14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE Communicating HOPE Delivering Essential Information in a Public Health Crisis
A Virtual Conference from UT Health San Antonio
Friday February 5, 2021, Noon - 5:00 pm CST Saturday February 6, 2021, 9:00 am - 1:00 pm CST Table of Contents
Overview Introduction...... 1 Conference Objectives...... 1 Welcome Letter...... 2 Agenda...... 3 Poster Session Details Virtual Community Partner Session...... 4 Virtual CSL Poster Session...... 5 Blue Ribbon Awards...... 6 Judges’ Choice Award...... 6 Interprofessional Education (IPE) Award...... 6 Presentation Summaries & Presenter Bios Communicating Hope: Welcome/Opening Remarks Delivering Essential Information Speaker: Melanie Stone, MPH, MEd...... 7 in a Public Health Crisis Opening Keynote: Communicating Hope: Science vs Anti-Science, Speaker: Ali S. Khan, MD, MPH, MBA...... 7 14TH ANNUAL COMMUNITY Panel: COVID Response: Lessons Learned about Health Communication SERVICE LEARNING (CSL) Moderated by Ruth Berggren, MD, MACP...... 8 CONFERENCE Breakout Workshop A: Evidence, Insights, and Strategy: Developing Effective Health Messages Speaker: Michael Mackert, PhD...... 8 Breakout Workshop B: Combining Ethics and Expertise: Health Literacy Best Practices for Public Health Emergencies, Speaker: Jamie Carlin Watson, PhD...... 9 Closing Keynote: Rebuilding Trust through Health Communication Speaker: Lisa Fitzpatrick, MD, MPH, MPA...... 9 Student Poster Abstracts Advocacy/Policy...... 11 Capactiy Building...... 15 Clinical Service...... 17 Education...... 29 Outreach...... 55 Acknowledgements Planning Committee...... 75 Faculty Mentors...... 76 Community Partners...... 77 Sponsors...... Inside Back Cover Index of Student Poster Abstracts...... 79 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 1 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Introduction
UT Health San Antonio is committed to engaging our community to improve health. In support of our university’s service mission, our students use what they learn both inside and outside of the classroom to empower medically underserved communities in San Antonio, across Texas and around the globe. The Community Service Learning (CSL) Program provides a structure to engage faculty, staff and institutional support of these activities.
CSL is a structured learning experience that combines community service with explicit learning objectives, preparation, mentorship and reflection. Health Science Center students address community-identified needs while learning about the context in which illness develops, connecting their academic coursework to real- life situations, and reflecting on their roles as future healthcare professionals. At the Center for Medical Humanities & Ethics, we believe CSL is ethics in action. We are proud of the leadership that our students exhibit and the promise that they will become community-connected healthcare providers who work to reduce disparities and enhance access to care throughout their careers.
The Annual CSL Conference at UT Health San Antonio originated in 2008 as an opportunity to learn from the CSL experiences of students, faculty, staff, and community partners in San Antonio and across Texas. Each year, the conference focuses on a theme relevant to service-learning and hosts experts and guest lecturers, provides skill-building sessions, and showcases CSL projects through students’ poster presentations. Presented by the Center for Medical Humanities & Ethics in conjunction with an interprofessional planning committee, the conference is free and open to the community.
Conference Objectives
• To share best practices and scholarship in community service learning with a focus on how to effectively deliver health information during a public health crisis.
• To bring together an interprofessional group of University of Texas (UT) Health Science Center students, faculty, and staff from across the state with community partners to foster service-learning collaborations.
• To highlight existing UT Health Science System community service learning projects and future opportunities.
• To recognize and reward excellence in community service learning within the UT Health Science System. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 2 Communicating Hope: Delivering Essential Information in a Public Health Crisis 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 3 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Conference Agenda – Virtual Format
All times CST Friday, February 5, 2021
Welcome / Opening Remarks Noon-12:15 pm Melanie Stone, MPH, MEd, Assistant Director, Community Service Learning, Center for Medical Humanities & Ethics, UT Health San Antonio
Opening Keynote: Communicating Hope: Science vs Anti-Science Ali Khan, MD, MPH, MBA, Dean, College of Public Health, University of 12:15-1:30 pm Nebraska Medical Center and Former Assistant Surgeon General, U.S. Public Health Service *This presentation has been approved for 1.25 AMA PRA Category 1 Credit™. † **
Panel: COVID-19 Response: Lessons Learned About Health Communication 1:40-2:40 pm Moderator: Ruth Berggren, MD, MACP, Director, Center for Medical Humanities & Ethics, UT Health San Antonio
Breakout Sessions: Choose one (1) *Both presentations have been approved for 1.0 AMA PRA Category 1 Credit™. † ** A. Evidence, Insights, and Strategy: Developing Effective Health Messages Michael Mackert, PhD, Director, Center for Health Communication, UT Austin 2:50-3:50 pm B. Combining Ethics and Expertise: Health Literacy Best Practices for Public Health Emergencies Jamie Carlin Watson, PhD, Assistant Professor of Medical Humanities & Ethics, University of Arkansas Medical Sciences
4:00-5:00 pm Virtual Community Partner Session
Saturday, February 6, 2021
9:00-10:00 am Virtual CSL Poster Session
10:00-11:00 am Presentation of Top CSL Posters with Live Judging
Closing Keynote: Rebuilding Trust through Health Communication 11:00 am- Lisa Fitzpatrick, MD, MPH, MPA, Founder and CEO, Grapevine Health and 12:15 pm Professor, The George Washington School of Medicine and Health Sciences *This presentation has been approved for 1.25 AMA PRA Category 1 Credit™. † **
Wrap-Up/Call to Action 12:15 -1:00 pm Ruth Berggren, MD, MACP; Director, Center for Medical Humanities & Ethics, UT Health San Antonio
CME: This activity has been approved for 3.50 AMA PRA Category 1 Credit™. †This presentation meets the Texas Medical Board criteria for formal continuing medical education involving the study of medical ethics and/or professional responsibility. **This presentation also meets the criteria for Risk Management Education (RME) credit. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 4 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Virtual Community Partner Session
Friday February 5, 2021, 4:00-5:00 pm
This year’s virtual Community Partner Session will feature brief, five-minute pre-recorded video presentations. Community partners have recorded videos that describe their organization’s mission, client services, etc. (an elevator pitch, so to speak) and identifies specific goals for a community service learning collaboration. They have uploaded their videos to Flipgrid - a video discussion platform.
Flipgrid works on most web browsers and mobile devices. We recommend Microsoft Edge or Google Chrome for the best web experience.
Please use the instructions below to view the online presentations. We encourage you to show our presenters your support and “like” or post a text comment for each presentation. Presenters will be available “Live” during the designated Poster Session on February 5, 4:00-5:00 pm, for immediate response to your comments. Feel free to exchange your contact info with the partners to develop CSL project ideas.
Viewing Instructions:
Step 1: Go to: https://flipgrid.com/cslconference2021
Step 2: To view community partner videos: click on View 2 Topics to choose the correct session (Community Partner Session).
Step 3: To make comments on a video: When you click the Comment box, you will be asked to “Join the Discussion” using a Google or Microsoft email. If you use Outlook or Gmail for any of your emails, please use that email to login. UTHSA staff and students: Use your .uthscsa.edu email or livemail.uthscsa.edu email. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 5 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Virtual CSL Poster Session
Saturday February 6, 2021, 9:00 -10:00 am
An index of posters and the abstracts are listed in the back of this program.
This year’s virtual Poster Session will feature brief, three-minute pre-recorded video presentations. Student presenters have narrated their presentations and uploaded their videos to Flipgrid - a video discussion platform.
Flipgrid works on most web browsers and mobile devices. We recommend Microsoft Edge or Google Chrome for the best web experience.
Please use the instructions below to view the online presentations. We encourage you to show our presenters your support and “like” or post a text comment for each presentation. Presenters will be available “Live” during the designated Poster Session on February 6, 9:00 -10:00 am, for immediate response to your comments. Feel free to exchange your contact info with the students to develop CSL project ideas.
Viewing Instructions
Step 1: Go to: https://flipgrid.com/cslconference2021
Step 2: To view poster videos: click on View 2 Topics to choose the correct session (Student Poster Session).
Step 3: To make comments on a video: When you click the Comment box, you will be asked to “Join the Discussion” using a Google or Microsoft email. If you use Outlook or Gmail for any of your emails, please use that email to login. UTHSA staff and students: Use your .uthscsa.edu email or livemail.uthscsa.edu email. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 6 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Poster Awards
Blue Ribbon Award
Note: the Blue Ribbon Winners that are denoted by an asterisk in the program book. These posters were selected by an interprofessional committee who reviewed all submissions and chose the top three outstanding abstracts. The 2021 Blue Ribbon Winners are:
Postpartum Depression Screening and Education
Student Team: Holly Miller, Gennipher Smith, Brionné Thompson, Lexie Cooper, Leslie Kim
Faculty Mentor: Melissa Martinez, MD
Other Faculty Mentor: Millicent Eke
Community Partner: Pregnancy Care Center San Antonio
The COVID-19 ID Virtual Outpatient Clinic: A Volunteer Service Supporting COVID-19 Outpatient Care in Bexar County
Student Team: Cory Nunn, Aditi Sharma, Quinn Benson, Madeleine Bousquet, Jessica Davis Bethel, Zainab Fatima, Dallin Busby, Sydney Tran, Nicoel Mattes
Faculty Mentor: Barbara Taylor, MD, MS
Other Faculty Mentors: Farah Al allawi, MD; Robert Geller
Community Partners: University Health, UT Health San Antonio Long School of Medicine
Bridging the Diaper Gap Project
Student Team: Elena Castoreno, Abbigail Garza, Nasaria Carmona, Elisabeth Marlow, Destiny Yanes,Destiny Sanchez, Patricia Rios, Jessalie Ornelas
Faculty Mentor: Beth Johnson, MSN, FNP-C
Community Partner: A Brighter Day
Judges’ Choice Award
Prior to the CSL conference, judges will review all posters and select five that will be presented during the poster session on February 6th, 10:00 -11:00 am. One poster will be selected for the Judge’s Choice Award. The winner will be announced during the conference wrap-up session and be awarded a monetary prize.
Interprofessional Education (IPE) Award
Also prior to the CSL conference, the poster featuring the best IPE project will be selected by judges and awarded a monetary prize. Second and third place will be provided a certificate. The winners will be announced during the conference wrap-up session. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 7 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Welcome/Opening Remarks
Speaker: Melanie Stone, MPH, MEd
Melanie Stone, MPH, MEd, directs the Community Service Learning (CSL) program through the Center for Medical Humanities & Ethics at The University of Texas Health Science Center at San Antonio. This innovative program promotes student and faculty engagement with community organizations in conducting service projects which benefit medically underserved populations in Texas. Her passion is health literacy and in her current role, she helps bring health literacy awareness, knowledge, and skills to the future healthcare professional workforce. She is actively involved in the community, serves on the governing council of the Texas Public Health Association, serves as the Vice President of Health Literacy Texas and is an alumni of Leadership San Antonio and Leadership Texas.
Opening Keynote: Communicating Hope: Science vs Anti-Science
Speaker: Ali S. Khan, MD, MPH, MBA
Session Description: Dr. Khan will explain the epidemiological transition in human history, and why the world is facing frequent intense pandemics in recent years. He will give an overview of the global pandemic with a focus on elements of a successful strategy compared to failed strategies. He will discuss the critical role of science in designing public health strategies and the influence of the anti-science movement on spreading disinformation and opportunities to better message for hope. Finally, Dr. Khan will share some thoughts on the Next Pandemic.
Learning Objectives:
1. Describe the speed of science post-COVID-19 and the critical components of disinformation.
2. Evaluate the science-based COVID-19 strategy compared to the U.S. ‘herd immunity’ strategy.
Ali S. Khan, MD, MPH, MBA, is Dean of the College of Public Health at the University of Nebraska Medical Center (UNMC) and a former Assistant Surgeon General with the U.S. Public Health Service. With a professional career focused on health security, global health, and emerging infectious diseases, Dr. Khan was one of the main architects of CDC’s national health security program and continues this work at UNMC, which has been nationally designated to prepare the American healthcare system to respond to outbreaks of high hazard pathogens. He has authored numerous papers and publications and has consulted extensively for multiple U.S. organizations, ministries of health, and the World Health Organization where he serves on the steering committee for GOARN. Dr. Khan is the author of The Next Pandemic: On the Front Lines Against Humankind’s Gravest Dangers. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 8 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Panel: COVID Response: Lessons Learned about Health Communication
Moderator: Ruth Berggren, MD, MACP
Session Description: This session will discuss lessons learned for community service learning (CSL) health communication through sharing successes and challenges from people on the front lines of community engagement during the COVID-19 pandemic. Featured on the panel will be a community health worker, a public health leader, an infectious disease expert, and a CSL student. The panel will be moderated by Dr. Ruth Berggren, Director of the Center for Medical Humanities & Ethics that houses the CSL program at UT Health San Antonio. Featured panelists are:
• Colleen Bridger, MPH, PhD, Assistant City Manager, Interim Health Director, City of San Antonio
• Meredith Hosek, MD/MPH Candidate Class of 2023; Research Assistant - Division of Infectious Diseases, Long School of Medicine, UT Health San Antonio
• Esmeralda Ibarra, CHW, Community Health Worker, Lower Rio Grande Valley Area Health Education Center (AHEC)
• Barbara Saatkamp Taylor, MD, MS, Associate Professor of Infectious Diseases and Assistant Dean for the MD/MPH Program, Long School of Medicine, UT Health San Antonio
Ruth Berggren, MD, MACP directs the Center for Medical Humanities & Ethics at UT Health San Antonio. In this role, she teaches ethics and professionalism while nurturing empathy and humanitarian values. Dr. Berggren is the Marvin Forland, MD, Distinguished Professor in Medical Ethics, and she holds the James J. Young, PhD, Endowed Chair for Excellence in Medical Education. Dr. Berggren is board-certified in both internal medicine and infectious diseases with significant experience and particular interest in clinical AIDS and viral hepatitis research, as well as in implementing HIV care in resource poor settings.
Breakout Workshop A Evidence, Insights, and Strategy: Developing Effective Health Messages
Speaker: Michael Mackert, PhD
Session Description: This presentation will focus on techniques for developing more effective health messages which participants can apply in their own work, as well as a process that can be used to consistently build evidence-based health communication campaigns. It will utilize a case study to demonstrate the use of those principles via a relevant case study, followed by a discussion of the principles discussed and how they can be used across health issues.
Learning Objectives:
1. Discover techniques for developing more effective health messages.
2. Understand the use of those tools through examples provided in a relevant case study of health communication.
Michael Mackert, PhD is the Director of The University of Texas at Austin Center for Health Communication and Professor in the Stan Richards School of Advertising & Public Relations and Department of Population Health. His research focuses primarily on the strategies that can be used in traditional and new digital media to provide effective health communication to low health literate audiences. He leads projects on a variety of public health issues – including tobacco cessation, opioid overdose prevention, and men’s role in prenatal health – that generate evidence-based health communication strategies for Center for Health Communication partners and contribute to health communication scholarship. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 9 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Breakout Workshop B: Combining Ethics and Expertise: Health Literacy Best Practices for Public Health Emergencies
Speaker: Jamie Carlin Watson, PhD
Session Description: In this breakout session, Dr. Watson will explain some ethical challenges posed by inadequate health literacy, using examples from the COVID-19 pandemic. He will then describe some health literacy best practices and explain how these can address these challenges and improve health communication during public health emergencies. Using Zoom’s breakout room function, participants will then work in small groups to apply these best practices to real examples of public-facing health information.
Learning Objectives:
1. Explain three ethical challenges posed by inadequate health literacy.
2. Use at least two health literacy best practices to address these ethical challenges.
Jamie Carlin Watson, PhD is Assistant Professor of Medical Humanities and Bioethics at University of Arkansas for Medical Sciences (UAMS). Dr. Watson is a clinical ethics consultant for UAMS and Arkansas Children’s hospitals, and he is affiliate faculty for the UAMS Center for Health Literacy. His primary research is in expertise studies, medical ethics, and health literacy.
Closing Keynote: Rebuilding Trust through Health Communication
Speaker: Lisa Fitzpatrick, MD, MPH, MPA
Session Description: Low health literacy is a little-discussed social driver of health outcomes. Failure to recognize low health literacy and adapt health communication to address it fosters distrust and negatively impacts the patient provider relationships. This discussion will highlight examples of low health literacy, the link to medical distrust and offer suggestions for how to recognize and intervene to improve patient outcomes.
Learning Objectives:
1. Understand how poor health communication fosters distrust in healthcare.
2. Understand how cultural context drives patient/provider trust.
Lisa Fitzpatrick, MD, MPH, MPA, is an infectious diseases physician and CDC-trained medical epidemiologist who recently served as the medical director for Washington DC’s Medicaid program. Dr. Fitzpatrick is a professorial lecturer for the George Washington University Milken Institute School of Public Health, an adjunct clinical professor at the George Washington University School of Medicine, an Aspen Institute Health Innovator fellow and member of the Aspen Institute Global Leadership Network. In addition to public health and infectious diseases, Dr. Fitzpatrick’s areas of professional interest include health literacy, patient engagement and health innovation for underserved communities, specifically digital health solutions. She founded Grapevine Health to provide a trusted source of credible health information for patients and underserved communities. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 10 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Notes 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 11 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Advocacy/Policy
Developing Community-based Stigma-free HIV Healthcare Guidelines for Bexar County
Project Discipline: Medicine
Primary Poster Presenter: Yolanda Crous
Other Student Team Members: Maria Benson
Faculty Mentors: Barbara Taylor, MD, MS; Gregory Casillas; Sean Greene, Andrea Moutria-Nino, Sofia Sepulveda, Glenda Small, Kristin Thompson, Junda Woo, MD
Community Partner: End Stigma End HIV
Project Location: San Antonio, Texas
Background: For people living with HIV, relationships with healthcare workers play a crucial role in care engagement. Healthcare-related stigma, on the other hand, can act as a barrier to testing, treatment, and retention in care. Though stigma-reducing healthcare guidelines have been implemented internationally, few guidelines have been developed in the U.S. and none for Bexar County, an epicenter of America’s HIV epidemic.
Objectives: To create evidence-based guidelines to decrease HIV stigma in healthcare settings as part of a multipronged effort to meet Bexar County’s 90-90-90 targets (90% of people with HIV to know their status; 90% to receive sustained anti-retroviral therapy; and 90% to be virally suppressed).
Methods: In October 2020, ESEHA formed a Stigma-Free Guidelines Task Force made up of medical students, a physician, and four HIV advocates, some living with HIV themselves. This group met over Zoom to review the organization’s HIV stigma research and develop the guidelines. The research included written experiences of stigma collected in journals, a transcript of a live HIV storytelling performance, and the results of an online survey and focus-group interviews assessing HIV stigma among local healthcare professionals. Review of the research revealed multiple stigma drivers, facilitators, and practices to target for intervention, including knowledge deficits, fear and discomfort, medical education, normative systems, and workplace culture.
Results: The task force created a five-page guidelines document to be distributed to Bexar County healthcare providers through the AIDS Education and Training Center. The guidelines outline antistigma interventions geared toward changing behavior and norms on the individual, work-culture, and organizational levels.
Conclusion: Next steps include developing anti-stigma fact sheets, an expanded anti-stigma white paper, and anti-stigma trainings to pilot at select institutions. It is our hope that our guidelines can serve as a template for other communities aiming to reduce barriers to care by decreasing HIV stigma in healthcare. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 12 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Avocacy/Policy
The Impact of Lifestyle and Income on Diabetes Outcomes: A San Antonio Study
Project Discipline: Medicine
Primary Poster Presenter: Edward Visnaw
Faculty Mentor: Inez Cruz, PhD, LMSW
Community Partner: UT Health San Antonio Long School of Medicine
Project Location: San Antonio, Texas
Background: Patient outcomes in diabetes mellitus care are an invaluable topic in the medical community. This study explores the relationship in our community between the social determinants of health of living situations and income security and diabetes management regarding diabetes quality of life and diabetes distress in terms of burden. The goal of this study is to determine San Antonio’s social determinants of health that impact diabetic patient outcomes, in order to better target and direct care, especially in a community where diabetes is so prevalent and management is so important.
Objectives: (1) Measure the correlation among income and living situations with diabetes management, distress, and quality of life in San Antonio. (2) Determine the most clinically significant social determinants of health and adverse diabetic outcomes in San Antonio.
Methods: Research is conducted at a family medicine clinic in San Antonio, Texas. The subjects of the study are patients at least 18 years old with type I or II diabetes. The 69-item patient survey measures social determinants of health, diabetes quality of life, and diabetes distress related to diabetes management.
Results: This project is expected to: (1) Specifically determine the scope of how different levels of income security and living situations impact diabetic patient outcomes in the community. (2) Help to better train future healthcare professionals, including medical students, residents, physicians, and all other faculty and staff.
Conclusion: The patient survey is inherently subject to response bias. Sometimes during the survey, the patients feel the need to tell us “what we want to hear.” It was stressed that their responses would not affect their healthcare decisions or relationship with the physicians. Although this challenge was accounted for, there seems to be a continued need to emphasize to patients that their healthcare is always unbiased and equal, which is something that can be improved. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 13 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Avocacy/Policy
The Impacts of COVID-19 on Mental Health in the Transitioning-From-Homeless Population at SAMMinistries
Project Discipline: Medicine
Primary Poster Presenter: Phillip Yang
Faculty Mentor: Nida Joy Emko, MD
Community Partner: San Antonio Metropolitan Ministries Transitional Living and Learning Center (SAMM TLLC)
Project Location: San Antonio, Texas
Background: SAMMinistries’ Transitioning Living and Learning Center (TLLC) supports up to 40 families transitioning-from-homelessness in a shared housing center. Little is known about COVID-19’s mental health impact on transitioning-from-homelessness families.
Objectives: Understand the mental health impacts of COVID-19 on TLLC families.
Methods: The survey consists of three sections: 1. General (coping ability, loneliness, stress levels, family situation, financial situation, mental health, and physical health), 2. Mental health (Depression [PHQ-9] and anxiety [GAD-7]), 3. COVID-19 vaccine (vaccine confidence, likely vaccine yourself, likely vaccine your child, and reasons for vaccine hesitancy). Parents answered for their children and compared pre-COVID-19 times to now (Likert scale). Family situation and financial situation were not assessed in children. 21 parents took the survey from November to December 2020.
Results: Parents reported worsening for 6 of 7 general questions (p<0.05). Financial situation was the most impacted. Loneliness was the least impacted. Parents reported worsening for 6 of 9 depression questions (p<0.05). Parents reported worsening for all 7 anxiety questions (p<0.05). There was a worsening, non- significant trend in parent-reported children’s general questions. Parents reported worsening for 2 of 9 depression questions for their children (p<0.05). Parents reported worsening for 5 of 7 anxiety questions for their children (p<0.05). 52% reported “not very confident” or “not at all confident” about the COVID-19 vaccine working. 52% reported “not very likely” or “not at all likely” to receive the vaccine for themselves or their children. The top two concerns about the vaccine are a “desire for more information” and “safety concerns”.
Conclusion: COVID-19 has a significant impact on the mental health of TLLC families. Parents reported worsening mental health compared to their children. Over half of the sample (52%) have vaccine hesitancy, which is greater than 27% reported vaccine hesitancy in the general population. Implementing mental health and vaccine education programs would benefit the TLLC residents. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 14 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Notes 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 15 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Capacity Building
Developing a Student-led Patient Navigator Program for Individuals Experiencing Homelessness
Project Discipline: Medicine, Physician Assistant, Public Health
Primary Poster Presenter: Ashlyn Lafferty
Other Student Team Members: Nicholas Campalans, Umaru Barrie, Thanos Rossopoulos, Alison Liu, Brayden Seal, Claire Abijay, Arlen Suarez, Kyle Swartz, Philip Day, Philip Day, PhD, Patti Pagels, MPAS, PA, Nora Gimpel, MD
Faculty Mentor: Nora Gimpel, MD
Community Partner: Union Gospel Mission
Project Location: Dallas, Texas
Background: People experiencing homelessness encounter complicated barriers to healthcare while facing greater burdens of disease. Patient navigation improves health outcomes for those with chronic illnesses experiencing homelessness. Additionally, patient navigation as a healthcare trainee promotes self- identification as a change agent.
Objective: To describe the development of a new student-led patient navigator program (PNP) for patients experiencing homelessness.
Methods: A PNP providing services at in-shelter clinics for people experiencing homelessness was designed, using a multi-pronged development structure over a nine-month period. An initial group of students met with community stakeholders to outline primary health-related needs and barriers faced by individuals experiencing homelessness. A mission and vision were then created, from which the following programmatic components were identified: curriculum, navigation system, resource database, quality improvement and research, and marketing and communications. Component leaders generated timelines, specific aims, and details of operation and substructure. Recruitment of a dedicated leadership team was accomplished by engaging peer networks via e-mail and in-person meetings. Reporting structures were built to ensure accountability and effective coordination between teams.
Results: By August 2020, over 40 students and numerous faculty from UT Southwestern Medical School and Health Professions programs were engaged in development of the PNP. A 3-month long curriculum was built in which an additional 47 students enrolled in fall 2020. These students committed to a 1.5-year- long fellowship experience, consisting of iterative cycles of longitudinal patient navigation, pairing navigator teams with clients for three 15-week cycles. A resource database of over 110 community, social service, and healthcare groups was created. Assessment tools and infrastructure were built to monitor client and learner- related outcomes.
Conclusion: Guided by a robust developmental structure, this program plans to bridge critical gaps in care for individuals experiencing homelessness, link curricular experiences with service-learning opportunities for health professions students, and generate additional insights into the optimization and implementation of this PNP. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 16 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Capacity Building
Travel Burden for Free Dermatologic Care in Uninsured and Homeless Populations from San Antonio and Surrounding Counties
Project Discipline: Medicine
Primary Poster Presenter: Rahul Patel
Other Student Team Members: Marie Vu, Jessica Wong, Tue Felix Nguyen, Andrea Lozano
Faculty Mentor: John Browning, MD, MBA
Community Partner: Travis Park United Methodist Church
Project Location: San Antonio and surrounding counties, Texas
Background: The Travis Park Dermatology Clinic is a student-run free clinic that serves homeless and uninsured populations in San Antonio and surrounding counties. Being one of the only dermatology free clinics in the city, our study aims to evaluate the geographic reach of our clinic and identify the extent of travel burden for dermatologic care within the populations we treat.
Objectives: The objective of the study is to highlight the need to reduce travel burden on patients by providing greater accessibility to dermatologic care for uninsured and homeless populations of San Antonio and surrounding counties.
Methods: Patient charts from an electronic medical record (REDCap) at the Travis Park Dermatology Clinic were reviewed to identify patient demographics, chief complaints, and zip codes at the time of visit. Travel burden was assessed by determining the distance from the recorded zip code to the clinic in miles.
Results: From March 2018 to March 2020, 445 of the 570 patient records documented in the REDCap database had a residential address which could be correlated with a zip code at the time of their clinic visit. In this population, 98 of the 445 patients resided within a 5-mile radius of the clinic. Further expanding the geographic reach, 165 of the 445 patients resided within a 10-mile radius of the clinic. Out of the 261 patients living outside a 10-mile radius from the clinic, there were 30 patients who lived outside a 25-mile radius.
Conclusion: The findings at our clinic suggest that a majority of patients are unable to access dermatological care near their residence and must travel further distances. This highlights the need to reduce the travel burden on patients by providing greater accessibility to dermatological care for uninsured and homeless populations. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 17 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Clinical Service
A Medical Snapshot of a Homeless Population Based on Health Fair Outcomes
Project Discipline: Medicine
Primary Poster Presenter: Lakshmi Menon
Other Student Team Members: Daniel Howard, Thanos Rossopoulos
Faculty Mentor: Philip Day, PhD
Community Partner: Union Gospel Mission
Project Location: Dallas, Texas
Background: Individuals experiencing homelessness often experience a variety of barriers to care that make awareness and management of chronic medical disease difficult to attain. Many such individuals may seek care at shelters and clinics; therefore, it is important that personnel at these facilities be aware of medical issues prevalent amongst their clients. A group of medical students and community partners organized a health fair at a shelter for men experiencing homelessness, during which health information was gathered and various screenings and services were provided.
Objective: Assess prevalence of common chronic medical conditions amongst shelter clients, determine healthcare services needed by the population, and inform community partners about areas for future intervention.
Methods: Study consisted of 79 men experiencing homelessness and accessing shelter resources who participated in a health fair on 08/2018 in Dallas, TX. Individuals were provided health services and medical screening for various conditions. Primary outcomes included participant-reported health rating, insurance, and chronic health conditions. Secondary outcomes included presumptive diagnoses of diabetes, hypertension, and kidney disease, based on screening data.
Results: Overall HTN prevalence: Elevated 6.2%; Stage 1: 16.9%; Stage 2: 44.6%. Per diabetes screening: 14% of participants met diagnostic criteria, with 3 individuals who did not report a previous diagnosis. CKD prevalence: Stage 3: 9.3%; Stage 4: 1.5%; Stage 5: 1.5%. Greater proportions of black than white individuals reported being homeless two or more times in the past 20 years (p=0.034). “Unhealthy” self- raters had higher mean Cr (0.031) and BMI (0.014) than “Healthy” self-raters, but these did not differ in terms of self-reported smoking status, DM, or HTN.
Conclusion: Preliminary results appear similar to national prevalence rates for hypertension and diabetes but higher for CKD. The results of this health fair can now inform prioritization of care in preventative and active management of these diseases through existing programs at UGM. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 18 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Clinical Service
Actinic Keratosis at Student-Run Free Clinic: Need for Patient Education
Project Discipline: Medicine
Primary Poster Presenter: Caroline Zhu
Other Student Team Members: Marie Vu, Jessica Wong, Giselle Guerrero, Kavina Patel, Pavela Bambekova
Faculty Mentor: John Browning, MD, MBA
Community Partner: Travis Park United Methodist Church
Project Location: San Antonio, Texas
Background: In 2009, the Travis Park Dermatology Clinic in San Antonio was established as a student- faculty collaborative practice to treat skin conditions in the homeless, indigent, and uninsured population of our community. Actinic keratoses (AK) are common, sun-induced lesions that can potentially progress to squamous cell carcinoma. AKs tend to recur, and patients are advised to follow-up once a year, and once every six months if there is a history of skin cancer.
Objectives: To better serve our patients with actinic keratosis, we sought to evaluate treatment and follow- up in patients with a new diagnosis of AK in our clinic.
Methods: We conducted a retrospective review using our RedCap electronic medical record (EMR) system. Patient charts were evaluated using multiple parameters such as sex, age, family history, lesion description, treatment, and follow-up.
Results: In the 24-month time frame since we transitioned to our EMR system, 8 patients were diagnosed with AK at our clinic, with an average of 2.5 lesions per patient. Seven of the eight patients elected to undergo treatment with cryotherapy. Six patients had discussions about sun protection; two patients had charted notes explaining the need for follow-up. Only one patient returned to the clinic, and this individual was found to have a recurrent AK lesion that required further treatment.
Conclusion: As most AK patients are advised to follow up once a year, it is crucial that our free clinic emphasize the importance of follow-up as well as sun protection. Actinic keratoses has been found to be highly recurrent, especially in patients with multiple lesions. As a treatable and preventable condition, actinic keratosis is one modifiable way our clinic can make a significant impact on the community. To help achieve this goal, we have created a patient handout on the natural progression of AK to skin cancer and the need for sun protection. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 19 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Clinical Service
An Evidence-Based Approach to High Quality Medical Record Abstraction at the COVID-19 Infectious Disease Virtual Outpatient Clinic (CIVOC) in San Antonio, Texas
Project Discipline: Medicine
Primary Poster Presenter: Madeleine Bousquet
Other Student Team Members: Brandon May, Meredith Hosek, Aditi Sharma, Cory Nunn, Zach Allen, Fatima Dollar, Katarina Pitka, Tracey Vuong
Faculty Mentors: Barbara Taylor, MD, MS; Farah Al Allawai, MD; Robert Gellar, Bill Sanns, Meredith Zosus, PhD
Community Partners: University Health, UT Health San Antonio Long School of Medicine
Project Location: San Antonio, Texas
Background: Medical record abstraction (MRA), the process of withdrawing medical data from a medical record to be used in a secondary data analysis, is a vital component of clinical research. Typically performed manually by humans, MRA is prone to several prominent limitations, most notably concerning data accuracy, completeness, and reliability. In the process of providing follow-up care to thousands of local COVID-19 patients, the CIVOC service generated a large database of REDCap reports which we now intend to analyze, which will be used to enhance the quality of CIVOC provision of care to the community.
Objectives: To design and implement a high-quality data abstraction protocol for clinical chart review and to use this protocol to establish a percentage value for inter-rater reliability of abstracted and re-abstracted charts.
Methods: The CIVOC Research Team designed an evidence-based methodology for high-quality chart abstraction. Students familiar with the clinical service were recruited for abstraction and creation of abstraction guidelines clarifying the location of each variable in the EMR and appropriate steps to take when information is incomplete. Finally, all charts within a defined clinical time period are being abstracted and re- abstracted by two different researchers to ultimately establish a quantitative inter-rater reliability value.
Results: Abstraction and reabstraction for this project are currently ongoing, and medical charting has intrinsic variability.
Conclusion: By approaching MRA through an evidence-based approach, this project serves as an example for other teams interested in capturing high-quality data for their analyses and will provide understanding of our data quality as the research team moves forward into secondary analysis. This enhanced understanding of Bexar county covid population will improve the quality of care the team provides and improve learners’ understanding of the complexities of data capture from existing electronic records 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 20 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Clinical Service
Analysis of Cutaneous Infections in Homeless Populations at Student-Run Free Clinic
Project Discipline: Medicine, Nursing
Primary Poster Presenter: Marie Vu
Other Student Team Members: Jessica Wong, Fredy Calderon, Jonathan Luu, Cara Schachter
Faculty Mentor: Richard Usatine, MD
Community Partner: Alpha Home, Pride Community Clinic
Project Location: San Antonio, Texas
Background: Travis Park Dermatology Clinic is a student-faculty collaborative practice that treats dermatologic conditions in homeless and indigent populations of San Antonio. Due to impoverished living conditions, homeless individuals are at risk of developing cutaneous infections with limited access to care. With the scarce resources for dermatologic care, patients tend to wait longer times, on average, before seeking medical care.
Objectives: The objective of the study is to better understand trends relating to cutaneous infections in the vulnerable populations of San Antonio. This will aid in planning targeted interventions for the community.
A retrospective chart review utilizing our REDCap electronic medical record identified patients who were diagnosed with cutaneous infections. Areas subject for further analysis included most common types of infections, location of infections, and treatment for infections. The average amount of time it took for patients to come to the clinic was also included.
Results: From March 2018 to March 2020, 100 patients were diagnosed with conditions of infectious etiology. Within this patient population, 46% of patients had conditions which affected their extremities. The most common diagnoses included tinea infection (23%), plantar warts (9%), folliculitis (9%), unspecified mycosis (6%), impetigo (5%), and scabies (5%). The most common treatment options utilized by the clinic included liquid nitrogen cryotherapy (17%), topical antifungals (15%), triamcinolone cream (9%), doxycycline (8%), and clindamycin (8%). The average time patients had symptoms before coming to clinic was 8.6 months, with a median of 2.5 months.
Conclusion: The data show that patients have delayed treatment for largely treatable infections. The review of cutaneous infection trends in vulnerable populations is important for planning appropriate intervention measures for the identification, treatment, and prevention of various skin infections. Future interventions at our clinic include patient education of such conditions, with emphasis on hygiene prevention and seeking appropriate care upon recognizing symptoms. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 21 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Clinical Service
Evaluating an Over-the-Counter Model for Contraceptionin a San Antonio STD Clinic
Project Discipline: Medicine
Primary Poster Presenter: Sarah Cox
Other Student Team Members: Chloe Jensen, Olivia Chen, Diana Palacios, Amy Hong, Michelle Sutanto, Maher Gill, Avery Kester
Faculty Mentor: Luke Newton, MD
Community Partner: San Antonio Metropolitan Health District STD/HIV Clinic
Project Location: San Antonio, Texas
Background: In 2016, 67% of Texas women reported significant barriers to obtaining contraception. This finding – compounded by Texas’s 54% unplanned pregnancy rate and rising incidence of STDs – suggest the importance of contraceptive access. Progestin-only pills (POPs) have fewer contraindications, adverse effects, and lower cost compared to combined oral contraceptives. We investigated the benefits and challenges to providing POPs in an over-the-counter model.
Objectives: This project aims to address contraception accessibility by decreasing the barriers of cost and provider access for women in San Antonio. We measured pregnancy rates, discontinuation rates, and reproductive knowledge through pre-post surveys.
Methods: Participants were non-pregnant, uninsured women of reproductive age referred by Metro Health. Participants completed a demographic survey and a pre-post education survey, and received a 3-month POPs supply. Participants were followed for twelve months; every 3 months, participants completed a survey assessing education retention, adherence, and side effects before receiving the next 3-month POPs supply. Enrollment is ongoing.
Results: From June 2019-December 2020, 45 women were enrolled and 8 completed the study. 41% of women reported no previous birth control use. Between the pre-and-post-survey, there were substantial increases in reproductive knowledge (p=0.0330) and contraceptive knowledge (p=0.0164); knowledge remained increased at the 3 month (p=0.0168), 6 month (p=0.0485), 9 month (p=0.0169), and 12 month (p=0.0072) follow-ups. 55.5% of women withdrew from the study. In exit surveys, 64.7% of women wanted to continue using POPs.
Conclusion: Our data suggests that an over-the counter POPs model could contribute to contraceptive access. Patient retention is a challenge, likely due to location and clinic hours. We believe that providing virtual follow-ups during the COVID-19 pandemic increased patient retention, solidifying our hypothesis that accessibility is a limiting factor for contraceptive use. Further direction includes reaching target enrollment (n=200) and maintaining increased retention. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 22 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Clinical Service
Evaluating Zoom as a Tool for Telemedicine Across Student Free Clinics
Project Discipline: Medicine, Nursing
Primary Poster Presenter: Marie Vu
Other Student Team Members: Brent Arcayan, Cameron Atkison, Amanda Boone, Ruth Bondurant, Josh Carrasco, Jaclyn Guzman, Varsha Karanam, Rebecca Rodriguez, Louisa Xie
Faculty Mentor: Richard Usatine, MD
Community Partners: Alpha Home, Pride Community Clinic
Project Location: San Antonio, Texas
Background: Due to the COVID-19 pandemic, all clinics associated with the Student-Faculty Collaborative Practice temporarily halted in-person clinic operations. In order to continue providing care to vulnerable communities, clinics switched to telemedicine via Zoom Video Communications (Zoom). As this was the first time the clinics had operated virtually, this study aimed to determine the efficacy of Zoom as a telemedicine platform for patients.
Objectives: The objective of this study was to analyze how effective the Zoom platform is for delivering virtual patient care. The results can guide clinic operations in situations where in-person healthcare is unavailable.
Methods: During September and October 2020, patients were asked to complete a survey after telemedicine visits at Alpha Home Clinic and Pride Community Clinic. Survey questions asked patients to rate items such as user-friendliness, comfortability, and satisfaction with Zoom for telemedicine. Ratings ranged from scores of 0 to 10. With satisfaction, for example, scores were explained as 0 = not satisfied at all, 5 = somewhat satisfied, 10 = extremely satisfied. Patient ratings were averaged for each question.
Results: There were 7 responses total, with one from Alpha Home Clinic and 6 from Pride Community Clinic. On average, patients gave a 9.43 rating on their comfortability with seeing a healthcare provider through Zoom. Patients also gave an average rating of 9.43 for Zoom’s user-friendliness. In terms of rating their healthcare provider’s ability to address their health concerns through Zoom, they gave an average rating of 9.86. For overall satisfaction with receiving telemedicine through Zoom, they gave an average rating of 9.71.
Conclusion: With high average patient ratings, Zoom has potential to be a mainstay telemedicine tool for the student-run clinics in instances where in-person operations are unavailable. Especially for a community that lacks access to healthcare, telemedicine can serve as a valuable alternative for delivery of healthcare services. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 23 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Clinical Service
Evaluation of Biopsy Management at Student-Run Free Clinic
Project Discipline: Medicine
Primary Poster Presenter: Caroline Zhu
Other Student Team Members: Marie Vu, Jessica Wong, Kavina Patel, Giselle Guerrero, Pavela Bambekova
Faculty Mentor: John Browning, MD, MBA
Community Partner: Travis Park United Methodist Church
Project Location: San Antonio, Texas
Background: The Travis Park Dermatology Clinic in San Antonio was established in 2009 as a student-faculty collaborative practice to treat skin conditions in the homeless, indigent, and uninsured population of our community. A 2016 manuscript from the Journal of the American Academy of Dermatology noted that the skin biopsy pathway is fraught with potential for error, and to deliver the highest quality of care, systems should be implemented in clinics to minimize mistakes.
Objectives: We sought to evaluate our current biopsy system and identify potential areas for improvement.
Methods: We conducted a retrospective review using our RedCap electronic medical record (EMR) system to identify patients who underwent a shave or punch biopsy at our clinic.
Results: In the 24-month time frame since we transitioned to our EMR system, 54 patients underwent biopsy. Eleven punch biopsies and 43 shave biopsies were performed. Of these, 28 pathology reports were on record in our EMR, with a variety of diagnoses, most notably: 6 basal cell carcinomas, 2 squamous cell carcinomas, 1 malignant melanoma, and 1 unusual melanocytic lesion. Only 9 of the 28 patients have record in their charts of communication of biopsy results. The average length of time from biopsy date to results communication was 36.5 days.
Conclusion: Effective communication of biopsy results is necessary to help patients understand their diagnoses and plan treatment options. Unquestionably, based on our results, our clinic has much to improve in this area. We have since carefully set in action a protocol to clearly record and follow each patient who undergoes biopsy in our clinic and ensure that results are communicated in a timely manner to secure necessary follow-up visits and treatment. This protocol involves creation of a biopsy book, weekly updates on biopsy reports, and precise record of communication, follow-up, and final treatment decisions. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 24 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Clinical Service
Factors Influencing COVID-19 Symptoms and Outcomes for Patients Evaluated at the COVID-19 ID Virtual Outpatient Clinic in San Antonio, Texas
Project Discipline: Medicine
Primary Poster Presenter: Zachary Allen
Other Student Team Members: Meredith Hosek, Brandon May, Aditi Sharma, Cory Nunn, Farah Alallawi, Fatima Dollar, Hueylie Lin, Katarina Pitka, Madeleine Bousquet, Tracey Vuong
Faculty Mentor: Barbara Taylor, MD, MS
Community Partners: University Health, UT Health San Antonio Long School of Medicine
Project Location: San Antonio, Texas
Background: Since the start of the COVID-19 pandemic, researchers and medical professionals have made immense strides in uncovering the different factors that affect the symptomatology and outcomes of COVID-19 infection. It is thought that disease outcome is significantly impacted by variables including race and ethnicity, socioeconomic status, pre-existing comorbidities, and lifestyle factors. Given Bexar County’s racially and ethnically diverse population, high prevalence of comorbid disease, and variety of socioeconomic backgrounds, University Hospital in San Antonio is an exceptional place for studying how these factors affect COVID-19 infected patients.
Objectives: The objective is to analyze how race, ethnicity, zip code, comorbidities, and smoking/vaping status contribute to COVID-19 disease timeline, symptomatology and severity for patients evaluated at the COVID-19 ID Virtual Outpatient Clinic (CIVOC).
Methods: Using telephone interviews and electronic medical record data abstraction, information was gathered from 4500 COVID-19 patients evaluated at the CIVOC from March to August 2020. Variables collected include age, gender, zip code, race and ethnicity, medical comorbidities, current or past smoking/vaping history, initial symptoms, and outcomes. These variables will be analyzed for correlations with COVID-19 outcomes. Outcomes to be examined include duration of illness, escalation of care to hospitalization, and survival.
Results: Results of correlation analyses are pending completion of data abstraction.
Conclusion: Results from this study will provide insight as to how individual differences impact the course of COVID-19 infection. This knowledge will allow for better care of patients with different backgrounds and lifestyles. Future goals include expanding the project to include more variables, allowing for the development of prediction models for care outcomes 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 25 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Clinical Service
Malnutrition in Orthopedic Trauma Patients: Relationship Between Nutrition and Adverse Outcomes in Acute Fracture Management
Project Discipline: Medicine, Public Health
Primary Poster Presenter: Katherine Jensen
Other Student Team Members: Mason Poffenbarger
Faculty Mentors: Melissa Valerio-Shewmaker, PhD MPH; Boris Zelle, MD
Community Partner: University Hospital
Project Location: San Antonio, Texas
Background: Malnutrition in the orthopedic trauma patient has been associated with increased healing time, non-union, development of ulcers and soft-tissue infection, and overall impaired bone homeostasis.
Objective: This project sought to identify modifiable nutritional risk factors, as well as demographic risk factors, for adverse outcomes in the orthopedic trauma population.
Methods: Upon admission to a Level 1 academic trauma center for traumatic fracture management, patients meeting inclusion criteria were asked to complete a voluntary survey. The survey collected information on demographics, injury specifics, nutritional habits, and a general nutritional knowledge questionnaire. Six months from the date of admission, a chart review was performed to identify incidence of adverse outcomes (post-operative complications, hospital readmission, and delayed wound healing).
Results: From April 2019 to October 2019, 106 patients were surveyed. Each patient had to have a completed survey and adequate follow-up to be included in analysis. Demographic risk factors for increased likelihood of post-operative complications included highest education level of high school diploma/GED or some college (OR = 3.84) and yearly household income of less than $60,000 (OR = 3.89). Nutritional analysis included association between adverse outcomes and patient-reported consumption of foods rich in Vitamins C, E, A, D, iron, calcium, copper, zinc, caffeine, alcohol, and protein. Nutritional risk factors for increased likelihood of delayed wound healing included consumption of less than 3.75 servings of zinc-rich foods per week (OR = 2.69) and consumption of more than 21 servings of caffeine per week (OR = 6.92). Nothing was significantly associated with increased readmissions .
Conclusion: This analysis has identified important risk factors, low consumption of zinc-rich foods and high caffeine consumption, of delayed wound healing in an orthopedic trauma population. This information can direct nutritional recommendations to optimize healing following surgical management of traumatic orthopedic injuries. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 26 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Clinical Service
Outpatient Surgery in Patients with Ankle Fractures Minimises Hospital Admissions and Utilisation of Healthcare Resources
Project Discipline: Medicine
Primary Poster Presenter: Robert DelBello
Other Student Team Members: Travis S. Bullock, Jose M. Gutierrez-Naranjo, Luis Salazar
Faculty Mentor: Boris Zelle, MD
Community Partner: University Hospital
Project Location: San Antonio, Texas
Background: The outbreak of the novel coronavirus (SARS-CoV-2) has emphasised the need to minimise hospital admissions and utilisation of healthcare resources. While in most situations, traumatic fracture care inevitably requires inpatient management, there are subsets of patients who may be treated through an outpatient approach. More specifically, some studies have shown improved outcomes and cost-savings with outpatient management of traumatic closed ankle fractures.
Objectives: The purpose of this study was to examine the outcomes of an outpatient surgery protocol for acute closed ankle fractures in order to mitigate the spread of SARS-CoV-2 and to more effectively utilize limited healthcare resources.
Methods: In this retrospective study, 262 patients underwent outpatient surgery for their closed ankle fractures at our level-1 trauma centre. A total of 196 patients met our inclusion criteria and were ultimately included in the final analysis. Our primary outcomes’ measures included post-operative admission to the emergency department within 30 days after surgery and unplanned hospital readmission within 30 days after surgery. Our secondary outcome measure included the incidence of surgical site infection (SSI) within 12 weeks after surgery.
Results: Thirty-two patients (16.3%) had an unplanned emergency department visit within 30 days of fracture fixation and two patients (1.0%) required hospital readmission within 30 days of their surgery. Sixteen patients (8.2%) developed SSI, which included 11 (5.6%) superficial and five (2.6%) deep infections.
Conclusion: Strategic outpatient management of acute closed ankle fractures is associated with acceptable rates of unplanned emergency department visits, hospital readmissions, and SSIs. In the context of the recent SARS-CoV-2 outbreak, outpatient management of these injuries may aid in the mitigation of nosocomial infections and the preservation of finite healthcare resources. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 27 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Clinical Service
Racioethnic and Age Trends in Patients Evaluated at the COVID-19 ID Virtual Outpatient Clinic from March-August 2020
Project Discipline: Medicine
Primary Poster Presenter: Aditi Sharma
Other Student Team Members: Meredith Hosek, Sydney Tran, Cory Nunn
Faculty Mentors: Barbara Taylor, MD, MS, Robert Geller, Martin Goros, MS, Jonathan Gelfond, MD, PhD, Farrah Al Allawi, MD
Community Partners: University Health, UT Health San Antonio Long School of Medicine
Project Location: San Antonio, Texas
Background: The COVID-19 epidemic in the U.S. has been marked by racial and ethnic disparities in both infection risk and disease outcomes. The COVID-19 ID Virtual Outpatient Clinic (CIVOC) in San Antonio follows up on all patients with COVID-19 tests within University Health, the Bexar County health system. As part of patient intake and virtual visits, CIVOC collects demographic data on patients diagnosed with COVID-19 within this public health safety net system.
Objectives: With reopening in Texas in late May and early June, there was much discussion around the changing demographics of transmission as younger people and people of color returned to front line labor. This study evaluates demographic trends around COVID-19 transmission during the first surge, with specific focus on recognizing marginalized populations.
Methods: Retrospective longitudinal chart review of CIVOC patients from 3/16/2020-8/31/2020 with specific attention to dates of reopening in Texas. REDCap data was de-identified, exported, and analyzed in SPSS software for trends over time in age and race/ethnicity.
Results: During this time, Hispanic/Latinx individuals comprised 77.1% of hospitalized patients with COVID-19, and 76.7% percent of outpatient diagnoses, a disproportionate disease burden for a county that is 60.7% Hispanic. Even more strikingly, from June 1-June 21, Hispanic individuals accounted for 86.5% of outpatient diagnoses and, from June 7-June 28, 84.3% of hospitalized diagnoses. Graphic trends of age reveal that median age of hospitalized patients steadily decreased over time, and that there was a dip in median age of outpatient diagnoses in mid-May through June.
Conclusion: This preliminary exploration of the data suggests an increased proportion of Hispanic/Latinx patients among those being diagnosed with COVID-19 within the UH system. Continued analyses will assist the team in interpreting how this data reflects changes in Texas policy around reopening of businesses. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 28 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Clinical Service
The COVID-19 ID Virtual Outpatient Clinic: A Volunteer Service Supporting COVID-19 Outpatient Care in Bexar County*
Project Discipline: Medicine
Primary Poster Presenter: Cory Nunn
Other Student Team Members: Aditi Sharma, Quinn Benson, Madeleine Bousquet, Jessica Davis Bethel, Zainab Fatima, Dallin Busby, Sydney Tran, Nicoel Mattes
Faculty Mentor: Barbara Taylor, MD, MS; Farah Al allawi, MD; Robert Geller
Community Partners: University Health, UT Health San Antonio Long School of Medicine
Project Location: San Antonio, Texas
Background: With the emergence of the novel coronavirus in Texas in March 2020, UT Health San Antonio students were taken out of their clinical rotations as a precaution and the healthcare workforce was stretched thin. Meanwhile, there was a new need to follow up with patients diagnosed with COVID-19 in Bexar County.
Objectives: The COVID-19 Virtual Outpatient Clinic (CIVOC) is a volunteer clinic founded in March 2020 to follow up with COVID-19 patients after outpatient or Emergency Room diagnosis or discharge from University Hospital. Volunteers include medical, physician assistant, nursing, and pharmacy students, along with medical residents and fellows. Dr. Barbara Taylor, associate professor of Infectious Diseases, was appointed as director of the clinic.
Methods: The Division of Infectious Diseases and the Office of Undergraduate Medical Education supported students in adapting a secure-data follow-up system in REDcap from Columbia University Medical Center and New York Presbyterian Hospital . Patients with concerning symptoms were scheduled for frequent calls and escalated to an Infectious Diseases attending. Patients were educated regarding COVID-19 isolation timelines and connected to University Health case management teams for additional resources.
Results: As of January 2021, 140 volunteers had assisted the CIVOC service in caring for over 8,300 patients, through over 7,400 phone calls. Volunteers have escalated 2,870 patients to the attending or fellow on call.
Conclusion: The CIVOC enabled health science students to play an integral role in the clinical care of COVID-19 patients, even when they were excluded from in-person care. Future research involves detailed chart reviews to investigate predictors of severe disease at the disease. There is also ongoing collaboration with Columbia University Medical Center and New York Presbyterian Hospital to compare and contrast our evolving outpatient follow up systems. This service may serve as a model to other institutions interested in establishing a virtual COVID-19 outpatient service.
‘
*Blue Ribbon Winner 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 29 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
A Digital, Interactive COVID-19 Testing Flowchart
Project Discipline: Medicine, Public Health
Primary Poster Presenter: Anastasia Perez
Other Student Team Members: Victoria Garza, Neil Gupta, Bennett Ahearn, Sanjana Reddy
Faculty Mentors: Melanie Stone, MPH, MEd; Jason Rosenfeld, DrPH, MPH; Barbara Taylor, MD, MS
Community Partner: San Antonio Metropolitan Health District
Project Location: San Antonio, Texas
Background: The CDC Website and San Antonio Metropolitan Health Website contain rich COVID-19 information for patients across the country and within our community. However, this information is scattered between multiple pages on different websites. In these anxiety ridden times, simplifying and streamlining the process of learning about COVID-19 is one way to lessen the burden on patients within our community. The Access Care Texas Team created a web and mobile friendly interactive website organizing and centralizing important COVID-19 information in the form of a flowchart.
Objectives: A survey was created as a qualitative means of capturing the website’s informational utility and usability. The survey had two parts: The first is a subjective survey assessing its educational value and ease of use, while the second is an objective survey asking questions about COVID-19 that can be found within the flowchart.
Methods: Utilizing a no-code development environment called Bubble.io, we designed health literate mobile and web applications which included information from the CDC Website and SA’s Metropolitan Health website. This “Covid-19 Steps to Testing” flowchart informs patients about symptoms, San Antonio area free testing sites, and proper COVID-19 protocol if patients believe themselves to be symptomatic or exposed.
Results: Results for the fourteen survey questions composed of six T/F or Y/N questions, four Likert Scale questions, and four content questions will be described by measuring frequencies, means, and standard deviations.
Conclusion: Creating the website provided a challenge as it was outside of our expertise. The information for testing sites in San Antonio and COVID-19 protocol changed and required frequent updating. We learned to assess design beforehand because reengineering takes effort and time. Future directions could be to create another flowchart for COVID-19 vaccination and sites within San Antonio. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 30 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Addressing Health Disparities at the Juvenile Detention Center in San Antonio, Texas
Project Discipline: Medicine
Primary Poster Presenter: Melissa Dang
Faculty Mentor: Nida (Joy) Emko, MD
Community Partner: Bexar County Juvenile Detention Center
Project Location: San Antonio, Texas
Background: The juvenile incarcerated population has been disproportionally impacted by higher numbers of preventable diseases and adverse health outcomes. The outpatient adolescent health clinic located at the Juvenile Detention Center in San Antonio, Texas has been identified as a specific population that can benefit from further health education to increase health literacy surrounding common adolescent topics surrounding sexually transmitted infections, birth control, pregnancy prevention, smoking, and e-cigarettes.
Objectives: Increase health literacy on sex education and smoking in patients ages 12-18. Reduce high-risk health behaviors in patients ages 12-18.
Methods: Conducting a literature review about juvenile incarceration and health outcomes to identify topics relevant to the San Antonio juvenile incarcerated community. The project design was developed by considering the social and cultural context of the San Antonio youth to create infographics that would appeal to this targeted demographic. Three specific posters were created on birth control, STDs, and smoking to display in the clinic.
Results: Surveys completed by attendings, residents, nurses, and medical students demonstrated that the posters were extremely helpful, that they were very satisfied with the clarity of information and were very likely to use these materials in future patient encounters. Further surveys are still being collected and expected to align with the results found in earlier surveys .
Conclusion: The need for socially and culturally competent information to increase health literacy in the juvenile incarcerated population is significant in order to reduce rates of preventable diseases and adverse health outcomes. In the future, primary care physicians play an important role and face considerable challenges ensuring continuity of care for adolescents’ post-incarceration. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 31 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Addressing Maternal Mortality Through Education at The Mommies Program
Project Discipline: Medicine
Primary Poster Presenter: Shawna Mattathil
Other Student Team Members: Holly Miller, Brittany Hansen, Amber Warren, Blair Creedle Reynolds, Allison Foster
Faculty Mentor: Luke Newton, MD
Community Partner: The Mommies Program
Project Location: San Antonio, Texas
Background: Due to the increasing opioid epidemic, CHCS, UHS, and DSHS collaborated to create The Mommies Program, a specialized female IOP substance abuse treatment center. The Mommies Program includes an obstetrics clinic dedicated to providing prenatal care to expectant mothers with opioid addiction whose addictions are currently being treated with methadone, a synthetic opioid agonist that prevents opioid cravings and withdrawal symptoms.
Objectives: The goal of the Mommies Program was to create a curriculum that educated women on the safety and efficacy of methadone treatment during pregnancy, as well as the importance of achieving sustained abstinence, and then evaluate the effectiveness of that curriculum.
Methods: Medical students discussed methadone use in pregnancy, reviewed resources for sustained peripartum abstinence, and developed a one-on-one curriculum to present to participants at their prenatal visits. Students assessed measurable objectives with pre- and post-intervention surveys.
Results: 26 women from the Mommies Program participated in education sessions. Of those surveyed, 61.1% were motivated to quit before pregnancy, but 100% were motivated to quit once pregnant. 94.4% of participants said learning about the effects of opiates would increase motivation for sobriety. 72.2% of participants knew it was safe to breastfeed on methadone, which improved to 77.8% in the post-survey. 66.7% falsely presumed they would be reported to authorities if they used methadone while pregnant, while only 27.8% believed so on the post-survey. Other topics that demonstrated enhanced understanding included neonatal abstinence syndrome (94.4% to 100% post-survey), CPS involvement during pregnancy (94.4% to 100% post-survey), and neonatal hospitalization following delivery (83.3% to 100% post-survey).
Conclusion: Pregnancy and education about opioids increased patients’ motivation to quit. Patients also gained knowledge about breastfeeding and the legality of methadone during pregnancy. Our future aim is to expand on available community resources in the postpartum period to ensure sobriety, increase project awareness, and expand educational research. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 32 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Adverse Childhood Experiences: Training Student-Run Free Clinic Partners to be Trauma Informed
Project Discipline: Medicine
Primary Poster Presenter: Jacob Houser
Other Student Team Members: Phillip Yang
Faculty Mentor: Rachel Pearson, MD, PhD
Community Partner: UT Health San Antonio’s Student-Faculty Collaborative Practices
Project Location: San Antonio, Texas
Background: Adverse childhood experiences (ACEs) are traumatic events experienced during childhood that have a significant and cumulative lifelong impact on health, well-being, and opportunities. ACEs are common, with up to 67% of the U.S. population having at least 1 of the 10 classic ACEs. However, higher ACE scores are associated with minority populations, people with lower socio-economic status, and people living with homelessness. Free clinic providers should be knowledgeable about ACEs and should have attitudes and practices that promote trauma-informed care.
Objectives: This study evaluated the effect of student-led ACEs training on the knowledge and attitudes of free-clinic student volunteers.
Methods: Two medical students trained as Master Presenters of the ACE Interface curriculum taught by Dr. Robert Anda, co-investigator of the original ACE study. A 1.5 hour ACEs curriculum was presented virtually to one group of medical students and three groups of nursing students (n=82). ACEs knowledge, collective hope, and trauma-informed attitudes were measured using a pre/post-survey.
Results: There was statistically significant improvement of the six ACEs knowledge questions (at least p<0.05 for all questions). There was statistically significant improvement in four of the seven trauma-informed attitudes questions (at least p<0.05 for statistically significant questions). While there was no statistically significant change of the six collective hope questions, the mean collective hope of all the questions are high (at least 6.0 out of 7 on a Likert scale for all questions). Analyses were conducted by independent t-test.
Conclusion: Training medical students as Master Presenters is an effective, efficient way to disseminate ACEs information within a community. Participants improved in both ACEs knowledge and trauma-informed attitudes, which are critical capacities for providing care for free-clinic patients with high ACE scores. One limitation was difficulty building community during the presentation due to the virtual format. Effects on care practices could not be measured. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 33 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Bexar County Immigrant and Asylum Health Resource Database: Outcomes of an Asylum and Immigrant Health Advocacy Program
Project Discipline: Medicine
Primary Poster Presenter: Arlynn Ambriz
Other Student Team Members: Jacob Canfield
Faculty Mentor: Barbara Robles-Ramamurthy, MD
Community Partner: Physicians for Human Rights
Project Location: San Antonio, Texas
Background: Due to boundaries such as language and legal status, asylum seekers and immigrants are often marginalized and unable to receive adequate healthcare. Increasing awareness of asylum and immigrant health issues in the Bexar County community including UTHSCSA is fundamental to improving the health of Bexar County and surrounding areas. Bexar County Immigrant and Asylum Health Resource Database aims to increase education and awareness about asylum and immigrant health issues among community workers in Bexar county through presentations, website engagement, and a mini-conference.
Objectives: This project aims to foster connections among local organizations that serve asylee and immigrant communities. This project also aims to increase awareness and education about immigrant and asylee health issues amongst UTHSCSA students and faculty members.
Methods: Monthly presentations were conducted via zoom to students and faculty members at UTHSCSA discussing various topics about asylum medicine. Surveys were given before and after the presentation to assess the participant’s knowledge about asylee health and their likelihood to become involved in immigrant/ asylee advocacy. A mini-conference about asylum medicine with various local organizations will be hosted on January 23. Surveys will be given before and after the conference to collect data on the efficacy of the presentation.
Results: From the presentation given, 91% of participants have shown an increase in knowledge and awareness about asylum medicine. It was found that interest in asylum medicine and advocacy was high (100%) amongst attendees of the presentation. Results from the mini-conference on January 23 are pending.
Conclusion: Bexar County Immigrant and Asylum Health Resource Database monthly presentations have shown an increase in education about asylum medicine among UTHSCSA students and faculty. Analyses from the mini-conference are pending. Local organizations have expressed interest and excitement to participate in the mini-conference. We expect the results from the mini-conference to support the efficacy of this project and its continuation. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 34 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Developing, Presenting, and Evaluating Anti-racism Tools to Serve Public Schools in South Texas
Project Discipline: Medicine
Primary Poster Presenter: Phillip Yang
Other Student Team Members: Yolanda Crous
Faculty Mentor: Barbara Robles-Ramamurthy, MD
Community Partner: Education Service Center, Region 20
Project Location: San Antonio, Texas
Background: School and educator racism and implicit biases harms students. Black and Hispanic students are more likely to receive school expulsions contributing to the school-to-prison pipeline. The deaths of George Floyd and others in 2020 charged organizations to act against racism. In this project, we collaborated with Education Service Center, Region 20 to provide anti-racism tools to South Texas educators. Dialectical Behavioral Therapy (DBT) skills, such as mindfulness and emotional regulation, were taught to promote anti- racism attitude growth.
Objectives: (1) Develop and share an anti-racism toolkit and resources. (2) Present and evaluate a two-day Train-The-Trainer anti-racism workshop.
Methods: A PDF anti-racism toolkit for educators was developed with 5 sections: (1) History of Racism, (2) Impact on Our Students, (3) Book and Media Resources, (4) Classroom Resources, (5) DBT and Self-care. The workshop slides were developed and presented in collaboration with UTSA Multicultural Student Center for Equity and Justice and included DBT skills, anti-racism education, situational role-play, small group discussions, and meta-cognitive activities. Additionally, each participant received three books on anti-racism.
Results: Eleven educators completed an application to attend the workshop. Nine educators attended the workshop. Data from the application showed three results: (1) Educators believe there is more racism among students than among teachers, (2) Teacher demographics do not reflect their students’ demographics, (3) Anti-racism work is not being done at their schools. Participant data from the pre-/ post-surveys showed improvements in both DBT skills and anti-racism attitudes.
Conclusion: Our study empowered school community leaders to lead anti-racism work in their schools by providing a comprehensive anti-racism toolkit, a Train-the-Trainer workshop and slides, and books for personal anti-racism growth. The workshop feedback was overwhelmingly positive. DBT skills were an effective way to promote participant anti-racism growth. One challenge was building community through a virtual platform. We aim to adapt this project to a live workshop. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 35 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Don’t Sugarcoat Diabetes 2020-2021: Virtual Outreach for Diabetes Prevention Among South Texas High School Students
Project Discipline: Medicine, Public Health
Primary Poster Presenter: Shwetha Menon
Other Student Team Members: Juliana Restrepo, Christopher Zhu, Ifeadi Emejulu, Kailey Ellis, Arlynn Ambriz, Hiral Bhardwaj
Faculty Mentor: Maria Danet Bluhm, PhD, RN
Community Partner: UT Health San Antonio Office of Recruitment and Science Outreach
Project Location: San Antonio, Texas
Background: Diabetes is a chronic, preventable condition that significantly affects the US population, especially in Texas. Unfortunately, it has become increasingly more prevalent in the younger populations. Therefore, the Don’t Sugarcoat Diabetes (DSD) Program aims to increase diabetes knowledge among high schoolers in South Texas to help foster a healthy lifestyle early on .
Objectives: The project goal is to increase the confidence of diabetes knowledge among 90% of high school participants. Moreover, it aims to create intent for behavioral change among 90% of students to encourage a healthy lifestyle such as eating a low sugar, healthy diet and engaging in physical activity. The project also encourages the students to share their diabetes knowledge with their family members and friends.
Methods: Due to the COVID-19 pandemic, the in-person interactive DSD program was conducted online via Zoom to South Texas high schools (n=4 ). The high school students (n=251) participated in the seminar and completed pre and post Likert surveys (n=163) which measured confidence, knowledge in diabetes and risk reduction, and intent to adopt healthier lifestyles after their participation. The scheduled 1-month follow-up survey is in progress.
Results: After participation in DSD, the participants demonstrated significant improvement in self-confidence regarding diabetes knowledge, risk reduction, and ability to share diabetes knowledge with others (mean increase 33.9%). There was also increased knowledge of diabetes and its risk reduction (mean increase 10.3%) and an intent to adopt healthy lifestyle changes such as becoming nutritionally proactive and physically active (mean increase 16.3%). Data for 1-month follow up are still being collected.
Conclusion: The DSD program improved high school students’ knowledge of diabetes and diabetes prevention, confidence, and advocacy. Despite limitations imposed by the COVID-19 pandemic on the project, the findings support the efficacy of the program and its continuation as an educational intervention for diabetes. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 36 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Elementary Nutrition: Bite-sized Lessons Even Little Ones Can Chew
Project Discipline: Medicine
Primary Poster Presenter: Angela Wang
Other Student Team Members: Malavika Perinchery
Faculty Mentor: Kenneth Stone, MD
Community Partner: Castroville Elementary School
Project Location: Castroville, Texas
Background: Obesity and heart disease remain increasingly prevalent in the United States(1). Although it has been evidenced that nutritional literacy can help curb these numbers, the CDC estimates that students in the US receive less than 8 hours of nutrition education each year, less than half the time needed to bring about sustainable behavioral changes (2). To address this issue, medical students at UTHSCA implemented a program called Elementary Nutrition (EN) in 2016 at Walzem Elementary in San Antonio, Texas. Due to the ongoing COVID-19 pandemic, in 2020, this project was administered in virtual format to second grade students at Castroville Elementary, a school with a majority low-income population.
Objectives: Since its inception in 2016, the goal of this program is to boost nutritional literacy in elementary- aged students and to measure the curriculum’s efficacy by assessing nutritional knowledge before and after the educational intervention.
Methods: Over eight weeks, ten medical students taught the EN curriculum in 5 second-grade classrooms at Castroville Elementary. Each 40-minute session was conducted in a virtual format over Zoom. Nutritional literacy and diet were assessed during the first and last session. Socio-demographic information was also collected in the first session.
Results: Overall, 38 students participated in the EN course. The average score on the pre-assessment was 58% (7/12) among the 38 students. Due to schedule changes during the pandemic, 21 students were able to complete the post-assessment with an average score of 83% (10/12).
Conclusion: Despite the limitations of virtual teaching and schedule changes, the EN curriculum addressed Castroville’s need for nutrition education. Some lessons were omitted and shortened, however, there was improvement in post-assessment scores. The success of the online curriculum, coupled with the enthusiasm demonstrated by the students in the course, indicate that a virtual format could be helpful for expanding the project to reach schools in farther locations. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 37 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Empowering Patients During a Pandemic: A New Skin-Cancer Education Program at the Haven for Hope Skin Clinic
Project Discipline: Medicine
Primary Poster Presenter: Thomas Etheridge
Other Student Team Members: Yolanda Crous
Faculty Mentor: Richard Usatine, MD
Community Partner: Haven for Hope
Project Location: San Antonio, Texas
Background: People experiencing homelessness have limited access to preventative healthcare, accompanied by heightened sun exposure, increasing their risk for skin cancer. As part of a continuing CSL-funded project, the coordinators of the Haven for Hope Skin Clinic (HHSC) organize annual skin-cancer screenings in the Haven for Hope Courtyard, where up to 700 unsheltered people sleep every night. Due to COVID-19 restrictions, these screenings were not permitted in 2020 and resumption required significant procedural modification.
Objective: To design and implement a new skin-cancer education and screening program that empowers patients to monitor their own skin health, promotes free screenings at the HHSC, and is sustainable throughout the COVID-19 pandemic and beyond. HHSC coordinators created a video that familiarizes patients with skin-cancer risk factors, prevention, self-exams, and appearance on all skin tones. Surveys were administered to evaluate changes in skin-cancer awareness and knowledge.
Methods: HHSC patients could elect to watch the 8-minute video and take pre- and post-video surveys while waiting to see a physician. Participants received a water bottle, baseball hat, SPF 30 sunblock, skin- cancer-prevention sticker, and hand mirror for self-screenings.
Results: On the program’s first night, one third of patients agreed to watch the video and complete the surveys. Preliminary data suggest that awareness of the following increased: importance of sunscreen, skin cancer self-screening steps, and ability to teach others about skin-cancer prevention. Screenings and data collection will continue on future clinic nights.
Conclusion: The program makes use of patient idle time during clinic appointments, adding value to patients’ experiences with minimal increases in volunteer workload—an important consideration during a time of social distancing and COVID-19 workforce restrictions. It will continue to be implemented during clinic nights at the HHSC and at post-pandemic screening events. Initial patient reaction was enthusiastic, and the HHSC is discussing extending the program to additional SFCP clinics. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 38 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Empowering Survivors Through Health Literacy and Self Advocacy: An Educational Program for Survivors of Sex Tra cking and Domestic Violence
Project Discipline: Medicine, Occupational Therapy
Primary Poster Presenter: Erin Hobbs
Other Student Team Members: Chloe Jensen, Zeba Bemat, Rachel Brown, Elizabeth Ademuwagun, Lisa Hernandez
Faculty Mentor: Melanie Stone, MPH, MEd
Community Partner: Providence Place
Project Location: San Antonio, Texas
Background: The women of My Mariposa Home at Providence Place are survivors of sexual assault, intimate partner violence, or human trafficking. These traumas negatively impact health via many factors, including increased presence of clinically significant psychiatric symptoms, increased substance use, restricted access to healthcare, poor autonomy, and decreased ability to navigate and advocate within healthcare.
Objectives: HELP aims to increase participants’ health literacy, self-efficacy, and autonomy as it relates to health and well-being via a trauma-informed education program.
Methods: Student leaders assessed clients’ needs and developed a four-month curriculum delivered twice- weekly, via hour-long Zoom sessions. Baseline health literacy and self-efficacy were measured via assessment and self-report, and post-program measurements will be conducted to assess progress. Program quality was also assessed via surveys. Additionally, one-on-one participant-leader pairs were established and met independently via Zoom to further discuss program topics.
Results: Twelve participants attended program sessions with varying regularity. Pre-program Strengths Self- efficacy Survey scores indicated that participants on average held a moderate level of confidence in their ability to apply self-identified strengths, with a mean score of 6.96 out of 10 across items. Pre-program scores from the Newest Vital Sign assessment ranged from 3 to 5 out of 6 possible points, indicating participants may have limited literacy. Mid-program feedback from participants indicated they were learning useful content and applicable skills. Post-program assessments are expected to yield increased scores.
Conclusion: HELP is on target to meet its objectives of increasing perceived self-efficacy and health literacy among My Mariposa Home residents. The virtual format presented challenges such as restricted interaction, limited rapport-building, and sporadic attendance; however, participation and engagement have improved over time, and attendees have reported improvements in their perceived ability to apply health literacy skills. Moving forward, leaders will seek to improve content and delivery and ensure program sustainability. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 39 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Empowering Youth at SAMMinistries’ Transitional Living and Learning Center to Create COVID-19 Safety and Awareness Campaigns
Project Discipline: Medicine
Primary Poster Presenter: Phillip Yang
Faculty Mentor: Nida Joy Emko, MD
Community Partner: San Antonio Metropolitan Ministries Transitional Living and Learning Center (SAMM TLLC)
Project Location: San Antonio, Texas
Background: SAMMinistries’ Transitional Living and Learning Center (TLLC) houses up to 40 transitioning- from-homeless families with children. Residents share facilities including the computer room, daycare, elevators, dining room, and kitchen. In response to COVID-19, the TLLC implemented various safety protocols such as hand sanitizing stations, social distanced dining tables, and mask rules. However, the TLLC reported challenges with residents adhering to safety protocols. Before COVID-19, this study aimed to hold mental health classes at the TLLC. However, due to the shift in community needs, the study was adapted to promote COVID-19 safety and awareness.
Objectives: Empower TLLC youth to: (1) create COVID-19 safety and awareness campaigns, such as posters, artwork, or videos. (2) display youth-created campaigns at the TLLC.
Methods: A COVID-19 safety and awareness campaign competition was held for four weeks, from July 20 until August 16, open to any TLLC youth. Informational flyers were created and displayed at the TLLC. TLLC staff also distributed flyers. Interested youth signed up via a Google Form link. Participants could request a medical student helper. Art supplies were provided to the participants. An optional 15-minute Zoom meditation and Q&A session was held weekly. At the end of the competition, a panel of five medical student judges scored the submissions. The top two submissions received the grand prize award (AirPods, stylish masks, hand sanitizer) and all other submissions received consolation prizes (stylish masks and hand sanitizer).
Results: Four youth submitted five projects. Youth ranged from 7th grade to 11th grade. All submissions were forms of physical artworks.
Conclusion: Empowering youth to promote COVID-19 safety was impactful to the TLLC community. The artworks were openly displayed at SAMMinistries, and residents had positive responses to the youth’s artworks. The project faced challenges in recruiting youth to participate in the competition. Close collaborations with the TLLC staff helped alleviate this problem. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 40 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Healthy Choices Team Year 2: Responding to Feedback and Empowering Community Leadership in Healthy Lifestyle Changes
Project Discipline: Medicine, Public Health
Primary Poster Presenter: Cameron Holguin
Other Student Team Members: Elizabeth Stewart, Yunsha Ehtesham, Samar Dawy, Erin Brasseaux, Meredith Hosek, Dylan De Muth
Faculty Mentor: Fozia Ali, MD
Community Partners: El Bari Community Health Center, Bexar Translational Advisory Board, South Central Area Health Education Center
Project Location: San Antonio, Texas
Background: In 2018 and 2019, a UT Health San Antonio research team conducted needs assessments at El Bari Health Fair, and nutrition was identified as a top health priority. An interdisciplinary Healthy Choices Team (HCT) was formed to respond to this. In Fall 2019/Winter 2020, semi-monthly small group sessions were held at El Bari Youth Center. Eleven community members graduated from these sessions. A community blog and virtual Ramadan cooking sessions were held in the Spring/Summer of 2020.
Objective: To foster healthy behavioral changes through community engagement and empowerment.
Methods: (1) Twice-monthly HCT sessions via Zoom (November 1, 2020 to February 28, 2021) – Year 1 graduates as community ambassadors and co-leaders. (2) Other resources provided: Booklet of handouts, space for personalized SMART goals, bingo card with 24 challenges, prizes for bingo completion (3) Session summaries on blog (4) Pre- and post-surveys on Redcap
Results: As of January 12, 2021, four of seven HCT sessions have been conducted. Future sessions are scheduled for January 24, February 7, and February 21. Fifty community members signed up for HCT Year 2 and filled out the pre-survey. Sixteen participants have participated in two+ sessions. The majority of participants are South Asian. 42% of respondents said that healthy living is “important” to them, and 50% said it’s “very important” to them. 30% of respondents exercise only one or two times per week, 50% of respondents are not tracking their salt intake, and 40% of respondents are eating zero or one serving of fruits and vegetables per day. Five community members have completed their bingo card. We anticipate many more. The WhatsApp group continues to be a source of support and ideas for the community.
Conclusion: Virtual sessions encouraged community engagement, communal learning, and accountability for individual goals. Maintaining continuity with this community will be integral to supporting lasting healthy behavioral changes. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 41 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Healthy Moms and Babies 2020
Project Discipline: Medicine, Nursing
Primary Poster Presenter: Laureen Gbordzoe
Other Student Team Members: Winona Gbedey, Jacob Bodden, Claire Fagen
Faculty Mentor: Laura Sisk DNP, RN
Community Partner: Healy-Murphy Center
Project Location: San Antonio, Texas
Background: The Healy-Murphy Center is a non-profit organization aimed at educating at-risk San Antonio youth and providing support services such as child care, health education, and counseling. A needs assessment conducted by the school’s nurse and the HMHB faculty mentor identified a knowledge gap in nutrition, exercise, and substance use. Medical students tried to address this gap through two interactive lessons delivered to the school’s health class.
Objectives: The goal of this CSL project is to educate the students at Healy-Murphy about nutrition, exercise, and substance use through presentations tailored to young minds.
Methods: Medical students developed nutrition, exercise, and substance abuse curricula and interactive activities that were presented to the Healy-Murphy health class via one live Zoom session and one 15 minute pre-recorded video. Tools and goodie bags to help the students continue their education and health practices were distributed after the presentations. The efficacy of these sessions were evaluated through pre- and post-surveys that assessed knowledge and attitudes on the presented subjects.
Results: Early results show that students scored an average of 37.5% on pre-survey fact checks, performing better on questions related to nutrition labels and poorly on questions about substance use, exercise, and nutrition during pregnancy and postpartum periods. These results confirm the need for these sessions among this demographic. Post-survey data is pending. Quantitative comments have been positive.
Conclusion: Based on our findings, students already engage in healthy nutritional and exercise behaviors. Knowledge of healthy practices during pregnancy and postpartum was limited. Following the advice from previous student leaders, we targeted the health class rather than the parenting class to reach more students; however, due to COVID-19, we were unable to teach many students as the school’s overall attendance was low throughout the semester. In the future, we recommend presenting to multiple sections of the health class to reach a wider audience. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 42 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Implementation and Evaluation of a Student Curriculum on Patient Navigation for Individuals Experiencing Homelessness
Project Discipline: Medicine
Primary Poster Presenter: Rachel Kim
Other Student Team Members: Arlen Suarez; Alison Liu; Jawaher Azam; Claire Abijay; Thanos Rossopoulos; Natalie Bonner, MS; Helena Zhang; Nidhi Desai; Aaron Shi; Nico Campalans; Umaru Barrie; Ashlyn Lafferty
Faculty Mentor: Nora Gimpel, MD
Community Partner: UT Southwestern Patient Navigator Program
Project Location: Dallas, Texas
Background: Providing quality care in primary care settings for individuals experiencing homelessness requires an understanding of the barriers they face. This novel curriculum at UT Southwestern Medical School (UTSW) introduces students to challenges experienced by homeless populations in Dallas, TX. Curriculum includes didactic sessions regarding social determinants of health, healthcare access, ethical decision making, motivational interviewing, and interviews with local community experts in homelessness topics.
Objective: Evaluate curriculum efficacy in changing student attitudes of, knowledge about, and confidence in administering healthcare related services to homeless populations.
Methods: Multi-year observational longitudinal study of UTSW medical and health professions students. Participation in six of seven two-hour sessions, completion of a student created navigation tool, and an interview with a community provider. Pre and post-course surveys, consisting of mainly Likert scale questions, have been administered. Surveys measure (1) attitudes towards homelessness using the Health Professionals Attitude Toward the Homeless Inventory (HPATHI), (2) objective knowledge on homeless populations at national and regional levels, (3) local needs, and (4) self-efficacy in working with homeless individuals.
Results: 54 students were enrolled from the medical and health professional school at UTSW. The curriculum has been completed and post-survey results are being analyzed. Intervention is expected to increase understanding of systemic inequities that result in homelessness, increase confidence in motivating patients to navigate the healthcare system, and improve attitudes toward homeless populations. Final surveys will be administered in Winter 2021 upon conclusion of experiential navigation program.
Conclusion: Curriculum development focuses on increasing awareness and knowledge on homeless populations. The goal is to develop necessary skills in future healthcare professionals to advocate and provide quality care for individuals experiencing homelessness. Success of intervention can serve as a model curriculum to improve quality of medical care provided by future healthcare professionals in addressing needs of patients experiencing homelessness and other underserved or migrant communities. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 43 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Increasing Practical Knowledge of Lice Infestation Among Families Experiencing Homelessness
Project Discipline: Medicine
Primary Poster Presenter: Shwetha Menon
Other Student Team Members: Thomas Etheridge, Yolanda Crous
Faculty Mentor: Richard Usatine, MD
Community Partner: San Antonio Metropolitan Ministries Transitional Living and Learning Center (SAMM TLLC)
Project Location: San Antonio, Texas
Background: Persons living in poverty, globally and in our country, are at higher risk of lice infestations. Risk factors for lice infestations include homelessness, living at close-quarters, decreased access to methods of personal hygiene, and lack of knowledge regarding preventative measures. Schoolchildren in general are at higher risk for head lice.
Objectives: The purpose of this project was to increase the practical knowledge of lice infestation and preventative measures within the San Antonio Metropolitan Ministries (SAMM) transitional living and learning center for families experiencing homelessness. Target goals were 50% improvements in survey performance on three categories of knowledge: risk factors, prevention, and common misconceptions regarding lice.
Methods: Over the course of three months, SAMM residents were invited to view a 13-minute student- produced educational video on lice to increase knowledge and reduce stigma. Participants answered questions via pre- and post-surveys to gauge the effectiveness of the video format as a health-education and lice-prevention tool.
Results: The pre- and post-surveys showed improvements in the residents’ (n=15) knowledge about lice including risk factors, common misunderstandings, and prevention. Residents’ awareness of common misconceptions about lice increased from an average of 58% to 97%, knowledge of risk factors increased from 82% to 98%, and knowledge of prevention techniques increased from 89% to 96%.
Conclusion: According to the Transtheoretical Theory of Behavior, increasing awareness of healthy behaviors is the first of ten processes of behavior change, and this project improved participants’ knowledge of lice in every category. Lice awareness has the potential to improve SAMM residents’ quality of life by reducing physical discomfort, stigma, and health risks from scratches or infectious disease. While COVID-19 restrictions limited the reach of the video in 2020, the goal is to expand video screenings to larger groups and potentially other sites in 2021. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 44 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Longitudinal Evaluation of a Community Outreach Infuenza Vaccine Drive and Educational Intervention Designed to Decrease Vaccine Hesitancy
Project Discipline: Medicine
Primary Poster Presenter: Swetha Maddipudi
Other Student Team Members: Ryan Wealther, Carson Cotrino, Emily Heydemann, Nayeon Kim
Faculty Mentor: Kaparaboyna Kumar, MD
Community Partner: Alpha Home
Project Location: San Antonio, Texas
Background: Despite the availability and safety of the influenza vaccine, vaccination rates remain suboptimal. We provided educational programming and optional influenza vaccinations for patients at Alpha Home (in 2019 and 2020) and Pride Community Clinic (in 2020), which are two student-run community clinics in San Antonio, Texas.
Objectives: The objective of this study was to compare and evaluate the effectiveness of two iterations of a community outreach vaccination drive and educational intervention designed to decrease vaccine hesitancy (VH).
Methods: This study used a pre-survey, intervention, post-survey format. The educational intervention was an interactive presentation and provided information on influenza and vaccinations. In the first iteration, overall differences in pre/post item response distributions were tested with the Bhapkar chi-square (α = 0.05). The second iteration of this project aggregated data from both Alpha Home’s and Pride Community Clinic’s flu vaccination drives. The adjectival scale used in the first iteration was converted to a continuous visual analog scale. Differences in the pre/post-survey responses were analyzed with a paired t-test (α = 0.05).
Results: In the first iteration, the response distributions for each item of the seven survey items shifted towards less vaccine hesitant responses on the post-survey. Two items achieved overall significance. In the second iteration, the response distributions of each item also shifted toward less vaccine hesitant responses. Four items achieved significance.
Conclusion: The study results from both iterations provide evidence that the interventions dispelled common myths and decreased VH. The power of our evaluation in the first iteration was limited due to survey design, which necessitated categorical analysis. In the second iteration, we increased the power of our evaluation by improving survey design and modifying the educational intervention. However, this adaptation did not translate to increased willingness to vaccinate. Implications for future studies include leveraging various aspects of both years’ interventions to maximize the efficacy of this program. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 45 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Needs Assessment and Intervention for Hepatitis C Virus (HCV) Among Vietnamese Americans in Texas
Project Discipline: Medicine, Nursing, Medical Laboratory Science
Primary Poster Presenter: Amy Shoga
Other Student Team Members: Marie Vu, Jonathan Luu, Stacey Uhm, Phillip Yang, Kim Lam, MLS (ASCP)CM, Trong Phat Do, Derrick Draeger
Faculty Mentor: Maria Danet Lapiz Bluhm, PhD, RN, FAAN
Community Partner: Lien Hoa Buddhist Temple
Project Location: San Antonio, Texas and Houston, Texas
Background: Hepatitis C virus (HCV) is a silent infection that significantly increases the risk of liver cancer. Among Asian Americans, liver cancer is highest among Vietnamese. Yet, there is minimal research to assess HCV infection risks and screening intent among Vietnamese Americans. There are no such HCV studies done among Vietnamese in Texas, highlighting the need for community-based research in this population.
Objectives: This project aimed to assess knowledge on HCV risks, infection, treatment and screening among Vietnamese living in the South and the Gulf Coast regions of Texas. It also tested the effects of a culturally- modified HCV educational intervention on HCV knowledge and screening intent.
Methods: HCV assessment and education (English and Vietnamese) were conducted through Qualtrics. Links were distributed via email, phone, and social media. Free HBV/HCV screening was conducted at Lien Hoa Temple, San Antonio and also offered to survey participants. The participants completed a survey (demographics, knowledge, attitudes about HCV, screening intention) before and after an educational video about HCV risk, infection, treatment, and screening importance. This study was patterned after published works. Data from 15 participants were analyzed for descriptive statistics.
Results: Most participants (77%) completed the survey in English. Potential HCV exposure was high (40%) reportedly through tattoo and piercing needles (100%) and acupuncture treatment (50%). Most (93%) never had an HCV screening or were unsure if screened before. The HCV educational video improved knowledge of participants (N=13) on the acute symptoms of HCV (37.46% to 84.62%) and treatment (15.38% to 92.31%). All respondents not yet screened for HCV indicated they would get screened if screening was free.
Conclusion: Vietnamese in Texas is at risk for HCV infection. The lack of knowledge of HCV and survey language preference pattern supports culturally tailored interventions for this vulnerable understudied population. Further, sustained collaborative relationships with Vietnamese communities will hopefully improve participation. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 46 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Preparing for Medical School Applications and Interviews During the COVID-19 Pandemic: An Analysis of the Mock and Talk Workshop at UT Health San Antonio
Project Discipline: Medicine
Primary Poster Presenter: Nathalia Simonettii
Other Student Team Members: Casandra Compean, Jaime Quirarte, Juliana Restrepo, Corina Badillo, Fredy Calderon, Matthew Maia
Faculty Mentor: Judianne Kellaway, MD, MEd, FACS
Community Partner: UT Health San Antonio Long School of Medicine Office of Admissions
Project Location: San Antonio, Texas
Background: Minorities make up 31% of the US population but are still significantly underrepresented in medical schools (15%) as measured in a 2011 study. Medical school admission workshops allow students to learn about the admission process and provide an opportunity to strengthen interview skills. The 2020-2021 application cycle shifted to online only interviews, utilizing a new virtual format. Our goal was to develop an outreach program to prepare underrepresented minorities in Texas for medical school applications and online interviews by providing virtual mock interviews and personal statement feedback.
Objectives: (1) Conduct virtual mock interviews utilizing Zoom and Spark Hire. (2) Assess and provide standardized feedback on students’ Personal Statement. (3) Host a workshop to enhance students’ preparedness for medical school applications. (4) Analyze the effectiveness of our completely virtual medical school application workshop.
Methods: Participants had the option to complete one mock interview with a medical student through Zoom, one pre-recorded video interview, and send in their personal statements for review. A medical school application presentation and Interviewing Skills seminar was led by Dr. Judianne Kellaway. Pre- and Post- Surveys collected demographic factors and utilized a 5-point Likert scale to assess the level of comfort and improvement participants felt upon workshop completion.
Results: Based on the results of the pre and post survey there was a 15.7% increase in understanding of how to approach a personal statement. There was also a 100% and 79.1% increase in comfort with the medical school interview process and video chat interviews respectively. After the workshop, applicants felt a 27% increase in overall preparedness for submitting medical school applications.
Conclusion: The Mock and Talk Workshop substantially increased the comfort of students with video interviews and the medical school interview process overall. We will continue to work on improving the Mock and Talk workshop, as it supports underrepresented undergraduates matriculating into medical school. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 47 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Promoting COVID-19 Health Insurance Literacy
Project Discipline: Medicine
Primary Poster Presenter: Neil Gupta
Other Student Team Members: Bennett Ahearn, Victoria Garza, Sanjana Reddy, Anastasia Perez
Faculty Mentor: Melanie Stone, MPH, MEd
Community Partner: Bexar County Health Collaborative
Project Location: San Antonio, Texas
Background: The Access Care Texas team sought to promote health insurance literacy regarding COVID-19 testing and treatment in the San Antonio community. In the early months of the pandemic, we saw a lack of consistent, easy-to-understand health insurance information specific to COVID-19. We aimed to address this by providing community members with accessible information regarding COVID-19 testing, treatment, and insurance options.
Objectives: (1) Develop COVID-19 health insurance resources - including flyers, training sessions, and informational meetings - and share information with the community and (2) By December 2020, at least 100 people will have attended training. (3) At one-month follow-up, community members who participated have improved their health insurance self-efficacy.
Methods: We researched and created an informative, health literate bilingual infographic that listed COVID-19 insurance information for private insurance, Medicaid, CHIP, and Medicare and for those who are uninsured. We then hosted interactive virtual meetings to present the different healthcare coverage options for COVID-19 testing and treatment. Assessment of these meetings involved a pre-survey and one-month post-survey to analyze knowledge and self-efficacy.
Results: There were 50 attendees to our sessions which included community health workers, health professional students, and insurance enrollers. We collected pre and post-survey information on some participants; however, the data was incomplete due to the difficulties of achieving community member virtual attendance. We received overall positive feedback from the variety of healthcare professionals we presented to.
Conclusion: We created a bilingual informational flyer and hosted multiple virtual informational sessions. Challenges included engaging community members to attend sessions and having complete participant survey data. We learned that it is critical to utilize partnerships with local organizations to succeed in advertising training sessions and to establish expectations for the partnership. Future direction involves having a monthly informational session that addresses COVID-19 insurance questions and continuing to distribute COVID-19 insurance information. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 48 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Promoting Patient Education and Chronic Disease Self-Management in Refugees at San Antonio Refugee Health Clinic (SARHC) 2020-2021
Project Discipline: Dentistry, Medicine, Nursing, Public Health, Nutrition/Dietetics
Primary Poster Presenter: Zachary Harbin
Other Student Team Members: Salma Yazji, Mahima Ginjupalli, Jessica Nguyen, Juan Alberto, Abimbola Somoye, So a Marediya, Winona Gbedey, Zeba Bemat, Aziz Saqr
Faculty Mentor: Nurani Kester, MD
Community Partner: Center for Refugee Services
Project Location: San Antonio, Texas
Background: Data from research done at SARHC in 2018 identifies a significant presence of uncontrolled diabetes and hypertension among its patient population.
Objectives: This project seeks to promote accessible and refugee-targeted patient education regarding self- management of diabetes and hypertension, with use of free monitoring devices, nutritional counseling, and medical follow-up. In this study, we identify patient needs with which to tailor our training program around.
Methods: Patients records from October 2019 to December 2020 were analyzed from the clinic Electronic Medical Record (EMR). Diabetic and hypertensive patients were contacted over the phone and a questionnaire was administered.
Results: Contact was attempted with 78 SARHC patients. 17 individuals successfully completed the questionnaire (diabetes=8, hypertension=13). 15 reported interest in the initiative. Of the 8 individuals with diabetes, 6 (75%) are currently taking medications for their condition, 3 (38%) report a confidence level <5 for measuring their own blood glucose, and 4 (50%) do not have access to a blood glucose monitor. Of the 13 individuals with hypertension, 9 (69%) are currently taking medications for their condition, 6 (46%) report a confidence level <5 for measuring their own blood pressure, and 8 (62%) do not have access to a blood pressure cuff. Of the 17 total respondents, 7 (39%) reported a <5 confidence level managing diet and physical activity, 12 (70.6%) reported not having insurance access, 9 (53%) had a >5 level of anxiety or stress regarding their condition, and 4 (24%) have a PCP outside of SARHC. Upon qualitative questioning, many respondents requested training regarding culturally conscious healthy diets, at-home use of monitoring devices, and a program including consistent follow-up.
Conclusion: Successful patient contact via telephone was a limiting factor. The questionnaire will continue to be administered to qualifying patients through July, and the interprofessional training program including nursing, dental, and nutritional staff will address patient needs. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 49 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Promoting Vaccine Education and Flu Vaccinations For Families Affected by Homelessness at SAMM TLLC
Project Discipline: Medicine
Primary Poster Presenter: Nisha Kalyanpur
Other Student Team Members: Phillip Yang
Faculty Mentor: Tharani Ravi, MD
Community Partner: San Antonio Metropolitan Ministries Transitional Living and Learning Center (SAMM TLLC)
Project Location: San Antonio, Texas
Background: San Antonio Metropolitan Ministry Transitional Living and Learning Center (SAMM TLLC) houses families transitioning from homelessness and provides services including medical care at SAMM Clinic. The clinic provides free flu vaccinations annually, but efforts are met with low turnout.
Objectives: Development of a vaccine education initiative to achieve a 75% survey participation rate and encourage vaccination to attain a goal of 50% increase in vaccinations through SAMM Clinic.
Methods: Surveys were given to each adult resident to collect thoughts, questions and concerns relating to the influenza vaccine. Surveys were collected anonymously, and the resultant misconceptions and concerns were addressed in an educational handout printed for distribution.
Results: Of 28 adult residents, 26 (93%) completed an anonymous survey yielding the following results: 42% self-report receiving a flu shot each year. 100% know that vaccinations are not limited to the doctor’s office but 8% do not know other specific locations. 46% believe the flu shot can cause a flu infection while 77% believe the flu shot can cause autism. Of those who had received a flu shot in the past (n=17), 24% still got the flu and thus doubt the vaccine’s efficacy. 27% do not feel the flu shot is safe (n=26). Following distribution of handouts to residents, at the conclusion of the flu drive, vaccination rates among kids and adults rose 200% (n=21) compared to the previous year’s vaccination rate (n=7).
Conclusion: Survey outcomes suggest that lack of knowledge surrounding locations to receive an influenza vaccine was a minor contributing factor to low vaccination rates compared to the prevalence of respective misconceptions about the influenza vaccine. Resultant customization of education proved efficacious. Knowledge gained can be applied to future initiatives to continue the vaccination efforts and is imperative given the current COVID-19 pandemic and upcoming COVID-19 vaccination efforts. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 50 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Remote Nutritional Counseling and SMART Goal-Setting
Project Discipline: Medicine
Primary Poster Presenter: Daniel Szabo
Other Student Team Members: Sarah Nagel
Faculty Mentor: Fred Campbell, MD
Community Partner: Methodist Healthcare Ministries
Project Location: Eagle Pass, Texas
Background: Eagle Pass residents have high rates of obesity, diabetes, heart disease, which are complicated by poor access to healthcare. The community also suffers from living in a “food desert”, with limited availability to obtain healthy, affordable meals. The COVID-19 pandemic has made these problems worse by limiting financial and health resources. Long School of Medicine students partnered with a local health promoter to address these needs.
Objectives: Our objective is to conduct 30-minute phone consultations with 20 Eagle Pass clients about nutrition and teach SMART (Specific, Measurable, Achievable, Relevant, Time-bound) goal-setting to elicit lasting healthy habits.
Methods: Prior to consultation, clients take a pre-survey measuring their healthy habits and goal-setting behaviors. We then interview clients over the phone, teach fundamentals of nutrition, and engage them in SMART goal-setting. Two weeks after the call, clients are eligible to pick up a basket of free essential supplies and take a post-survey on how their motivation and goal-setting behaviors have changed due to the intervention.
Results: So far, 16 clients have completed the virtual training in nutrition and goal-setting. Most clients were observed to have foundational knowledge of, and practice, healthy nutrition. Initial survey results indicate their motivation, confidence, frequency, and success in goal-setting increased after the training, but the differences are not statistically significant.
Conclusion: Clients needed little instruction in healthy nutrition. The clients, however, struggled with making a goal to improve their health. Future programs should teach clients about making healthy goals before focusing on specific goal-setting techniques, such as SMART goal-setting. The effects of our program were likely limited by the virtual delivery required by the COVID-19 pandemic. Other methods of administering the program virtually should be explored to find the most helpful remote techniques. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 51 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Sunscreen Dispensers in San Antonio, Texas
Project Discipline: Medicine
Primary Poster Presenter: Ashley Chakales
Other Student Team Members: Anisha Guda, Katie Smith, Margaret Anderson, Maryann England, Aaron Fanus, Hari Krisnakumar, Madeline Mathieu, Alexandra Montgomery, Tue Felix Nguyen, Cory Nunn, Yousef Salem, Katie Smith, Marie Vu, Caroline Zhu
Faculty Mentor: John Browning, MD, MBA
Community Partner: San Antonio Parks & Recreation
Project Location: San Antonio, Texas
Background: Skin cancer is the most common cancer in the United States despite 80% of skin cancer being preventable. Sunscreen is one of the main forms of sun protection, and yet sunscreen is not readily available at many of our city’s pools and trailheads. In an effort to solve this problem, we have partnered with the San Antonio Parks and Recreation Department to purchase and install sunscreen dispensers in two of San Antonio’s local parks.
Objectives: The objectives of this project are to increase awareness of skin cancer, encourage use of sun protective measures, as well as assess the usefulness of public sunscreen dispensers.
Methods: Sunscreen dispensers were installed at Elmendorf Lake Park and Greenway Trails. Each dispenser displays a handout regarding sun safety practices. Student volunteers surveyed park visitors and educated them on sun protection and skin cancer prevention. The survey was designed to assess helpfulness of the dispensers as well as knowledge of sunscreen practices and skin cancer.
Results: Because the dispensers were placed in early fall, survey responses were limited. However, more responses and use of the sunscreen dispensers are anticipated when the weather is warmer. Nevertheless, surveyed respondents found the stations to be helpful, several noting the dispensers were a great way to encourage the use and reapplication of sunscreen. Overall, awareness was mixed. Of particular note, only 30% of respondents knew that one in five Americans will develop skin cancer in their lifetime.
Conclusion: In conclusion, we confirmed the usefulness of the public sunscreen dispensers. We also identified some gaps of knowledge in the community regarding sun safety. We hope to address these issues through installation of additional dispensers in other locations and plan on hosting a seminar in collaboration with the San Antonio Parks and Recreation Department on sun safety. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 52 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
The New Back-to-School Basics: COVID-19 Hygiene Education for Elementary Students
Project Discipline: Medicine, Nursing
Primary Poster Presenter: Sophia Desrosiers
Other Student Team Members: Rebecca A. Rodriguez, Marisa Rangel, Scott Anderson, Matt Kannenberg
Faculty Mentor: Fozia Ali, MD
Community Partner: Rainbow Foundation San Antonio
Project Location: San Antonio, Texas
Background: In the midst of the COVID-19 pandemic, constant undulating statistics of new cases and deaths, and schools reopening in the fall of 2020 after a long hiatus, the objective was to address the need of preparing children to safely return to school.
Objective: To educate 1st - 5th-grade elementary school children in health and safety precautions during the COVID-19 pandemic.
Method: Three once-a-month virtual zoom sessions were implemented focusing on hygiene, physical activity, and coping mechanisms during a pandemic. The hygiene lecture included interactive demonstrations for handwashing, coughing/sneezing precautions, and appropriate mask-wearing methods. In the coping mechanisms session, children were asked to use art or free text to answer the question, “How has COVID-19 changed my feelings?” The physical activity session discussed safe ways for children to stay active during the pandemic. Both quantitative (pre and post knowledge assessment quizzes) and qualitative (free text, drawings) data were collected through electronic surveys. Quizzes were designed for the appropriate grade level and used a combination of multiple-choice, free text, checkboxes, and pictures to address common themes.
Results: Final results show six 1st - 2nd graders and nine 3rd – 5th graders consistently participated in the project. Children could identify proper mask-wearing, how to properly cough, and when to wash hands. Emotions reported were both positive (ex. happy) and negative (ex. Sad, bored). Reported activities were indoor electronic games and work. Children reported missing friends and going to parks.
Conclusion: These educational sessions were organized to better prepare children to safely return to school but also help them adapt physical activity and coping skills while maintaining social distancing. 1st - 5th graders answered most questions correctly, and thus, had a good initial fund of COVID-19 safety knowledge. The children are experiencing mixed emotions during the pandemic due to feelings of social isolation. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 53 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
The Use of a Brief Educational Presentation to Mitigate Commonly-held Vaccine Misconceptions During Two Community-based Influenza Vaccination Drives
Project Discipline: Medicine
Primary Poster Presenter: Emily Heydemann
Other Student Team Members: Nayeon Kim, Drew Sanderson, Sanjana Reddy, Varsha Karanam, Ruth Bondurant
Faculty Mentor: Kaparaboyna Kumar, MD
Community Partner: Alpha Home, Pride Community Clinic
Project Location: San Antonio, Texas
Background: Influenza infections present a significant public health issue, even more so with COVID-19, which can potentially result in dangerous co-infections and/or overwhelm the healthcare system. While vaccination remains an important method of combating the spread of the flu, misconceptions about the influenza vaccine continue to play a role in suboptimal vaccination rates, particularly in the uninsured population.
Objectives: The purpose of this study was to evaluate whether a brief educational presentation would result in a significant decrease in the confidence to which vaccine misconceptions were held. This was measured by scores of agreement on a 7-item visual analog scale derived from the CDC and WHO.
Methods: In October 2020, we conducted flu vaccine drives at two UTHSA student-run community clinics. Prior to dispensing the flu shots, we offered optional participation in a survey on common vaccine misconceptions, followed by a brief educational presentation on the truth behind these misconceptions, followed by a post-survey.
Results: Thirty individuals participated. The results indicated a decrease in agreement with the following misconceptions: “I believe that influenza (the flu) is not serious so I do not need the vaccine” (p=0.03), “I believe that the flu vaccine can give me the flu” (p<0.001), “I am concerned that vaccinations might not be safe” (p=0.007) and “I believe that actually getting the flu provides better protection than the flu vaccine” (p=0.03). The compared means of all questions as a whole showed significance between pre- and post- survey (p<0.001). However, there was no significant change on the question of likelihood of receiving the vaccine.
Conclusion: Valuable lessons were learned on coordinating a flu vaccine drive during a pandemic, such as encouraging patient recruitment and ensuring safety. We hope to continue to conduct these drives and educate the community about vaccines in the future. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 54 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Education
Two’s Company: Interdisciplinary Lessons in Empathic Listening to Hospital Patients
Project Discipline: Medicine, Nursing, Occupational Therapy, Physician Assistant, Speech Pathology
Primary Poster Presenter: Skyler Kanegi
Other Student Team Members: Jacob Seiber, Caitlyn Swopes, Jaime Quirarte, William Johnston, Korinna Romero, Thomas Etheridge, Matthew Maia, Isabella Evangelista, Lauryn Martin Sweet, Denise Medina-Ancira, Cynthia Cantu, Marina Habashi
Faculty Mentor: Kristy Kosub, MD, FACP
Community Partner: University Health Patient Family Advisory Council
Project Location: San Antonio, Texas
Background: UTHSA students have limited patient-facing interdisciplinary volunteer opportunities. Survey of 82 LSOM MS2s found 75.6% felt they did not have access to these experiences, worsened by the COVID-19 pandemic. The LSOM and HP preclinical curricula contain <10 hours of interdisciplinary activities.
Objectives: To establish an interdisciplinary volunteer program with patient-facing social interactions that teach empathic listening.
Methods: Partnering with UHS PFAC, we established a pilot program where students have virtual social interactions with patients, learning about their values and interests. We planned a two-step study of student satisfaction with the experience and future assessment of patient satisfaction. Patients were identified by UH nursing supervisors. Students completed a communication training module and quiz. Conversations occurred through Cisco WebEx on Kindle Fire tablets. Students completed an optional exit survey rating their interaction from 1 to 7 (7 representing optimal enjoyment).
Results: Leadership team of seven medical, two nursing, and four HP students engaged in 119 hours of interdisciplinary collaboration establishing Two’s Company, a volunteer program connecting thirty- eight students with patients for virtual social interactions. Six medical and ten health professions students completed the survey. There was no significant rating difference between medical (4.83, [CI: 2.50,7.17]) and health professions students (5.30, [CI: 3.18,7.42], P=0.22). 88% of students wanted to speak with a patient again. Three interactions lasted <=15 minutes, six lasted 16-39 minutes, and seven lasted 40-50 minutes. A one-tailed t-test showed a significant rating difference between interactions lasting <=15 minutes (4.33, [CI: 3.18,5.49]) and 16-50 minutes (5.31, [CI: 3.09,7.53], P<0.05).
Conclusion: Interprofessional students with diverse perspectives collaborated to establish an active volunteer program. Ratings of patient interactions did not vary significantly depending on the student’s profession. Patient interactions longer than fifteen minutes may provide more benefit for students. Next steps include bolstering nursing student participation, enhancing learned communication skills, and studying patient satisfaction with the interaction. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 55 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
An Investigation of the Impact of COVID-19 on Food Access and Security in Bexar County
Project Discipline: Dentistry, Medicine, Nursing, Nutrition/Dietetics
Primary Poster Presenter: Olivia Chen
Other Student Team Members: Corina Badillo, Dirk Wristers
Faculty Mentor: Fozia Ali, MD
Community Partner: San Antonio Food Bank
Project Location: San Antonio, Texas
Background: The food insecurity rate of Bexar County was 14.1% in 2018, 2.6% percent greater than the national average, according to Feeding America. Since the COVID-19 pandemic has affected Texas, Bexar County saw skyrocketing unemployment rates that reached 13.5% in April 2020. As a result, local community organizations like SAFB experienced a significant rise in their original client base during 2020. These drastic increases in unemployment and demand for food assistance emphasize the need for exploration of the changes in food-related behaviors since the onset of COVID-19.
Objectives: We plan to investigate the impact of COVID-19 on food access and security in Bexar County. Specifically, the project will seek to identify food barriers that have emerged due to COVID-19, how rates and severity of food insecurity have shifted in Bexar County, and how food purchasing behaviors have changed since COVID-19.
Methods: This study design utilizes a mixed methods approach; quantitative data was collected through a 10-minute Qualtrics survey that was distributed to SAFB clients (goal n=250). Qualitative data was collected through virtual focus group interviews. Participants for the focus group interviews (goal n=25) were recruited by inviting eligible survey participants.
Results: Since the survey was launched in October 2020, 195 responses have been collected. Preliminary data analyses have shown that total food insecurity among SAFB clients living in Bexar County increased from 72% to 90.5% since March 2020. 88% of respondents who lost their job have been moderately to severely food insecure since COVID-19. 91% of respondents stated that due to COVID-19, their household had difficulty affording the amount of food they typically bought.
Conclusion: A major challenge faced was ensuring adequate attendance to focus group interviews. In response, the researchers increased the number of invites for each focus group from 5 to 10 participants, in addition to creating phone call/text reminder protocols. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 56 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Art Cart: The Benefits of Art in an After-School Program, 2020
Project Discipline: Medicine
Primary Poster Presenter: Kristopher Caro
Other Student Team Members: Nisha Kalyanpur, Shwetha Menon, Nichole Henkes
Faculty Mentor: Glen Medellin, MD
Community Partner: Madonna Center
Project Location: San Antonio, Texas
Background: Art Cart is an after-school art program established at Madonna Neighborhood Center, a local community center for children ages of 4-14 from families largely affected by poverty and related socioeconomic factors. The Art Cart program aims to provide positive emotional outlets of creative expression for these children in the hopes of mitigating the effect of outside stressors on emotional health.
Objectives: Development of a weekly art therapy program for students from low socioeconomic backgrounds at the Madonna Neighborhood Center that achieves improvements in symptoms of anxiety and mood in at least 50% of the participants.
Methods: The original in person curriculum has been adapted to COVID-19 restrictions to consist of five weekly online one-hour activities, including 4 step-by-step project tutorials followed by a final session for children to apply newly cultivated concentration and art skills in an art competition among peers. Effectiveness of sessions were evaluated through administration of a 12-question anonymous Likert scale survey at each activity’s conclusion, which measured mood, self-esteem, and group dynamics.
Results: Completion of surveys yielded the following results: Sessions resulted in an improvement in overall average mood (n=124), with 90% of kids reporting feeling more calm and relaxed and 90% in a better mood.
Conclusion: Survey results suggest art classes can be an effective emotional outlet in adolescents. Compared to previous years’ results, survey questions assessing the impact of teamwork and peer involvement on mood slightly declined, likely a result of COVID-19 limitations resulting in virtual sessions. Despite additional barriers, outcomes remained positive and comparable to previous years’ and further underscores the importance of providing kids with a sense of comfort and accomplishment, now more than ever. Art Cart additionally hopes to resume sessions at centers that had reservations regarding COVID-19 modified curricula this semester, after proving successful implementation at the Madonna Neighborhood Center. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 57 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Assessing the Healthcare Needs of the Asian Indian Community in San Antonio
Project Discipline: Medicine
Primary Poster Presenter: Joshua Katuri
Other Student Team Members: Michel Tabet, Anusha Sherwani, Aishwarya Kothare
Faculty Mentor: Fozia Ali, MD
Community Partner: India Association of San Antonio
Project Location: San Antonio, Texas
Background: According to the 2019 ACS survey, an estimated 12,452 Asian Indians live in San Antonio. The India Association of San Antonio (IASA) hosts free annual health fairs to help serve this community.
Objectives: This project aimed to assess the healthcare needs of the Asian Indian community by building on our results from 2019. Our research team surveyed the top three health concerns of the community and the top three personal barriers to healthcare. We also collected demographics such as age, gender, race, education, and BMI.
Methods: Due to the COVID-19 cancellation of IASA health fair, a virtual anonymous survey via REDCAP was sent to the IASA community to assess their top three health concerns and barriers. A short video was filmed to introduce our team and shared along with the survey at a virtual IASA Diwali celebration.
Results: In 2019, 153 members completed the survey and identified the top three health issues as nutrition (18.9%), tobacco and alcohol abuse (11.8%) and obesity (11.5%). The top three barriers to health were lack of parks and trails (21.8%), discrimination (12.9%), and transportation (10.7%). Unfortunately, due to the current pandemic limiting in person contact, survey completion was minimal. However, a similar priority on nutrition and obesity is expected based on feedback from IASA leadership.
Conclusion: In 2019, nutrition and obesity were two of the top three community health needs. Furthermore, the primary barrier to health was lack of access to trails. These findings portray a community that is concerned with eating and exercising properly. Our success in 2019 was due to our ability to establish rapport and convince members about the value of our survey. While the video attempted to create that rapport virtually, it was ultimately insufficient. We plan to reestablish that connection and increase engagement by sharing the survey via IASA social media groups. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 58 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Betelnut Availability and Knowledge Among Ethnic Populations in San Antonio
Project Discipline: Dentistry, Medicine, Medical Laboratory Sciences
Primary Poster Presenter: Phillip Yang
Other Student Team Members: Aziz Saqr, Kim Lam, Zachary Harbin
Faculty Mentor: Chatchawin Assanasen, MD
Community Partners: Lien Hoa Buddhist Temple, Islamic Center of San Antonio and Center for Refugee Services
Project Location: San Antonio, Texas
Background: Betelnut is the fourth most used psychoactive substance in the world and is associated with oral lesions and cancer. Unknown in the U.S., it is commonly consumed in South Asia, Southeast Asia, Pacific Islands, and Taiwan. San Antonio hosts many communities that are culturally connected with betelnut consumption.
Objectives: (1) Investigate the availability of betelnut in ethnic grocery stores. (2) Assess betelnut knowledge and consumption in ethnic communities.
Methods: Three search terms were used to identify stores (“Asian/Middle Eastern/Indian grocery market in San Antonio”). Betelnut was purchased and documented from 5 stores. Betelnut knowledge, usage, and availability were assessed by survey in collaboration with 3 community partners: Lien Hoa Buddhist Temple, Islamic Center of San Antonio, and Center for Refugee Services.
Results: 13 of the 19 (68%) identified grocery stores carried betelnut. Participants (n=71) were grouped into four categories: Southeast Asian (n=30), South Asian (n=27), Middle East and Africa (n=11), and White (n=3). 83% Southeast Asians, 97% South Asians, 17% Middle East and Africa, and 0% White participants knew what betelnut is. About half of Southeast Asians (48%) and South Asians (50%) have ever used betelnut. Over half of the Southeast Asians and South Asians knew someone who uses betelnut in San Antonio (64% and 58%, respectively) and knew where to buy it (76% and 65%, respectively). Only 28% of Southeast Asians knew its harmful effects while 73% of South Asians knew its harmful effects. Betelnut usage is associated with older age, male sex, and recent immigration.
Conclusions: Betelnut usage is retained among cultural populations, especially recent immigrants, in San Antonio. Interestingly, older immigrants are more likely to be past users and second-generation immigrants are more likely to not know what betelnut is, indicating that betelnut usage diminishes with assimilation in U.S. culture. Further work is needed to raise betelnut awareness among healthcare workers. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 59 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Bridge to Unity: Connecting Medical Education to the Patients We Serve
Project Discipline: Medicine
Primary Poster Presenter: Tristan Dorn
Faculty Mentor: Inez Cruz,PhD, LMSW
Community Partner: Madonna Center
Project Location: San Antonio, Texas
Background: Community Health Needs Assessments (CHNAs) are an effective way to improve healthcare providers’ understanding of the community by using real-world learning opportunities to identify local economic and social conditions and community health needs. This allows medical professionals to connect health issues to the illnesses they manage. Our CHNA focused on identifying key health needs of residents of downtown San Antonio.
Objectives: The objectives of this study are to identify the demographics of the community served by the Family Health Clinic, to identify their prevalent illnesses and health needs, and to increase our understanding of barriers to healthcare.
Methods: English and Spanish-language surveys were conducted by during the annual “Bridge to Unity” Health Fair at the Madonna Center over 2 years. In 2018, there were a total of 121 responses (83% Hispanic) to a 13-question survey. In 2019, there were a total of 74 responses (80% Hispanic) to a 27-question survey.
Results: 195 respondents participated. 7 of 10 respondents have a PCP. 67.2% of respondents reported that they are in “excellent” or “good” health. 32.0% of respondents “agree” or “strongly agree” with the statement, “I feel like I have little control over risks to my health.” 58% of respondents considered “diabetes and high blood pressure” to be a top health concern in 2018. 20.3% of the respondents reported having diabetes in 2019. In total, 63.5% of respondents either have diabetes themselves and/or live with someone with diabetes in their household.
Conclusion: The CHNA results allowed us to learn about the local community and their health needs. There is a disconnect between their rate of diabetes and their perceived health. A majority of respondents reported that they are in excellent or good health. However, almost 1/3 of respondents do not feel like they have control over their health status. This incongruency is an unexpected outcome. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 60 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Bridging the Diaper Gap Project*
Project Discipline: Nursing
Primary Poster Presenter: Elena Castoreno
Other Student Team Members: Abbigail Garza, Nasaria Carmona, Elisabeth Marlow, Destiny Yanes, Destiny Sanchez, Patricia Rios, Jessalie Ornelas
Faculty Mentor: Beth Johnson, MSN, FNP-C
Community Partner: A Brighter Day
Project Location: Lytle, Texas
Background: Diaper dermatitis is the most common skin disorder during infancy. The best means of prevention is frequent diaper changes. Unfortunately, one in three American families cannot afford diapers. A Brighter Day nonprofit organization helps provide education and essential baby material assistance to families in underserved populations.
Objectives: The purpose of this project was to decrease the number of occurrences of diaper dermatitis for low-income families in Lytle, Texas by providing free education and baby material assistance to the parents. A secondary objective was to evaluate our financial monthly impact for each family.
Methods: Visual pop-up educational signs, diaper dermatitis signs and symptoms pamphlet, how to change a diaper education flyer, and face-to-face training on what diaper dermatitis is, were all presented and read to the participants in the project. To assess project outcomes, participants knowledge of training content was assessed via pre- and post-test surveys.
Results: A total of 90% of 40 participants were able to attend two diaper distributions days, but 10% attended one diaper distribution day. During the three months in Lytle, Texas 97% of the participants children did not have an occurrence of diaper dermatitis. Post-surveys showed 77.5% of participants stated the diaper dermatitis pamphlets helped educate them on how they viewed diaper dermatitis and treated it. Post education test showed 80% of participants passed and comprehended the education provided. Thus, correlating to the decreased occurrence of diaper dermatitis. On average each family saved $42.25 a month.
Conclusion: Educating participants on diaper dermatitis and providing free baby material assistance on a monthly base significantly increased their knowledge of preventable measures of diaper dermatitis, decreased the number of occurrences, and increased the participant financial stability. A Brighter Day has pledged to continue the Bridging the Diaper Gap Project in Lytle Texas and hopes to expand to other underserved communities.
*Blue Ribbon Winner 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 61 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Combating Diabetes in the Times of COVID-19
Project Discipline: Medicine
Primary Poster Presenter: Eric Chan
Other Student Team Members: Casandra Compean, Jaisal Patel
Faculty Mentor: Rachel Pearson, MD, PhD
Community Partner: Good Samaritan Community Services
Project Location: San Antonio, Texas
Background: Diabetes is a serious comorbidity of COVID-19 that negatively impacts the severity and outcome of those affected by the virus. The Hispanic population in particular has been disproportionately impacted by this pandemic, and studies have suggested an influencing factor could be the rates of Diabetes in this community. As such, we held diabetes screening and education at Good Samaritan Center in San Antonio during a flu vaccination event, which served families who are predominantly Hispanic and of low socioeconomic status.
Objectives: Assess individuals’ understanding regarding Diabetes and its risk factors Discern how the COVID pandemic has impacted risk factors for Diabetes Analyze the effectiveness of Diabetes education.
Methods: We will be creating pre and post-education surveys to assess the effectiveness of our teachings on diabetes awareness. Individuals will have their blood glucose taken, and a Frontera student volunteer will briefly educate individuals one-on-one on diabetes concepts. We will look at how knowledgeable individuals are on the concept of diabetes. We will also look at demographics and lifestyle behaviors and how that impacts the prevalence of diabetic risk factors.
Results: Overall, we saw an improvement of scores and improvement in confidence levels in terms of diabetes understanding between pre/post suggesting individuals did learn from the brief diabetes education that they received. Our education involved directed education based on their blood glucose levels. Individuals with BG levels over 140 received diabetes management education while those under 140 received diabetes prevention education.
Conclusion: The awareness of the impact of Diabetes on COVID outcomes will play an important role in minimizing the disparity currently seen in the morbidity/mortality rates of COVID in Hispanics versus non- Hispanic Whites. We faced logistical issues implementing the surveys in conjunction with the flu drive. Based on the efficacy of this year’s education, it is possible to continue this at future flu shot drives. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 62 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Community Health Assessment and Flu Vaccination Among Vietnamese Americans During the COVID-19 Pandemic
Project Discipline: Medical Lab Services, Nursing
Primary Poster Presenter: Denise Partosa
Other Student Team Members: Mara Cabungcal, Kim Thanh Lam
Faculty Mentor: M. Danet Lapiz-Bluhm, PhD, RN, FAAN
Community Partner: Lien Hoa Buddhist Temple
Project Location: San Antonio, Texas
Background: There is limited research about Vietnamese Americans’ health. With funding from the Center for Medical Humanities and Ethics (CMHE), we determined community health conditions, unhealthy behaviors, and health factors among the Vietnamese in South Texas. Many Vietnamese reported not to have received flu vaccinations. Subsequent CMHE funding was proposed for a collaborative community effort to address some issues but was not possible due to the COVID-19 pandemic.
Objectives: The project assessed Vietnamese community health needs in South Texas during the COVID-19 pandemic and their uptake of flu vaccination.
Methods: Community health needs assessment (English and Vietnamese) were uploaded into Qualtrics. Survey links were published on the temple website, sent to contacts, and posted on social media sites. The flu clinic was conducted on November 1 at Lien Hoa Buddhist Temple, with appropriate COVID precautions. Data were analyzed for descriptive statistics.
Results: Survey participants (N=34) identified the most important health issues (heart disease, diabetes, cancer, and mental health), unhealthy behaviors (alcohol abuse, lack of exercise, angry behavior, not able to get check-up), and factors that impact their well-being (access to health services, job opportunities and less poverty). The first two important issues were similar to pre-COVID data. However, issues related to mental health, job security, and poverty surfaced in this assessment. Individuals (N=28) received flu vaccination; about 60% were not vaccinated in the last five years.
Conclusion: The data reflect health issues seen pre-COVID. However, community needs can be attributed to the COVID-19 pandemic due to the imposed social distancing, and lockdowns (i.e., mental health and economics) were also prioritized by the Vietnamese participants. The minimal survey participation highlights the need for continued engagement in this community to promote trust to address their needs and concerns. Knowledge of these healthcare issues allows for better-targeted healthcare promotion interventions for Vietnamese populations in South Texas. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 63 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Community Needs Assessment of South Asian Americans in South Texas
Project Discipline: Medical Lab Services
Primary Poster Presenter: Megan Rodriguez
Other Student Team Members: Mara Cabungcal
Faculty Mentors: Jolly Punchamannil PhD, DNP, CMSRN, NE-BC; M. Danet Lapiz Bluhm, PhD, RN
Community Partners: St. George Indian Orthodox Church, San Antonio San Antonio Indian Nurses Association,Indian Association of San Antonio(IASA), San Antonio Tamil Sangam (SATS),Telugu Association of San Antonio (TASA)
Project Location: San Antonio, Texas
Background: South Asians are the third largest and fast-growing racial-ethnic group in the United States (US). Previous health-related research studied Asians in aggregate, with limited studies on South Asians. There are no studies on the health needs of South Asians in South Texas. Knowledge of community health concerns is essential in prevention, early detection, and disease management.
Objectives: The project aimed to identify significant community health concerns and unhealthy practices, and well-being among South Asians in San Antonio. Knowledge of these factors will inform the development of community-based interventions.
Methods: An English community health assessment questionnaire translated into South Asian languages (i.e., Hindi, Tamil, Telugu, and Malayalam) was uploaded into Qualtrics. The Qualtrics survey link was sent to community partners through e-mail and social media. Participants (N=138) started the survey completion; 98 had all sections completed. Data (N=98) were analyzed for descriptive statistics.
Results: Participants were mostly from India (93%), live in Bexar County (91%), female (65%), and have private health insurance (75%). The common age distributions were 18-20 (23%), 41-50 (23%), and >51 (22%). Their main health concerns were diabetes (24%), heart diseases (17%), and cancers (13%); their main unhealthy behaviors were lack of exercise (23%), poor eating habits (21%), and angry behaviors (11%). They identified access to healthcare (18%), healthy food choices (18%), and job opportunities (14%) as major factors influencing well-being. Although most (75%) see primary care provider consult when sick, 10% indicated they do not see medical attention.
Conclusion: The identified health and healthcare-related issues among South Asians in Bexar County showcase a population at-risk for lifestyle modifiable chronic conditions such as diabetes and cardiovascular diseases. Screening, education, and appropriate interventions are required to identify at-risk individuals to promote behavioral changes towards healthy lifestyle. Collaborative relationships with the South Asian community will help determine culturally-congruent acceptable interventions. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 64 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Cross-Sectional Analysis of COVID-19 Vaccine AcceptanceAmong Healthcare Students at the University of Texas Health Science Center in San Antonio
Project Discipline: Medicine
Primary Poster Presenter: Meredith Hosek
Other Student Team Members: Autumn Chidester
Faculty Mentor: Barbara Taylor, MD, MS
Community Partner: UT Health San Antonio
Project Location: San Antonio, Texas
Background: Within one year of sequencing the novel coronavirus, scientists and global leaders have collaborated to design, test, and distribute a vaccine. On December 11, 2020, the F.D.A. approved the first COVID-19 vaccine for Emergency Use Authorization. By mid-December, vaccines were on hand in San Antonio, Texas, with early shipments allocated for all 3,955 health science students at UT Health San Antonio (UTHSA). Despite the vaccine’s approval, many earlier studies had suggested healthcare professionals may be wary to accept the vaccine.
Objectives: To evaluate the degree of COVID-19 vaccine acceptance among healthcare students, to assess whether perceived threat of COVID-19 was associated with vaccine acceptance, and to identify top perceived barriers to vaccination.
Methods: A web-based, anonymous survey was distributed to all students at UTHSA from 12/17/2020- 12/23/2020. Data was analyzed in STATA to assess for correlations with vaccine acceptance.
Results: 1,032 students completed the survey, for a 30% response rate. 80.58% of students were accepting of COVID-19 vaccination. 33.43% of students reported no concerns with the vaccine, while the other 66.57% reported their top concerns as long-term side effects, quality control due to accelerated development, and waiting until tested on by more people. Students who perceived themselves as higher-risk for contracting COVID-19 were more accepting of vaccination (p < 0.05). Age, gender, and the in-person clinical care of patients did not have an association with vaccine acceptance.
Conclusion: At this moment, with only two COVID-19 vaccines approved for emergency use by the F.D.A., the study of health behavior around COVID-19 vaccination is a new and emerging field. With a survey of this size and breadth across medical disciplines, this information may be helpful to other institutions interested in vaccinating their health science students, or for anyone interested in understanding barriers to and predictors of COVID-19 vaccine acceptance. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 65 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Dealing with Distress from the COVID-19 Pandemic: Mental Health Stressors and Coping Strategies in Vulnerable Latinx Communities
Project Discipline: Medicine, Public Health
Primary Poster Presenter: Ruth Bondurant
Other Student Team Members: Nina Luskey
Faculty Mentor: Luz Garcini, PhD, MPH
Community Partner: Center for Research to Advance Community Health (REACH)
Project Location: San Antonio, Texas
Background: This study was designed to identify the mental health needs of underserved Latinx communities along the Texas-Mexico border, San Antonio, and the surrounding areas during the COVID-19 pandemic.
Objectives: The objective of this study was to identify stressors faced by underserved Latinx communities in South Texas during the COVID-19 pandemic and coping strategies used to manage these stressors. Such information can be used by Community Health Workers (CHWs), who work directly with this population, to better inform their efforts to address the mental health crisis instigated by the pandemic in a culturally and contextually sensitive manner.
Methods: CHWs were recruited based on the following two criteria: (a) fluency in English and/or Spanish; and (b) involvement with underserved Latinx communities in South Texas. CHWs completed a Qualtrics survey and participated in one of three one-hour virtual focus groups to discuss mental health concerns and coping strategies relating to the COVID-19 pandemic that had been reported by their communities. Focus groups were transcribed and translated into English. Then transcripts were coded and analyzed to identify and quantify important themes regarding stressors and coping strategies.
Results: Evaluation of specific stressors and coping strategies in focus group responses revealed six important themes relating to mental health stressors – economic stressors, immigration-related concerns, misinformation, family stressors, physical health, and social isolation – and four themes describing helpful coping strategies – behavioral strategies, cognitive strategies, social support, and spirituality.
Conclusion: The results of this study illuminate several stressors that are specific to or especially significant within the population evaluated and demonstrate ways in which mental health concerns are amplified by compounded stressors within the Latinx population. Thus, one challenge is generalizability. Moving forward, these findings are being used to create resources that can be accessed by CHWs to more effectively address the mental health needs of their communities. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 66 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Effects of COVID-19 on Asthma Severity and Social Determinants of Health for Children with High Risk Asthma in San Antonio
Project Discipline: Community Health Workers (CHWs), Medicine, Public Health, Respiratory Care
Primary Poster Presenter: Amy Shoga
Other Student Team Members: Valeria Velazquez
Faculty Mentors: Mandie Svatek, MD;, Paul Kloppe, MBA, RRT; Rodrigo Cornejo, CWH; Imelda Duran, CHW; Tracy Compean, CHW; Cara Hausler, MPH; Rose Ramos, PhD, MPH
Community Partners: San Antonio Kids BREATHE Program, San Antonio Metropolitan Health District
Project Location: San Antonio, Texas
Background: Asthma affects more than 6 million children living in the U.S. and disproportionately affects minority and impoverished children. Additionally, the persistent influence from disparities in social determinants of health (SDOH) have likely been exacerbated during the COVID-19 pandemic. The San Antonio Kids BREATHE (SAKB) program addresses these disparities through free education and symptom management support for children with asthma and their families.
Objectives: We quantified the effect of COVID-19 pandemic among high-risk children with asthma in San Antonio. Our specific interests included: asthma control, asthma-related quality of life (QoL) for child and caregiver, medication adherence, and SDOH.
Methods: Newly-enrolled families and families enrolled prior to COVID-19 were informed of this assessment by SAKB community health workers (CHWs). With mentorship and guidance from the SAKB leadership, medical students developed and administered a survey specifically designed for SAKB-enrolled children with asthma and their caregivers.
Results: We found that 71% of children (n = 14) had caregivers who reported at least one SDOH difficulty during the pandemic. These caregivers were also more likely to report a decreased QoL score when compared to caregivers who did not report SDOH difficulty (90% vs 25%). Additionally, 78% of children (n=9) self-reported a decreased asthma-related QoL score. Interestingly, a majority of participants (57%) reported increased asthma control throughout the pandemic. Finally, participants enrolled in SAKB prior to the pandemic (before March 13, 2020) reported greater asthma control as well as a lower burden of SDOH through the pandemic when compared to those who enrolled after March 2020.
Conclusion: These results underscore the importance of programs, such as SAKB, in monitoring barriers to disease management during a pandemic among vulnerable families experiencing chronic disease. Future directions include increased enrollment and further elucidation of the impact of SDOH on children with asthma, especially during a public health crisis. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 67 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Fiesta Youth: A Prospective Mental Health Intervention for LGBT+ Youth
Project Discipline: Medicine
Primary Poster Presenter: Jay Jeon
Other Student Team Members: Cole Odlozil, Brent Arcayan, Korinna Romero
Faculty Mentor: Rene Olvera, MD, MPH
Community Partner: Fiesta Youth
Project Location: San Antonio, Texas
Background: LGBT+ groups have demonstrated a greater risk of negative mental health outcomes including drug addiction and depression. This includes LGBT+ youth who share these risk factors secondary to discrimination, stigma, and violence against them. Although social support is a buffer to these risk factors, there is limited research on the role of community-based groups in benefiting LGBT+ youth.
Objective: Determine the effect of Fiesta Youth, a local LGBT+ youth group, on LGBT+ adolescent depression, social support, and self-esteem.
Methods: Survey was designed to consist of demographic information including gender, sexuality, age, ethnicity, and duration of attendance in addition to the CES-D-10, MSPSS, and a self-esteem scale. Survey was distributed every third month at Fiesta Youth’s weekly meetings. Participants were voluntarily recruited early in the meeting. Following pandemic, the methods were adjusted to provide a virtual link to the survey during the Zoom meeting. Additionally, the survey was included as an optional portion of newcomer paperwork. All responses were anonymous.
Results: Overall social support, peer social support, and significant other social support were greatest among Fiesta Youth attendees with over 6 months of attendance relative to newcomers and attendees with less than 6 months of attendance. Depression was significantly more common in older LGBT+ adolescents between the ages of 14 – 18 versus adolescents aged 11 – 13. Additionally, significant differences in rates of depression were determined between male-identifying (cis male, trans male), female-identifying (cis female, trans female), and nonbinary genders. Overall social support was significantly decreased during pandemic.
Conclusion: Fiesta Youth adolescents with longer attendance report greater social support. Longitudinal data is needed to determine whether Fiesta Youth retains more social adolescents versus directly benefiting individuals. Demographic findings to consider for LGBT+ adolescent depression screening include age and gender identity. Further studies needed to determine impact of pandemic on LGBT+ youth. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 68 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Immunizing Underserved Populations During the COVID-19 Pandemic
Project Discipline: Medicine
Primary Poster Presenter: Jessica Wong
Other Student Team Members: Corina Badillo, Cameron Atkison
Faculty Mentor: Adelita Cantu, PhD, RN
Community Partners: San Antonio Metropolitan Health District, San Antonio City Council District 7, Population Health Advisory Committee
Project Location: San Antonio, Texas
Background: Frontera de Salud is a student-run organization that provides preventive health services to the medically underserved populations in San Antonio. With the rise of the COVID-19 pandemic, it has been even more urgent to address their immunization needs. During flu season, influenza vaccinations help mitigate stress on the healthcare system and protect community health.
Objectives: The objective of this project was to provide influenza immunization and vaccine education in underserved areas of San Antonio hardest hit by the COVID-19 pandemic. A secondary objective was to assess community perceptions of the COVID vaccine so that areas of hesitancy can be addressed in future COVID immunization efforts.
Methods: Based on the number of cases, life-expectancy, and per-capita income, a needs assessment identified San Antonio’s District 7 as one of the hardest hit areas by COVID-19. After receiving vaccine administration training, an interprofessional team of medical, nursing and health professions students provided no-cost flu vaccinations at two drive-thru flu vaccine drives held at local schools. Student volunteers also provided vaccine education, and surveyed opinions on the forthcoming COVID vaccine.
Results: Between the two vaccine drives, 462 people received flu vaccines, with 65% coming from District 7. Fifty-three percent were not annual recipients of the flu vaccine; 67% would get the COVID vaccine if offered, citing reasons such as wanting to protect themselves and prevent the spread of COVID; 19.8% were undecided and 13.2% would not get the COVID vaccine, citing lack of information on the vaccine and safety concerns.
Conclusion: The flu vaccine clinics provided immunization for many in the targeted community who might not otherwise have been vaccinated. Survey showed mixed opinions on the COVID-19 vaccine, which is an area that Frontera can help address. Frontera hopes to use the infrastructure developed with this project to assist in distribution of the COVID-19 vaccine in the future 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 69 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Implementation and Evaluation of Pilot Program Providing Patient Navigation to Individuals Experiencing Homelessness
Project Discipline: Medicine
Primary Poster Presenter: Tri Pham
Other Student Team Members: Alison Liu, Brayden Seal, Akshat Patel, Kevin Ma, Natalie Bonner, Ashlyn Lafferty, Nicholas Campalans, Thanos Rossopoulos, Umaru Barrie
Faculty Mentors: Philip Day, PhD; Nora Gimpel, MD; Patti Pagels, MPAS, PA-C
Community Partner: Union Gospel Mission
Project Location: Dallas, Texas
Background: Individuals experiencing homelessness demonstrate higher incidence of disease, limited access to healthcare, and overall poorer health outcomes. The unique obstacles faced by homeless populations require novel solutions in order to reduce barriers to care and ensure timely delivery of health services. A novel student-led Patient Navigator Program (PNP) connects persons experiencing homelessness to community resources and services specific to each client’s goals and health needs. A pilot is underway to evaluate program design and readiness for implementation on a large scale.
Methods: The pilot program is currently underway and will be completed in November. A team of four medical student patient navigators are working with one client and their family to develop six SMART (specific, measurable, actionable, realistic, and time-bound) goals based on the client’s social or health- related needs, identified by a pre-survey. The primary outcomes include the number of successful patient- navigator encounters and completion of SMART goals. Secondary outcomes include changes in patient attitudes and self-efficacy scores, as measured by pre- and post-surveys.
Results: The team has documented 16 total direct client-navigator encounters over the course of 15 weeks, in addition to weekly electronic communication and community resource management. Of note, prior to PNP engagement, the client reported three unsuccessful attempts to apply for healthcare financial assistance, which we were able to achieve by week six of the cycle, linking her to primary care for “the first time in many years.” Post-survey is incomplete and survey results have not been analyzed at this time.
Conclusion: A core challenge in achieving health equity is addressing the specific barriers to care faced by individuals experiencing homelessness. The pilot of PNP has provided insight into the future implementation of a sustainable community-based program to improve health outcomes among individuals experiencing homelessness. The program has expanded and now have nine teams working with clients this spring semester. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 70 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Postpartum Depression Screening and Education*
Project Discipline: Medicine, Doctor of Osteropathic Medicine
Primary Poster Presenter: Holly Miller
Other Student Team Members: Gennipher Smith, Brionné Thompson, Lexie Cooper, Leslie Kim
Faculty Mentors: Melissa Martinez, MD; Millicent Eke
Community Partner: Pregnancy Care Center San Antonio
Project Location: San Antonio, Texas
Background: The American Psychiatric Association estimates 14.3% of U.S. women experience symptoms of postpartum depression (PPD). Risk factors include having stressful life events, having financial or employment problems, and lacking social support. The Pregnancy Care Center is a non-profit crisis pregnancy center that serves clients with these risk factors.
Objectives: To contact women 2-4 weeks after their due date, screen them for PPD, and offer free education and treatment resources, while encouraging these women to talk to their obstetrician at their postnatal appointment. Record epidemiological data.
Methods: After developing an appropriate screening script, medical students called women 2-4 weeks after their baby’s due dates. The PHQ2 was used to initially screen for depressive symptoms; if positive, then additional screening using the Edinburgh Postpartum Depression Score was completed.
Results: Seventy-five women were screened. To date, 8 (10.7%) screened positive for possible PPD. The women who screened positive ranged in age from 19 to 39 years (mean = 27). While 50% initially considered abortion, 50% initially planned to parent; 25% were first time mothers; 100% had full term pregnancies. Relationships to the father of the baby varied such that 12.5% were other, 50% were friends, 25% were boyfriends, and 12.5% were husbands; 75% anticipated partner involvement while 25% were unsure.
Conclusion: Combining the PHQ-2 and EPDS identifies women at risk for PPD in a high-risk population.10.7% is lower than estimated by the APA, and results could have been affected by phone administration, timing of survey administration, and sample size. The variety of situations reported suggests that PPD does not discriminate based on relationship status or intention to parent. This project will continue as a collaboration between UT Health MD and UIW DO students, with expectations to include other health professional students, as well as an opportunity to begin this project with another community partner.
*Blue Ribbon Winner 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 71 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
San Antonio Vision and Eye Studies (SAVES): A Geographic Visualization of Eye Screening Results in Bexar County
Project Discipline: Medicine
Primary Poster Presenter: Christopher Zhu
Faculty Mentor: Daniel Johnson, MD, MBA
Community Partners: Lions Sight Research Foundation, Lions Clubs of San Antonio
Project Location: San Antonio, Texas
Background: The number of Americans with ocular disease is expected to double between 2010 and 2050. The National Eye Institute reports that of the U.S. population, 2% have elevated intraocular pressure (IOP), 10% are far-sighted, and 24% near-sighted. However, neither Bexar nor its neighboring counties have comparative demographics for these ocular conditions. The Lions Mobile Eye Screening Unit (MESU) provides free eye screenings in these counties and collects this regional information.
Objectives: SAVES aimed to compare information collected in the region by MESU volunteers to state and national averages to identify local areas in greatest need of community outreach. This pilot study visually stratified failed eye exams by zip-code to allow community providers to better comprehend these discrepancies and to most efficiently direct their resources.
Methods: Volunteers recorded aggregated results at the conclusion of each screening for all patients (n=879). IOP failure was any pressure ≥22 mmHg in 1+ eyes. Failed visual acuity was defined as non-20/20 vision. Results were analyzed with state and national data and visually represented as a demographic heatmap.
Results: Bexar County demonstrated significantly higher failure rates for IOP (6.5%, p<0.001), far vision (26.8%, p<0.001), and near vision testing (39.0%, p<0.001) compared to both state and national averages. Six geographically diverse areas stood out for statistically significant failure rates of all three exams: 78260, 78216, 78213, 78205, 78221, and 78220. Individually, the zip-code with the highest failing rate for IOP was 78109 (21%, n=24, p<0.001), for far vision 78209 (75%, n=16, p<0.001), and for near vision 78201 (71%, n=24, p<0.001).
Conclusion: This SAVES pilot investigation demonstrated that Bexar County has significantly higher prevalence rates of failed visual acuity and IOP exams than both state and national averages with failure rates varying by zip-code. This provides an impetus for future changes in resource allocation by ocular health providers and continued demographic studies. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 72 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Understanding COVID-19 Vaccine Hesitancy Among Healthcare Providers in Bexar County
Project Discipline: Medicine
Primary Poster Presenter: Hari Krishnakumar
Other Student Team Members: Lucas Rivas, Jay Shah
Faculty Mentor: Jason Rosenfeld, DrPH, MPH
Community Partner: San Antonitio Metropolitan Health District COVID-19 Community Response Coalition
Project Location: San Antonio, Texas
Background: COVID-19 challenged our healthcare systems and unsurprisingly, so did its vaccine. Chief amongst these were the uniquely politicized nature and logistical difficulties surrounding its deployment. Understanding provider attitudes towards the vaccines and their willingness/ability to deliver them to our community are essential to developing an ideal vaccine distribution plan for Bexar County.
Objectives: The project goal was to assess provider attitudes and their organizational capacity for COVID-19 vaccine administration. This includes providers’ vaccine concerns along with logistical barriers impeding vaccination efforts. A secondary objective was to identify zip codes with limited access to resources and infrastructure for adequate vaccine administration.
Methods: The Education Workgroup of the COVID-19 CRC created an electronic survey sent to providers serving adult patients across Bexar County. This includes hospitals, members of Bexar County Medical Society, and members of the Metropolitan Health District’s vaccination programs. The survey measured provider attitudes towards the vaccines and asked logistical questions regarding patient hesitancy and clinic infrastructure.
Results: Responses were collected from 54 zip codes, having 367 providers answering the survey. Respondents who were unlikely to recommend the vaccine (3%) shared concerns involving distrust of the vaccine manufacturing process. Recommendations made by physicians to support their vaccine administration efforts included broadening the reporting timeframe (n=35), providing trained support staff (n=18), and improving logistical support (n=14). Furthermore, responses showed that only 14.44% of provider facilities were able to meet refrigeration requirements to store Pfizer’s vaccines compared to 87.47% for Moderna’s.
Conclusion: In order to address concerns and causes for vaccine hesitancy, the COVID-19 CRC and Metro Health can work with providers to create pamphlets, media campaigns and programs with community leaders to reassure civilian concerns about the vaccine. Additionally, working with physicians and provider groups to manage barriers such as infrastructure, trained staff, and reporting requirements would improve vaccine distribution. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 73 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Student Poster Abstracts
Outreach
Yoga for Teen Moms: Prenatal and Postnatal Yoga as a Means to Reduce Stress in Adolescent Mothers
Project Discipline: Medicine
Primary Poster Presenter: Katrina De Leon
Other Student Team Members: Nisha Kalyanpur, Shawna Mattathil, Holly Miller
Faculty Mentor: Ruth Berggren, MD
Community Partner: Seton Home
Project Location: San Antonio, Texas
Background: Seton Home is a transitional center for pregnant and parenting adolescent mothers seeking refuge from abuse or neglect. Through counseling and related support services, Seton Home strives to mitigate the effects of adolescent pregnancy and related stressors on mental health with the hopes of alleviating statistically significant risks for depression, mood disorders, and substance abuse, among others, through wellness based initiatives, such as yoga classes.
Objectives: Development of a weekly wellness-based yoga initiative to achieve a decline in stress levels in at least 75% of participants at the conclusion of each session and a self-implementation of stress reducing techniques in at least 50% of participants during personal times of stress experienced during the week.
Methods: A certified yoga instructor led yoga sessions with antepartum and postpartum appropriate exercises and relaxation techniques via Zoom meetings weekly for nine sessions. Following this instruction, surveys were given to participants to ascertain the effects of the respective session on stress levels before and after, the implementation rates of techniques outside of the weekly session, and the overall effect on mood.
Results: Over 9 sessions, 36 surveys were completed by residents following participation in yoga sessions. Higher initial stress levels were associated with a greater percentage of participants reporting changes in final stress levels. Overall, 88.9% of participants answered that the yoga session made them feel less stressed, and 72% of participants indicated successful self implementation of the learned stress-coping techniques at least once during the week outside of the weekly yoga session.
Conclusion: Survey results suggest yoga sessions and learned stress management techniques better equipped the residents at Seton Home with healthy outlets for stress. Despite the limitations of virtual sessions, including decreases in expected attendance, outcomes were achieved. Additionally, the virtual format allowed recording of sessions for Seton Home’s keepsake to implement beyond the original initiative. 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 74 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Notes 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 75 Communicating Hope: Delivering Essential Information in a Public Health Crisis
14TH Annual CSL Conference Planning Committee
Le’Keisha Johnson, MBA, Director, Office of Committee Chair Student Life, UT Health San Antonio
Melanie Stone, Angela Kennedy, SLPD, CCC-SLP, Assistant MPH, MEd, Assistant Professor & Clinical Coordinator, Department of Director of Community Communication Sciences and Disorders, School of Service Learning, Center for Health Professions, UT Health San Antonio Medical Humanities & Ethics, UT Health Nancy Maebius, PhD, RN, Community Relations San Antonio Liaison, Galen College of Nursing
Mary Kate Martin, MEd, MPH, Research Ruth Berggren, MD, MACP, Professor of Coordinator III, UTHealth School of Public Health in Medicine, Director, Center for Medical Humanities San Antonio & Ethics, UT Health San Antonio Carol Nguyen, RDH, MSDH, Associate Professor Leticia Bland, MPAS, PA-C, Assistant Professor, and Dental Hygiene BS Completion Program Associate Clinical Coordinator, Physician Assistant Director, Division of Dental Hygiene, School of Studies, School of Health Professions, UT Health Dentistry, UT Health San Antonio San Antonio Rebekah Salt, PhD, RN, Associate Professor, Adelita Cantu, PhD, RN, Associate Professor, School of Nursing, UT Health San Antonio School of Nursing, UT Health San Antonio Pegeen Seger, MA, MLIS, Head of Campus & Irene Chapa, PhD, Director, Office of Recruitment Community Engagement, UT Health San Antonio and Science Outreach, UT Health San Antonio Libraries
Mosh Farokhi, DDS, MPH, FAGD, Clinical Cindy Sickora, DNP, RN, Vice Dean for Practice Associate Professor, School of Dentistry, UT Health and Engagement, School of Nursing, UT Health San Antonio San Antonio
Christine Gaspard, MSLS, Librarian-Senior, Liaison Casey Strobelt, MD Candidate Class of 2023, to the School of Medicine, UT Health San Antonio School of Medicine, UT Health San Antonio Briscoe Library Melanie Taverna, RDH, MSDH, Assistant Ruth Grubesic, RN, DrPH, PHCNS-BC, Associate Professor and Director of Dental Hygiene Online Professor for Nursing and Public Health, Schreiner Graduate Programs, Division of Dental Hygiene, University School of Dentistry, UT Health San Antonio
Stephanie Gutierrez, Senior Program Coordinator, Barbara Saatkamp Taylor, MD, MS, Associate MD/MPH Program, UT Health San Antonio Professor of Infectious Diseases and Assistant Dean for the MD/MPH Program, School of Medicine, UT Derek Holbrook, MEd, Senior Program Health San Antonio Coordinator, Office of Undergraduate Medical Education, Long School of Medicine, UT Health Rajia Tobia, AMLS, former Executive Director of San Antonio Libraries, UT Health San Antonio
Sheila Hotchkin, MBA, Assistant Director of Jacqueline Tovar, Program Coordinator, Administration, Center for Medical Humanities Community Service Learning, Center for Medical & Ethics, UT Health San Antonio Humanities & Ethics, UT Health San Antonio 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 76 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Faculty Mentors
Thank you to the mentors who have provided their critical guidance for the students’ projects.
Jordan Abel, MD Jonathan Gelfond, MD, PhD Luke Newton, MD Farrah Al Allawi, MD Robert Geller Rene Olvera, MD, MPH Fozia Ali, MD Andrea Gerla, MD Patti Pagels, MPAS, PA-C Adriana Arocha MD Nora Gimpel, MD Wen Pao, ACNP Chatchawin Assanasen, MD Michelle Gonzaba MD Rachel Pearson, MD, PhD Richel Avery, MD Martin Goros, MS Julie K Peterson-Newman, Ruth Berggren, MD, MACP Sean Greene MSN, RN Leticia Bland, PA-C Ruth Grubesic, RN, DrPH, Jolly Punchamannil, PhD, DNP Elizabeth Bowhay-Carnes, MD PHCNS-BC PaiRose Ramos, PhD, MPH John Browning, MD, MBA Peter Guarnero, RN, PhD, MSc Tharani Ravi, MD Delia Bullock, MD Cara Hausler, MPH Janet Realini, MD, MPH Fred Campbell, MD Peggah Hemmat, DDS Barbara Robles-Ramamurthy, MD Adelita Cantu, PhD, RN Michael Hilliard, MD Jason Rosenfeld, DrPH, MPH Gregory Casillas Ibis Ibarra Joseph Ryan, DO Jimena Cervantez Elena Jimenez-Gutierrez, MD Rebekah Salt, PhD, RN Tracy Compean, CHW Beth Johnson, MSN, FNP-C Bill Sanns Tatiana Cordova, MD Daniel Johnson, MD, MBA Sofia Sepulveda Rodrigo Cornejo, CHW Judianne Kellaway, MD, MEd Alexander Shepherd, MD Sean Cook, MD Nurani Kester, MD Sandy Shepherd, MD; Inez Cruz, PhD, LMSW Paul Kloppe, MBA, RRT Laura Sisk, DNP, RN DeWayne Davidson, PharmD Kristy Kosub, MD Glenda Small Imelda Duran, CHW Kaparaboyna Kumar, MD Allison Stocker, MD Nida Joy Emko, MD Christopher Lam, MD Kenneth Stone, MD Adelita Cantu, PhD, RN M. Danet Lapiz-Bluhm, PhD, RN Melanie Stone, MPH, MEd Elizabeth Casiano Evans, MD Ryan Joseph, MD Mandie Svatek, MD Tiffany Cortes, MD Paula Lyons MD Barbara Taylor, MD, MS Philip Day, PhD Nandini Mandlik, DO Kristin Thompson Christopher Dayton, MD Martha Martinez, MD Richard Usatine, MD Millicent Eke Melissa Martinez, MD Melissa Valerio-Shewmaker, PhD, MPH Glenn Ermer, RN Shannon McCann, MD Pamela Venegas MD Kirk Evoy, PharmD Glen Medellin, MD Browning Wayman, MD Moshtagh Farokhi, DDS, MPH Heidi Miller, MSN, FNP-BC Wendi Wohltmann, MD Lark Ford, PhD, MA, MSN, RN Priti Mody-Bailey, MD Junda Woo, MD Sean Garcia, MD Maria Montanez MD Heidi Worabo, DNP, RN, FNP-BC Luz Garcini, PhD, MPH Rebecca Moote, PharmD Boris Zelle, MD Gretchel Gealogo-Brown, RN Andrea Moutria-Nino Meredith Zosus, PhD Michael Geelhoed, PT, DPT, Abigail Myers MD OCS, MTC Samuel Nessman, MD 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 77 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Community Partners
Thank you to our many partners who make community service learning possible.
A Brighter Day Raindrop Foundation San Antonio Alamo Area Resource Center (AARC) Ransomed Life Alpha Home Salud America American Gateways San Antonio City Council District 7 Bexar Translational Advisory Board San Antonio Food Bank Bexar County Health Collaborative San Antonio Indian Nurses Association Bexar County Juvenile Detention Center San Antonio Kids BREATHE Program Castroville Elementary School San Antonio Metropolitan Health District (SAMHD) Center for Healthcare Services San Antonio Metropolitan Health District COVID-19 Center for Refugee Services Community Response Coalition Center for Research to Advance San Antonio Metropolitan Health Community Health (REACH) District STD/HIV Clinic Child Advocates of San Antonio San Antonio Metropolitan Ministries Transitional Living and Learning Center (SAMM TLLC) ChildSafe San Antonio Parks and Recreation Columbia Heights Elementary School San Antonio Tamil Sangam Common Thread Seton Home Community Health Clubs of the Lower Rio Grande Valley SLEW Cancer Wellness Center Education Service Center, Region 20 South Central Area Health Education Center (AHEC) El Bari Community Health Center South Texas Trauma-Informed Care Consortium End Stigma End HIV St. Francis Episcopal Church Fiesta Youth St. George Indian Orthodox Church, San Antonio Good Samaritan Community Services Telugu Association of San Antonio Haven for Hope Texas Memory Café Network Healy-Murphy Center Travis Park United Methodist Church India Association of San Antonio University Health Islamic Center of San Antonio University Health Patient Family Advisory Council Lien Hoa Buddhist Temple University Hospital Lions Club of San Antonio Union Gospel Mission Lion Sight Research Foundation UT Health San Antonio Madonna Center UT Health San Antonio Long School of Medicine Mercy Ministries of Laredo UT Health San Antonio Long School of Medicine Office of Admissions Methodist Healthcare Ministries of South Texas UT Health San Antonio Office of Recruitment Mission: Border Hope and Science Outreach The Mommies Program UT Health San Antonio Student-Faculty National Alliance on Mental Illness (NAMI) Collaborative Practices Physicians for Human Rights UT Southwestern Patient Navigator Program Pregnancy Care Center San Antonio Woods Elementary School Pride Community Clinic Providence Place 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 78 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Notes 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 79 Communicating Hope: Delivering Essential Information in a Public Health Crisis
Index of Student Poster Abstracts
Advocacy/Policy
1. Developing Community-Based Stigma-Free HIV Health-Care Guidelines for Bexar County...... 11 2. The Impact of Lifestyle and Income on Diabetes Outcomes: A San Antonio Study...... 12 3. The Impacts of COVID-19 on Mental Health in the Transitioning-From-Homeless Population at SAMMinistries...... 13
Capacity Building
4. Developing a Student-led Patient Navigator Program for Individuals Experiencing Homelessness.....15 5. Travel Burden for Free Dermatologic Care in Uninsured and Homeless Populations from San Antonio and Surrounding Counties...... 16
Clinical Service
6. A Medical Snapshot of a Homeless Population Based on Health Fair Outcomes...... 17 7. Actinic Keratosis at Student-Run Free Clinic: Need for Patient Education...... 18 8. An Evidence-Based Approach to High Quality Medical Record Abstraction at the COVID-19 Infectious Disease Virtual Outpatient Clinic (CIVOC) in San Antonio, Texas...... 19 9. Analysis of Cutaneous Infections in Homeless Populations at Student-Run Free Clinic...... 20 10. Evaluating an Over-the-Counter Model for Contraception in a San Antonio STD Clinic...... 21 11. Evaluating Zoom as a Tool for Telemedicine Across Student Free Clinics...... 22 12. Evaluation of Biopsy Management at Student-Run Free Clinic...... 23 13. Factors Influencing COVID-19 Symptoms and Outcomes for Patients Evaluated at the COVID-19 ID Virtual Outpatient Clinic in San Antonio, Texas...... 24 14. Malnutrition in Orthopedic Trauma Patients: Relationship Between Nutrition and Adverse Outcomes in Acute Fracture Management...... 25 15. Outpatient Surgery in Patients with Ankle Fractures Minimises Hospital Admissions and Utilisation of Healthcare Resources...... 26 16. Racioethnic and Age Trends in Patients Evaluated at the COVID-19 ID Virtual Outpatient Clinic from March-August 2020...... 27 17. The COVID-19 ID Virtual Outpatient Clinic: A Volunteer Service Supporting COVID-19 Outpatient Care in Bexar County*...... 28
Education
18. A Digital, Interactive COVID-19 Testing Flowchart...... 29 19. Addressing Health Disparities at the Juvenile Detention Center in San Antonio, Texas...... 30 20. Addressing Maternal Mortality Through Education at The Mommies Program...... 31 21. Adverse Childhood Experiences: Training Student-Run Free Clinic Partners to be Trauma Informed...... 32
*Blue Ribbon Winner 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 80 Communicating Hope: Delivering Essential Information in a Public Health Crisis
22. Bexar County Immigrant and Asylum Health Resource Database: Outcomes of an Asylum and Immigrant Health Advocacy Program...... 33 23. Developing, Presenting, and Evaluating Anti-racism Tools to Serve Public Schools in South Texas.....34 24. Don’t Sugarcoat Diabetes 2020-2021: Virtual Outreach for Diabetes Prevention Among South Texas High School Students...... 35 25 Elementary Nutrition: Bite-sized Lessons Even Little Ones Can Chew...... 36 26. Empowering Patients During a Pandemic: A New Skin-Cancer Education Program at the Haven for Hope Skin Clinic...... 37 27. Empowering Survivors Through Health Literacy and Self Advocacy: An Educational Program for Survivors of Sex Tra cking and Domestic Violence...... 38 28. Empowering Youth at SAMMinistries’ Transitional Living and Learning Center to Create COVID-19 Safety and Awareness Campaigns...... 39 29. Healthy Choices Team Year 2: Responding to Feedback and Empowering Community Leadership in Healthy Lifestyle Changes...... 40 30. Healthy Moms and Babies 2020...... 41 31. Implementation and Evaluation of a Student Curriculum on Patient Navigation for Individuals Experiencing Homelessness...... 42 32. Increasing Practical Knowledge of Lice Infestation Among Families Experiencing Homelessness...... 43 33. Longitudinal Evaluation of a Community Outreach Infuenza Vaccine Drive and Educational Intervention Designed to Decrease Vaccine Hesitancy...... 44 34. Needs Assessment and Intervention for Hepatitis C Virus (HCV) Among Vietnamese Americans in Texas...... 45 35. Preparing for Medical School Applications and Interviews During the COVID-19 Pandemic: An Analysis of the Mock and Talk Workshop at UT Health San Antonio...... 46 36. Promoting COVID-19 Health Insurance Literacy...... 47 37. Promoting Patient Education and Chronic Disease Self-Management in Refugees at San Antonio Refugee Health Clinic (SARHC) 2020-2021...... 48 38. Promoting Vaccine Education and Flu Vaccinations For Families Affected by Homelessness at SAMM TLLC...... 49 39. Remote Nutritional Counseling and SMART Goal-Setting...... 50 40. Sunscreen Dispensers in San Antonio, Texas...... 51 41. The New Back-to-School Basics: COVID-19 Hygiene Education for Elementary Students...... 52 42. The Use of a Brief Educational Presentation to Mitigate Commonly-held Vaccine Misconceptions During Two Community-based in Uenza Vaccination Drives...... 53 43. Two’s Company: Interdisciplinary Lessons in Empathic Listening to Hospital Patients...... 54 Outreach
44. An Investigation of the Impact of COVID-19 on Food Access and Security in Bexar County...... 55 45. Art Cart: The Benefits of Art in an After-School Program, 2020...... 56 46. Assessing the Healthcare Needs of the Asian Indian Community in San Antonio...... 57 47. Betelnut Availability and Knowledge Among Ethnic Populations in San Antonio...... 58 48. Bridge to Unity: Connecting Medical Education to the Patients We Serve...... 59 49. Bridging the Diaper Gap Project*...... 60
*Blue Ribbon Winner 2021: 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE 81 Communicating Hope: Delivering Essential Information in a Public Health Crisis
50. Combating Diabetes in the Times of COVID-19...... 61 51. Community Health Assessment and Flu Vaccination Among Vietnamese Americans During the COVID-19 Pandemic...... 62 52. Community Needs Assessment of South Asian Americans in South Texas...... 63 53. Cross-Sectional Analysis of COVID-19 Vaccine Acceptance Among Healthcare Students at the University of Texas Health Science Center in San Antonio...... 64 54. Dealing with Distress from the COVID-19 Pandemic: Mental Health Stressors and Coping Strategies in Vulnerable Latinx Communities...... 65 55. Effects of COVID-19 on Asthma Severity and Social Determinants of Health for Children with High Risk Asthma in San Antonio...... 66 56. Fiesta Youth: A Prospective Mental Health Intervention for LGBT+ Youth...... 67 57. Immunizing Underserved Populations During the COVID-19 Pandemic...... 68 58 Implementation and Evaluation of Pilot Program Providing Patient Navigation to Individuals Experiencing Homelessness...... 69 59. Postpartum Depression Screening and Education*...... 70 60. San Antonio Vision and Eye Studies (SAVES): A Geographic Visualization of Eye Screening Results in Bexar County...... 71 61. Understanding COVID-19 Vaccine Hesitancy Among Healthcare Providers in Bexar County...... 72 62. Yoga for Teen Moms: Prenatal and Postnatal Yoga as a Means to Reduce Stress in Adolescent Mothers...... 73
*Blue Ribbon Winner Sponsors
We recognize this year’s sponsors for helping make this conference possible.
Center for Medical Humanities & Ethics LINC (Linking Interprofessional Networks for Collaboration) Long School of Medicine Office of the President School of Dentistry School of Health Professions
We thank the following sponsors for supporting the Center for Medical Humanities & Ethics Community Service Learning program.
Center for Medical Humanities & Ethics Long School of Medicine Office for Research
St. Luke’s Lutheran Health Ministries, Inc. 14TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
Communicating HOPE Delivering Essential Information in a Public Health Crisis
For more information about the Annual Community Service Learning (CSL) Conference or to download a PDF of this handout, go to texashumanities.org/cslconference.
The evaluation for this activity is available online at surveymonkey.com/r/2021CSLConf or scan this QR code and take the survey now!