Department News

DFPM-RED News: April 2021

News about RED

DFPM-RED is happy to share …

The Northwest Arkansas team is currently in process of moving locations; we will temporarily be in Lowell co-located with ACH – Center for Children and future location(s) is TBD.
COVID changes for children: Using data from parents in early childcare programs in Arkansas, two internal reports were produced (happy to send if you are interested). Key findings you might find interesting:
- COVID (as expected) reduced visits to the library to near zero which makes things very difficult for low-income families.
- On the positive side, the time someone read to children remained steady except a reduction in the summer of 2020. The number of books in the home also dropped in the summer of 2020, but returned to near normal by the fall of 2020
- Young children also need the stimulation of activities outside the home. We found sharp drops in children joining in shopping trips (safe decision re: COVID); however, there were reductions in walks and attending athletic events (which for preschoolers are usually outside and safer).

Updates from Faculty

Dr. Whiteside-Mansell is focusing on funding for grant proposals related to the assessment of adverse childhood experiences in clinical settings. One was internal (123-GO) and was not funded but will be considered in the next round of funding. It was in collaboration with two regional programs. She has recently submitted an NIH/BIR proposal in collaboration with CAFES on the topic.

Dr. Edge: Nikki and DFPM/PRI team members submitted an application for a SAMHSA grant which would allow for the development and dissemination of trauma-informed care resources in early learning settings nationally, in partnership with Georgetown University and Arkansas State University. Cross your fingers for good news in the fall!

Dr. Lewis: has submitted a KL2 (UAMS Translational Research Institute: TRI career development award) proposal, with her primary mentor Dr. McKelvey, that will examine the effectiveness of Home Visiting programs delivered via telehealth compared to in-person.

Ms. Martel: Isis and the Northwest Arkansas team are focusing on proposals that will expand current work with vulnerable populations. They have successfully assisted 3 community organizations to apply for Substance Treatment Funding and RED will be doing the evaluation for each of these projects when awarded. We have also applied in partnership with ARBEST for a SAMHSA grant: “Parents and Children Together” (PACT) that aims to reduce adverse childhood experiences of children with parents who have a substance use disorder and/or criminal justice involvement. Isis has partnered with Melissa Zielinski in Psychiatric Research Institute to submit manuscripts for publication; the first article is under review.

New Funding

Isis Martel’s team in NWA RED was awarded a sub-award to continue partnership with Washington County Drug Court evaluation for a new 5 year (see update from Martel above)

The HIV Team hits again! Courtney Hampton – a new HIV coordinator hired recently – working with mentorship from LaTunja Sockwell have just received word that her application to the Ark Dept of Health was funded. The project will receive five years of funding at $200K per year to contribute to their focus on ending the HIV Epidemic. Her key activiites will be:

Activity: Pre-Exposure Prophylaxis (PrEP) Awareness and Navigation

I. Targeted PrEP awareness campaign.

II. A website and toll-free number for connecting to a PrEP navigator.

III. Implementation of services for ensuring PrEP retention, continuous HIV testing and counseling, and linkage to PrEP provider services.

IV. Implementation of a developed logistics plan for ensuring transportation assistance to a PrEP provider for care services.

Recent Publications and Updates

Yoong, S.L., Jones, J., Pearson, N., Swindle, T., Barnes, C., Delaney, T., Lum, M., Golley, R., Matwiejczyk, L., Kelly, B., Kerr, E., Love, P., Esdaile, E., Ward, D., & Grady, A., (In Press). An overview of research opportunities to increase the impact of nutrition intervention research in early childhood and education care settings according to the RE-AIM framework. International Journal of Environmental Research and Public Health.
Yoong, S.L., Jackson, J., Barnes, C., Pearson, N., Swindle, T., O’Reilly, S., Tabak R., Belski, R., Brown, R., Brown, A., & Sutherland, R. (In Press). Examining research published in top-tier nutrition and dietetics journals in 1988 and 2018. Journal of Nutrition Education and Behavior

DFPM-RED News: March 2021

News about RED Faculty

Dr. Lorraine McKelvey will be promoted to Professor on July 1.

Dr. Taren Swindle will be promoted to Associate Professor on July 1.

Ms. LaTunja Sockwell and Ms. Isis Martel have been notified that they will be promoted to Instructor faculty positions on July 1, 2021. Both have consistently funded their research agendas with external funding in non-faculty position. Ms. Sockwell’s work focuses on HIV prevention and education. Ms. Martel leads RED’s work in Northwest Arkansas and has focused on substance use prevention efforts. Both of these amazing individuals have functioned like faculty for some time. I am sure we will see them progress even further.

Updates from Faculty

Dr. Whiteside-Mansell has submitted an application to conduct preliminary work to integrate pediatric adverse childhood experiences in partnership with Drs. Edge and McKelvey and UAMS clinical faculty. She is also working an NIH funding to continue this work.

Dr. Edge continues her efforts on a statewide initiative to reduce expulsion of preschool children and has several ongoing efforts to expand her funding to support K-12 children who may be experiencing trauma at home.

Dr. McKelvey has been ask to be an expert consultant with CCDF Lead Agencies build their capacity to conduct narrow cost analyses; combine findings from narrow cost analyses with market rate survey data; and use both price and cost data to inform the setting of child care subsidy reimbursement rates.

Dr. Swindle is nervously awaiting news about the funding status of her NIH R01 submissions which will focus on testing an adaptive implementation strategy for WISE. This strategy seeks to optimize providing ECE settings with the right amount of support to succeed in WISE implementation, recognizing that some sites will need more, and some sites will need less support.

Dr. Lewis is preparing a KL2 (UAMS Translational Research Institute (TRI) for career development) that will examine the effectiveness of community interventions delivered in-person compared to using telehealth. See also her and Dr. McKelvey’s new publication in the prestigious journal Pediatrics.

Ms. Sockwell is working on a new community grant in partnership with a community organization to expand her work in the prevention of HIV from SAMSHA.

Ms. Martel will be busy implementing her new grant (see below). She has drug treatment grant’s in collaboration with adult drug courts in NWA in the works.

New Funding

NWA RED has been informed of intent to fund new ADH grant under “rural opioid” category. Partnership with Washington County Drug Court expansion into Madison County for supportive services to be added there and provided by Harbor House. UAMS is grantee Isis Martel as PI.

Recent Publications and Updates

1. Whiteside-Mansell, L., Sockwell, L., Knight, D., Crone, C. (in press Feb 2021) Community Legal Systems: Targeting PrEP and HIV Education to Decrease Risk of HIV Transmission, Aids and Behavior

Just accepted for publication! Summarizes the implementation of our intervention in Pulaski County Drug Court to reduce HIV and the stigma associated.

2. Conners Edge, NA, Kyzer, A, Abney, A, Freshwater, A, Sutton, M, Whitman, K. Evaluation of a statewide initiative to reduce expulsion of young children. Infant Ment Health J. 2021; 42: 124– 139. https://doi.org/10.1002/imhj.21894

Results of a State of AR intervention co-developed by Dr. Edge: Teachers receiving IECMHC services reported significant improvements in children’s symptoms of emotional and behavioral problems.

3. McKelvey, L. M., Lewis, K.N., Beavers, J., Casey, P.H., Irby, C., & Goudie, A. (2021, In Press). Home Visiting for Neonatal Intensive Care Unit Graduates: Impacts of Following Baby Back Home. Pediatrics.

Results of the Children’s Hospital Intervention- Following Baby Back Home. In the first year of life, compared to propensity-score matched non-program control group infants, infants in the Following Baby Back Home program had more medical appointments, immunizations, and had a lower likelihood of infant mortality.

4. Swindle, T., Zhang, D.,* Johnson, S.L., Whiteside-Mansell, L., Curran, G.M., Selig, J.P., Martin, J., & Bellows, L. (2021). A mixed-methods protocol for identifying successful sustainability strategies for nutrition and physical activity interventions in childcare. Implementation Science Communications. 2(8): 1-10. PMCID: PMC7807398

Study protocol for a new study: The study will examine two interventions and the strategies link sustaining the them in real world settings.

5. Swindle, T., Phelps, J., McBride, N., Rutledge, J.M., Selig, J., & Manyam, S.* (2021) Table Talk: Revision of an observational tool to characterize the feeding environment in early care and education settings. BMC Public Health. 21(80). 1-11. PMCID: PMC7792155

Update on: Swindle, T., Ward, W, & Whiteside-Mansell, L. (2018). Facebook: The use of social media to engage parents in a pre-school obesity prevention curriculum. Journal of Nutrition Education and Behavior, 50 (1), 4-10. PMCID: PMC5769705

Most read article 2020, 2019 and 2018!

6. Update on: Whiteside-Mansell, L., McKelvey, L., Saccente, J., & Selig, J. P. (2019). Adverse Childhood Experiences of Urban and Rural Preschool Children in Poverty. International Journal of Environmental Research and Public Health, 16(14), 2623. https://doi.org/10.3390/ijerph16142623

The article metrics show: – 3 citations – 1408 views

Long-Time Family Medicine CME Conference Goes Virtual

Graphic with text: 24th Annual Family Medicine Update, a Virtual Conference. October 20-23, 2020. Text at the bottom reads: Tobacco and Disease Symposium Oct. 23!

After 42 years of live CME/CE conferences, the Department of Family and Preventive Medicine’s Community Health and Education Division hosted its first virtual conference October 20 – 23 titled the 24^th Annual Family Medicine Update with Tobacco and Disease Symposium. More than 150 healthcare providers joined the conference for up to 16 hours of CME/CE.

Team members who planned the event include Alysia Dubriske, M.Ed., Marybeth Curtis, RN, BSN, and Andrea Hooten, MBA, along with Annemarie McGahagan, B.S.E., Leesa Freasier, M.Ed., Matt Mitchell, B.S., Colleen Lassiter and staff from UAMS Learn on Demand and UAMS audiovisual. Emily Bernard from California was the conference moderator.

screen image of Dr. Jose Romero — Arkansas’ Secretary of Health Jose Romero, M.D., describes the latest in COVID-19 vaccines.

computer screen image of Don Teater’s presentation — Don Teater, M.D., is a national expert on opioid addiction.

Presenters included these UAMS clinicians and faculty:
Tesa Ivey, APRN — hormone replacement therapy
Dr. Kevin Sexton — improving telemedicine for practitioners
Dr. Stephan Dehmel — colorectal cancer screening
Dr. Bill Ventres and Dr. Melissa Zielinski — practicing positive family medicine and how to help patients cope during Covid-19
Dr. John Mounsey — AFib and reading an EKG
Kaci Boehmer, Pharm.D. – anticoagulants
Dr. Matthew Steliga — treating lung cancer patients during Covid-19
Pat Franklin, APRN — low-dose CT scans for high-risk tobacco users
Dr. Anand Venkata — bronchiolitis obliterans or popcorn lung.

Tweets and Facebook posts from the meeting can be found at #24thFMU.

DFPM-RED HIV Team Partners with UAMS HealthNow

Aids Awareness Ribbon. Isolated on white.

RED’s HIV team will partner with UAMS HealthNow to offer a new digital health program for the prevention of HIV Infections. The program will include telehealth access to screening, monitoring, and medication services focused on decreasing the impact of HIV.

Read the full story on the UAMS News site.

Family Medicine Resident Wins Prestigious NIH Travel Grant, Sees Future in Health Policy

By Amy Widner

COVID-19 really made Alexa Martin, M.D., a third-year resident in the Department of Family and Preventive Medicine, see the “big picture.”

Thankfully, the last six months have also made her feel like she can tackle it, because of leadership experiences and educational opportunities she couldn’t have imagined before.

“I think I was always interested in the big picture, but sometimes as a med student and resident you’re so focused on learning that you can get task-oriented – focusing on one skill at a time, one patient at a time,” Martin said. “The COVID-19 pandemic really reminded me of the big picture of what medicine is all about – improving human health.”

Martin received the highly competitive and prestigious travel award from the National Institutes of Health and the National Medical Association to attend the NMA’s 2020 annual Convention and Scientific Assembly, which was held virtually in August.

She was recommended for the award because of the leadership role she held with UAMS’ drive-thru COVID-19 screening and testing triage that sprang up quickly in the early days of the pandemic’s impact on Arkansas.

“When the triage was only a few days old, they started pulling some of the residents in to help,” Martin said. “I did my first shift, and I did a good job at it and didn’t complain too much while I was sweating under my PPE. When it was time to go, my replacement didn’t show up, so I stayed on, and they were like, ‘hey, you’re good at this, can you train the next shift?’ So I did, and that’s how it all started.”

Martin ended up as a physician lead, training others who volunteered or were assigned to help. She spent all her spare time reading up on the latest on the disease. She and a few other residents turned out to have a knack for understanding systems and workflow, so when it came time to identify gaps and make improvements, she gave valuable feedback.

She was one of the staff members who suggested that the Family Medicine Clinic create a special clinic dedicated to acute respiratory illnesses so that patients who didn’t need hospitalization could still get valuable care in a time when fears were high but hospital beds were scarce. She also participated in the first mobile triage unit to take the skills of UAMS across the state. Their first stop was Helena.

“It was really good experience to see how quickly we could make changes and come up with solutions,” Martin said. “More than once since then in the hospital I’ve run into professors who under any other circumstances would outrank me, and they’ll say, ‘hey, you were the one that trained me my first day at triage!’ It’s humbling, but also empowering to have an experience as a resident where you see that you can really step into a leadership role and make a difference.”

It was through the COVID-19 triage that Martin met Gloria Richard-Davis, M.D., executive director of the Division of Diversity, Equity and Inclusion at UAMS, who recommended she apply for the NIH travel award, which would have covered travel and expenses for the weeklong conference if it had been held in person.

Although the conference was held online, Martin said she still benefitted from learning about the opportunities the NIH offers for early-career physicians who are interested in research or academics. The award came with the title of 2020 academic medicine fellow, and Martin was featured in the conference program under that header and was able to do plenty of networking – even virtually – because of the prestigious distinction.

“I met so many people and learned so much,” Martin said. “I didn’t know there were so many avenues for research and funding to help with loan repayment. It was great to see all of these avenues that I didn’t know about.

“The COVID-19 pandemic had already made me start thinking about whether I should pursue a master’s in public health and go into issues dealing with community and population health, maybe getting involved with state or federal health offices or the Surgeon General’s office – places where you can practice medicine but also be involved in policymaking. This travel grant and fellowship helped me see what the next steps on that path might be.”

Husband and Wife Find Breastfeeding Worth the Effort

August 25, 2020 | Stacy Durham and her husband Clint had the birth of their son mapped out: a healthy baby delivered full-term who easily breastfed, a standard hospital stay and return home to their new nursery. But as Stacy describes it, “it just wasn’t in the cards.”

Everything had gone smoothly during her pregnancy, but after a day of labor and two to three hours of pushing, they discovered that baby Carson had swallowed meconium mixed with amniotic fluid and didn’t take a breath for four minutes. The baby was rushed to NICU where he spent five days.

“They had brought him close to me before they took him away, but I don’t remember ever seeing his face,” Stacy said. “They had to get as much done as they could in the room to get him suctioned out. It was very nerve-wracking.”

Stacy’s primary care physician, Cassie Hunter, M.D., who had encouraged her to breastfeed, said the couple worked diligently to make sure their baby boy had the important colostrum and breast milk he needed while he was in NICU.

“She remained committed despite having to go to the NICU a floor away from where she was with a fresh C-Section wound,” said Hunter. “Since her production was low in the beginning (which is normal), NICU asked if they could ‘top’ off the feedings with formula to give the baby calories it needed. She pumped her heart out and was so worried that, since the baby got a bottle from the beginning of his life, that he would never nurse.” Hunter is also part of the breastfeeding initiative sponsored by UAMS’ State Physical Activity and Nutrition, a CDC grant to combat obesity.

Clint did what he could to help in supplying the baby with breastmilk. He walked the freshly pumped milk upstairs to NICU every two hours and washed the breast pump between sessions.

Carson was born on a Friday, but it wasn’t until Sunday that he got to feed at his mom’s breast. He transitioned well, though, and every two hours he would latch on with supplements ceasing the following day.

“All in all, I was only able to breastfeed six months, and then I had to pump because I went back to work as a teacher,” Stacy said, who teaches second grade at Hillcrest Elementary in Lynn, Arkansas. Actually, Stacy surpassed the average time moms breastfeed their infants in Arkansas. A recent report by the CDC showed that only 43 percent of Arkansas moms breastfeed to the six-month mark. The American Academy of Pediatrics recommends that all infants be breastfed at least six months to get the full benefits, such as reducing risks of asthma, obesity, Type 1 diabetes and other diseases in infants. But as Stacy’s story illustrates, it’s critical to have the support from healthcare professionals, family and a worksite that is breastfeeding friendly.

She offers this piece of advice to new moms: “Breastfeeding isn’t the easiest route to take and you will have hurdles to overcome, but do your best. It’s worth it.”

$420,000 Gift Realizes Alumnus’ Longtime Wish to Support Education and Training of Family Physicians

By Benjamin Waldrum

The University of Arkansas for Medical Sciences (UAMS) has received a $420,000 gift from the estate of Jack T. Steele, M.D., to finalize the creation of the Jack T. Steele, M.D. Endowed Chair in Family and Preventive Medicine in the College of Medicine.

Jack T. Steel, M.D.

Endowed chairs allow UAMS to recruit and retain top leaders in the medical field who can provide the best care for patients. A chair is established with gifts of at least $1 million, which are invested and the interest proceeds used to support the educational, research and clinical activities of the chair holder. An endowed chair is among the highest academic honors a university can bestow on a faculty member. Those named to a chair are among the most highly regarded scientists, physicians and professors in their fields. UAMS will announce a professor to the Steele Chair at a later time.

Steele, a 1952 College of Medicine graduate and longtime supporter of UAMS, died March 6. Over several years, he gave more than $620,000 toward the creation of an endowed chair. Together with the $420,000 estate gift, Steele’s combined lifetime giving to UAMS exceeds $1million.

“We are grateful for the late Dr. Steele’s generosity and longtime support for our university and college,” said Christopher T. Westfall, M.D., executive vice chancellor of UAMS and dean of the College of Medicine. “As a family physician, Dr. Steele understood how important primary care physicians are for our patients and communities, and this has never been more true than today. The Jack T. Steele, M.D., Endowed Chair in Family and Preventive Medicine will support outstanding education and training of family physicians for generations to come.”

“Practicing medicine was integral to my dad’s identity,” said son Jeffrey Scott Steele, M.D. “He had a difficult time retiring completely from his practice and continued to work at least part-time, well beyond the age when most would have retired. Even after retiring he maintained his state medical license and satisfied the required continuing medical education.”

Steele was born in 1926 in Lynn, Arkansas, and moved to Walnut Ridge at age 3. He was a cadet at the U.S. Naval Academy from 1945-1946, and graduated from the University of Arkansas at Fayetteville in 1948 with degrees in psychology and philosophy. In 1952, he graduated from the University of Arkansas School of Medicine (now UAMS), and completed an internship with the St. Louis City Hospital. He then served as a Navy physician from 1954-1956. Steele had a longtime medical practice in the greater St. Louis area, including Ferguson and Bridgeton. Four of his sons are physicians.

WISE study on “Pester Power”

A new study from researchers from the University of Arkansas for Medical Sciences and Louisiana Tech University highlights how children’s pester power may influence food consumption and habits at home. The study appears in the Journal of Nutrition Education and Behavior.

Press Release

Article

UAMS Receives $2.5 Million CDC Grant to Increase Colorectal Cancer Screening in Arkansas

July 27, 2020 | The UAMS Department of Family and Preventive Medicine has received $2.5 million from the Centers for Disease Control and Prevention (CDC) for a five-year project to increase colorectal cancer screening in Arkansas.

Partnerships in Colorectal Cancer Screening in Arkansas is a project of the Department of Family and Preventive Medicine’s Community Health and Education Division. Alysia Dubriske, director of Community Health and Education at UAMS, is leading the program and managing the grant.

Arkansas ranks near the bottom of the list at 34th in the nation for the number of people per capita who are screened annually for colorectal cancer. Nationwide, colorectal cancer is the second leading cause of cancer-related deaths when men and women are combined.

The American Cancer Society predicts 1,540 Arkansans will be diagnosed with colorectal cancer in 2020 and 610 will die of the disease. According to CDC guidelines, people over the age of 50 should be screened annually for colorectal cancer, and people with a family history of the disease should start at a younger age.

Alysia Dubriske

“This grant allows us to address these disparities in Arkansas by working with both health care providers and the public,” Dubriske said. “We will educate providers on evidence-based approaches for increasing colorectal cancer screening and then partner with them to implement those interventions. This will be supported by a communication campaign directed at the public so they better understand the importance of screening.”

The approaches include automatic reminders for health care providers to touch base with patients who are overdue for screenings, increasing public awareness about screening though media and communication efforts, and reducing structural barriers that allow Arkansans in rural areas access to prevention, early stage diagnosis, and treatment.

The program will target primary care clinics, especially in counties with low screening rates and low average household incomes. The program will work directly with providers to teach them best practices and help them implement the techniques in their clinics.

“Ultimately, our goal is to reduce the amount of late-stage colorectal cancer in Arkansas and the number of colorectal cancer deaths in Arkansas,” Dubriske said. “Colorectal cancer is a highly treatable disease, especially if caught early, and we know that screening saves lives. We’re looking forward to partnering with clinics to make a difference.”

UAMS will work with Federally Qualified Health Centers and Arkansas’ Quality Improvement Organization to implement the project.

DFPM-RED Faculty Member Recognized by NIH

The National Institute on Minority Health and Health Disparities has named Dr. Taren Swindle a 2020 Health Disparities Research Institute Scholar.

Dr. Swindle Studies factors in early childcare and home environments that affect obesity. Co-Inventor of WISE, a prevention program for children under age 7, which has shown significant improvements in child and parents’ nutrition practices using principles of implementation science.