Six proof-of-concept grants awarded to interdisciplinary UW project teams

Optimizing the Population Impact and Equity of Collaborative Care Delivery: Evaluation of the Collaborative Care Fidelity Checklist

Investigators
Anna Ratzliff, Department of Psychiatry & Behavioral Sciences
Elizabeth Austin, Department of Health Systems and Population Health
Brittany Blanchard, Department of Psychiatry & Behavioral Sciences

Project abstract
The Collaborative Care Model (CoCM) is an integrated population health approach for addressing mental health in general healthcare settings. CoCM is effective for treating common mental health conditions and implemented in clinics across the nation. Two challenges in implementing complex interventions in the real world are fidelity and resources. Clinics may not deliver the model to fidelity, so patients may not receive core components of the interventions. Lack of fidelity can contribute to healthcare disparities. Many clinics may not be able to implement CoCM but could implement some of the evidence-based components to reduce healthcare disparities. However, there is no current measure of CoCM fidelity or knowledge about which components lead to patient improvement.

The UW Advancing Integrated Mental Health Solutions (AIMS) Center recently developed the CoCM Checklist, a structured measure assessing fidelity to CoCM core components, to address these needs. The CoCM checklist was developed using a community-informed approach but has not been formally evaluated. For this Tier 2 application, we propose a multidisciplinary collaboration across the UW Departments of Psychiatry and Health Systems and Population Health to 1) develop item(s) to assess health equity in CoCM delivery, 2) conduct a mixed-methods psychometric evaluation of the CoCM Checklist with equity items and 3) conduct a preliminary evaluation of CoCM components associated with patient improvement. If successful, this project would yield a measure of CoCM fidelity for clinical and research settings. Pilot data will support a future application to compare the effectiveness of CoCM versus specific components.

Piloting the Equity in Injury Prevention Toolkit with People Who are Unhoused

Investigators
Barclay Stewart, Department of Surgery
Megan Moore, School of Social Work
Tony Machacha, King County Regional Homelessness Authority
Caitlin Orton, Department of Surgery

Project abstract
The burden of burn and cold injuries carried by people experiencing homelessness (PEH) is increasing in the US given factors such as weather extremes, unsafe cooking and heating conditions and substance use. In Seattle, the incidence of emergency calls for fires involving PEH has grown from 663 in 2019 to 2,798 in 2024. As a result, almost a quarter of patients cared for at the UW Medicine Regional Burn Center (UWMRBC) are unhoused at the time of their burn or cold injury.

To prevent these injuries and address the critical gap in fire and burn and cold injury prevention education, UWMRBC partnered with King County Regional Homelessness Authority (KCRHA) to develop and consumer-test prevention education. This partnership and Population Health Initiative Tier 1 funding led to the creation of the Equity in Injury Prevention (EQUIP) Toolkit (e.g., prevention education, dissemination strategies, PEH preferred fire extinguishing equipment). We aim to pilot the EQUIP Toolkit with PEH living within high burn injury risk areas of Seattle and evaluate the implementation using the RE-AIM Framework. Piloting EQUIP will allow UWMRBC and KCRHA to strengthen their partnership and collect critical implementation data ahead of scaling EQUIP Toolkit dissemination.

Measures of success are 1) evaluation of the EQUIP Toolkit Pilot in Seattle, 2) creation of consumer tested, evidence-based EQUIP Toolkit implementation guidelines, and 3) a stronger partnership between UWMRBC and KCRHA to include a plan for scaling dissemination.

First Bite: A Pilot Caregiver Training and Consultation Program to Address Critical Feeding Challenges for Autistic Children and Reduce Waitlist Length

Investigators
Brittany St John, Department of Rehabilitation Medicine
Tanya St. John, Department of Speech & Hearing Sciences
Yev Veverka, Institute on Human Development & Disability
Sara Kover, Department of Speech & Hearing Sciences
Jessica Greenson, Institute on Human Development & Disability
Nicole Bergstrom, Institute on Human Development & Disability
Sarah Lemke, Institute on Human Development & Disability
Kelleen Dunley, Institute on Human Development & Disability

Project abstract
Autistic children experience high rates of feeding challenges that negatively impact their health, development, nutritional status and family well-being. Effective and targeted intervention is essential to reduce long-term consequences. However, the demand for intervention is far greater than the capacity of providers, as demonstrated by extensive waitlists. In addition, families face significant barriers to accessing feeding intervention including cost for services, location or distance from feeding programs, and time commitment. Our interdisciplinary team, with extensive clinical and feeding expertise, worked collaboratively to design an accelerated intervention option for families awaiting services.

The First Bite program is designed to provide an accessible caregiver education intervention to reduce the need for individualized services and shorten wait times for feeding supports for families. First Bite is a caregiver focused intervention delivered virtually to families while children are on the waitlist for feeding services. First bite is a 10-week program including eight group caregiver education sessions and four individual consultation sessions with a program therapist. This project will pilot First Bite at UW Autism Center to evaluate the effectiveness of the program for 1) achieving child feeding goals and 2) reducing the need for direct feeding services.

This project will provide proof-of-concept data including measures of feasibility, effectiveness and resource utilization of the First Bite program. Findings from this project will provide the foundation for future collaborative grant proposals to accelerate the translation of innovative and impactful interventions to address feeding challenges with autistic children and their families.

Exploring the Effectiveness and Implementation of Paid Leave Programs for Domestic Violence

Investigators
Avanti Adhia, ScD, Department of Child, Family, and Population Health Nursing
Heather D. Hill, Daniel J. Evans School of Public Policy & Governance
Krista Neumann, Department of Pediatrics
Ann Richey, Department of Epidemiology

Project abstract
Domestic violence (DV) is prevalent and has substantial individual, community and societal costs and consequences. Paid leave, which can strengthen economic supports for families, is one potential strategy to address DV at the outer layers of the social ecology. Thirteen states and the District of Columbia have passed paid leave into law since 2004. Several states with paid leave programs include DV as a qualifying reason for leave, which could allow DV survivors to attend counseling or court hearings and seek medical treatment.

Despite paid leave programs gaining momentum, there is limited empirical evidence about how these programs relate to DV and, importantly, how these programs are used and implemented in the context of DV. The overall goal of this project is to provide preliminary evidence about the potential effectiveness and implementation of paid leave programs for DV. Specifically, we will: 1) conduct an in-depth policy landscape analysis of state paid leave programs in the context of DV; 2) examine the association between state paid leave programs and physical DV before and during pregnancy using CDC’s Pregnancy Risk Assessment Monitoring System state-level data via a difference-in-differences approach; and 3) explore the use of paid leave for DV in two states with different paid leave program structures through key informant interviews with relevant legal and social service partners.

This project addresses the PHI pillars of human health and social and economic equity by examining an upstream economic support mechanism with important potential health impacts.

Advancing Equitable AI for Stroke Diagnosis: A Global Foundation Model for Non-Contrast CT and CTA Imaging

A portion of the funding for this award came via a partnership with the UW Office of Global Affairs, which seeks to enhance the UW’s global engagement and reach.

Investigators
Mehmet Kurt, Department of Mechanical Engineering (and by courtesy, Bioengineering and Radiology)
Jacob Ruzevick, Department of Neurosurgery
Udunna Anazodo, McGill University and Crestview Radiology Ltd., Lagos, Nigeria
Maruf Adewole, Medical Artificial Intelligence Laboratory (MAI Lab), Crestview Radiology Ltd., Lagos, Nigeria

Project abstract
Stroke is a leading cause of mortality and long-term disability worldwide, yet timely and accurate diagnosis remains a significant challenge, particularly in low-resource settings. Advanced imaging tools, such as MRI, are often unavailable or impractical in many regions due to cost and accessibility barriers. As a result, stroke diagnosis in these settings relies primarily on non-contrast CT (NCCT) and CT angiography (CTA), which require specialized expertise for accurate interpretation.

This project aims to develop a globally applicable diagnostic framework that improves stroke detection using NCCT and CTA, making high-quality stroke care more accessible in diverse healthcare environments. By leveraging collaborations with clinical and research partners in Nigeria and other regions, we will validate our approach across different populations and healthcare infrastructures. Our goal is to support equitable stroke diagnosis by integrating advanced imaging analysis into existing clinical workflows, ultimately improving patient outcomes in under-resourced healthcare systems worldwide.

Pilot Study to Integrate Low-Barrier, Culturally and Linguistically Responsive Mental Health Care into Community-Based Social Services

Investigators

Lesley Steinman Department of Health Systems & Population Health
Najma Mohamed, Neighborhood House
Jacob Bentley, Department of Rehabilitation Medicine
Tricia Aung, Department of Human Centered Design & Engineering
Roberto Orellana, School of Social Work
KeliAnne Hara-Hubbard, Department of Health Systems & Population Health
Farhiya Osman, Neighborhood House

Project abstract
Mental health inequities persist globally as millions face poor access to care. This care gap is pronounced for U.S. immigrants and refugees who face additional barriers from racism, historical trauma, poverty and other injustices. While building capacity of non-clinical providers in community-based organizations (CBOs) is one effective solution, this has been less practiced in under-resourced settings in the U.S.

Our Tier 1 project builds upon our successful Tier 1 co-design work where Neighborhood House staff and community members identified the need for low barrier, culturally and linguistically appropriate mental health care. We prioritized the Somali community as the community with the highest need for services and untapped cultural wealth. Our community-academic partnership adapted WHO’s Problem Management Plus (PM+) program which teaches problem solving, stress management, behavioral activation and social support strategies to reduce depression, anxiety and posttraumatic stress.

Tier 2 funding will support a pilot study to evaluate whether and how adapted PM+ works for social service providers, clients and families. We will train CBO providers from housing, early childhood education, employment and case management to assess both PM+ impact and delivery for clients, families and providers. In addition to piloting PM+ feasibility in U.S. CBOs, the pilot will allow for fine-tuning methods for future CBO-engaged mental health research. This Tier 2 project aligns with PHI’s pillars to promote human health by improving access to mental health care and to address social and economic equity by embedding care into social services that reach underserved communities of color and address drivers of health inequities.