How one Penn center is addressing Philadelphia's opioid epidemic

CPHI was recently featured in the Penn Current. " The Center for Public Health Initiatives is hosting speakers, forming important working groups, taking on tough topics, and running full steam ahead in educating the community about the opioid epidemic." 

Read the full article here.
CPHI is Celebrating 15 Years of Public Health! 

The Center for Public Health Initiatives (CPHI) and the Master of Public Health (MPH) Program are thrilled to celebrate the anniversary of 15 years of public health on Penn's campus. From the inception of the MPH degree program in 2002, to the formation of CPHI in 2007, public health has grown tremendously at Penn. We continue to celebrate this growth, as well as the accomplishments of our students, faculty, fellows, and community partners.

Read our Anniversary Report to learn about the exciting activities and initiatives
CPHI Seminars and Talks
Innovation and Digital Health 
Thursday, February 15 at 12:00 PM | Light Lunch Provided 
Bodek Lounge in Houston Hall 

Raina Merchant, MD MSHP
Associate Vice President and Director 
Center for Digital Health Penn Medicine

Dr. Raina Merchant is an Associate Vice President at Penn Medicine and an Associate Professor of Emergency Medicine at the University of Pennsylvania. She has secondary appointments in the Department of Internal Medicine and Department of Anesthesia and Critical Care. She is the Director of the Center for Digital Health and Co-Director of the Penn Robert Wood Johnson Foundation (RWJF) Clinical Scholars Program (CSP) and the National Clinician Scholars Program.

Dr. Merchant attended Yale University for her undergraduate degree, University of Chicago for Medical School, and the University of Pennsylvania for a Masters of Science in Health Policy Research and the RWJCSP. Her work is at the intersection of digital media and health. She has specifically conducted projects evaluating health behaviors and communication on digital platforms like Facebook, Twitter, Yelp, Instagram, and Google. One of her projects in this area involves "banking language" through the development of a unique longitudinal database of social media data merged with health record data. Much of her work also bridges new technologies in the field of cardiovascular health and resuscitation science. In this context, she is the Director of the MyHeartMap Challenge, (http://www.med.upenn.edu/myheartmap/) a social media and crowdsourcing project aimed at improving (automated external defibrillator) AED access and awareness by engaging the public to serve as citizen scientist.

Dr. Merchant is currently funded by the NIH and has over 100 peer-reviewed publications in journals such as NEJM, JAMA, Circulation, and Health Affairs. Her work has been featured in Wired, the Economist, the Wall Street Journal and others. She was recently recognized by the Robert Wood Johnson Foundation as one of 10 young investigators likely to have a significant impact on the future of health and healthcare in the US.

Use of Teledermatology in Global and Community Health
Thursday, March 15 at 12:00 PM | Light Lunch Provided 
Claudia Cohen Terrace Room 

Description: Teledermatology has the potential to improve access for patient care within local and global health care systems and provide an efficient, patient-centered experience. Teledermatology can be used to improve patient care, access, and outcomes in a variety of ways, including triage, urgent care, inpatient consultation, direct follow-up with known patients, and patient monitoring, when integrated into the patients' overall medical care. In order to optimize the use of telemedicine in a particular site, many issues need to be taken into account, including motivation of providers to participate, participation of local health care entities, provider and patient access to high speed internet/ cellular service, and m any others. This lecture will cover a global experience with teledermatology, as well as challenges and pitfalls that can be faced when working with technology in low resource environments.

Carrie L. Kovarik, MD is an Associate Professor of Dermatology, Dermatopathology, and Infectious Diseases at the University of Pennsylvania. Dr. Kovarik has a special interest in global and community health, telemedicine, informatics, and HIV-related skin disease. She created the Penn Dermatology Global Health program, through which she works to provide clinical care and education in developing countries and underserved communities in the United States. Dr. Kovarik is the Head of Dermatology, Informatics, and Telemedicine for the Botswana-UPenn Partnership and has created a global telemedicine consult service which is a collaborative effort between Ministries of Health, local telecommunication and software companies, universities, specialty organizations, numerous countries, and local governments. She is now focusing on developing, sustaining, and researching new models of health care that can increase access to care through telemedicine.

Other CPHI Events
Wellness Walks for Penn Employees 
Friday's from 12:00-1:00 beginning at College Green 

Spring 2018 Dates: 
February 16 (Indoor at Palestra) 
March 16 (Indoor at Palestra) 

We meet at the Ben Franklin statue in front of College Hall (except when indoors) at 12 noon. The walk begins with stretching, followed by a 2 mile walk around campus and beyond. This is a great opportunity to get away from your desk and walk with others. Plus- you'll receive points for Penn HR's "Be In the Know Campaign" if you are a Penn employee. 
 
Visit the HR website to sign up. 
 CPHI Fellow Highlights and Publications 

The mediating role of sleep in the fish consumption - cognitive functioning relationship: a cohort study

CPHI Senior Fellow Jianghong Liu , CPHI Executive Director Jennifer Pinto-Martin and colleagues have linked regular consumption of fish to better sleep and higher IQ scores in children. Fish consumption grants ingestion of omega-3s, which are known to be related to better sleep and improved intelligence. The present study makes the connection between these three variables. The group found that children who consume fish at least once a week have IQ scores 4 points higher on average. These findings implicate recommendations for introducing regular fish consumption to children's diets. Read more.

Weight status, diet quality, perceived stress, and functional health of caregivers of children with autism spectrum disorder

CPHI Executive Director Jennifer Pinto-Martin  and Associate Fellow Tanja Kral , along with colleagues, investigate the role of possible increased levels of stress in caregivers of children with autism spectrum disorder (ASD). Specifically, the group compares the weight status, diet quality, perceived stress, and functional health and well-being of caregivers of children with ASD and typically developing children. The results are as follows. In terms of weight status, the two groups of caregivers did not differ in BMI or obesity prevalence, despite caregivers of children with ASD consuming significantly fewer empty calories. In terms of perceived stress, the parents of children with ASD reported significantly higher levels of stress related to parenting. Overall, though, the two did not differ significantly in health outcomes.   Read more.

Perceptions about supervised injection facilities among people who inject drugs in Philadelphia

CPHI Fellows Evan Anderson, Rosemary Frasso,  and MPH alumni Robert Harris and Jessica Richardson evaluated the perceptions of injection drug users on prospective use of a supervised injection facility (SIF). SIFs are locations which provide a safe and clean environment for sterile injection drug use, though none exist currently in the United States. The group enlisted perceptions from individuals at a Philadelphia syringe exchange program. The researchers found a difference in preferences regarding a prospective SIF between individuals with and without stable housing. Those with stable housing explained that they would prefer to continue injecting at home for security reasons. Other findings include the overall perception that SIFs would improve public health and neighborhoods. Read more.

A qualitative study of the experience of lower extremity wounds and amputations among people with diabetes in Philadelphia

CPHI Senior Fellows Frances K. Barg , Peter F. Cronholm , and collaborators studied the perspectives of diabetes patients who had either a foot ulcer or a lower extremity amputation. Data for this research was purely qualitative, gathered through interviews, coded, and assessed for similarities. Notable results include: both groups of patients expressed disruption and loss of independence, patients with foot ulcers expressed difficulty in treatment recommendations, and patients with amputations expressed initial fear, but eventual adaptation and acceptance. Overall, an important point of discussion was quality of life, and the researchers discuss how quality of life should factor into care decisions. Read more.

Coercive Control in Intimate Partner Violence: Relationship With Women's Experience of Violence, Use of Violence, and Danger

CPHI Senior Fellow Melissa E. Dichter and Fellow Karin V. Rhodes , along with colleagues, investigate coercive control and its associations with women's experiences of forms of intimate partner violence, use of violence, and risk of future violence. Coercive control is defined as a "systematic pattern of behavior that establishes dominance over another person through intimidation, isolation, and terror-inducing violence or threats of violence." Findings show that those experiencing coercive control reported higher frequency of each form of intimate partner violence as well as high levels of risk of revictimization. Additionally, the group found an association between coercive control and use of physical intimate partner violence, which may be a survival strategy. The group further discusses implications of the discovered associations. Read more.

Declining Medicaid Fees and Primary Care Appointment Availability for New Medicaid Patients

CPHI Senior Fellow Daniel Polsky , Fellow Karin Rhodes , and partners examine whether lower fee levels for Medicaid was associated with decreased primary care appointment availability for new Medicaid patients. Historically, when Medicaid fees increased in 2013-2014, primary care appointment availability for new Medicaid patients also increased. The team conducted an audit study, in which new Medicaid patients were simulated and called randomly selected primary care offices to request the earlier appointment available; this study occurred in 2012, 2014, and 2016, representing key points in the Medicaid fee transitions. The appointment availability in 2012 was 56.2%, 65.5% in 2014, and 61.5% in 2016, following the pattern of fee increase followed by fee decrease. Though, this relationship is robust, and the researchers claim that it is not a dependent relationship. Read more.

Impact of school-based and out-of-school mental health services on reducing school absence and school suspension among children with psychiatric disorders

CPHI Senior Fellows Rinad S. Beidas and David S. Mandell , along with collaborators, investigated the impact of Philadelphia's School Therapeutic Services (STS) teams, specifically regarding absenteeism and suspension. Additionally, the researchers examined the effects of such interventions relating to out-of-school, community-based mental health services. STS teams are responsible for optimizing the integration of mental health services in schools. They found that community-implemented, school-based mental health services reduce school suspensions, and out-of-school mental health services correlated to reduced absences. Also, they found an increase in the use of out-of-school services during the STS enrollment year. These findings are important for policy decisions regarding the most effective settings for youth and adolescent mental health services. Read more.

Does Seeking e-Cigarette Information Lead to Vaping? Evidence from a National Longitudinal Survey of Youth and Youth Adults

CPHI Senior Fellow Robert Hornik and colleagues investigate the relationship between health information seeking behavior and e-cigarette use and vaping among young adults. Interestingly, e-cigarette use has recently been put under the oversight of the Food and Drug Administration, and the results of this study is designed to inform on how information seeking behaviors influence the beginning or continuation of such behaviors. The group administered a nationally representative survey of teens and adolescents. The results show that "both vaping intentions and e-cigarette information seeking predicted vaping or using e-cigarettes six months later." The group comments on the implications of the high volume of pro-e-cigarette information available and offers suggestions regarding regulation. Read more.

Elders and Money

CPHI Senior Fellow Jason Karlawish was mentioned in a Philly.com article titled "Elders and Money," for his presentation at a conference in December 2017 featuring the Federal Reserve Bank of Philadelphia and the University of Pennsylvania. Karlawish presented research demonstrating a correlation between "decline in cognitive ability in older adults and poor financial judgment." Implications for this correlation include vulnerability to exploitation and fraud.

Where do bike lanes work best? A Bayesian spatial model of bicycle lanes and bicycle crashes

CPHI Senior Fellow Douglas J. Wiebe and colleagues seek to identify specific locations where bike lanes would effectively reduce crash incidence. The group utilize Bayesian conditional autoregressive logit models to determine where such locations may exist in Philadelphia. The results show that bike lanes were "associated with reduced crash odds of 48% in street segments adjacent to 4-exit interactions." Furthermore, areas of one- or two-way stop intersections were associated with reduced crash odds of 40%, and high traffic volume regions were associated with odds of 43%. The group concludes that "the effectiveness of bicycle lanes appears to depend on most of the configuration of the adjacent interactions and on the volume of vehicular traffic." Such findings can be transferrable to other municipalities, as claimed by the researchers. Read more.

Risky movies, risky behaviors, and ethnic identity among Black adolescents

CPHI Associate Fellow Amy Bleakley and colleagues examine whether a relationship exists between exposure to explicit content in mainstream and Black-oriented movies and corresponding behavior among Black youth. To do so, the researchers examined survey data from 1000 Black adolescents, which granted data on self-reported exposure to alcohol, sexual activity, and violence in popular and Black-oriented films. Corresponding risky behaviors included actions such as frequent alcohol use, risky sexual behavior, and physical aggression. The group found that films including violent or alcohol content were associated with the aforementioned corresponding risky behaviors. Moreover, they found that strong group identity, related to ethnicity, strengthened the relationship between certain films involving sexual activity. Read more.

Measurement Error Due to Patient Flow in Estimates of Intensive Care Unit Length of Stay

CPHI Associate Fellow Michael Harhay and colleagues investigated the effects of immutable time, or additional time accrued by patients after they are deemed ready for discharge, on the measurement and statistical comparison of patients' intensive care unit (ICU) length of stay. ICU length of stay is a common endpoint measurement in related randomized clinical trials, and it is often compared between trials. The group found that, on average, immutable time attributed to an additional one-third of a day to patients' total length of stay in the ICU. The group explains that such effects "might either mask true treatment effects or suggest false treatment effects relative to analyses of time to discharge readiness." Read more.

Critical Access to Care: Bringing Contraception to Adolescents in Nontraditional Settings

CPHI Associate Fellow Cynthia J. Mollen and a colleague provide a comprehensive overview of the climate surrounding contraceptives for adolescents, specifically in nontraditional settings such as the emergency department, which is sometimes the only source of healthcare for some individuals. The pair discuss issues currently faced by stakeholders of this topic. For example, a prominent obstacle involves confidentiality and policies surrounding an adolescent's ability to consent to contraceptive care. Mollen and colleague call for more research, program, and policy efforts in this arena to improve health outcomes for adolescents. Read more.
Want to become a CPHI Fellow?
CPHI welcomes new voices and representations from various sectors related to health. 
To become a Fellow, please visit our website and apply!

Other Public Health Events

Philadelphia Public Health Grand Rounds
Gun Violence in Philadelphia:Actions and Solutions 
February 28, 5:30-7:30 | College of Physicians at 19 S. 22nd St

Local public health officials, health-care providers, and community advocates come together to discuss the epidemiology of gun violence in Philadelphia, the effects it has on individuals, families, and communities, and innovative approaches to prevention.

This free Philadelphia Public Health Grand Rounds will discuss what is known about gun violence in the city and activities in the Philadelphia community to prevent future injuries and deaths from firearms.  Register here 

College of Physicians Senior Health Forum lectures
College of Physicians at 19 S. 22nd St

Wednesday February 14, 2018 @12PM
Jack Ende-"The Annual Physical Exam:  What to Bring, What Should Happen, and With What Should You Leave"
 
Wednesday March 14, 2018 @12PM
Janet Haas--  "Palliative Care:  What It Is & What It Isn't"
 
Wednesday April 11, 2018 @12PM
Gail Scott-"Older People Don't Do/Use Drugs, Do They?"
 
Wednesday May 9, 2018 @12PM
Heather Claus-"What's All the Fuss About Vaccinations for Older People?"

Population Health Colloquium
March 19-21, 2018 | Loews Philadelphia Hotel 
This 3-day conference will bring together stakeholders including healthcare providers, payers, pharmaceutical executives, leading technology and solutions companies, academia and government to share best practices, case studies, expert insights and industry trends. 

With more than 700 attendees, the Colloquium has become the leading conference on population health. The full conference agenda  can be found on the  Colloquium website. 

Global Health & Innovation Conference: Call for Abstracts 
April 14-15, 2018 | Yale University, New Haven, Connecticut
The Global Health & Innovation Conference at Yale on April 14-15, 2018, is the world's leading and largest global health conference as well as the largest social entrepreneurship conference, with 2,000 professionals and students from all 50 states and more than 55 countries. This must-attend, thought-leading conference convenes leaders, changemakers, professionals and students from all sectors of global health, international development, and social entrepreneurship.  Register Here. 
Public Health Job & Fellowship Opportunities

ORISE Research Opportunity 
The U.S. Army Public Health Center is actively seeking to fill one  ORISE research opportunity is available located at Fort Benning, GA.  This is a twelve month appoint and can be renewed up to five total years of participation.  The ideal candidate will have completed a Masters of Public Health, Masters of Science or equivalent who is familiar and has experience with clinical research.  U.S. Citizenship is required.  This opportunity includes, but is not limited to, the following:

Fort Benning, Georgia is the Maneuver Center of Excellence, the 75th Ranger Regiment and the 4th Airborne Ranger Training Brigade and this post trains over 67,000 Trainees in the US. Army. In addition, we are in the process of establishing a Heat Injury Center of Excellence. We have numerous research opportunities on Musculoskeletal Injury, Heat Injury, and Performance Optimization. The intern should be able to:
a) participate and assist with clinicians, family medicine residents and faculty to help build a clinical research division and research portfolio in a large military hospital setting at Martin Army Community Hospital, Fort Benning, GA;
b). Assist with coordinating and obtaining necessary and required documents needed for Institutional Review Boards, clinical trials and other research activities involving human subjects

c) Maintains effective communication and interaction with Principle Investigators, Clinical Site Managers, IRBs, regulatory personnel and others to ensure the development of the research program.

d) Assists in developing, creating and writing clinical protocols for submission to the Regional IRB. Participates in developing research project, assists in statistical design, statistical analysis and overall program analysis. 

Interested candidates must apply to the research opportunity:

Project Title: Clinical Research
Project ID: APHC-3807113239

Be sure to check out the  ASPPH Friday Letter  for News, Events, and Opportunities.  Click here  to sign up to receive the letter. 
Please send us news and events to include in this digest: [email protected]
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