Health Sciences – Page 13 – UROP Spring Symposium 2021

Health Sciences

Redesigning Prenatal Care: Social and Structural Determinants of Health in Prenatal Care

Prenatal care guidelines have not changed substantially in almost a century. Following COVID-19, many new approaches to prenatal care, including reduced visit schedules and telemedicine, were incorporated into practice. The purpose of this project is to generate the evidence to directly support these new prenatal care guidelines. This presentation will focus on the social and structural determinants of health (SDoH) in prenatal care. Social and structural determinants of health (SDoH) are factors that affect health and health outcomes, such as socioeconomic status, educational status, and exposure to discrimination. Formal attention to SDoH is atypical in standard prenatal care services, prompting the evaluation of prenatal care structure and content. This presentation provides information on the barriers and opportunities to change current prenatal care guidelines in addressing SDoH needs.

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Prefrontal-Hippocampal Interactions Supporting Memory Consolidation During Sleep

In this research I will explore how short term memories are supported by the hippocampus and prefrontal cortex. For this project, I trained a cohort of rats on a trace fear conditioning task to evaluate hippocampal-dependent learning and memory. Trace fear conditioning is a hippocampus-dependent learning task that obligates the cohort of rats used to associate an auditory conditioned stimulus (CS) and a minor shock used as the unconditioned stimulus (US) that are separated by an empty trace interval time period. I am currently analyzing the behavior of this cohort through characteristics such as ultrasonic vocalizations (USVs), freezing, and other behavioral traits. With this preliminary data, this project will exploit the effective methods of chronic electrophysiological and calcium imaging recordings in the future. These techniques will be used to probe how sleep influences long-term changes in cortical neurons following learning of a trace fear-conditioning memory task.

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Study of Pandemic Publishing: How Scholarly Literature is Affected by COVID-19 Pandemic

Borui Zhang Pronouns: He/Him/His Research Mentor(s): Yulia Sevryugina, Chemistry Librarian/ Senior Associate Librarian Research Mentor School/College/Department: Library, Presentation Date: Thursday, April 22, 2021 Session: Session 4 (2pm-2:50pm) Breakout Room: Room 15 Presenter: 6 Event Link Abstract For privacy concerns this abstract cannot be published at this time. Authors: Borui Zhang Research Method: Library/Archival/Internet Research

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Developing an eHealth Yoga Program for Children

With the rise in popularity of children’s yoga and a greater emphasis on both mental and physical health it is important to establish potential benefits that are reliable and backed by evidence found with strong methodology. Recent systematic reviews, focusing on school aged yoga studies, concluded that methodological limitations such as not measuring fidelity of program implementation (FOI) make it difficult to provide trustworthy conclusions. A component of FOI assessment is establishing Inter-rater reliability for observational measures. This study will explore the potential benefits in children as a direct result of a virtual yoga program implemented into the school day, looking specifically at levels of physical activity, stress, and interoceptive awareness, as well as sleep patterns. Trained raters will identify whether children are on task or off task during the virtual yoga sessions. To measure outcome changes, parents/guardians will complete online surveys using valid and reliable scales. In order to limit statistical ambiguities between raters, they completed three rounds of trainings and practice using recorded yoga sessions. Percent agreement and Cohen’s kappa were established, and necessary adjustments were made to the coding system before the next round of practice. Agreement between the raters improved over the practice trials demonstrated by a change in Cohen’s kappa (k = 0.56 to 0.80). Having reliable participation data will allow the researchers to compare levels of participation with data collected from the parent/guardian surveys. Results will establish reliable new evidence for the field and have important applications for future yoga research in school-based settings.

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The role of pathology explanation clinics as a treatment decision aid for men with prostate cancer

Sophia Kurnot Pronouns: she/her/hers Research Mentor(s): Cathryn Lapedis, Assistant Professor Research Mentor School/College/Department: Pathology Department, Michigan Medicine Presentation Date: Thursday, April 22, 2021 Session: Session 4 (2pm-2:50pm) Breakout Room: Room 10 Presenter: 5 Event Link Abstract For privacy concerns this abstract cannot be published at this time. Authors: Sophia Kurnot, Sarah Bergholtz, Melissa DeJonckheere, Todd

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Individualized Cancer Care Follow-Up Study: A study examining women’s health care experiences since diagnosis with breast cancer

Improvements in breast cancer screening and treatment have led to a positive but difficult complication – the healthcare system is suddenly faced with an overwhelming influx of survivors it has little experience in managing, and the lasting effects of the disease and its treatments make long-term follow-up care necessary. Socio demographic disparities and the exponentially growing number of survivors necessitate the involvement of both oncologists and primary-care physicians (PCPs) in survivorship care, and this adds further potential obstacles in the way of universal high-quality care for survivors. To better understand these disparities and the current reality of how survivorship care is delivered by oncologists and PCPs, we conducted a five-year follow up survey of 2500 women with a history of breast cancer in California and Georgia. PCP involvement in survivorship care was assessed, with an emphasis on discovering any disparities therein. Overall disparities in the quality of survivorship care based on socio demographic factors were also investigated. Lastly, we assessed whether increased PCP involvement in survivorship care led to an increase in the quality of survivorship care received. We hypothesized that oncologists would play a primary role in survivorship care with the PCPs role lacking consistency across the sample population. We also hypothesized that clear care-based disparities would exist across socio demographic lines and that greater PCP involvement would reduce these disparities. Assessing the current status of survivorship care will help reveal the system’s flaws in more detail, allowing for a focused approach on specific improvements moving forward.

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A population-based virtual solution to reduce gaps in genetic risk evaluation (GRE) and management in families at high risk for hereditary cancer syndromes

Genetic test results and their implications, which carry weight not only with the patient but with the patients first and second-degree relatives, are currently understudied. The U01 GeneLINK Trail is “a population-based virtual solution to reduce gaps in genetic risk evaluation (GRE) and management in families at high risk for hereditary cancer syndromes.” There are many complexities in the clinical context after initial genetic risk evaluation takes place and even more arise in communicating this to at risk relatives(ARRs). Barriers like language and socioeconomic status can also play a role in determining the likeliness of someone seeking out GRE. That is why this study aims to develop and test a virtual family-centered communication and decision-making platform, the Family Genetic Health Program (FGHP). As well as determine the independent effects of two design features -level of personalized family genetic risk support and cost of genetic testing for relatives.The study population is selected from the Georgia-California SEER Genetic Testing Linkage Initiative, their data spanning from 2013-2019. Uniform surveying will be the main data collection method.With this study we expect to find out more about 1) cancer patients’ appraisal of communication & engagement with relatives about genetic risk evaluation; 2) relatives’ appraisal of decision-making and receipt of genetic testing (primary outcome); 3) relatives’ completion of formal genetic risk evaluation. The hopes are that this will help lower-resourced practices as well as minority communities who may face a number of barriers that bar them from typically seeking out formal GRE.There is huge potential to improve the ways that patients and ARRs navigate GRE and also aid the prevention of heritable cancer syndromes in the US.

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SIMPL User Engagement

This study aims to assess the impact of sending a list of the 5 most active faculty and residents to programs on the program’s engagement with a trainee operative performance assessment mobile application known as SIMPL. SIMPL is a mobile app that allows trainees to request evaluations of their operative performance and also supports supervising attendings submitting evaluations independent of the trainee. Because the evaluation process is dependent on a person going into SIMPL and submitting the evaluation, engagement with the application has been historically low. General surgery programs were randomly assigned to two cohorts of the intervention arm of the study. The A cohort were sent their top 5 list weekly and the other B cohort recieved it bi-weekly. Each program was emailed a slide of the top 5 faculty & resident users for the designated time period according to the cohort to which the program has been assigned. Faculty and trainee engagement data were recorded for the designated time period and will be used to create the “top 5” slides. A third cohort, Cohort C, where no action was taken was identified and engagement data tracked. An analysis of the engagement data among the three cohorts will be conducted to determine what if any impact sending a leadership board has on user engagement with the SIMPL application. If engagement was improved by sending a leadership board, an effort to automate the manual task of sending a leadership board will begin. This information can also be helpful to improve engagement with other medical education applications.

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SIMPL User Engagement

SIMPL User Engagement This study aims to assess the impact of sending a list of the 5 most active faculty and residents to programs on the program’s engagement with a trainee operative performance assessment mobile application known as SIMPL. SIMPL is a mobile app that allows trainees to request evaluations of their operative performance and also supports supervising attendings submitting evaluations independent of the trainee. Because the evaluation process is dependent on a person going into SIMPL and submitting the evaluation, engagement with the application has been historically low. General surgery programs were randomly assigned to two cohorts of the intervention arm of the study. The A cohort were sent their top 5 list weekly and the other B cohort recieved it bi-weekly. Each program was emailed a slide of the top 5 faculty & resident users for the designated time period according to the cohort to which the program has been assigned. Faculty and trainee engagement data were recorded for the designated time period and will be used to create the “top 5” slides. A third cohort, Cohort C, where no action was taken was identified and engagement data tracked. An analysis of the engagement data among the three cohorts will be conducted to determine what if any impact sending a leadership board has on user engagement with the SIMPL application. If engagement was improved by sending a leadership board, an effort to automate the manual task of sending a leadership board will begin. This information can also be helpful to improve engagement with other medical education applications.

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A National Study of Barriers and Facilitators of Expedited Partner Therapy Use in Emergency Departments: A Qualitative Study

Background: Emergency Departments (ED) are the primary source of healthcare for many patients diagnosed with sexually transmitted infections (STIs). Expedited partner therapy (EPT), treating the partner(s) of patients with STIs without an exam, is an evidence-based practice for individuals who might not otherwise seek care. Methods: We conducted semi-structured, open-ended interviews with ED medical directors and key medical personnel within different institutions. Participant enrollment continued until thematic saturation was reached. Our interview guide and initial coding were informed by the Consolidated Framework for Implementation Research (CFIR). Interviews were recorded, transcribed, and iteratively coded, and qualitative thematic analysis was used to identify themes and subthemes by consensus. Results: We interviewed 12 medical directors and key informants, including a resident, follow-up nurse, program director, 2 pharmacists, and a physician champion. Some of the primary barriers to EPT were legal liability, lack of a specific implementation process, and the stigma surrounding sexual health. Facilitators of EPT included a clear delineation of task-sharing responsibilities for prescribing EPT, efficient electronic medical record prescribing, and leadership engagement. Many participants acknowledged the ED’s potential role in improving sexual health especially for marginalized populations and expressed a desire to use this practice if it was streamlined and did not affect departmental flow. Conclusions: The non-traditional processes involved in EPT present many challenges for adoption in the ED. Understanding these barriers and facilitators will assist in designing strategies for the implementation of EPT.

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