March 2024

DIRECTOR'S MESSAGE

It's March in the Triangle which means our thoughts turn to basketball. Three area teams are still in the men's tournament - UNC (HOORAY!), NC State (good for them!), and another local team who I have forgotten at this moment. As I watched the games over the weekend, I thought about the parallels between research and high stakes athletics like the NCAA Tournament – many of which are covered in this issue of the Newsletter. We know the importance of long term experienced leadership (whether they are coaches or project managers), talent cultivation, advanced analytics, and standing in front of people grilling you with questions.

We also continue the tradition of asking for support from our boosters -- please consider participating in GiveUNC Day today to help cultivate the next class of health services researchers. They are doing amazing things, and we appreciate your help in enabling their further career development.

Go Heels!

SHEPSTER SPOTLIGHT!

Johanna Hickey, MSW & Kathryn Wessell, MPH

Project managers play a crucial role in ensuring the success and efficiency of research endeavors at the Sheps Center. Johanna Hickey and Kathryn Wessell have served as project managers with the Program on Aging, Chronic Illness, and Long-term Care for many years and are invaluable to the Center. Read below to learn more about these wonderful Shepsters and their contributions to health services research across our state.

Johanna Hickey, MSW is a project coordinator with the Program on Aging, Chronic Illness, and Long-term Care. The Program conducts research with the goal of improving the well-being of older adults and the quality of care they receive. Johanna has been with the Program since 2018, and in that time has managed over a dozen research projects from inception to dissemination. Her role in the Program is to provide daily oversight of research management, supervise field staff, and provide consultation to ongoing projects as well as proposals and grants.

Kathryn Wessell, MPH is a project manager with the Program on Aging, Chronic Illness, and Long-term Care. In her almost 20 years at Sheps, she has worked on numerous research studies focused on improving the quality of care for people living with advanced illness, including Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD). Kathryn is also interested in outcome measurement for seriously ill populations and has been a research associate with the Palliative Care Research Collaborative (PCRC) Measurement Core and the NIA IMPACT Collaboratory Patient and Caregiver Relevant Outcomes Core (PCRO).

Today is the day! GiveUNC is Carolina’s university-wide day of giving—a day when alumni, friends, faculty/staff and other Carolina supporters come together to support the causes they care about most, like the Sheps Center.

As an important member of the Sheps Center community, you have an opportunity over the next 24 hours to make a difference. Your gift today will support early career health services researchers by providing them with mentorship, training opportunities, interdisciplinary faculty connections, a dedicated workspace in our building with a built-in peer network, and so much more, including fostering successful research and policy work that will affect the health of our communities, our state, and our nation.

Follow us throughout the day as supporters from all over come together to benefit the Sheps Center and the entire Carolina community!

Where Are They Now?

The Sheps Center supports several health services research and primary care research trainees each year, many thanks to GiveUNC gifts. Please take a look at the list below and see where some of these trainees are now.

On faculty at UNC:

• Joannie Ivory, MD, MSPH (Oncology)
• Christopher Jensen, MD, MSCR (Hematology)
• Deshira Wallace, PhD (Health Behavior)
• Bianca Allison, MD, MPH (Pediatrics)

At other universities and research organizations:

• Lexie Grove, PhD, MSPH (CMMI)
• Ryan Kandrack, PhD (Aledade, Inc)
• Leslie Adams, PhD (Johns Hopkins)
• Tainayah Thomas, PhD (Stanford)

Sheps Researchers on Capitol Hill

Mark Holmes, PhD, director of the Cecil G. Sheps Center for Health Services Research, testified before the U.S. House Committee on Veterans’ Affairs on January 11, 2024. The hearing, titled “Rural Access: Is VA Meeting All Veterans Where They Live?” aimed to assess the Department of Veterans Affairs’ provision of care and benefits in rural areas. Dr. Holmes highlighted the vulnerabilities of the non-VHA rural health care system for many rural veterans accessing community providers. 

Read more about this

On Wednesday March 6, 2024, Dr. Erin Fraher, Deputy Director for Policy and Director of the Program on Health Workforce Research & Policy at the Cecil G. Sheps Center for Health Services Research and Dr. Emily Hawes, Professor in the Department of Family Medicine and Associate Professor of Clinical Education in the UNC Eshelman School of Pharmacy briefed a bipartisan group of U.S. Senate Finance Committee staff and senior legislative assistants on rural healthcare workforce shortages and the importance of federally funded training and research support in addressing shortfalls.  

Sheps Center Hosts Inaugural Data Science Week

On January 17-19, 2024, the Sheps Center hosted the first Sheps Data Science Week. This event consisted of daily presentations covering topics from leveraging large observational data to using explainable boosting machines.

Neil Kamdar, MA, lead methodologist at the University of Michigan’s Institute for Healthcare Policy and Innovation and a consulting methodologist with the Sheps Center, was the key note speaker for the hybrid event and presented to a room full of people at the Sheps Center as well as about 60 attendees on zoom.

Recordings of the presentations can be found on the Sheps Center website.

Many rural communities in the U.S. face a shortage of behavioral health clinicians. This is worsened with the greater demand for care with the opioid epidemic and, on the positive side, a growing cultural acceptance of receiving mental health care.

Rural and underserved-focused training programs and clinical placements for behavioral health students is a common approach taken to help prepare students for later work in these settings. A study team from the UNC Schools of Medicine and Social Work as well as the Sheps Center was created. This team included Drs. Donald Pathman, Brianna Lombardi, Lisa Zerden, and colleagues at 3RNET - a partner featured in a previous issue. They recently assessed whether training in these special settings in fact better prepares behavioral health clinicians who go on to work in rural and underserved communities. The findings were published in a paper for the Journal of Rural Health.

In analyses of longitudinal survey data from more than 2,000 Licensed Clinical Social Workers, Licensed Professional Counselors and Psychologists working in community health centers, public mental health facilities and substance use disorder facilities within rural counties in 21 states, they found that nearly two-thirds had received some amount of training in providing care in underserved communities. Further, those who reported more training in rural, underserved settings also reported feeling better integrated into, and happier within, their rural communities than those with less such training. They also anticipated remaining longer in their safety net practices.

Forecasting Future Supply of Pediatric Subspecialties: Addressing Misalignment with Population Health Needs

The Program on Health Workforce Research and Policy at the Sheps Center partnered with Strategic Modelling and Analysis Ltd. (SMAP) and Dr. Colin Orr from the Department of Pediatrics at UNC-CH to develop a model forecasting the future supply of 14 pediatric sub-specialties. The model, released in January 2024, forecasts pediatric subspecialist supply out to 2040 at the national and subnational level. Findings suggest that the supply, and training locations, of pediatric subspecialists are not well aligned with population health needs. This work was undertaken with funding and collaboration from the American Board of Pediatrics Foundation. In addition to an interactive, web-based model that allows users to access and customize forecasts for specific subspecialties and geographies of interest, the model’s methods and findings were published in a supplement of Pediatrics in February 2024. Seven articles in the supplement were authored by the team that developed the model.

The projected growth of the pediatric subspecialty workforce does not align with projected growth of the child population. The South and West census regions are projected to increase their child populations more than the Northeast and the Midwest regions by 2040. Yet the supply of pediatric subspecialists is projected to be highest in the Northeast (Figure 1), a region where a large number of fellowship positions are located. The Northeast region is projected to see a 4% growth in the child population (0-18 years) by 2040 compared to a 19% growth in the South and 23% growth rate in the west.

Figure 1: Projection of Workforce Supply for All Pediatric Subspecialties (Combined) by Census Division, Baseline Scenario, 2040 

The North Carolina Department of Health and Human Services (NCDHHS) has launched the Child Behavioral Health dashboard as part of its commitment to enhance the well-being of children and families in North Carolina. A team from the Sheps Center and UNC School of Social Work, led by Dr. Paul Lanier, contributed to the development of the dashboard by preparing the Medicaid metrics, and organizing and analyzing the data.

This publicly available tool consolidates data from multiple sources, providing key metrics on indicators of need, child behavioral health diagnoses, and utilization of behavioral health care. Stakeholders, including policymakers, providers, and the public, can use this dashboard to identify and address gaps and disparities in behavioral health services for children. 

Read this press release from DHHS to learn more.

Shelby Rimmler, MPH

Workforce Program

Shelby is a research program manager for the HRSA-funded Rural Residency and Teaching Health Center Planning and Development Technical Assistance Centers. She has previously managed the development, implementation, and evaluation of two federally-funded health workforce development programs focused on increasing health provider supply to meet population health needs in rural and underserved communities.

Melissa Sandahl

Data Analytics and Research Team

Melissa is a data scientist on the Data Analytics and Research Team. She works with health care claims data to help investigators at Sheps and elsewhere at UNC answer research questions. She aims to provide new insights into the data for researchers and provide expertise on best practices for working with health care data.

Tess Koenigsmark

NC Medicaid 1115 Waiver Evaluation

Tess works with Sheps and NC Medicaid on evaluation and monitoring for North Carolina's Medicaid Reform Demonstration. This includes the transition to managed care, the substance use disorder waiver, and the Healthy Opportunities Pilot.

Salma Ali

Sheps Research Coordinator

Salma joined Sheps as a Research Coordinator for the Healthy Opportunities Pilots (HOP) evaluation team with Dr. Seth Berkowitz. Her work focuses mainly on conducting qualitative research as it relates to the evaluation of the HOP program.

Joanna Hinson

Program on Aging, Chronic Illness, and Long-Term Care

Joanna is a Research Assistant at the Sheps Center. With a background in Public Health, Joanna is passionate about serving her community and improving the quality of life for all. Joanna works on the Mouth Care Without A Battle project.

John Tuong, MSW

Program on Aging, Chronic Illness, and Long-Term Care

John is a social clinical research assistant the Sheps Center. His work focuses on engaging in projects to better improve nursing home care for older adults.

Russell P. Harris, MD, MPH

Dr. Russell Harris is Professor Emeritus of Medicine and Adjunct Professor of Public Health at UNC Chapel Hill and is a senior research fellow at the Sheps Center. He retired in 2018 but remains active in health services research. He is a prolific leader in the field of medical screening and prevention. Dr. Harris led a long and impactful career at UNC, beginning in 1985. During that time, he helped write the first Procedure Manual for the US Preventive Services Task Force (USPSTF), assisted in the creation of the UNC MD-MPH program, developed syllabi for multiple UNC School of Medicine courses, and authored many papers on screening for multiple conditions, prevention, and methodology. Dr. Harris lead the UNC section of the RTI-UNC Evidence-based Practice Center for many years and has served as PI on several projects related to quality of care and screening. Prior to coming to UNC, Dr. Harris helped to establish rural health clinics in Wilkes County and was the first medical director of Hospice of Wilkes, the first community-based Medicare approved hospice in NC. He now enjoys spending time with family, exploring our state, and staying involved with the current public health issues.  



What is your favorite Sheps-related memory?

My favorite memories are of the people. I have been very fortunate in my career to work with innovative, thought-provoking thinkers and educators. Many of these people were at Sheps. Just to name a few of the many people I learned from at Sheps: Anne Jackman, Bob Konrad, Bob Schwartz, Tim Carey, Gordon DeFriese, Jane Stein, Jamie Kohls, Erin Fraher, Dan Jonas, Mike Pignone, Noel Brewer, and many others. I had a hand in hiring many good people I learned from, including Audrina Bunton and Colleen Barclay.  

What is your current hobby/interest at the moment?

I am still involved in health issues, including screening, critical appraisal, methodology of guidelines. I have now been able to expand my interest in more public health issues, including the unhoused, poverty, addiction, opportunities for disadvantaged children, climate change. I am also – with my wife Linda Kinsinger – an avid hiker and have an interest in conservation of our mountains. I also love to read and have far too many books, and have done much more non-medical reading since leaving Chapel Hill. I also love to write and have been doing a bit of that too.

What is the best thing about retirement?

Being able to set my own schedule, decide on what project I will work on today. And spending more time with my wife, traveling, seeing my son, daughter, and new grandson more often.  

UPCOMING SHEPS EVENTS

Grand Book Launch of Equal Care: Health Equity, Social Democracy, and the Egalitarian State

April 9, 2024

1:00 - 2:30 PM

Sheps Center room 2002

Speaker: Author, Seth Berkowitz, MD, MPH

Spring IT Lunch & Learn: An Introduction to Double Machine Learning with DoubleML for Python and R

April 10, 2024

11:00 AM - 12:30 PM

Virtual

Speakers: Philipp Bach, PhD, MSc & Sven Klaaßen, PhD, MSc