Public Health Policy

The purpose of this study is to investigate the effectiveness of a sexual assault prevention program, Enhanced Assess, Acknowledge, Act (EAAA) program, by replicating a Canadian randomized controlled-trial (RCT) at five U.S. universities. EAAA consists of four 3-hour units that involve education in the form of games, mini-lectures, and facilitated discussion, and application and practice activities. The standard of care (SOC) control group study participants will have a variety brochures made available to them about campus sexual assault prevention and resources and will participate in a 15-minute group participant-led question-and-answer session with a trained research team staff member. Study participants will be first-year college women. All participants will complete a survey before the intervention begins, then a week later, and then every 6 months over the next two years (6, 12, 18, and 24-month follow-up). We will use this data to evaluate whether EAAA is more effective than the SOC intervention at reducing sexual assault victimization. This project is receiving funding from the Arnold Ventures Foundation and the Chris and Carrie Shumway Foundation via the Consortium on Gender-Based Violence. 

The objectives of this project were to analyze pilot data to evaluate the impact of a locally-developed antibiotic stewardship protocol developed for Arizona Nursing Homes, and to understand perspectives on antibiotic use, prescribing and stewardship among nursing home personnel. Funding Source: University of Arizona

Our objectives are to identify all healthcare facilities serving Arizona residents within 25 miles of the US-Mexico border, create a database describing each facility’s procedure for clinical microbiology and antimicrobial resistance investigations, and to enter into data sharing agreements allowing the de-identified extraction of data to share with providers for regional education on resistance profiles. Funding Source: Arizona Health Education Center

The objective of our project is to develop an HAI QMRA model for healthcare settings that can be verified to observational. Funding Source: Centers for Disease Control and Prevention

This project will enable us to strengthen collaboration with research partners in Sonora, Mexico in a binational effort to compare antibiotic resistance data from clinical laboratories serving healthcare facilities along the Arizona/Sonora border. We will also execute a binational survey on antibiotic knowledge and behaviors. Funding Source:University of Arizona International Research Program Development

This is a contract awarded by the CDC in response to a Broad Agency Announcement requesting tools to implement improved testing for Valley fever and reduce delays in diagnosis. This proposal addresses the gap in prompt diagnosis of Valley fever that results from the turnaround time for current diagnostic tests of at least one and usually three or more days. John N. Galgiani (PI) Funding Source:Centers for Disease Control and Prevention

We enroll and actively survey a longitudinal cohort of SARS-CoV-2 seropositive and seronegative frontline workers to study the incidence, predictors, and consequences of infection and reinfection. Funding Source:Centers for Disease Control and Prevention

We work with high-risk congregate care settings in Pima County and in neighboring border counties to identify optimal strategies for implementing infection prevention practices in these unique and resource limited settings. Funding Source:National Association of City and County Health Officials (NACCHO)

The Title V legislation requires the state, as part of its Application, to carry out a statewide Needs Assessment every five years that identifies the need for preventive and primary care services for pregnant women, mothers and infants up to age one; children and adolescents; and children with special health care needs up to age 26. The University of Arizona College of Public Health is collaborating with Arizona Department of Health Services (ADHS) to contribute the qualitative components of the Title V needs assessment, including focus groups, community forums and dissemination of results to community partners. Our approach involves (i) participation at state-wide meetings; (ii) conduct of focus groups with selected communities not traditionally heard including African American, Hispanic, Refugees, LGBTQ, Farm Workers, Families with Children with Special Health Care Needs and Youth; (iii) facilitation of community forums with community members and providers to get feedback on preliminary findings; and (iv) dissemination of results to community partners. Results will feed into priority setting for Title V programming for the next five years 2020 – 2025.  This project is funded by the Arizona Department of Health Services (ADHS).

Patient navigation programs can serve as a key approach to achieving the triple aim in cancer care by improving patient experience, improving population health, and reducing health care costs. The goal of this project is to develop a model which can be used by various cancer centers to predict costs and outcomes involved in implementing and managing a patient navigation program. Model variables will be derived from literature review and various scenarios will be built into the model for screening, diagnosis, survivorship, and end of life care. Outcome projections from the model can be used to develop a business case for implementing patient navigation programs. Dr. Prashanthinie Mohan is also a collaborator on this project. 

This project is a randomized control trial of the Safer Bars Program at three major universities in Arizona and trains liquor serving staff to intervene in situations that could be precursors to sexual assault.  Researchers look at individual level outcomes in servers that are using these intervention strategies, peer-level changes in feeling supported to intervene, bar level changes to create a less rape-supportive environment, and community change through police calls for sexual assault within a one-mile radius of each campus of these universities. The goal is to evaluate the Arizona Safer Bars Alliance bystander sexual assault prevention program designed for liquor serving the staff of bars surrounding three Arizona Universities (UA, ASU, NAU). This project was funded by the National Institute on Alcohol Abuse and Alcoholism. 

The goal of this project is to provide technical assistance and evaluate the Arizona Safer Bars Alliance (ASBA) bystander sexual assault prevention program designed for liquor serving staff of bars throughout Arizona. This project is funded through the Arizona Department of Health Services.  Elise Lopez was transitioned to PI of this project in 2017. 

This goal of this project is to develop an antibiotic stewardship program, or “playbook,” for prescribing antibiotics to treat infectious diseases in skilled nursing facilities in Arizona. This playbook will be developed by implementing an antibiotic stewardship protocol across 16 Arizona skilled nursing facilities. This grant award is the result of an academic-community research partnership between Dr. Ellingson, community partners, and Peter Patterson, MD, MBA, a subject-matter expert in antibiotic stewardship with Patterson LTC Consults. This project is funded through an Arizona Biomedical Commission Investigator Grant.  Funding Source: Arizona Biomedical Research Commission

There are estimates of over 500,000 abandoned mines in the US, many with the potential to impact health and economies of local communities. Developing a successful model of capacity building related to spill response has great potential to be valuable not only to the Diné but to communities vulnerable to environmental problems throughout the world. The K’é bee da’ahiiniita: Strength Through the Diné (Navajo) Clan System team focused on creating transformational change in the relationship of the Diné to the US government and other entities by building tribal capacity through training of Diné tribal college students, environmental interns, and community health representatives. Before this project, a study funded by the National Institute of Environmental Health Sciences was done to assess the short-term exposure and risk perceptions of the Gold King Mine spill. This project received funding support from the Agenese Nelms Haury Program in Environment and Social Justice in the form of a Challenge Grant.  Researchers for this project spanned multiple colleges and communities. A list of collaborators that are not currently part of the College of Public Health has been provided below.  Janene Yazzie, To’Bee Nihi Dziil, Mae-Gilene Begay, Navajo Community Health Representatives, Perry Charley, Diné College, Jani Ingram, Northern Arizona University, Manley Begay, Northern Arizona University, Rebecca Clausen, Fort Lewis College, Nicolette Teufel-Shone, Northern Arizona University 

Fire and Emergency Services (EMs) departments have marked variation in injury rates based on national and local policies, training, and traditions.  International partnerships and comparative studies therefore provide ideal mechanisms to identify cost-effective safety and health interventions.  The major goal of this project was to conduct international policy-related research on safety and health programs for fire/EMS. The host institutions included the London Fire Brigade (LFB) in the United Kingdom (UK) and the Paris West suburb division of the Service d’Aide Médicale Urgente/Service Mobile d’Urgence et Reanimation and the Service de Santé et de Secours Médical Haute-Corse du Service Départemental d'Incendie et de Secours in France. The study had to major focuses. The first was to evaluate the frequency and distribution of firefighter injuries and illnesses over the last 10 years in the UK and French partners and assess how specific previously implemented safety and health interventions changed injury and illness patterns and costs. None of the data collected in this evaluation included personal identifiers.The second was for this evaluation to lead to the formation of a roadmap for future EU and US fire/EMS safety and health policy and program development. This project was done within a six-month sabbatical and was sponsored by the Fulbright-Schuman grant program. 

The overall goal of this project Cumulative Environmental Effects: Expanding Research with the Hopi Tribe is to use a community-based participatory research (CBPR) project is to collaborate with the Hopi Tribe investigating household exposures to inform policy decisions. Household exposures are major sources of environmental hazards encountered by many American Indian and Alaska Native (AI/AN) communities.  Household exposures include combustion by-products from heating and cooking, particulate from nearby mining and other land uses, and water and food contamination.  These exposures, and co-exposures such as unemployment and lower resilience, impact respiratory health and obesity among children and adults, and warrant evaluation of AI household exposures within a social ecological framework. The Hopi Tribe in Northern Arizona has identified several areas of concern, including the impact of burning coal and biomass in homes for heating and its potential impact on respiratory health. Other issues include concerns about arsenic and uranium species in drinking and surface water.  This application seeks to expand existing relationships to include Hopi officials in the Hopi Environmental Protection Office and university environmental scientists and health promotion experts. The project proposes to 1) Characterize magnitude of environmental exposures to particulate matter (PM), arsenic species, uranium and other contaminants from air, water, and food in selected households on Hopi tribal lands. 2) Evaluate how exposures are moderated by social determinants of health and social capital/community resilience, and 3) Expand Hopi capacity to address areas of environmental concern.  The effort will build additional capacity within the Hopi tribe to evaluate and mitigate propose mitigation for environmental hazards of concern to the tribe. The proposed joint project provides an opportunity to develop and strengthen a relationship built on trust between the Hopi tribe and university researchers and to increase the capacity of the Hopi Environmental Protection Office to monitor its air and water quality.  Anticipated results include modeling of cumulative exposures to arsenic and uranium species among Hopi residents and address environmental concerns of the tribe in terms of health inequities. The study will build Hopi capacity to conduct research of adverse exposures and develop informed tribal environmental and health policies for a sustainable future.

Abstract not available. 

The quality of irrigation water drawn from surface water sources can vary greatly. This is particularly true for waters that are subject to intermittent contamination events such as runoff or direct entry of livestock upstream of use. Such pollution in irrigation systems increases the risk of food crop contamination. A single sample does not adequately characterize the risk potential present in large irrigation systems often utilized in the Southwestern US. This project aimed to define optimal monitoring strategies for irrigation water quality and develop guidelines for the irrigation of food crops. Following the analysis of 1,367 samples for Escherichia coli and physical and environmental parameters, the following key irrigation water collection approaches are suggested: 1) Explore up to 600m upstream to ensure no major contamination or outfalls exists; 2) Sample before noon; 3) Collect samples at any point across the canal where safe access is available; 4) Collect samples at the surface of the water; and 5) Composite five samples and perform a single E. coli assay. These recommendations consider the entirety of our data as well as sampling costs, personnel effort, and scientific knowledge of water quality characterization in the Southwest region. These guidelines will better characterize risks from microbial pathogen contamination in irrigation waters and aid in risk reduction practices for agricultural water.

This pilot project is funded by the newly created, Patient Centered Outcome Research Institute, created through federal appropriation. This was part of the inaugural funding from this institute and this was the only award in the State of Arizona (the project was scored at 1% from over 800 submissions with 50 awarded; http://www.pcori.org/pilot-projects/).  In this participatory research project two innovative methods to improve the delivery of patient-centered behavioral health services are being tested in a federally qualified health center in Yuma County: Sunset Community Health Center (SCHC).

Research: Conducting a mail/phone/internet survey of @300 homeowners in Maricopa County - baseline and follow-up.  I am coordinating and managing all aspects of the study. Created multiple drafts of the baseline survey (over 400 variables), learned and programmed the ILLUME software, drafted IRB materials and all survey documents and scripts. Hired, trained and supervised interviewers. This project has taken more like a .3-4 FTE this year.

A five year REACH (Racial and Ethnic Approaches to Community Health) cooperative agreement\subcontract to help reduce health disparities and improve health through community efforts in six States. This project began November 1, 2012. We are partnering with Hidalgo Medical Services, University of Texas and the Northwest Regional Primary Care Association in the REACH: Su Comunidad Consortium to address health disparities in nutrition, physical activity and healthy weight among Hispanics/Latinos in six states. The four organizations have developed the REACH: Su Comunidad Consortium to address health disparities in nutrition, physical activity and healthy weight among Hispanics/Latinos in the six states.  The Consortium will sub-award funds to fifteen sub-recipient communities and provide intensive training and technical assistance. Using a Community Health Worker (CHW) model, the Consortium will help sub-recipient communities to develop or expand multi-sector community leadership teams, conduct community assessments and develop and implement community action plans that utilize relevant policy, systems and environmental (PSE) strategies to promote nutrition, physical activity and healthy weight.   A five year REACH (Racial and Ethnic Approaches to Community Health) cooperative agreement\subcontract to help reduce health disparities and improve health through community efforts in six States. This project began November 1, 2012. We are partnering with Hidalgo Medical Services, University of Texas and the Northwest Regional Primary Care Association in the REACH: Su Comunidad Consortium to address health disparities in nutrition, physical activity and healthy weight among Hispanics/Latinos in six states. The four organizations have developed the REACH: Su Comunidad Consortium to address health disparities in nutrition, physical activity and healthy weight among Hispanics/Latinos in the six states.  The Consortium will sub-award funds to fifteen sub-recipient communities and provide intensive training and technical assistance. Using a Community Health Worker (CHW) model, the Consortium will help sub-recipient communities to develop or expand multi-sector community leadership teams, conduct community assessments and develop and implement community action plans that utilize relevant policy, systems and environmental (PSE) strategies to promote nutrition, physical activity and healthy weight.  

In this contract I oversee evaluation of the impact of a train the trainer leadership curricula on the activities of community health workers across the U.S.  To date, we have gathered baseline data from master trainers and trained CHWs. In the next year, we will gather post evaluation data on curriculum competencies as well as conduct interviews with CHWs about their leadership activities 6 months following the training.  

A Review of the Public Behavioral Health System in Rural Arizona

This project was connected to the ADHS Medical Marijuana Project. This project focused on research-data manipulation in order to create a service-draft of an annual report on medical marijuana for communicating findings to various communities. As part of collecting research data, training for CME and other workforce development was offered through online courses. 

Description: An increasingly militarized border region has deeply embedded immigration enforcement policy into the daily lives of residents, including farmworkers living and working in the region. Objective: The institutionalization of ethno-racial profiling in immigration and local law enforcement, and the sanctioned use of Mexican appearance as probable cause for citizen inspection is a potential structural determinant of health yet to be explored.  Research:  data manipulation including conducting qualitative ad quantitative data analysis, results generation and manuscript development. Samantha Sabo was a contributor on this project but has since left the University of Arizona.

Maia Ingram provided evaluation expertise to Mariposa Community Health Center for a USDA Community Food Grant designed to improve the sustainable food system in Santa Cruz County. Activities included community food mapping and photovoice.

The overall purpose of this proposal is to strengthen an interdisciplinary, inter-institutional working group to build a Transborder Observatory for Health at the U.S. Mexico Border and develop a model of guiding principles to define a place-based regional approach for public health research and evaluation of best practices to impact policy decisions in the border region.

This Center of Excellence, named The Center for Health Promotion of Northern Mexico, was part of 11 Center of Excellence around the world. The specific aims of project work done at this center were threefold: to conduct a scoping review of community health worker-based chronic disease primary prevention programs on the U.S.-Mexico border region; to look specifically at promising and evidenced-based interventions identified from our review of the literature, and focus on a community health promotion intervention based on social cognitive theory and the socio-ecological model. The methods used to evaluate the different types of intervention employed a quasi-experimental pre-test, post-test study, with follow-up measures of physiological changes among low-income participants residing in an urban setting in northern Mexico.

This grant provides funds for some rural health research and evaluation activities. The following were conducted in 2012 and some are continuing into 2013.Each activitie is identified as research, service, or training. RESEARCH: Conducted an Investigation of Rural Women's Health Literacy Levels and Preferred Sources of Health Information - IRB approval was secured early in 2012, data was collected from 350 subjects between February and May 2012, data analysis was conducted from August to December 2012, and data analysis is still ongoing. RESEARCH: Evaluation of the impact of the MEZCOP Arizona Rural Health Professions Program's rurally-based week-long, intensive service-learning courses on public health graduate students subsequent career plans and choices related to rural practice. Planning of this research project began in November 2012, and the IRB application will be submitted by the end of February 2013. The project will survey all MEZCOPH current students and alumni who have participated in any of the rural or underserved area Service-Learning Institutes since they began in 2008. The purpose of the survey will be to determine if the goal of the Rural Health Professions Program - to increase the numbers of public health students who practice in rural and underserved communities in the state of Arizona - is being achieved. SERVICE: Conducted two Community Conversations on Health Care - one in Marana and one in Ajo - to collect community health needs assessment data, and document the findings through a report for each event provided to the community and published on the Center for Rural Health Website. This research project will continue throughout 2013. SERVICE: Performed additional collection, analysis, and publication on the Center for Rural Health Website of existing health-related data resources for the border counties of Cochise, Santa Cruz and Yuma in the in the "Arizona Border Region Data Resources and Virtual Library." This project will continue throughout 2013. SERVICE: Planned and conducted a community needs assessment project for Mohave County Health Department and Kingman Regional Medical Center in Kingmam, Lak Havasu, and Bullhead City. Reports documenting findings were prepared for each site and delivered to the Mohave County Health Department. Project is still ongoing. TRAINING: Provided Community Health Needs Assessment skills training to selected staff of the Mohave and Navajo County Health Departments. Training for others is planned for 2013.

The goal of this project was to develop and implement an electronic decision rule within the health system’s electronic medical record to detect hospitalized patients at risk of having severe sepsis. To do this, the sensitivity, specificity, and predictive value of the rule needed to be determined. This project was part of data generation and manipulation, such as statistics, modeling, results generation, intervention effectiveness, and program evaluation. Project funding came from the University of Alabama at Birmingham.