Initiative awards four winter quarter 2023 Tier 1 pilot grants to UW research teams

Socioecological conflict in Brazil: Equitable land tenure, ecosystem destruction, and health

Investigators
Julianne Meisner, Department of Global Health
Peter Rabinowitz, Department of Environmental & Occupational Health Sciences
Kevin Bardosh, Department of Environmental & Occupational Health Sciences
Tabata Berg, State University of Campinas
Emilio Nieto, University Center of Viçosa
Krista Jacobs, Landesa

Project abstract
In Brazil, ecosystem degradation compromises ecosystem services and facilitates the spillover of novel viruses into human settlements. The regional biomes of the Amazon, Pantanal, and Cerrado have been inhabited by Indigenous ethnic groups and Quilombola people for centuries, and ecosystems managed by these communities are resistant to degradation, indicating such governance structures may convey resistance to pathogen emergence. Roll-backs of environmental protection policies under the Bolsonaro government have led to a dramatic increase in forest fires in the Pantanal and Cerrado, in turn driving arbovirus outbreaks.

Through formative qualitative data, we will generate proof-of-concept results demonstrating that land tenure regularization for Quilombola communities reduces ecosystem degradation. We will also build relationships between UW researchers and Landesa, an organization focused on land tenure advocacy, and strengthen existing community relationships to foster the success and equity of a future project studying the effect of land tenure regularization on ecosystem degradation and disease emergence. This project represents a collaboration between epidemiologists, physicians, veterinarians, activists and social scientists from the U.S. and Brazil.

Understanding unmet needs among people with violence-related spinal cord injury: A mixed methods study

Investigators
Heather M. Barnett, Department of Rehabilitation Medicine
Deepika Nehra, Department of General Surgery
Catherine Wolff, Department of Anesthesiology & Pain Medicine
Chelsea Hicks, Department of Pediatrics
Deborah Crane, Department of Rehabilitation Medicine
Jeanne Hoffman, Department of Rehabilitation Medicine
Monica Vavilala, Department of Anesthesiology & Pain Medicine

Project abstract
Violence is the third leading cause of spinal cord injury (SCI) in the United States, a condition that results in high morbidity and high lifetime costs of care, with worse outcomes among vulnerable populations. Violence-related injury disproportionately affects Black and Hispanic Americans and likely contributes to racial and ethnic health disparities. Patients with violence-related SCI have poor psychosocial outcomes and increased medical complications compared to patients with other SCI etiologies; lack of access to optimal acute and rehabilitation care may contribute to poor outcomes following injury in this population.

These types of disparities in tertiary prevention after injury and violence are an understudied but important determinant of long-term outcomes and population health, particularly among those living at the intersection of disability and other marginalizing social structures. We propose a novel evaluation of access to medical care and rehabilitation services after violence-related SCI in a mixed methods study of SCI patients treated at Harborview Medical Center.

This study will include (1) interviews with patients with violence-related SCI from urban and rural areas to understand unmet needs, barriers and facilitators to care, and patient recommendations for improvement and (2) analysis of medical records and medical claims data from the Washington All-Payer Claims database to quantitatively evaluate differences in care utilization between patients with violence-related SCI and other SCI etiologies. Our novel results will enable the submission of future grants to develop and pilot a support program to facilitate outpatient care, community reintegration and improve outcomes among patients with violence-related spinal cord injury.

Understanding the needs of families caring for Chinese American older adults and opportunities for digital health tools to promote health equity

Investigators
Andrea Hartzler, Department of Biomedical Informatics and Medical Education
Serena Jinchen Xie, Department of Biomedical Informatics and Medical Education
Michael Woo, Kin On
Cindy Dong, Pacific Northwest Chinese Nurses Association
Weichao Yuwen, School of Nursing & Healthcare Leadership (Tacoma)

Project abstract
One in eight people provided unpaid care for family or friends aged 50 or older in the last 12 months in the U.S. Among these individuals, caregivers from racial and ethnic minority groups experience significantly more physical, financial and emotional stress than their White counterparts. Asian Americans, the largest and fastest-growing race and ethnic minority group in King County, make up 21% of the County’s population and 10% of Washington State’s population. Chinese Americans are the largest group in this community.

Barriers to care and health disparities exist partially due to the lack of linguistically and culturally tailored care. Digital health tools have the potential to address these barriers at scale and enable more equitable access to care. We partner with two local community organizations, Kin On and the Pacific Northwest Chinese Nurses Association (PCNA), to identify the shared needs of families caring for Chinese American older adults. We will work closely with community partners and conduct interviews to identify the needs and addressable gaps to inform the development of high-impact digital health solutions for this community.

This funding will establish the critical foundation to help us envision what the caregiving ecosystem could evolve to with the support of effective, scalable, linguistically and culturally tailored digital tools. Findings will shed light on factors contributing to health disparities among Chinese American families, laying a solid foundation for a future larger proof-of-concept project in developing and pilot testing a digital health tool.

Community Healing: Lessons from Asian Organizers for Mental Health Providers

Investigators
Jondou Chase Chen, College of Education
LeiLani Nishime, Department of Communication

Project abstract
Today, we are experiencing a rise in (documented) anti-Asian violence in response to the systemic ways Asian folks and communities around the world are targeted by white supremacy. However, this violence is not new. From the extraction and exploitation of Asian laborers to the colonization of Asian countries, to restrictive immigration laws, and so on, Asian communities have never been safe from white supremacy in the US. Further, traditional schools in the US have and continue to perpetuate damage-centered (Tuck, 2009) narratives and the invisibility of Asian stories. These ongoing structures of anti-Asian racism are life-threating, linking to chronic illness such as respiratory and cardiovascular conditions, mass murder and negative psychological symptoms (Gee et al., 2007; Zhao, 2021; Nadal et al., 2015).

Yet, Asian communities in the US continue to resist oppressive forces and refuse inclusion into a white supremacist and settler colonial school structures by passing down experiential knowledge in community learning spaces. These knowledges and skills quite literally save the lives of Asian folks. Therefore, the co-PIs, two Asian professors in Education and Communications will supervise the AsianCrit Collective (an Asian graduate student-led group) in facilitating one-on-one interviews, focus groups, and arts-based storytelling methods to learn with and from 13 local Asian community educators, artists, healers and organizers about their experiences, perspectives, values, and practice regarding social justice, healing, and education of local Asian communities. Their stories and perspectives will be used to inform a Continuing Education (CEU) for mental health providers serving Asian communities.