Poster Abstracts
POSTER CATEGORIES
Community Partner/Healthcare Provider or Professional:
Abstracts # 1-10
Student: Abstracts # 11-13
Faculty/Staff: Abstracts # 14-23
1. Asthma Camp Improves Children’s Asthma Knowledge and Self-Efficacy
Lori McQuillan, Joni Zyber, Janice Roberts, Michelle Cox, Donna Bruce
Abstract:To dispel misperceptions about asthma and exercise we have instituted an
annual Asthma Camp to educate patients and parents to pay attention to asthma
symptoms and the importance of taking their medications, even when they feel well.
With education, physical activity and camaraderie asthmatic children can better
understand their disease, and listening to their bodies and reduce their risk of an
asthma attack. Objective: To provide a camping experience for kids with asthma that
supports asthma self-care. Design/Method: We recruited a total of 20 children between
the ages of 7 and 14 who have been diagnosed with asthma. A pre-experimental onegroup pretest/posttest design was used. Education was in the form of games and
activities using the teach-back method. Parents/guardians were mailed the 3-month
follow-up questionnaire to determine their satisfaction with the camp and if any
reportable changes in the child’s asthma has occurred. Results: The majority of the
children (70%) had never been to any camp before, and 30% percent had attended this
camp before. Questions on perceived self-efficacy and general asthma knowledge were
asked and the kids increased their knowledge on all questions asked. Most of the
children already knew about asthma, the triggers, the symptoms and the importance of
taking their medication, which we would like to believe is partly due to the education
they received from their Asthma nurse or physician.
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2. Implementation of Post-Discharge Telephone Follow-Up with Pediatric
Patients; A Comparison of Two Interview Tools
Renay Gagleard, Mahesh Sharman, Brian Nolan, D. Kay Taylor, Lori McQuillan, Laurie
Shafer, Mattie Pearson, and Jill Folts
Background: There has been a renewed focus to improve upon discharge information.
Follow-up calls prove to be an invaluable tool in increasing post-discharge compliance.
Objective: To determine the effectiveness of a revised tool used for follow up calls to
parents of discharged pediatric patients. Design/Methods: Questionnaire #1 asked
child’s post-discharge condition, if prescriptions were filled, and if appointments were
made. After one year, the tool was revised to ask if the parent name the prescribed
meds, the Dr. to be followed up with, and the child’s health status. This was expected to
provide us with more insight into improving the discharge follow-up telephone protocol
so that we could better identify and tackle problems with readmissions. Results: While
this study did not prove that one form was better than the other in a statistical sense,
questionnaire #2 did ask more and clearer questions than questionnaire #1, so one
could surmise that the change was for the better. Also, this study is a useful step to our
overall Quality Improvement goal and will be an important step in the next few studies;
which includes a new Asthma Navigator program to reach out to patients discharged
with an asthma diagnosis and a future plan to institute a Diabetes Navigator as well.
Conclusion: While no statistical significance was made in this study, many qualitative
findings were noted that lead to us considering this study a success. These calls DO
make a difference and are now an important part of our standard operations.
3. Improving Patient Outcomes Virtually: Converting Evidence-Based Practice to
Action
Kristen Miller, DrPH, MSPH, Beth King, RN, BSN, MA, CCM
Despite the power of modern medicine and the introduction of complex technologies,
medicines, and treatments, hospital-acquired conditions continue to develop in patients
- conditions that could reasonably have been prevented through the application of
evidence-based guidelines. To combat hospital-acquired conditions and similar
preventable conditions, the VA National Center for Patient Safety adapted the IHI
Breakthrough Series (BTS) model into a virtual collaborative based on evidence-based
guidelines which has resulted in improved patient-centered outcomes. The BTS
combines condition-specific subject matter experts with coaches to help hospital unit
teams select, test, and implement changes. Hospital teams focus on improving patient
outcomes by systematically implementing evidence-based practice at the bedside. Past
BTS have included Prevention of Injurious Falls and Reducing Postoperative
Respiratory Failure. A current collaborative is focused the Prevention of HospitalAcquired Conditions: Catheter-Associated Urinary Tract Infections (CAUTI) or Hospital
Acquired Pressure Ulcers (HAPU). Based on a culture of safety and quality
improvement, the collaborative learning includes leadership, evidence-based practice,
data-driven decision-making, communication, teamwork, a learning culture, and patientcenteredness. This model of implementation is efficient and effective for multi-unit
improvement efforts. Many innovative health care organizations have made important
breakthroughs in the design and performance of safer systems by focusing on
evidence-based practice. The VA National Center for Patient Safety has demonstrated
success leading collaboratives using this model. Researchers have published significant
evidence on methods of prevention and the Veterans Health Care Administration (VHA)
has been a leader on many efforts for years.
4. Employing Community Led Strategies to Address Gender-based Analysis
Findings and Improve Health Equity in African American Women
Sandy Waddell, RN, BSN; Jodi Burke, MSW; Arthur Franke, PhD
A gender-based analysis and community led needs assessment in Inkster, Michigan
revealed that women are disadvantaged due to social determinants of health.
Psychosocial, economic, and environmental factors were identified as significant
challenges in navigating the health care system and to adopting healthier lifestyles that
could prevent and control diabetes. Compared to Michigan, Inkster has lower income
and education, both of which are significant predictors of health. Multi-level socioecological approaches including empowering women with tools to make healthy
choices, promoting social interactions, supporting healthy decision making, reducing
access barriers to health care and partnering with community health workers (CHW’s),
were employed. A community-engaged implementation method was used to address
health inequities, specifically how to effectively improve diabetes-related health
practices influenced by gender. Three approaches were selected: health literacy
mentoring, increasing opportunities for access and use of community preventive
services using CHW’s; and providing messages designed to positively influence lifestyle
and gender norms. This project goals are to improve overall health status and diabetes
self-management of African-American women in Inkster by: (1) Implementing a socioecological approach to disease management using social support, empowerment, and
health literacy; (2) Improve access to and utilization of health care services and
community supportive resources to promote healthy lifestyles; and (3) Build community
networks and increase awareness of gender-based disparities and their impact on
women. Data will be analyzed for changes in attitudes and behaviors to assess the
effectiveness of community led gender-based approaches as a promising method to
improve diabetes-related health management and outcomes in women.
5. Healthy Men Healthy Communities
Rohan Jeremiah, PhD, MPH, Glenda Sneed, MA, Trudy Hall, MPH
The purpose of this study was to provide health and wellness information with
measurement tools and metrics to African American fraternity members of the Ann
Arbor-Ypsilanti-Inkster Alumni Chapter of the Kappa Alpha Psi Fraternity. Furthermore,
this program also convened a health summit to educate its members on ways to monitor
their personal health status as well as to keep personal health a priority. The study
methods included administering a men’s health needs assessment and presenting the
results at a first African American Men’s Health Summit. Our findings indicate that most
fraternity members represented a higher socioeconomic status (SES) in contrast other
African American men in their communities. However, despite a higher SES status and
access to health insurance, most fraternity members had similar patterns of concerns
for chronic health conditions. The significance of this study draws attention to fact that
higher income, education and access to health insurance were not protective factors for
the fraternity men’s health outcomes. The implications of our findings motivated several
men consider establishing a community health advocate program to educate and
motivate African American men to be aware of their health status.
6. Surgical Stapler Adverse Events in the Veterans Health Administration: Root
Causes and Lessons Learned
Helen J.A. Fuller, Ph.D., Douglas E. Paull, M.D., Linda Williams, R.N. M.S.I.
Many operations require the controlled ligation and division of blood vessels and other
structures, often through use of a combined cutting and stapling device. Previous
studies have found low rates of stapler malfunction, but because of the prevalence of
use, many patients may still be affected. Device malfunction has been identified in some
cases, and use error, including override of safety functions, may also play a role. The
Veterans Health Administration’s Root Cause Analysis (RCA) database was searched
for events involving use of a non-skin closure surgical stapler. The resulting 12 RCAs
from 13 adverse events were examined. The operations were pulmonary surgery (7/13),
laparoscopic nephrectomy (3/13), and bowel surgery (3/13). Patient outcome was death
in 46% of cases, transfusion with survival in 31%, and bleeding with no transfusion
specified in 23%. Surgical stapler failure mode was unspecified in 5/13 cases. There
were two cases in which the failure was identified as a misfire. There were two cases of
staple line failure. In addition, there was one case each of the following: use of the
stapler without a cartridge; improperly formed staples; and a tear along the suture line.
Contributing factors were possible malfunction (4/13), unfamiliarity with device (3/13),
and misaligned stapler cartridge (1/13). There are vulnerabilities in the device design
that are often not obvious on visual inspection. Since the source of harm may derive
from multiple causes and adverse outcomes are rare, the surgical team may not be
sufficiently aware of the risk posed by the device.
7. Life Goals Collaborative Care to Improve Health Outcomes for Veterans with
Serious Mental Illness
Michelle M. Barbaresso, MPH, Margretta G. Bramlet, MEd, Amy M. Kilbourne, PhD,
MPH, Kristina M. Nord, MSW, Zongshan Lai, MPH, Lilia Verchinina, PhD, MA, David E.
Goodrich, EdD, Joanna G. Bratton, BSW
Individuals with serious mental illnesses (SMI, including schizophrenia, bipolar disorder,
and major depression) experience a disproportionate burden of medical comorbidity,
particularly increased risk of cardiovascular disease (CVD), and are more likely to die
earlier than the general population. Life Goals Collaborative Care (LGCC) is an
evidence-based collaborative care program designed to address suboptimal health
behaviors and the lack of medical care coordination that may increase risk of CVD
among persons with SMI. In previous studies, LGCC has been shown to improve
physical and mental health outcomes for persons with bipolar disorder, but to date, has
not been tested for a broader SMI patient population. The goal of this single-blind
randomized controlled trial is to determine whether LGCC, which combines health
behavior change strategies with Chronic Care Model principles, compared to usual care
improves outcomes and reduces CVD risk among patients with SMI. Our primary
hypotheses are that within 12 months, LGCC will be associated with reduced CVD risk
factors (lower blood pressure, lower cholesterol or blood sugar levels, or decreased
weight), improved health-related quality of life, reduced psychiatric symptoms, or
improved health behaviors compared to usual care. In this single-blind randomized
controlled effectiveness trial, patients diagnosed with SMI and >=1 CVD risk factor
receiving care at The VA Ann Arbor Mental Health outpatient clinic randomized to the
LGCC intervention or usual care. LGCC is an evidence-based psychosocial program
designed to promote health behavior change and in this study, includes 5 selfmanagement sessions covering personal goal-setting and mental health symptom
management reinforced through healthy lifestyles; identification and monitoring of
patient medical risk factors via a registry; and medical care management and
coordination of care with general medical providers. Primary outcomes assessed at 6
and 12 months include changes in CVD risk factors (e.g., blood pressure, BMI),
psychiatric symptoms, and health-related quality of life. Evidence-based interventions
such as LGCC, that combine healthy lifestyle coaching with Chronic Care Model
principles, may lead to improved health outcomes for patients with SMI and CVD risk
factors. Findings from this randomized controlled trial will inform ongoing initiatives to
implement collaborative care programs for persons with SMI.
8. Latino Health Equity is Crucial in Washtenaw County
Adreanne Waller, Daniel J. Kruger, Charo Ledon, Sharon P. Sheldon, Mikel Llanes,
Felipe Riaño, Leonardo Riaño, Glenda Isela Flores
Title IV of the Affordable Care Act (ACA) emphasizes the need to "allow for the ongoing,
accurate, and timely collection and evaluation of data on disparities in health care
services and performance on the basis of race, ethnicity, sex, primary language, and
disability status [to enable the utilization of] preventive services to promote wellness,
reduce health disparities, and mitigate chronic disease." Between 2000 and 2010, the
proportion of Hispanic Washtenaw County residents increased 125% and is projected to
increase 233% between 1990-2035. Hispanic births in Washtenaw County increased
151% between 2000-2009. This young and growing population is a critical cultural and
economic contributor to our local economy. The average age of death of Washtenaw
Latinos (58 years) is 17 years younger than that for Washtenaw Whites and six years
younger than Blacks. Increasing access to healthy environments, employment,
education and health care provides greater opportunity to maximize the mental and
physical health, as well as productivity of these vital community members. To address
the chronic lack of population health data on Washtenaw County Latinos, local public
health, academics and Latino community collaborated on a community benefit driven
assessment called Encuesta Buenos Vecinos (EBV). EBV was designed to assess and
enhance the health, wellbeing, and social support of this population. Over 500
Washtenaw County Latinos responded to face-to-face, group and Internet surveys. This
presentation will describe the links between health care utilization, access, barriers,
diagnoses, as well as numerous associated social determinant predictors providing
opportunity for informed intervention of ACA requirements.
9. Here for Youth: Developing and Mobilizing a Community Advisory Board to
Assess and Improve Mental Health Services for Adolescents
Kate Guzman, Caitlin Martin, Craig VanKempen, Max Abuelsa, Jessica Ashmore,
Olatola Ibrahim, Carol Fisher, Laura Alexander, David Cordova
Mental health problems play a significant role in the burden of disease in the United
States (SAMHSA, 2013). Therefore, the prevention of mental health problems
represents a major public health concern facing America. In Ypsilanti, the current study
location, a recent needs assessment identified mental health as a tier-one priority.
Primary health care centers, including the Corner Health Center, provide an innovative
context to deliver mental health services to patients who otherwise would not receive
mental health services. Mental health services are effective only to the extent that they
are embraced by the community. Developing a community-advisory board (CAB) is
essential to work toward this goal. Therefore, the purpose of this presentation is to
describe the nature of developing and mobilizing a CAB in an effort to work toward
assessing and improving mental health services for adolescents. Methods: The present
study was guided by community-based participatory research (CBPR) principles.
Consonant with CBPR tenets, we established a community advisory board (CAB) in an
effort to (a) develop a process by which community members could contribute to
identifying community strengths and challenges, (b) establish trust with members of the
community, (c) facilitate the recruitment, engagement and retention of the targeted
sample, and (d) ensure that research findings accurately described the needs of the
community as perceived by participants (Isreal et al., 2005; Minkler and Wallerstein,
2003). In line with the Corner Health’s mission, the CAB represents diverse key
stakeholders, including youth. Results: Preliminary findings indicate a marked
enthusiasm among CAB members to participate in this process, as well as an increased
knowledge among Corner Health Center staff with respect to community members’
perspectives on integrated health services. Conclusions: CBPR methods, including the
development of a CAB, help ensure mental health services are tailored to meet the
needs of the targeted community. This project has provided Corner Health Center staff
the opportunity to learn and seek guidance from CAB members with regard to best
practice approaches to integrating mental health services. Perhaps more importantly,
this process aims to give voice to key stakeholders in the community, an opportunity
that unfortunately is not always the case in research. These developments are
necessary steps aimed at establishing community-university-based partnerships for
enhanced patient-based outcomes.
10. Community priorities for patient-centered outcomes research
Susan Dorr Goold, Zachary Rowe, Lisa Syzmecko, Marion Danis, Stephanie Solomon,
Dan Myers, Charo Ledon, Terrance R. Campbell, Carla Cunningham, Sal Martinez
Morally complex policy decisions, including research priority-setting, may enjoy greater
public trust if they result from fair and public processes. Academic-community
partnerships in Michigan and Missouri developed a version of CHAT (CHoosing All
Together) to engage minority and underserved communities in deliberations (in English
and Spanish) about patient centered outcomes research (PCOR) priorities. PCOR
funding options were developed from existing funding priorities, interviews with
community organizations and clinicians serving in underserved areas and other key
informants. Groups deliberated for 2-2.5 hours in diverse communities. Data collection
included pre- and post-deliberation surveys and individual and group priorities. To date,
10 groups (n=123) have deliberated in rural and urban settings. Over 3/4 of participants
were minority, 1/3 reported income <$10,000, and 1/4 reported fair/poor health. Quality
of life, special needs, patient-doctor relations and access were prioritized over
comparing approaches to diagnosis and treatment. Asked “how much input do people
like you have in setting research priorities?” 20% said a great deal, 64% some and 16%
none at all. Asked “How much input should people like you have in setting research
priorities?” 44% said a great deal, 53% some and 3% none at all. Nearly all (94%) found
the exercise easy to understand, 74% agreed “Our discussion included responding to
each others' arguments,” and 77% agreed “I would trust a process like this to inform
funding decisions.” Results suggest underrepresented populations welcome the
opportunity to deliberate about PCOR priorities, and prioritize research on quality of life,
special needs, patient-doctor relations and access.
11. Transforming Culturally Diverse Communities Through Music Education
Michael Spencer, PhD, John Ellis, PhD, Michael Hopkins, PhD, Sue Ann Savas, MSW,
Anthony Provenzano, MPA, MSW Candidate, Peter Felsman, PhD Candidate, Paula
Dedoux, MSW Candidate
El Sistema is a renowned Venezuelan music intervention program that has inspired a
global movement due to its social impact on fighting poverty and improving the human
condition. The El Sistema model provides high-quality music instruction to children from
a broad range of socio-economic backgrounds in over twenty-five countries around the
world (Fundacion, 2012). Internationally adopted, this socially innovative paradigm fills a
special need in the corridor between Ann Arbor and Detroit, Michigan. This reasons for
starting this pilot program in southeast Michigan are threefold: 1) serving socially,
racially, and linguistically diverse children in the University of Michigan (U-M)
community; 2) planning the scale up of the El Sistema music intervention to include
schools and other venues in Detroit; and 3) developing a Social Engagement curriculum
of greater depth for University of Michigan School of Music, Theatre, and Dance
(SMTD). A single group pretest-posttest multi-method research design will be used to
evaluate the effectiveness of the El Sistema Ann Arbor pilot project. The El Sistema
program will target 5th grade string instrument students at Mitchell Elementary School.
If the intervention is successful, it is expected that by having children participate in
regularly and extensively high-quality, ensemble music education students will develop
music literacy, a strong sense of personal agency, improved academic performance,
and increased sense of community. In addition, U-M graduate student music instructors
will develop a sense of social consciousness in delivering music instruction in
untraditional community settings using the El Sistema pedagogical model.
12. Development of a theory based video to increase CPAP compliance
Rie Suzuki, PhD
Obstructive sleep apnea (OSA) is one of the most common sleep disorders, affecting an
estimated 20 to 30 million Americans. Seventy percent of all patients with OSA are
obese and eighty six percent of all obese patients with type 2 diabetes have OSA. The
prevalence of OSA increases with age, with a higher prevalence in persons 65 years
and older. However, few educational materials have targeted on the Aged Obese
Diabetic OSA patient. The purpose of this project is to develop the theory based
educational video for patients newly diagnosed with OSA at the University of Michigan
Center for Sleep Disorders. The inclusion criteria encompasses patients aged 65 and
older, a BMI >30, insulin dependent diabetic, and an apnea hypopnea index>15.The
patients also have completed a baseline polysomnogram and are scheduled to return to
the lab for a continuous positive airway pressure (CPAP) titration. Social Cognitive
Theory was utilized for this project. The video will address not only the knowledge of
OSA and diabetic nutrition but also the benefits and the strategies used to increase
CPAP compliance and to increase healthy diabetic dieting in patients with OSA. The
proposed research design is a pre-post test to access the impact of watching the
developed video at home on wearing CPAP every night and eating 3 healthy diabetic
meals per day. Self-efficacy, outcome expectations, social support, and knowledge of
OSA, how to use CPAP, and the contents of diabetic diet will be measured.
13. Retained Guidewires - A Persistent Problem
Theodore E. Dushane, Ph.D, M.D., Douglas E. Paull, M.D.
Introduction: More than 6 million central venous catheters are placed each year in the
United States. The guidewire can be left behind in the central circulation, which can
result in numerous complications, some of them fatal. Because retained guidewires are
frequently retrieved by interventional radiologists without long term harm, the problem
has received little attention; we used the National Center for Patient Safety database
from the 153 VA hospitals over a decade to find relevant root cause analyses (RCAs)
and better to describe circumstances, causes, and proposed solutions. Methods: We
found 30 RCAs. We coded the root causes using the NCPS Triage System for Root
Cause Analysis. We coded the strengths of proposed actions from the RCAs as defined
in The Healthcare Failure Mode Effect (HFMEA) Process. Results: We found significant
harm using the NCC MERP Index. There was no predominant root cause. Most of the
proposed solutions were weak according to the HFMEA Process. Discussion and
Conclusions: Also of concern, the actions proposed among the RCA committees across
the VA reveal the difficulty of solving device design issues. We will propose (in the
poster) significant work-process improvements to ameliorate the situation until a hard fix
for the problem is developed.
14. Public, Advocate, and Community-Practice Engagement in the Development
of Decision Support Tools for Breast Cancer
Alexandra Jeanpierre, MPH, Gregory Powers, MPH, Rachel Tocco, MA, Rebecca
Morrison, MPH, Rose Juhasz, PhD, Sarah Hawley, PhD, MPH
As part of a National Cancer Institute grant investigating the challenges of
individualizing treatment for breast cancer patients, we developed an online decision
support tool for newly diagnosed women with early-stage, invasive breast cancer. The
tool is part of a randomized control trial to determine if an enhanced decision aid with
patient-tailored components (i.e. knowledge building, values clarification, and patient
activation) leads to greater patient knowledge about breast cancer treatment options, as
well as a preference-concordant decision (i.e. treatment is consistent with the patient’s
preferences). During tool development, we engaged with several stakeholder groups to
elicit feedback on its content and implementation. Since nearly 1 in 8 (almost 12%) of
women in the United States will develop invasive breast cancer over the course of her
lifetime, we surveyed a sample of women from the general female population (n=250)
on interest in decision support tools. Results from an online survey showed 56% were
very or quite interested in a tool designed for them for a major health decision, while
57% were very or quite interested in one designed for a family member. We also
conducted cognitive interviews and usability testing of the tool with breast cancer
advocates to refine content and make technical improvements. Once the tool was
finalized, the study was launched in several surgical practices in the Detroit and Atlanta
metropolitan areas. We are currently seeking feedback on the implementation process
from surgeons, nurses, and office managers who identify potential users and introduce
them to the tool.
15. Assessing the modification, development and implementation of nutrition
education curriculum appropriate for effectively working with cognitive
impairements
Michelle Gordon-Releford
Cognitive Impaired/Special Needs (CI/SN) Nutrition Education Curriculum Committee
consists of supervising Educators, programing staff and key community stakeholders
who understand the needs of the population with CI/SN. Initial responsibilities of the
Committee reviews current nutrition education curriculums, and identify best practices
and desired outcomes as to how it applies to groups with CI/SN. Learning materials and
evaluation materials will be modified for ease while keeping the integrity of the original
curriculum. Staff is trained to interact respectfully with individuals with CI/SN, and how
to administer the nutrition education curriculum, with modifications, appropriately. MSU
Extension Human Resources and Organization Diversity Staff-External Diversity
Organization oversee the training. Both departments encourage staff to approach the
nutrition education curriculum with confidence to promote self-efficacy and selfsustainability to participants. Training will also insure consistency across the surveyed
population where individuals with CI/SN will provide reliable survey data for the NPA
work team to evaluate. The Committee works closely with Institutional Review Board to
ensure that the curriculum adheres to accepted privacy and security of collected
information and does not infringe on participant rights. Objectives: 1. Nutrition education
that is appropriate and useful to CI/SN participants. 2. Increase self-efficacy and selfsustainability through nutrition education that includes food safety, budgeting, and
nutrition. 3. Measurable changes in participant behavior will be documented through
surveys and participant success stories. 4. Empowerment to market nutrition education
to potential community partners who serve individuals with CI/SN. 5. Proficiency offering
an additional venue for professional development, with an emphasis on diversity.
16. Cluster Randomized Adaptive Implementation Trial Comparing a Standard
Versus Enhanced Implementation Intervention to Improve Uptake of an Effective
Re-Engagement Program for Patients with Serious Mental Illness
David E Goodrich, Nicholas W. Bowersox, Daniel Almirall, Zongshan Lai, Kristina M.
Nord, Amy M. Kilbourne
Poor continuity of medical care contributes to premature mortality in persons with
serious mental illness. The Veterans Health Administration (VA) developed Re-Engage,
an outreach program to identify Veterans with SMI lost-to-care and to reconnect them
with VA services. However, such programs often encounter barriers getting
implemented into routine care. Adaptive designs are needed when the implementation
intervention requires augmentation within sites facing challenges. This poster describes
the rationale for an adaptive design study to compare the effectiveness of a standard
implementation strategy (Replicating Effective Programs- REP) with REP enhanced
with External Facilitation (enhanced REP) to promote Re-Engage uptake. The study
employs a four-phase, two-arm, longitudinal, clustered randomized trial design. VA sites
(n=158) across the U.S. with a designated provider, at least one Veteran with SMI lostto-care, and who received REP during a 6-month run-in phase. Sites with inadequate
uptake were stratified at the cluster level by geographic region and regional service
network and randomized to REP (n=49) vs. enhanced REP (n=39) in Phase 2. The
primary outcome was the percentage of Veterans on facility outreach lists documented
in an electronic registry. The intervention consisted of REP versus REP enhanced by
external phone facilitation consults. At 12 months, enhanced REP sites returned to REP
and 36 sites with inadequate uptake received enhanced REP for six months in Phase 3.
Secondary outcomes included the percentage of Veterans contacted directly and the
percentage re-engaged in care. Adaptive designs may produce more relevant, rapid,
and generalizable results by validating or rejecting new implementation strategies.
17. Research Program Partnerships to Examine Challenges of Individualizing
Breast Cancer Care
Rose Juhasz, PhD, Rachel Tocco, MA, Rebecca Morrison, MPH, Gregory Powers,
MPH, Alexandra Jeanpierre, MPH, Ann Hamilton, PhD, Kevin Ward, PhD, Jennifer
Griggs, MD, MPH, Christopher Friese, PhD, RN, Steven Katz, MD, MPH,
The Cancer Surveillance and Outcomes Research Team has established numerous
partnerships to lead a large program on the challenges of individualizing breast cancer
care. We conduct patient-centered, population-based survey research in collaboration
with several Surveillance, Epidemiology, and End Results (SEER) Programs of the
National Cancer Institute. Our current study involves a survey of 6,600 patients with
early-stage breast cancer to learn more about how these women make testing
(Magnetic Resonance Imaging, BRCA genetic tests, and tumor tests) and treatment
(surgery, chemotherapy, and radiation) decisions. Survey topics include a variety of
patient-reported outcomes such as quality of life, worry about recurrence, satisfaction
with testing and treatment decisions, and quality of provider communication. We work
with the SEER registries at the Los Angeles County Cancer Surveillance Program
(based at University of Southern California) and the Georgia Center for Cancer
Statistics (based at Emory University) to ensure the diversity of our patient samples and
to secure high response rates for surveys administered in English and Spanish. We also
have partnerships with: 1) industry to acquire gene expression assay results for our
respondents that estimate risk of cancer recurrence and 2) a cancer cooperative group
conducting clinical trials to determine if respondents’ chemotherapy decisions are driven
by a research protocol assignment. Taken together, these partnerships enable a
detailed assessment of the individualization and quality of systemic and locoregional
tests and treatments received by early-stage breast cancer patients. Study results will
be used to improve the quality of care for women with breast cancer.
18. Supporting and maintaining strong partnerships and community-academic
connections through evaluation of a statewide community health worker alliance
Nicholas Yankey, MPH, MSW, Katherine Mitchell, MSW, Edith Kieffer, MPH, PhD,
Caitlin Buechley, BS, Loan Nguyen, BA, Gloria Palmisano, BS, MA, Lee Anne Roman,
MSN, PhD
Partnerships are essential to supporting and promoting community health worker
(CHW) sustainability. In Michigan, connections between community partners and
academic institutions have facilitated CHW programs for years. Through these
connections, the Michigan Community Health Worker Alliance (MiCHWA) formed to
collaboratively support the CHW profession as a united group of stakeholders. Since
identifying evaluation as essential to sustainability, MiCHWA’s Steering Committee
incorporated evaluation as one of its goals and established the MiCHWA Program
Evaluation Advisory Board. The board unites academic and community partners to
develop and conduct MiCHWA’s process, context, and outcome evaluation. As an
initiative that relies on stakeholder participation, MiCHWA’s evaluation focuses directly
on building, maintaining, and strengthening partnerships to promote its work and
support CHWs and their programs. The board conducted a partnership survey in 2012
and 2013 to assess Steering Committee member perceptions of the initiative and gauge
partnership strength. The survey yielded quantitative and qualitative data showing
improvement in Steering Committee members’ knowledge of other community agencies
and CHW activities statewide. The data also identified areas for improvement, including
new constituencies to add to the Steering Committee and steps to improve partnership
activities. This poster will discuss key evaluation elements identified by our communityacademic evaluation board and the tools, findings, challenges, and next steps
associated with evaluating partnerships like MiCHWA. The poster will also discuss the
need for strong community-academic partnerships to maintain CHW alliances at the
state level and maintain CHW programs at the local level.
19. Evaluation Partnership with a Community-Based Client Using a Collaborative,
Utilization-Focused Approach: Girls Group, A Case Example
Sue Ann Savas, MSW; Laura Sundstrom, MSW; Lindsey Miller, MSW Candidate
Girls Group is a community-based program in serving Ann Arbor and Ypsilanti designed
to enable young women to develop self-sufficiency and become first generation college
students. Over the past ten years, Girls Group has provided individual mentoring and
counseling, academic support, and empowerment programming, as well as many other
groups, activities, workshops, and camps. The guiding principles for Girls Group are the
development of character, leadership, self-confidence, and social consciousness.
During the 2013-2014 academic year, with the support of the Community Foundation for
Southeast Michigan, Girls Group is implementing a pilot of the Pioneer High School
program, the first in-school programming for high school students. The Curtis Center
Program Evaluation Group (CC-PEG) at the University Of Michigan School Of Social
Work is partnering with Girls Group to evaluate the implementation of the Pioneer
program. Using a collaborative, utilization-focused approach, CC-PEG will gather,
analyze, report, and interpret program data for program improvement and internal
capacity building. The mixed methods design utilizes surveys, observations, focus
groups, and key informant interview with program participants, Girls Group staff, and
stakeholders. The purpose of the evaluation is to assess the program’s impact on
participants and to guide Girls Group on areas of development and capacity building.
20. Engaging High School Students in Injury Prevention
Bethany Buschmann, MPH, Peter Ehrlich, MD, MSc, Susan Morrel-Samuels, MPH, MA,
Joseph Filipiak
Background: The University of Michigan Injury Center’s mission is to conduct highquality research and training, to translate scientific discoveries into practice and policy,
and to reduce injuries, violence and related disabilities. The Outreach and Translation
Core (OTC), aims to increase awareness and knowledge of injury and violence
prevention topics, resources, and interventions and create partnerships within the
community to expand the Center’s reach. Methods: To increase injury awareness
among adolescents, the OTC implemented an injury prevention campaign contest in the
winter of 2013 with Romulus High School in Metro Detroit. The OTC Coordinator
delivered a presentation beforehand to the participating classrooms to educate the
students on the contest details and provide them with an introduction to the field of
injury prevention. Students were asked to create unique injury or violence prevention
messages relevant to their peers, in the form of a print or multimedia project. The
contest entries were evaluated on 4 criteria with a rating scale of 0 (poor) to 5
(excellent). Entries were judged on clarity (relevance to peers), presence of actionable
prevention message, accuracy (images support content and free of grammar errors),
and quality (overall design and preparation/effort). Results: In 2013, 28 students
participated and 11 entries were submitted. This year student participation more than
doubled; 65 students participated and 18 projects were submitted. Evaluation of the
contest entries is currently in progress and a presentation will be held to recognize the
winners and award them with Visa gift cards.
21. The Interdisciplinary Model: An Effective Approach to Patient Family-Centered
Healthcare at a Tertiary Care Specialty Center
Linda Yang, MD, PhD, Sheela Pandey, MSW, Denise Justice, OTLR, Kate Change, MS
Objectives: In this study, we evaluated the program’s strengths, weaknesses, and
opportunities for improving the patient centered care model as it relates to the care of
children with brachial plexus injury. Methods: 50 patients with the diagnosis of Neonatal
Brachial Plexus Palsy (NBPP) and their families (children between the ages of 2m-14y;
22 males and 28 females) were sequentially recruited from the University of Michigan
NBPP clinic. Patients and families completed the “Family-Centered Care SelfAssessment Tool.” Questions were asked to understand how often patients/families
experienced ideal care as they interacted with our interdisciplinary brachial plexus team.
Results: The sections regarding “Giving Diagnosis” (2.7± .03) and “Decision Making”
(2.53±.46) demonstrated good application of patient centered care, whereas “Family to
Family and Peer Support” (1.72±1.07) and “Transitioning to Adulthood” (1.8±.95)
afforded potential areas of improvement. Patients with Narakas Classification level 1 or
2 (less extensive) and their families had much better experiences with “Family to Family
and Peer Support” than patients with Narakas Classification of level 3 or 4 (more
extensive) and their families (p=.04). Conclusions: The “Family-Centered Care SelfAssessment Tool” was valuable in evaluating the strengths and weaknesses in patient
centered care of patients with brachial plexus injury.
22. Evaluating the FATE Program: A commitment to Detroit youth in their pursuit
to higher education
Sue Ann Savas, MSW, Laura Sundstrom, MSW, Brandon Alford, MSW Candidate,
Kimson Bryant, MSW Candidate
The FATE Program of Give Merit, Inc. is a four-year, cohort-based program that
provides resources and opportunities for underserved youth with the goal of motivating
each student to graduate high school and attend college. FATE is in the second year of
implementation with the first cohort of students from the Jalen Rose Leadership
Academy in Detroit, MI. Participants travel to Ann Arbor one Saturday a month for
interactive workshops facilitated by community partners related to one of the four FATE
guiding principles: academic enrichment, social and cultural awareness, career
development, and student mentorship. FATE participants are partnered with a student
mentor from the University of Michigan. Participants who complete all four years of the
FATE program and graduate high school will receive a $5,000 scholarship to the college
of their choice. The University of Michigan School of Social Work Curtis Center Program
Evaluation Group (CC-PEG) has partnered with the FATE program for year two of the
ongoing evaluation for program improvement and sustainability. The mixed methods
design utilizes surveys, observations, focus groups, and key informant interviews with
program participants, staff, mentors, and stakeholders. CC-PEG is working with FATE
Program stakeholders to document, track, and analyze program implementation and
outcomes.
23. A Community in Crisis: Trauma and Dissociation in Detroit
Ellen Barrett-Becker, Amanda Burnside, Karen Calhoun, Julie B. Kaplow
The city of Detroit has long been identified as a dangerous city to call home. Exposure
to community violence and bereavement, particularly deaths involving traumatic
circumstances, are common experiences for residents. Despite the media attention
Detroit has received, little is known about the rates of trauma exposure or traumaspecific reactions of Detroit’s youngest residents, such as PTSD and dissociation.
Research examining the impact of such adversity suggests that dissociation is both
common in chronically traumatized youth and detrimental to mental health. The current
study evaluated rates of exposure to traumatic events, trauma symptoms, and
dissociative symptoms in a sample of eighty-four adolescents, ranging in age from 1018. Results suggest that participants in this sample have experienced a high level of
trauma and evidenced elevated levels of posttraumatic symptoms. More than 35% of
the sample reported dissociating at least some of the time in the last month. According
to the new DSM-V criteria, 23.5% of the sample met criteria for the dissociative subtype
of PTSD. Specific types of traumatic experiences were also associated with
dissociation. Implications for assessment, diagnosis, and intervention are discussed.