Initiative announces awardees of spring quarter 2023 Tier 3 pilot research grants

Evaluating the impacts of military aircraft noise pollution on human health and well-being: a community-based inquiry

Investigators
Julian Olden, School of Aquatic & Fishery Sciences
Edmund Seto, Department of Environmental & Occupational Health Sciences
Anne Harvey, Sound Defense Alliance
Bob Wilbur, Citizens of Ebey’s Reserve
Brian Silverstein, Quiet Skies over San Juan County
Lauren Kuehne, Omfishient Consulting

Project abstract
Impacts of noise on human health and well-being are pervasive, but lack of federal regulations have led to substantial knowledge gaps and weak policy levers whereby noise-impacted communities can advocate for mitigation. This disconnect between exposure-science and policy has become readily apparent in western Washington communities impacted by increasing military activity, due to national consolidation of aircraft operations to Naval Air Station Whidbey Island.

With the Tier 2 funding from the Population Health Initiative, our project team took the important first step of translating archives of noise monitoring data into spatially explicit maps of noise exposure and literature-based estimates of population health risks. The products being produced are supporting our community partners in their efforts to shift policy through education, outreach, legislative advocacy, and legal action.

The Tier 3 project builds on this work through continued, and new, collaborations with community partners to answer priority research needs regarding the lived experience of individuals exposed to different intensities of military aircraft noise. Impacts will be assessed using two complementary approaches involving text and sentiment analyses of long-term noise complaint data and a public survey that quantifies personal experiences of annoyance, sleep disturbance, and compromised psychological well-being caused by military noise. This information will support our partners in their ongoing advocacy efforts, and help advance research on health impacts from military aviation noise; a well-recognized knowledge gap. We further scale the scientific and policy impact by working with national organizations to build a transferable framework for noise impact assessment that can be implemented in other communities.

Project Nature: An Intervention to Promote Nature Contact and Play Equity for Children via Primary Care

Investigators
Pooja S. Tandon, Department of Pediatrics
Kirsten Senturia, Department of Health Systems and Population Health
Emily Kroshus, Department of Pediatrics
Georgia Griffin, Department of Pediatrics
Danette Glassy, BestStart Washington

Project abstract
Daily outdoor play and physical activity is recommended by experts to promote child health and well-being. A growing body of evidence indicates that nature contact can confer both physical and mental health benefits for children of all ages, and is associated with pro-environmental attitudes and behaviors. Critically, there are disparities in access to parks and greenspace based on sociodemographic and neighborhood-level factors. Pediatric health care providers are uniquely positioned to encourage and support families in safe physical activity and nature contact with consideration of their community’s assets and needs.

Project Nature (PN) is a family-centered, adaptable and easily disseminated tool used during well-child visits for children ages 1-10 to promote active outdoor play and nature contact. PN includes a brochure, an age-appropriate nature toy, website and guidance delivered by a health care provider. Building upon foundational work and pilot testing, PN is ready to be scaled, in English and Spanish, to more clinics serving children throughout Washington.

The aims of this proposal are to: 1) Create an online toolkit to scale PN using a mixed methods usability testing protocol rooted in human-centered design; 2) Assess feasibility, acceptability, and preliminary efficacy of the PN toolkit in clinics across Washington using a mixed-methods approach. This proposal leverages the expertise of an interdisciplinary team to address population health pillars of human health, environmental resilience and equity. The creation of the online resources and statewide implementation will serve as exemplars for a larger grant application for scaling nationally.

Centering community voices in partnered mixed methods approaches to addressing health disparities with diverse communities

Investigators
Theresa Hoeft, Department of Psychiatry & Behavioral Sciences
Nora Coronado, UW Medicine Office of Healthcare Equity
Giselle Zapata-Garcia, Latinx Health Board
Diem Nguyen, Vietnamese Health Board
Lan Nguyen, Vietnamese Health Board

Project abstract
The COVID-19 pandemic has had devastating effects in terms of morbidity, mortality and social and economic impacts on communities, bringing attention to widening health disparities. The pandemic has also highlighted and widened community members’ feelings of social isolation and desire for connection to community, culture and physical spaces for gathering, factors that affect individual and community mental health and well-being. Given histories of past harms to marginalized communities, community partnered approaches to research are vital to reduce health inequities.

University of Washington researchers, in partnership with the Community Health Board Coalition (CHBC) in Western Washington and a group of methods experts from around the U.S., created a community partnered mixed methods toolkit that can be used during times of crisis, like the COVID-19 pandemic. The toolkit may also be useful in fast-paced implementation science research aimed at reducing health disparities.

To refine and broadly disseminate the toolkit we are seeking funding to:

1. Pilot the toolkit with two communities from the CHBC;
2. Use pilot experience to refine the toolkit with our community advisory board (CAB), an expanded methods advisory group, and through broader discussions with CHBC health boards, including discussions on how the toolkit may be useful in implementation science research; and,
3. Disseminate the toolkit and our findings through the expanded team’s extensive networks via email, our websites and webinars.

Next steps include developing an R01 grant from our pilot data to study a community health worker intervention centering connections to community, culture, and land/physical spaces (e.g., land-based healing).

Improving Health Equity and Closing Health Care Gaps for Children in Foster Care with an Innovative Secure Data Sharing Platform

Investigators
Kari Gillenwater, Department of Pediatrics
Benjamin deHaan, School of Social Work
Elana Feldman, Department of Pediatrics
Delilah Bruskas, School of Nursing & Health Studies (UW Bothell)
Kimberly Collins, Department of Family Medicine
Kelsey Potter, Apple Health Coordinated Care of Washington
Maureen Sorenson, Apple Health Core Connections
Sarah Yatsko, UW Center for Social Sector Analytics & Technology
Staci Garrison, UW Medicine IT Services
Anna Bender, Department of Pediatrics
Caitlin Crumm, Department of Emergency Medicine
Jack Hessburg, Department of Pediatrics
Ajay Koti, Department of Pediatrics
Catherine (Katie) Wolff, Department of Anesthesiology & Pain Medicine

Project abstract
Children in foster care experience worse health outcomes compared to the general population and the overwhelming majority enter care with chronic physical, developmental and/or behavioral health concerns related to adversity and trauma. Placement instability while in care and poor information sharing between the medical and child welfare systems lead to fractured care, with serious health consequences including medical errors, missed appointments, poor medication adherence, polypharmacy and increased utilization of emergency services. This health inequity affects an already vulnerable population, and the burdens fall disproportionately on children of color.

Although effective information sharing between the health and child welfare systems has been identified as a priority, Washington still lacks a mechanism to support this communication. Our project brings together members from the Schools of Medicine, Social Work, and Nursing, in collaboration with Coordinated Care, the single managed care plan in Washington for children in foster care, to implement and evaluate the Integrated Data Environment to Enhance Outcomes in Custody (IDENTITY) at UW Medicine. IDENTITY has been shown in other states to connect critical information, facilitating effective and equitable care for children in foster care.

This implementation and effectiveness study will assess whether the model is feasible in Washington State and how best to customize this for our specific populations and systems. This will prepare us for a future state-wide system of information sharing to increase the quality of health care for children in foster care.