collaborative model that brings legal services directly into the health care setting to assist patients in maximizing health and social benefits.  Legal remedies can resolve many socioeconomic and environmental issues common to vulnerable and underserved populations.  Also MLPs vary in structure, three components are central to the model: (1) providing direct legal assistance, (2) transforming health and legal institutions, and (3) achieving policy-level change.  These partnerships are uniquely suited to address necessary social and legal needs in an accessible clinical setting. This research addresses the current MLP educational environment by conducting interviews with MLP educators throughout the country to better understand how health care and law students are prepared to work in this unique, collaborative setting and the current challenges to providing MLP education.

Kaitlyn Meirs, MPH

Investigatory research on the distribution and accessibility of physicians with environmental expertise in the Gulf of Mexico

Disparate access to health care has been well documented, however, little is known about access to providers trained in assessment of environmental exposure and related care. Industries depend on occupational clinics that employ physicians with environmental expertise to provide exposure care to industry employees. Physicians employed in this setting are generally unavailable to see patients other than those employed by contracted companies due to potential conflict of interest. Our project evolved from concerns related to a lack of access to physicians with environmental expertise in the Gulf of Mexico and is supported through the Community Outreach and Engagement Core (COEC) of the Center of Excellence in Environmental Toxicology (CEET) supported by NIEHS (P30ES013508).

Current students:

Natalie Stollon, MSW, MPH(c)

Transitioning from pediatric to adult services: A public health approach

Due to advances in neonatal and pediatric care, patients with chronic illnesses and disabilities are surviving well into adult life and are faced with needing to navigate the challenging transition to adult care. As with all medical transitions, there is valid concern that patient morbidity and mortality are adversely affected during this time. We carried out a pilot Primary Care Transition Program, a randomized controlled trial that evaluated whether participation in three different transition interventions increased transition readiness, successful transition to an adult care provider and patient, caregiver and provider satisfaction and systematically evaluated and implemented transition plans for CHOP patients and families as they transitioned from pediatric to adult care. At this point the RCT is ongoing. 6-month and 10-month post-intervention surveys are being collected. We have 33 young adults and 10 caregivers enrolled in the study. Analysis will be complete by May 2014.

Caren Steinway, MSW(c), MPH(c)

Transitioning from pediatric to adult services: A public health approach

Due to advances in neonatal and pediatric care, patients with chronic illnesses and disabilities are surviving well into adult life and are faced with needing to navigate the challenging transition to adult care. As with all medical transitions, there is valid concern that patient morbidity and mortality are adversely affected during this time. We carried out a pilot Primary Care Transition Program, a randomized controlled trial that evaluated whether participation in three different transition interventions increased transition readiness, successful transition to an adult care provider and patient, caregiver and provider satisfaction and systematically evaluated and implemented transition plans for CHOP patients and families as they transitioned from pediatric to adult care. At this point the RCT is ongoing. 6-month and 10-month post-intervention surveys are being collected. We have 33 young adults and 10 caregivers enrolled in the study. Analysis will be complete by May 2014.

Bridget Keogh, BS

Building a trauma-informed care peer workforce

This session provides a description of the implementation of a statewide, four year trauma-informed mental health (MH) and co-occurring disorders (COD) care systems change initiative. The goals of the systems change are to: 1) prepare outpatient mental health and co-occurring system providers and specialists to build a system of care based on a consumer-defined set of principles and values that integrate lived trauma experiences into MH and COD recovery services; 2) provide universal trauma screening and assessment to all individuals who enter the recovery system; and 3) to build a workforce of trauma peer specialists to provide trauma-informed recovery services across the service and provider network. The primary focus of this initiative is to change the culture of the treatment delivery system; incorporating a trauma-informed recovery philosophy and activities into all recovery services. This session will provide a description of the process of implementing universal screening and assessment and an analysis of the data of over 2,000 individuals who were screened for trauma experience at the onset of entering the recovery system over a three year period and on the design, implementation, and outcomes of trauma peer-delivered recovery services.

Ebony Easley

Psychosocial implications of uncertainty in genomic testing of children with autism

Chromosomal Microarray Analysis (CMA) is a genome-wide technology that enables identification of genomic alterations, many of which are of uncertain clinical significance. Clinical guidelines recommend CMA testing for children with Autism Spectrum Disorder (ASD), which occurs in approximately 1% of the US population. Increasingly, families are offered CMA testing, and many receive complex and uncertain results.  In this study we examined the psychosocial implications for parents of children with ASD who received uncertain results from CMA testing. We collected data using in-depth interviews and self-report questionnaires. We used purposive sampling to recruit 57 parents, including three subgroups with positive, negative and uncertain results. This presentation focuses on the uncertain subgroup (n=20).

Written by: Allison Golinkoff, MPH Candidate 2016

MPH Student Moderates Discussion on The Changing Roles of Pharmaceuticals

WUHC conference panel

First year MPH student, Matthew Kearney (far right), moderated the Wharton Undergraduate Healthcare Club’s first-ever conference on “The Changing Roles of Pharmaceuticals.”

On Saturday, November 8,2014 the Wharton Undergraduate Healthcare Club (WUHC) hosted its first-ever conference at the International House on Chestnut Street. The club’s stated goal is to improve healthcare and cultivate leadership, and the conference was intended to explore the future of the healthcare industry. The organizers of this event asked if I would be willing to moderate a panel on “The Changing Role of Pharmaceuticals” – one of four panels happening in the afternoon portion of the conference. As a first-year Master of Public Health student, I wanted to take advantage of the opportunity to learn more about the Wharton community’s perspective on health, as well as gain experience as a panel moderator. Thus, I accepted their offer.

The panel consisted of four current and former members of the pharmaceutical industry: Debbie Cooper, Ph.D., a former pharmacologist for Merck, Wyeth, and GlaxoSmithKline; Baali Musisi Muganga, US Development Director for Aesica Pharmaceuticals; Andrew Reaume, MBA, President and CEO for Melior Discovery; and Richard Hoddeson, MBA, former VP of Finance for Pfizer. The conference’s keynote speaker was Dr. Roy Vagelos, former CEO and president of Merck Pharmaceuticals as well as the former chairman of the board for the University of Pennsylvania. As someone at the conference put it, there were certainly several “heavy-hitters” in attendance. No big deal, right?

In a previous life (a.k.a. the last five years), I taught high-school level Biology. Believe it or not, moderating this panel was remarkably similar. First, I had to do my share of class prep before showing up. As a rule, I like to be over prepared, rather than run out of material halfway through a discussion. Therefore, I spent the weeks leading up the conference drumming up possible questions from various sources. Second, once I’d settled on several “juicy ones”, I practiced rephrasing them multiple different ways, in case anyone asked for clarification. I asked my friends and colleagues for advice, and for possible responses, so that I could better direct conversation on the day of the panel. Lastly, I wanted my lesson to be engaging for those involved, so I poured over the résumés of the panelists, and tried to imagine which questions would fit them best.

After discussing the role of the moderator with my research mentor, and then attending the CPHI’s Peter Singer talk, I realized that the panelists were only part of the equation: the panel discussion would be followed by a “brief” Q&A from the audience. This turned out to be the most difficult component, particularly when one of the audience members interrupted the discussion to make a rather well rehearsed question (cough, statement), which I unfortunately had to cut off. During the post-discussion, official Q&A, I again had to facilitate some question clarification. Should I ever moderate another panel, it might be a good idea to collect questions ahead of time and screen/translate them.

Moderating this panel and attending the conference were excellent experiences, and I am thankful for the WUHC for making it all possible. Obviously, I learned a lot about pharmaceuticals and healthcare in the 21st century. Perhaps more importantly, I got to see the personal side to two industries that are often perceived as profit-driven. As a future public health worker, I have a better understanding of the necessary collaboration between the public and private sectors, and can better appreciate the process that drives innovation in healthcare. For those interested, more information can be found at www.uhcpenn.org. If anyone wants to hear more about the panel discussion, please contact me at kearnm@mail.med.upenn.edu.

Written by: Matthew Kearney, MPH Candidate 2016

A Vision on Building a Culture of Health

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PHILADELPHIA–The Center for Public Health Initiatives kicked off its seminar series with Dr. Risa Lavizzo-Mourey MD, MBA lighting a flame in the hearts of faculty and students here at the University of Pennsylvania.

Dr. Lavizzo-Mourey is the CEO and President of the Robert Wood Johnson Foundation, the nation’s largest philanthropy devoted exclusively to health and health care. She holds more than 30 years of experience as a medical practitioner, professor, policy-maker, and non-profit executive.

Lavizzo-Mourey opened the seminar series with warm welcomes and thanks, expressing her delight to return to her alma mater; “It’s great to be home.”

Before sharing her foundation’s vision and charge for shifting our nation’s focus towards health, she first shed light on the stark realities we face.

Our Nation’s Current Health status

Approximately 75 percent of the country’s 17 to 24 year old youth are currently ineligible for military service, largely because of education, obesity, and physical ailments that make them unfit for the armed forces, according to a report recently presented to Congress by a group of retired military leaders.

She pointed out that improving quality of life and maintaining health starts at birth. Statistics show that the zip code where we are born in and reside may determine our life expectancy. She displayed a number of alarming U.S. statistics, highlighting in particular our nation’s capital, Washington D.C.. Metro area residents living in the predominantly affluent Montgomery County, Maryland, have an average life expectancy of 84 years whereas miles away in downtown D.C. the average life expectancy is seven years shorter.

Another troubling statistic is that 4 out of 5 physicians agree that addressing patient social needs are as important as dealing with medical conditions, yet an alarming majority of physicians admit they don’t know how to effectively address them.

Shifting Towards a Culture of Health

“A shift in this magnitude starts with an idea. Think back to the 1970’s, recycling was not part of our culture. Now it’s instinctive to recycle, because we made it easy. Recycling now is on every sidewalk and if we throw away a bottle in the trash, most of us feel guilty.” She also gave a great example of the 911 emergency response system and how years ago such a system never existed. Now, every child knows to dial 9-1-1 for an emergency.

Then Lavizzo-Mourey, turned to the faculty and students,

“We are the nation’s largest philanthropy dedicated to health. But we don’t make policy. We don’t sell anything. We don’t deliver any healthcare services; the only power we have is to invest in you.”

So how can we build a culture of health together? How can we ingrain healthy habits into our culture such that being healthy and staying healthy become instinctive? How can we turn around the stark reality that the zip code that we reside in may restrict our life expectancy? How can we create adequate social support systems to improve quality of life preventing re-admissions that plague hospitals throughout the nation? How do we start right here in the city of Philadelphia?

A vision this large will take a concerted effort from all members of the community, health care, social work, government, education, business, places of worship, and families to tackle the barriers to create an environment where a culture of health will thrive.

If each one of us does our part, small victories will turn into national success.

Written by: Amy Rajan, MSN/MPH Candidate 2016