Introducing the Newest Members of CHPR’s Grant Development/Management Team
CHPR is pleased to announce its new Chief Administrative Officer (CAO), Michael Webster. Michael comes very highly recommended from his previous position, Extramural Finance Manager in the Department of Internal Medicine at UC Davis Health. He has worked in the UC system for a total of 17 years, 13 of them at UC Davis. In addition to his other administrative duties, Michael will head up CHPR’s grant development/management team.
The addition of Beatrice “Bea” Le, our new Contracts/Grants Analyst and Fiscal Compliance Officer, fills out CHPR’s grant development/management team. Bea comes to us from the Comprehensive Cancer Center at UC Davis Health where she served as interim Business Officer. Her expertise is in financial management and grant submissions and she will be providing a high level of financial analysis and dedicated pre- and post-award support to CHPR faculty, staff, and leadership. CHPR faculty members in need of her assistance can contact her at firstname.lastname@example.org.
Welcome Michael and Bea!
Firearm-related violence is a big problem in the United States. Every day over 100 people die, and another more than 200 people are treated in emergency departments, as a result of firearm-related injuries.
In an effort to understand and prevent firearm violence, the U.S. Centers for Disease Control and Prevention (CDC) awarded 16 grants this month to researchers across the country investigating strategies for preventing firearm-related injuries, deaths, and crime. Three investigators from UC Davis were among the 16 awardees.
CHPR faculty member Aimee Moulin, M.D. and a professor of Emergency Medicine at UC Davis Health, is one of them. Dr. Moulin will examine the synergistic impacts of firearm access and opioid-related harm on firearm suicide risk at the individual and population levels in the state of California. Her two-year research project is titled “Firearm Access, Opioid Use, and Firearm Suicide Mortality.”
The other two UC Davis awardees are assistant professors with the Violence Prevention Research Program at UC Davis Health. Nicole Kravitz-Wirtz, Ph.D., M.P.H., will study the “Prevalence of Community Gun Violence Exposure and Consequences for Adolescent Well-Being” for her two-year project and Rose Kagawa, Ph.D., M.P.H., will examine “Physical, Social, and Economic Environments and Firearm Fatalities Among Youth” over the course of her mentored career development (K01) award.
According to the CDC, the 16 awards represent research that is an “important step toward keeping individuals, families, schools, and communities safe from firearm violence and its consequences.”
UC Center Sacramento Event The COVID-19 Pandemic and the Role of the Public Research University
In a special UC Center Sacramento session, UC Davis Chancellor Gary May and UC Davis Vice Chancellor David Lubarsky will spoke at noon on Wednesday, September 23rd, about how public research universities can contribute to public health and economic recovery in the current COVID-19 era. Drawing on their experiences as leaders of a UC Campus and its affiliated health system, Drs. May and Lubarsky described how UC Davis is discharging its myriad and sometimes conflicting responsibilities to students, faculty, staff, patients, and the public.
Following brief remarks, Drs. May and Lubarsky will engaged in conversation with UC Center Sacramento Director and CHPR core faculty member Richard Kravitz, followed by questions from the audience.
Results of UC Davis pilot studies on the impacts of COVID-19, sponsored by the Center for Healthcare Policy and Research (CHPR), the Center for Health and Technology (CHT) and the Behavioral Health Center of Excellence (BHCOE), are starting to come in.
Professor Paul Hastings described some early findings from the survey he and colleague Camelia Hostinar undertook with their pilot funds in a UC Davis LIVE conversation hosted by Soterios Johnson on September 10th. Hastings and Hostinar both are professors in the UC Davis Psychology Department and faculty affiliated with the UC Davis Center for Mind & Brain. Their survey project is titled “Parenting during the COVID-19 Pandemic: Implications for Parent and Child Mental Health and Well-being.”
Hastings told UC Davis LIVE listeners that more than half of the 500 parents who responded to the survey reported that “things were going well”—some 20% of them even describing things as “better” than before the pandemic. Hastings attributed involving kids in identifying safe, preferably physically active, things they could do near their friends and establishing limits for time spent on social media as being associated with better overall well-being.
But about a third of the families surveyed said they were struggling or could be doing better. Dr. Hastings suggested that lack of social support, from spouses or otherwise, and “profound” financial influences are likely factors contributing to the struggles of those families. He plans to look specifically at how these stresses affect women—whom he noted still bear the brunt of caring for children, by comparing results of this pilot survey with those from another survey he has been conducting.
In answer to “What can we do to be more resilient?” Dr. Hastings suggested that people focus on what they have some control over: self-care. Unplug from electronic devices, get enough exercise, take care of others (which studies have shown improves one’s own well-being) and avoid abusing substances. In following his own advice, he instituted “Sober September” in his own home.
Drs. Hastings and Hostinar are conducting additional analyses of the long-term ramifications of pandemic-related stressors on the mental and physical health of parents and children. They also plan to longitudinally follow study participants in a subsequent, larger project to determine resilience factors that allow some parents and families to navigate the COVID-19 quarantine more effectively than others.
The UC Davis Center for Healthcare Policy and Research (CHPR) has published two reports that follow up on the Center’s previously published “Integrating Care for People Experiencing Homelessness: A Focus on Sacramento County.” The initial report, published in March 2020, outlined options for innovative, coordinated care programs that could be provided for people experiencing chronic homelessness in Sacramento. It highlighted examples of integrated service models being utilized in the United States that combine healthcare, social services, and housing options for homeless individuals with complex, co-occurring conditions, including mental illness, substance use disorders and/or physical conditions.
CHPR’s newly published “Governance Options and Funding Sources for an Integrated Care Organization Serving Sacramento’s Chronically Homeless Population” provides details on how such integrated care organizations could be governed and funded, while “Economic Analysis of Options for Helping People Experiencing Homelessness in Sacramento” examines the costs and outcomes associated with the different options for providing integrated care services.
The economic analysis was conducted by CHPR Associate Director and Chief of the UC Davis Division of Health Policy and Management (HPM), Jeffrey Hoch, Ph.D., and Logan Trenaman, Ph.D., an HPM Post-Doctoral Scholar. Their results indicate that, under base case assumptions, an integrated care option would incur $70 million more in building costs and $77 million more in staffing costs relative to the status quo, but would reduce emergency department (ED) costs by $20 million (25,000 fewer ED visits), inpatient costs by $45 million (16,000 fewer inpatient days), victimization and criminalization costs by $17 million, and other costs by $14 million over five years.
Hoch and Trenaman suggest that a key next step in helping Sacramentans experiencing homelessness would be to embark on a collaborative approach to financing an integrated care organization. They cite “Social Determinants as Public Goods: A New Approach to Financing Key Investments in Healthy Communities” (Nichols & Taylor, 2018) in concluding that taking such a collaborative approach could not only finance the provision of integrated care to the chronically homeless, but also enable all stakeholders to enjoy the benefits of their investment in this public good.
A summary of the current state of the global literature on potential diagnostic errors related to COVID-19 was recently published on the website of the Patient Safety Network (PSNet) of the U.S. Agency for Healthcare Research and Quality (AHRQ). Patrick Romano, M.D., M.P.H., Co-Editor-in-Chief of AHRQ’s PSNet with Debra Bakerjian, Ph.D., A.P.R.N. of the UC Davis Betty Irene Moore School of Nursing, authored the Patient Safety Primer “Coronavirus Disease 2019 (COVID-19) and Diagnostic Error” on behalf of the AHRQ PSNet team, which is based in part at the UC Davis Center for Healthcare Policy and Research (CHPR). The latest evidence on both test-related and clinician-related contributors to diagnostic errors is reviewed in the document.
Current diagnostic tests are described as analytically sensitive and highly specific for SARS-CoV-2, the virus that causes COVID-19, for example, but test accuracy can be substantially lower in actual clinical practice due to variation in how specimens from patients are obtained and handled, and the stage of a patient’s illness when the testing is performed. False-negative rates can be so high, in fact, that symptomatic individuals with an intermediate or high clinical suspicion of having COVID-19 should be retested when an initial test comes back negative.
Dr. Romano also describes the various kinds of biases that may contribute to errors in diagnosing COVID-19 and other conditions with which COVID-19 is confused. For example, implicit biases—those outside conscious awareness that lead to negative evaluations of people based on characteristics such as race and ethnicity, nationality, disability, and socio-economic status—may be contributing to the disproportionate impact of COVID-19 on African-American and Hispanic communities in the U.S. This Primer highlights the importance of conscious efforts to identify and address these implicit biases, as well as other biases, that can interfere with the diagnostic process.
“COVID-19 and Diagnostic Errors” outlines approaches healthcare providers can take to minimize the impact of biases, summarizes current guidance for improving the fidelity of diagnostic testing, and references additional resources on this important topic. It will be updated over time to incorporate new information and evidence in this rapidly evolving field.
Over 100 million adult Americans suffer from chronic pain. Dr. Ian Koebner, Director of Integrative Pain Management and an Assistant Professor in the Division of Pain Medicine at the UC Davis School of Medicine, wants to help reduce that suffering through an innovative collaboration between UC Davis Health and Sacramento’s Crocker Art Museum. You can help too, by enrolling in his research study.
Previous studies have demonstrated an association between physical pain and social disconnection, and also that increasing social connectedness can decrease pain intensity. Dr. Koebner and his team want to translate these findings into clinical care for patients. To that end, Dr. Koebner has been working with staff at Crocker to design museum programming for people with chronic pain and use it to test whether attending those programs helps sufferers feel more socially connected and less intense pain. In response to the COVID-19 pandemic, these museum programs—one on art and another on artful meditation—will now be presented virtually, yet are still designed to promote social connectedness.
So if you are an adult who suffers from chronic pain and are interested in participating in a study to determine whether museum programs, delivered online, can help relieve pain and improve social connectedness, please visit the study’s webpage. There you can learn study details, including eligibility requirements and how to enroll. Ruchi Rawal, Project Manager for this study, would be happy to answer any additional questions you may have as well.
New Study Finds Patient Adherence to an Effective Health Management Strategy Declines after Rehospitalizations for Heart Failure
Because patients with heart failure often retain fluid during the week before an admission to hospital, daily weighing has become an important management strategy for patients with heart failure. A recent systematic review on this topic found that weight telemonitoring, i.e. patients transmitting their daily weight readings from home directly to their clinicians, is associated with significant decrease in patient mortality.
But a new study from the UC Davis Center for Healthcare Policy and Research (CHPR), recently published in the Journal of Cardiovascular Nursing, suggests that rehospitalizations are followed by diminished adherence to daily weighing. This finding was surprising because the researchers expected events like rehospitalizations after an initial heart-related hospital admission to lead to greater adherence to daily weighing. The authors of the study offered possible explanations for these findings in their paper and also concluded that rehospitalizations and visits to emergency departments present “teaching moments” when the importance of adherence to daily weighing, as well as to other health management behaviors, could be reinforced by healthcare professionals.
Sarah Haynes, Ph.D., M.P.H., the paper’s first author, was a Ph.D. student in the UC Davis Graduate Group in Epidemiology and based at CHPR when she led this study. Additional authors include Dr. Patrick S. Romano, who was Dr. Haynes’ Ph.D. advisor, and Drs. Daniel Tancredi and Jeffrey S. Hoch who were members of Dr. Haynes’ Ph.D. advisory committee; all are core faculty members with CHPR. Dr. Haynes is currently a postdoctoral scholar in the UC Davis Department of Pediatrics.
|Sarah Haynes, Ph.D., M.P.H.||Daniel Tancredi, Ph.D.||Jeffrey Hoch, Ph.D.||
Patrick Scott Romano, M.D., M.P.H., FACP, FAAP
Collaboration and teamwork by three UC Davis/UCDH centers are supporting new research on the impacts of COVID-19 on health outcomes, behavioral health and telehealth. A pilot grant competition funded five pilot studies. The Center for Healthcare Policy and Research (CHPR), the Center for Health and Technology (CHT), and the Behavioral Health Center of Excellence (BHCOE) collaborated in conducting the competition and sponsoring the awards.
The five projects receiving funding are:
- “Parenting during the COVID-19 Pandemic: Implications for Parent and Child Mental Health and Well-being,” to be carried out by Paul D. Hastings, Ph.D., and Camelia Hostinar, Ph.D., both affiliated with the Center for Mind & Brain and professors in the Psychology Department. They will assess the long-term ramifications of pandemic-related stressors on the mental and physical health of parents and children, and plan to longitudinally follow study participants in a subsequent, larger project to determine resilience factors that allow some parents and families to navigate the COVID-19 quarantine more effectively than others.
Paul D. Hastings, Ph.D. Camelia Hostinar, Ph.D.
- “Impacts of COVID-19 on the Neurodevelopmental Community and a Plan for Continued Care,” led by Leonard Abbeduto, Ph.D., Professor of Psychiatry and Behavioral Sciences and Director of the MIND Institute. He and colleague Lauren Bullard, M.S., will work with providers and families of children with autism spectrum disorder, Down Syndrome and fragile X syndrome to determine impacts COVID-19 closures have had on services normally provided to these families; results will be used to design a self-guided platform with telehealth features to help bridge service gaps.
Leonard Abbeduto, Ph.D. Lauren Bullard, M.S.
- “Virtual Family-Centered Rounds during COVID-19 in the Neonatal Intensive Care Unit,” will be led by Jennifer Rosenthal, M.D., in collaboration with Kristin Hoffman, M.D., both in the Department of Pediatrics. In response to the inability of parents to visit their children in the neonatal intensive care unit because of the pandemic, these researchers began studying the use of Zoom to allow parents to virtually attend weekday “family-centered rounds” (FCR); they will use this grant to conclude their pilot clinical trial of the feasibility and acceptability of virtual FCRs and explore the effects of FCRs on parents and quality of care.
Jennifer Rosenthal, M.D Kristin Hoffman, M.D.
- “Sacramento Area Breast Imaging Registry (SABIR): Impact of COVID-19 on Breast Cancer Screening, Surveillance, Diagnosis, and Treatment,” carried out by Diana L. Miglioretti, Ph.D., Professor and Division Chief of Biostatistics, Department of Public Health Sciences. Dr. Miglioretti will document delays in breast cancer screening and related care due to COVID-19, determine whether disparities in access, timeliness of care, and treatment quality in vulnerable populations have been compounded during the quarantine, and use that information to develop best practices for prioritizing breast cancer screening and care services during and after the pandemic.
Diana L. Miglioretti, Ph.D.
- “Hand Therapy App Video-visit Optimized Care (HAVOC) Study: Maintaining Hand Surgery Outcomes Amidst COVID-19 Pandemic,” led by Clifford T. Pereira, M.D., in collaboration with Chetan Irwin, M.D., and Andrew Li, M.D., all professors in the Surgery Department. These researchers responded to the challenge of delivering post-operative, surgeon-directed hand therapy to patients sheltering-in-place by developing a smartphone app and utilizing video visits; they will determine the efficacy of these adaptations for post-operative care of hand injuries and design an improved app with the support of this grant.
Clifford T. Pereira, M.D. Chetan Irwin, M.D. Andrew Li, M.D.
All of these projects were designed to produce rapid results that can be used to seek extramural research funding to devise strategies that address challenges presented by the COVID-19 pandemic.
Project findings will be reported on our website when available so please check back often.
Click here to access full article: https://health.ucdavis.edu/health-news/newsroom/pilot-grants-boost-covid-19-research/2020/06
Third UC Davis Virtual COVID-19 Symposium was held on June 3rd
A third UC Davis Virtual COVID-19 Symposium was be streamed via Zoom on Wednesday, June 3, from 5:00 to 7:00 p.m. and focused on the topic of vaccines.
UC Davis Chancellor Gary May delivered the welcoming address. Dr. Robert Gallo, world-renowned virologist and distinguished professor at the University of Maryland’s School of Medicine, headlined the group of expert panelists. Dr. Dean Blumberg, professor and chief of Pediatric Infectious Diseases, UC Davis Health and Dr. Allison Brashear, dean of the UC Davis School of Medicine, joined Dr. Gallo on the panel.
Among those who asked questions of the panel: Jennifer Cash, newest faculty member of the UC Davis College of Biological Sciences; Fred Gould, National Academy of Sciences member; UC Cooperative Extension advisor Surendra Dara; and University of Brasilia graduate student Raquel Silva. Viewers were also encouraged to submit their questions for the panel prior to the start of the symposium.
Additionally, retired UC Davis Medical Center nurse Carolyn Wyler of Sacramento, a passenger on the ill-fated Grand Princess cruise ship, talked about her COVID-19 outbreak experiences from ship to shore.
In response to the U.S. Patient Protection and Affordable Care Act of 2010 (AKA ObamaCare), California expanded Medi-Cal to cover more Californians with low incomes. But an already limited number of available primary care clinicians prompted Joy Melnikow, M.D., M.P.H., director of the UC Davis Center for Healthcare Policy and Research (CHPR), to investigate the availability of new patient appointments for Medi-Cal enrollees and how that availability, or lack thereof, might relate to emergency department (ED) use. Melnikow led a team of CHPR-affiliated researchers in conducting the required research in eight contiguous counties in Northern California in 2015.
Results of the study, which included simulated patients making phone calls seeking new patient appointments and analysis of ED use in each county, were published in the May/June 2020 issue of the Annals of Family Medicine.
Melnikow et al. found that, despite standard statewide reimbursement rates and in contrast to findings in other states, access for new Medi-Cal patients to primary care was limited and varied among the counties. Counties with more limited access to primary care appointments (Sacramento, San Joaquin, and Solano) also experienced higher ED use by Medi-Cal enrollees compared to counties with better access (Yolo).
Additional authors of the study include CHPR staffers Guibo Xing, Shauna Durbin and Dominique Ritley, and former CHPR QSCERT post-doctoral fellows Ethan Evans, Brock Daniels and Lindsey Woodworth.
Register now for a 90-minute AHRQ web conference about how telehealth can increase access to care and improve healthcare quality. There is no charge for the web conference, which will be held on June 9 from 2-3:30 p.m. ET.
Presenters will discuss their work on the effectiveness of telepsychiatry, the impact of telemedicine on chronic disease management, and the factors that help or hinder the use of telemedicine in urban areas. The web conference will also cover the evidence about how telehealth can be used routinely and during public health emergencies such as a pandemic.
Speakers will include Glen Xiong, M.D., a clinical professor in the Department of Psychiatry and Behavioral Sciences at the University of California at Davis; Elizabeth Ferucci, M.D., M.P.H., a clinical rheumatologist and researcher at the Alaska Native Tribal Health Consortium; and Kenneth McConnochie, M.D., M.P.H., a professor emeritus at the University of Rochester Medical Center in Buffalo, NY.
The panel will be moderated by U.S.P.H.S. Commander Derrick L. Wyatt, R.N., M.S.N., from AHRQ’s Division of DigitalHealthcare Research. Participants can earn up to 1.5 CE/CME contact hours.
Learn more and register.
New Blog from UC Davis Health Spotlights Elisa Tong
Elisa Tong, M.D., an associate professor in Internal Medicine and a core faculty member with the Center for Healthcare Policy and Research (CHPR) at UC Davis, “cultivates health” by providing motivation and support to help people quit smoking. That’s why Dr. Tong’s tobacco cessation work was recently highlighted in UC Davis Health’s new blog “Cultivating Health.” Cultivating Health explores the latest research, cutting-edge technology and deep reserve of expertise at UC Davis being utilized to develop creative solutions to today’s challenging problems.
Tong has been helping Californians quit smoking for years through programs like UC Quits and CA Quits, and now she is medical director for the new UC Davis Stop Tobacco Program (SToP). Launched by the UC Davis Comprehensive Cancer Center with funding from the National Cancer Institute, SToP is designed to integrate tobacco treatment into cancer care because quitting tobacco can mean fewer infections and fewer side effects from their medications, and better healing and survival outcomes, for cancer patients.
For more information about Dr. Tong and SToP’s programs to help cancer patients quit, check out Cultivating Health.
UC Davis Virtual COVID-19 Symposium was held April 23
Nathan Kuppermann, M.D., M.P.H., Professor and Chair of the Department of Emergency Medicine at UC Davis Medical School and a faculty affiliate with the UC Davis Center for Healthcare Policy and Research (CHPR), served on the panel of experts for the Virtual COVID-19 Symposium that was held April 23.
Walter S. Leal, Distinguished Professor of Entomology in the Department of Molecular and Cellular Biology, organized and moderated this UC Davis Symposium, which was available to UC Davis staff, faculty and students, as well as international partners and the public in general. Chancellor Gary May gave a Welcome Address and then the panel of experts—comprised of UC Davis professors as well as State Senator Dr. Richard Pan and Yolo County Health Officer Dr. Ron Chapman—answered pre-submitted and real-time questions.
Social Media Posts Used for Predicting Daily Case Counts of COVID-19 in China
Bo Feng, Ph.D., a faculty affiliate with CHPR, and her colleagues in the UC Davis Department of Communication and at the University of Science and Technology of China in Hefei, China, and at Tsinghua University in Beijing, have determined that social media posts about symptoms and diagnoses of COVID-19 from early in the current pandemic could be used to predict daily case counts of the illness up to seven days ahead of official statistics.
These researchers developed a machine-learning classifier to identify “sick posts”—reports of one’s own and other people’s symptoms and diagnoses related to COVID-19—among more than 12 million COVID-19-related posts on Weibo, a popular Twitter-like social media platform in China, from November 20, 2019 to March 3, 2020. They then modeled the predictive power of sick posts in terms of daily case counts and found that the sick posts were predictive both in Hubei province, where COVID-19 originated, and in the rest of mainland China. Their working paper, “Reports of Own and Others' Symptoms and Diagnosis on Social Media Predict COVID-19 Case Counts in Mainland China” by Shen et al., contains this call to action: “It is imperative that international organizations such as the World Health Organization integrate such data into their outbreak forecasting management practices, in order to mobilize and coordinate relief efforts to help combat COVID-19.”
For more information, please see ‘Sick Posts’ on Social Media Help Early Tracking of COVID-19.
Even before COVID-19, studies showed that smoking weakens the immune system, hampering one’s ability to fight infections, and that smokers can be twice as likely to develop viral respiratory infections as those who do not smoke. And, so far, studies of COVID-19 indicate that smoking doubles your risk of getting really sick (e.g. requiring intensive care and/or ventilation, dying) from that particular viral infection.
That’s why Dr. Elisa Tong, Associate Professor of Internal Medicine at the UC Davis School of Medicine and a core faculty member with the UC Davis Center for Healthcare Policy and Research (CHPR), posted a public health message spreading the word about why now is a better time than ever to quit smoking.
Dr. Tong leads “CA Quits,” a tobacco cessation effort funded by the California Tobacco Control Program. CA Quits promotes use of the California Smokers’ Helpline, a free call-in counseling service to help smokers develop their own personal quit plans by phone or chat. CA Quits is designed to reach California's more than three million smokers to help them quit smoking and vaping.
As part of an effort to help prevent the spread and intensity of COVID-19, Dr. Tong and CA Quits are making over 1000 free nicotine patches available in April to people who call the California Smokers’ Helpline for help in quitting smoking and vaping.
Jeffrey Hoch, M.A., Ph.D., Professor and Chief, Division of Health Policy and Management, Department of Public Health Sciences, and
Associate Director of the Center for Healthcare Policy and Research (CHPR) has been named to the Editorial Board of Health Care Management Science.
The journal publishes papers dealing with health care delivery, health care management, and health care policy. More infromation is available at https://www.springer.com/journal/10729.
ongratulations to all our Top Docs!