As 2022 approaches an end, I – like most of you, certainly – reflect on what the last year has brought personally and professionally. Flipping the calendar is a metaphorical opportunity to pause and step back -- What are we doing well? Where are we succeeding? Over the last two months in particular I have had occasion to step back and take a more holistic view of Sheps Center achievements, and there is a lot to be proud of. But it’s also important to think critically -- What are key topics in health services research we could do more in? Is there a niche we could fill? How do we get there? Are there opportunities we can capitalize on?
Behavioral health has long been a strength of Sheps, largely drawing from work by people like former Deputy Director Joe Morrissey. While retirements and other departures have slowly eroded some of this activity, other Sheps investigators (e.g. Dr. Green) have kept as busy as ever. But the last few months have seen new projects and interest that have injected new energy, resources, and interest into behavioral health. The new Behavioral Health Workforce Research Center and the evaluation of North Carolina’s SUD waiver provide infrastructure and a critical mass of investigators and staff with interest and expertise. Meanwhile, new connections across campus are forming, with many of them centered at Sheps – through behavioral health-related projects, other projects that suggest new innovations applicable to behavioral health, or infrastructure engagement. In this newsletter, we review some recent activities of note in the behavioral health field.
I hope you enjoy reading about your colleagues’ accomplishments and welcome the new faces. More personally, I hope you and your loved ones have a happy, healthy, and safe holidays and I look forward to continuing our work together next year.
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Sherri Green, Ph.D., Dipl Ac., MSW, LCSW
Dr. Green is a Research Fellow at the UNC Sheps Center for Health Services Research and an Associate Research Professor in the Department of Maternal and Child Health. She is also an executive leadership coach. Dr. Green primarily works at the intersections of health and behavioral health for women, children, and families affected by substance use disorders and chronic health conditions amplified by experiences of trauma, racial and ethnic bias, poverty and rural access to care barriers. Dr. Green has had a distinguished career working with state and national leaders on health policy and in bringing millions of dollars in grant monies to North Carolina aimed at increasing access to integrative care and reducing healthcare barriers. Two of her recent projects were funded by AHRQ, one focused on expanding access to primary care based medication-assisted treatment in North Carolina for persons with opioid use disorders, and the other as part of a national pandemic response that aimed to increase support and capacity for those working with some of our most vulnerable elder populations. In all of her work, Dr. Green aims for inclusivity and to support the value of integrative and collaborative care. One could summarize by saying that Dr. Green works as a bridge encouraging practice to inform research and research to inform public health policy and evidence based care.
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Paul Lanier named Co-Director of the Mental Health Program |
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Dr. Paul Lanier is an Associate Professor in the School of Social Work and a Research Fellow at the Sheps Center. He will co-direct the Mental Health and Substance Abuse Services and Systems Research program at Sheps, joining Dr. Marisa Domino. Dr. Lanier will bring his expertise in mental health and child welfare to the program. Center leadership is thrilled that Dr. Lanier is stepping into this role and is excited to see this program flourish. |
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T he Sheps annual holiday party was held in early December after a two-year break. Shepsters enjoyed gathering in the renovated space, which was perfect for this type of event. A delicious meal was catered by Vimala's CurryBlossom Café and a lively white elephant gift exchange took place following lunch. The Center is looking forward to bringing back more in-person events in the new year, including the DeFriese Lecture in March 2023.
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Workforce Program receives federal funding for two research centers |
The Cecil G. Sheps Center for Health Services Research has been awarded two Health Resources and Services Administration (HRSA) agreements to fund research centers.
With the 5-year $4.5M award, Brianna Lombardi and deputy director Lisa de Saxe Zerden will become the only federally-funded workforce center specifically focused on the behavioral health workforce. The UNC Behavioral Health Workforce Research Center (UNC-BHWRC) will conduct rigorous, data-driven research that will inform policy and planning to strengthen the behavioral health workforce and increase access to quality services delivered by practitioners from diverse backgrounds. UNC-BHWRC will produce the evidence needed to inform funding programs and strengthen training that improves access to, supply of, distribution, diversity, and quality of the behavioral health workforce.
The Program on Health Workforce Research and Policy also received a 5-year, $2.25 million award to support the Carolina Health Workforce Research Center (CHWRC). The CHWRC, established in 2013 and directed by Erin Fraher, focuses on a wide range of emerging health workforce topics. This year, the CHWRC will conduct research on: the changing number and composition of the nation’s health workforce in response to the pandemic and evolving care delivery and payment models; the organizational, professional and societal factors that contribute to provider wellness and career satisfaction; the interprofessional, team-based models of care needed to provide integrated primary, behavioral health, and social care to underserved populations; and the contributions of Historically Black Colleges and Universities to physician workforce diversity.
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ACURE4Moms aims to reduce Black-White disparities in perinatal outcomes |
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ACURE4Moms is a randomized controlled trial that aims to improve maternal health outcomes, satisfaction, and communication, particularly for Black moms. ACURE stands for “Accountability for Care through Undoing Racism and Equity.” A team of clinicians leads the study, community-based doulas, and researchers across the state.
The study aims to reduce Black-White disparities in perinatal outcomes, including low birth weight, through practice-based interventions. There are 4 different “arms” of this study – ranging from: standard care management, practice-based data interventions, community-based doula support for high-risk patients, and a combination of both the data interventions and doula support.
For the 20 practices in the two data intervention arms, the NC Health Information Exchange will be building 1) a disparities dashboard and 2) a real-time maternal early warning system. The Sheps Data Analytics (DA) Team and the Sheps Integrated Research Solutions (SIRS) Team will both be collaborating with the NC Health Information Exchange (HIE) on this effort. The DA Team will be managing all the data from the practices and from HIE to generate progress reports throughout the study and to perform final data analysis. The SIRS team will receive data from the DA team and build a custom tracking system for project management, A4MTracker, to track all project consents, surveys and incentives.
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2022 Hettleman Prize awarded to Dr. Seth Berkowitz |
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The annual Phillip and Ruth Hettleman Prizes for Artistic and Scholarly Achievement have been awarded to four promising faculty members who exemplify groundbreaking and innovative research and future career promises.
Seth Berkowitz, MD, MPH, associate program director for the HRSA Primary Care Research Fellowship and Associate Professor of Medicine, was awarded for his research contributions. His work examines and addresses health-related social needs that impact social medicine and inspire faculty and students at UNC-Chapel Hill to consider that, in many cases, the most important root causes of health are social and economic.
Throughout over 50 peer-reviewed original research publications, Berkowitz has moved from epidemiologic studies of food insecurity to designing and testing innovative interventions to address it. His work has been published in high-impact journals and has impacted nutrition and health policy; he has had many Sheps-based grants including Healthy Food First.
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Sheps Center's ongoing independent evaluation of the Substance Use Disorder (SUD) for Medicaid Waiver |
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The Substance Use Disorder (SUD) component of the North Carolina Medicaid 1115 Waiver began on January 1, 2019 and will expire on October 31, 2023. In 2018, The Sheps Center was awarded the contract to become the independent evaluator of this waiver.
The broad project consists of over thirty investigators, consultants, subcontractors (Arizona State University, Virginia Commonwealth University, and Duke University), and Sheps Center staff, including the Data Analytics and Web Development teams. Although the managed care component of the waiver often gets the headlines, the Substance Use Disorder (SUD) waiver is also being evaluated. Sheps Senior Research Fellows Marisa Domino and Kathleen Thomas recently led a Midpoint Assessment to gauge progress on the SUD waiver. This interdisciplinary team uses mixed methods to examine the services for SUD provided to Medicaid enrollees and how the waiver is affecting outcomes. With one of the three goals of the Medicaid Waiver being to reduce substance use disorder, the evaluators use specific metrics to determine whether expanded coverage of SUD services is helping to meet that goal.
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NEW FACES AT THE SHEPS CENTER |
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Marta Orellana, MPA
Data Analytics
Marta is a Research Associate / Data Analyst for the Sheps Center. Her love for data began during her master’s program when she did research to help launch the New York State Slavery Records Index. It continued to grow when she became a program manager for CUNY LEADS PLUS. After taking courses, her favorite programming languages include SQL, R and now SAS.
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Jessica Vaughan
UNC-RTI EPC
Jessica is a Research Specialist with the RTI-UNC Evidence-based Practice Center, assisting with project coordination. She joined the team at Sheps in January 2022. Her background is in psychiatry and clinical research. Jessica’s research interests include maternal and sexual health, mental health, epidemiology, and data analytics.
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Chase Latour
NRSA Predoctoral Trainee
Chase Latour is a 4th year doctoral student in the Department of Epidemiology at UNC-CH Gillings School of Global Public Health. Her broad goals as a researcher are to provide evidence on medication safety and efficacy among patients typically excluded from clinical trials while investigating methodologic issues that complicate these study questions. Her dissertation is focused on pharmacologic treatment of chronic hypertension in pregnancy and exploring how to better investigate these questions in electronic health record data.
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Orrin Ware, PhD
Research Fellow
Dr. Ware is an Assistant Professor in the School of Social Work and his research examines adult substance use disorder treatment, especially among those with co-occurring mental health disorders. He is interested in the whole gambit of substance use disorder treatment, from reducing barriers to treatment entry to improving outcomes for individuals after they are discharged from treatment. To answer his research questions, Dr. Ware uses large publicly available datasets, electronic medical records, and data captured by primary data collection. Dr. Ware uses his interdisciplinary background as an applied public health researcher and licensed clinical social worker to inform his research agenda.
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Assisted living too often fails older, sicker residents, ...
Assisted-living communities too often fail to meet the needs of older people and should focus more on residents' medical and mental health concerns, according to a recent report by a diverse panel of experts. It's a clarion call for change...
Read more
www.washingtonpost.com
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Should NC operate its Medicaid oral health program?
As lawmakers ponder whether to expand Medicaid to add some 600,000 more people to the rolls, the North Carolina Oral Health Collaborative looks at a different aspect of the federal- and state-sponsored insurance programs.
Read more
www.northcarolinahealthnews...
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Rural hospitals in trouble if Congress doesn't renew
Between 2010 and 2021, 136 rural hospitals closed, according to the UNC Cecil G. Sheps Center. Nineteen of these closures occurred in 2020, the most of any year in the past decade.
Read more
www.healthcarefinancenews.com
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Tillis co-sponsors bill to establish nursing workforce
Healthcare professionals and leaders from the local level to the federal government have a large problem on their hands - the national nursing shortage.
Read more
portcitydaily.com
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Black Voters Matter to host statewide rallies
The Atlanta voting rights group will host several rallies and pop-up health clinics at five locations where rural hospitals have closed.
Read more
www.11alive.com
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One company is flipping abandoned hospitals in rural TN
With fresh paint on the walls, new equipment, and wiring, this hospital in western Tennessee is ready to provide care again.
Read more
www.10news.com
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New rural hospital model draws interest - and questions
Dozens of small community hospitals with low inpatient volumes will likely be good candidates to convert to the rural emergency hospital model.
Read more
www.crainsdetroit.com
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“Frontline, Essential, and Invisible: The Needs of Low-Wage Workers in Hospital Settings During COVID-19” was recently published in Workplace Health and Safety and co-authored by Lisa de Saxe Zerden, Erica L. Richman, Brianna Lombardi, and doctoral student Alexandria B. Forte. This project, funded by HRSA as a yearly project for the Carolina Health Workforce Research Center, directed by Erin Fraher, sought to understand the unique experiences of low-wage, essential, frontline hospital workers during COVID-19 to better identify ways to support them during and beyond the pandemic.
While COVID-19 considerably increased individual and health systems’ awareness of burnout and how best to support the health and wellness of the healthcare workforce, little focus has been given to essential yet often invisible workers such as those who work environmental services (a.k.a., housekeeping), patient transportation, and food services. These workers help hospitals stay clean, fed, and moving yet research suggests they are also more likely to be from marginalized backgrounds and likely to experience heighted economic hardship. This study conducted in-depth qualitative interviews with twenty workers across three states to better understand their experiences working in a hospital during the first 6-months of the pandemic. Seven primary themes emerged, four focused on primary sources of burnout including 1) changes in responsibilities and being understaffed; 2) fear of contracting or spreading COVID-19; 3) desire for recognition about the importance of their jobs, and 4) lack of clarity around HR benefits and COVID-19 supports. Three protective factors buffered workers experiences of burnout: 1) paid time off specifically designated for COVID-19; 2) organization efforts to provide mental health supports, and 3) self-coping strategies and a sense of pride in their jobs. Findings underscore the importance of clear communication and system level policies to support healthcare workers’ tangible needs, while also creating a shift in how all types of the health workforce are valued and respected for their essential work in hospital operations and patient care.
This team is launching the new UNC Behavioral Health Workforce Research Center. Click here to learn more about this new Center.
A full list of Sheps Center publications can be found here.
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Have feedback on this newsletter or suggested content for future newsletters? Contact Lindsay McCall.
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