Enhancing Early Detection of Cognitive Impairment With the KAER Model

Dates: Sept. 30, 2020 – Sept. 29, 2023

Overview: Improve early detection of cognitive impairment — such as dementia — by reviewing, refining, testing, and evaluating components of the KAER model, which are used by primary care providers. The KAER model is a four-step process — developed by the Gerontological Society of America — to detect cognitive impairment and earlier diagnosis of dementia (Kickstart the cognition conversation; Assess for cognitive impairment; Evaluate for dementia; Refer for community resources).

Findings: Providers found the toolkit useful, and that addressing cognitive evaluation would be easy to implement in a clinical workflow. They also stressed simplicity, ease and efficiency for implementation of of a cognitive assessment toolkit. Incorporation of these findings into the development of clinical tools and workflows may increase cognitive evaluations conducted by PCP’s.

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Funding: U.S. Centers for Disease Control and Prevention (CDC), $500,000

Principal Investigator: Annette Fitzpatrick

Evaluation of Evidence-Based Programs Delivered Remotely

Dates: Oct. 15, 2020 – Dec. 31, 2022

Overview: Evaluate the remote delivery (videoconferencing, mail, phone, etc.) of previously in-person programs that are for older adult health promotion and evidence-based. Conduct surveys and interviews with program participants and providers, focusing on underserved communities, such as communities of color, people who live in rural areas, and/or people with disabilities. UW HPRC is leading the evaluation in partnership with the Society for Public Health Educators, Sound Generations, the Evidence Based Leadership Collaborative, and more than 100 community-based organizations across 25 states.

Principal Investigator: Lesley Steinman

Funding: This project had three separate funding sources.

• Society for Public Health Education (SOPHE), $188,095
• Funding Dates: Oct. 15, 2020 – June 30, 2022
• U.S. Administration on Community Living (ACL), $116,820
• Funding Dates: March 1, 2021 – Sept. 30, 2022
• RRF Foundation for Aging, $84,110
• Funding Dates: Jan. 1, 2021 – Dec. 31, 2022

PEARLS Connect

Dates: April 1, 2017 – March 31, 2022

Overview: Study the effect of the Program to Encourage Active, Rewarding Lives (PEARLS) on social isolation, along with the economic impacts the program could have on older adults using health services or transitioning to nursing homes. UW HPRC researchers are working with organizations who were already offering PEARLs in Florida, Maryland, New York, Texas, and Washington.

Findings: To come.

Funding: AARP Foundation, $887,178

Principal Investigator: Lesley Steinman

Piloting a Social Isolation Screener for Older Adults

Dates: Jan. 1, 2019 – Dec. 31, 2020

Overview: Collaborate with Texas A&M School of Public Health and Maintaining Active Citizens (an area agency on aging in Maryland) to partner with local clinical and community organizations and develop a brief, actionable social isolation screener for older adults.

Findings: To come.

Funding: AARP Foundation, $5,000; UW School of Nursing, $1,000

Principal Investigators: Basia Belza and Lesley Steinman

Physical Therapists Recommending Enhance®Fitness to Expand Reach (PT-REFER)

Dates: Sept. 30, 2014 – Sept. 29, 2019

Overview: Create a nationally scaled version of Enhance®Fitness in YMCAs that focuses on reducing racial related health disparities for people who arthritis. UW HPRC researchers developed and tested an intervention to increase the outreach capacity of YMCAs to physical therapy clinics about referring older adult patients to Enhance®Fitness.

Findings: There was a clear and consistent call from YMCAs for desired support and tools for outreach. This information helped Y-USA understand that there is an appetite for the type of in-depth support provided in our toolkit and provided the organization an opportunity to formulate solutions for overcoming reported barriers for outeach.

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Funding: U.S. Centers for Disease Control and Prevention (CDC), approximately $1.84 million

Principal Investigator: Miruna Petrescu-Prahova

Colorectal Cancer Screening Engagement Evaluation

Dates: Aug. 1, 2020 – July 31, 2021

Overview: Evaluate National Association of Chronic Disease Directors and U.S. Centers for Disease Control and Prevention’s efforts to:
1) Improve participating state health department’s capacity (skills, knowledge, and ability) to engage with health systems and payers to increase evidence-based colorectal cancer screening efforts;
2) Engage state health departments, health systems, and payers to reduce or eliminate barriers and gaps that impede evidence-based colorectal cancer screening efforts;
3) Help determine the effectiveness and added value of the Colorectal Cancer Screening Engagement Project approach on collaborative colorectal cancer screening efforts.

Findings: The project was successfully implemented as intended and yielded positive results in the short-term. There was a strong indication that both states and partners need more and enhanced technical assistance going forward to support their engagement and CRC screening efforts.

Funding: National Association of Chronic Disease Directors (NACDD), $60,000

Principal Investigator: Jeff Harris

Formative Study of Patient Navigators with NBCCEDP & CRCCP

Dates: Sept. 30, 2017 – Sept. 29, 2019

Overview: Provide the first survey among patient navigators affiliated with two national CDC administered cancer screening programs — National Breast and Cervical Early Detection Program (NBCCEDP) and Colorectal Cancer Control Program (CRCCP) — that serve people who have low incomes and are uninsured or underinsured. Patient navigators reported their background, roles and responsibilities, work environment, and training and/or technical assistance needs.

Findings: While navigators reported that patients had high levels of structural barriers to screening (e.g., transportation challenges and conflicts with work hours), most navigation activities focused on addressing patient-level barriers (e.g., understanding the cancer screening process and appointment reminders). Detailed descriptions of patient barriers and navigation activities can help program administrators and partner organizations adjust practices and messaging to be more patient-centered, responsive to structural barriers, as well as supportive of navigators in their work to promote equity in cancer control. Ultimately, researchers will use these data to support efforts to optimize and scale-up navigation activities for program grantees across all 50 states as well as multiple tribal entities and U.S. territories.

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Funding: U.S. Centers for Disease Control and Prevention (CDC), $500,000

Principal Investigator: Wendy Barrington

BeneFIT At-Home Colorectal Screening Kit

Dates: Sept. 30, 2015 – Sept. 29, 2019

Overview: Collaborate with two Medicaid and Medicare health plans to develop, conduct, and evaluate a health plan-based direct mail FIT program to increase colorectal cancer screening.

Findings: The implementation of mailed FIT outreach by health plans may be effective and could reach many individuals at risk of developing colorectal cancer.
Health Plan Washington mailed an introductory letter and FIT kit to 8,551 individuals. Staff also called 839 of those people to remind them about completing the kit. Health Plan Washington had 1,557 of 8,551 people (18.2%) complete the screening kit.
Health Plan Oregon mailed an introductory letter to 2,812 people. They sent a FIT kit and reminder postcard to 2,650 people. In Health Plan Oregon, 488 of 2,812 (17.4%) people who received the introductory letter completed the screening kit, while 484 of 2,650 (18.3%) people who were mailed the FIT kit and reminder postcard completed the kit

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Funding: U.S. Centers for Disease Control and Prevention (CDC), $1.68 million

Principal Investigators: Laura-Mae Baldwin, Gloria D. Coronado, and Beverly B. Green

Evaluating Patient Navigation Intervention for Colonoscopy Screening

Dates: Sept. 30, 2016 – Sept. 29, 2019

Overview: Determine the potential success of replicating patience navigation from the New Hampshire Colorectal Cancer Screening Control Program. We partnered with one Colorectal Cancer Control Program grantee and one large health system to implement the patient navigation program and determine if that implementation increased rates of colonoscopy completion. During this study, we also wanted to identify facilitators and barriers of using the program in real-world settings.

Findings: The majority of patients enrolled in one site’s adapted patient navigation program completed their colonoscopy. Program adaptations made the program more feasible for the site and could reduce program implementation costs. The second site focused on patients with a positive home screening test who needed colonoscopy to complete the screening process; in this site with fully-insured clients, the patient navigation program did not increase completed colonoscopy. Implementation challenges and difficulty reaching participants by phone highlighted opportunities for future dissemination and implementation research to optimize navigation and contact protocols, as well as focusing navigation programs on populations at greater risk for not completing colonoscopy. LEARN MORE

Funding: U.S. Centers for Disease Control and Prevention (CDC), $500,000

Principal Investigator: Peggy Hannon and Allison Cole

HPV Vaccine Impact Among Gay Men & Transgender Women

Dates: Sept. 30, 2016 – Sept. 29, 2019

Overview: Conduct a cross-sectional study to determine real-world impact of HPV vaccination effectiveness against anal and oral HPV infections in gay men and transgender women, ages 18 to 26 years old. This study was funded as a part of a multi-site project between the University of Washington and the University of Kentucky. Researchers assessed self-collected anal swab and oral rinse specimens from 1,767 participants in three U.S. cities (Seattle, Chicago, and Los Angeles) for 37 types of HPV.

Findings: There is real-world effectiveness of HPV vaccination among young adult men and transgender women, ages 18 to 26 years old. This effect was stronger with younger age at vaccination. Among 1767 participants, 704 (39.8%) self-reported receiving HPV vaccine. Quadrivalent vaccine-type HPV was detected in anal or oral specimens from 475 (26.9%) participants. Vaccine-type HPV prevalence was lower among vaccinated (22.9%) compared with unvaccinated (31.6%) participants.

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Funding: U.S. Centers for Disease Control and Prevention (CDC), $310,000

Principal Investigator: Rachel Winer

Promoting HPV Vaccination in Washington’s East African Communities

Dates: Sept. 30, 2016 – Sept. 29, 2019

Overview: Gain a better understanding of perceptions of HPV vaccines in East African (Somali, Ethiopian, and Eritrean) communities within the U.S. to develop, implement, and evaluate a multi-level communications intervention to promote uptake of HPV vaccines in adolescents. Our multi-level intervention targeted mothers, adolescents, and health care providers.

Findings: This study included multiple findings, from perceptions of the HPV vaccine to development and evaluation of educational interventions for mothers and adolescents and training for health care providers.
Perceptions of HPV Vaccine
Strategies for increasing HPV vaccinations among East African immigrants need to address factors that shape HPV vaccine perceptions among caregivers. Negative vaccine perceptions, lack of HPV vaccine knowledge, and concerns about side effects are factors that keep East African women from vaccinating their adolescent children. Having a provider who engages parents on HPV vaccination and takes responsibility for vaccine-related risks emerged as factors that improve access to the vaccine. Availability of vaccine information resources (e.g., person-to-person, word of mouth education for parents) were also enabling factors. Social, cultural, and religious factors influence HPV vaccination rates as well. Women exerted strong social influence on vaccine decisions (social), had concerns about pork gelatin in vaccines (religious), and felt discussions about sex with children were culturally unacceptable (cultural). LEARN MORE
Community Education to Improve HPV Vaccination
The educational forum for East African mothers significantly increased mothers’ HPV vaccine-related knowledge, attitudes, and intentions to vaccinate their adolescent children. East African adolescents who participated in the educational comic book intervention showed statistically significant pre/post differences in HPV-vaccine knowledge, comfort discussing HPV and the vaccine with parents, and willingness and intention to get vaccinated. LEARN MORE
Health Care Provider Training
Provider confidence in their ability to make strong HPV vaccine recommendations to East African families and address common parental concerns increased significantly after taking the training. LEARN MORE

Funding: U.S. Centers for Disease Control and Prevention (CDC), $397,290

Principal Investigator: Rachel Winer

American Cancer Society Technical Assistance Project

Dates: Oct. 1, 2016 – Oct. 31, 2020

Overview: Assist the American Cancer Society’s global division to develop, implement, and evaluate innovative approaches to workplace health promotion nationwide among companies enrolled in CEOs Against Cancer.

Findings: Developed and tested a new cancer-focused workplace health promotion tool that ACS continues to use nationwide with large employers. The tool was pilot-tested with 37 large employers nationwide, then the tool and its data-tracking system were handed over to ACS for further implementation.

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Funding: American Cancer Society, $317,000

Principal Investigator: Jeff Harris

Delivering Connect to Wellness With Washington State Health Jurisdictions

Dates: Oct. 2014 – June 2020

Overview: Partner with the Washington State Department of Health and six local health jurisdictions to deliver Connect to Wellness (then known as HealthLinks) to small worksites (20-250 employees) throughout the state with the goal to increase implementation of evidence-based interventions for chronic disease prevention and control.

Findings: Connect to Wellness, delivered by local health jurisdiction staff, increased implementation of evidence-based interventions at small worksites in six months. Worksites were also able to maintain their increased implementation of communications, new policies, healthy eating, and tobacco cessation up to one year after implementation began. During this study, local health jurisdiction staff worked part-time to deliver Connect to Wellness. They were nearly as successful as prior staff working full-time to deliver the program.

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Funding: Washington State Department of Health (DOH)

Principal Investigator: Peggy Hannon

Partnership for Vaccine Confidence (PaVC)

Dates: May 11, 2021 – Sept. 10, 2023

Overview: Increase vaccination rates for underserved communities within King County, Washington, specifically focusing on Latino, Black, and immigrant multigenerational households with elders and adults working in essential industries.

Funding: CDC, $500,000

Principal Investigators: Barbara Baquero

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Piloting the Remote Delivery of Falls Prevention Programs

Dates: Aug. 1, 2020 – March 31, 2022

Overview: Conducted evaluation for this project, including interviews with program administrators, staff, instructors, and leaders providing remote delivery of evidence-based fall prevention programs. Assessed what helped or created barriers during remote delivery. The project was led by the National Council on Aging, which contracted work with UW HPRC.

Finding and Products: A list of best practices for remote delivery of evidence-based fall prevention programs that can support organizations offering these programs.

Funding: U.S. Administration on Community Living, $64,000

Principal Investigators: Marlana Kohn

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Participatory Active Transportation for Health in South Seattle (PATHSS)

Dates: March 1, 2020 – June 30, 2021

Overview: Understand and address mobility challenges and opportunities in Beacon Hill, a South Seattle neighborhood that has historically been home for working-class community members of color. The PATHSS project is centered around the perspectives and needs of people of color. The research team will use participatory research methods guided by the principles of mobility justice, which includes youth photography-enhanced storytelling (photovoice), interviews with Beacon Hill partners and community members, and mobility audits.

Findings: To come.

Funding: UW Population Health Institute, $50,000

Principal Investigators: Barbara Baquero and Katherine Hoerster

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Technical Assistance for Washington State’s Arthritis Program

Dates: Jan. 1, 2019 – June 30, 2021

Overview: Provide technical assistance to Washington State Department of Health to disseminate and support the implementation of innovative practices for arthritis management.

Findings: A main focus of this project was to adapt and promote the Physical Therapist Referral Toolkit (PT-Refer Toolkit). Despite challenges presented by the COVID-19 pandemic, researchers were able to successfully connect with community partners and present at meetings and conferences to disseminate information about the PT-Refer Toolkit as well as update the toolkit to include possible remote delivery of the evidence-based program Enhanced Fitness.

Funding: Washington Department of Health Services, $36,100/year

Principal Investigator: Anne Turner

Compre Saludable (Shop Healthy) Seattle

Dates: July 1, 2020 – Nov. 30, 2020

Overview: Determine the links between economic sustainability, social value, and health in tiendas (Latino food retail businesses) with a community-based participatory and health equity approach to accomplish the following aims:
1) Identify challenges, opportunities, and strategies tiendas used to continue to operate during the pandemic.
2) Evaluate the feasibility, acceptability, and usability of a toolkit for tiendas to operate profitably and safely during the pandemic.

Findings: To come.

Funding: UW Population Health Initiative (PHI) Covid-19 Economic Recovery Research Grant, $35,000

Principal Investigator: Barbara Baquero

Progestin-Based Contraceptives & HIV

Dates: Sept. 30, 2014 – Sept. 29, 2019

Overview: Explore the association between hormonal contraceptive and antiretroviral therapy (ART) used by people who have HIV. Researchers investigated whether either treatment reduced the effectiveness of the other and whether progestin-based injectable contraceptive methods like DMPA create an enhanced HIV risk.

Findings: This study produced multiple findings, including ones not listed here.
Hormonal Contraceptives Impact on ART Effectiveness
The hormonal contraceptives assessed were not associated with reduced ART effectiveness among HIV-positive women initiating ART. HIV-positive women should continue to be offered contraceptive options, including hormonal ones, that best meet their needs. LEARN MORE
ART Impact on Hormonal Contraceptives
Hormonal contraceptive methods are highly effective in reducing pregnancy risk in HIV-infected women, including those concurrently using ART. LEARN MORE
DMPA & HIV Risk
The results of this study served as an important prelude to the ECHO trial, which evaluated the relationship between DMPA and HIV risk in a randomized trial. LEARN MORE

Funding: U.S. Centers for Disease Control and Prevention (CDC), $735,000

Principal Investigators: Jared Baeten and Jairam Lingappa