Practicum Topics

Serving Size: 1 Practicum per Student Servings per e-Magazine: 43

Hours per Week per Student Approximately 12

Campuses 4

Student Austin Regional Campus

Out-of-School Time Opportunities Mandy Ackerman

Keep Austin Breastfeeding Amy Brandes Improving Nutrition in Migrant Camps Magdalena Hernandez Outdoor Advertising/ Public Health Research Ana Herrera

Refugees and Recreational Needs Amy Hoskins Acute pesticide exposures in Texas Katherine Kantzes Project Development/Creating Change Kelli Lovelace Communication is Key Blaine Mallon After-School Program in Uruguay Irene Parobii Perinatal Hepatitis B Prevention Hailey Rucas

Special Olympics - Special Smiles Bhumit Shah Patient Handoff Research Daniel Thomas

Brownsville Regional Campus

Summer Food Service Program Ileana Chapa Mosquito Trap Database Angel Guevara

Parent Wellness and Health Alessandra Jiménez

Dallas Regional Campus

Gay City Health Project James Bowen Can Pediatricians Help Prevent Bullying? Nia Jones

The BVM Effect Christopher Leba Tobacco Cessation in Dallas Jiesu Lee

The Agape Clinic: Strategic Planning Leigh Logsdon Nutritional Literacy and Knowledge Antonio Lopez

Childhood Obesity Saundra Nguyen

Sickle Cell Disease Research Hellen Oduor

Fever Phobia in Community Care Clinics Reema Patel

Preventing Childhood Obesity Shilpa Patil Childhood Obesity and Nutrition Nessa Philip

Public Health Syndromic Surveillance Romero Santiago

Tactical Emergency Medical Support (TEMS) Thomas Schaeffer

Chemical Contamination of Ecosystems Justin Stuart

El Paso Regional Campus Society, Community and the Individual Jeffrey Mohlman Influenza Types in El Paso Alice Nyakeriga

Public Health Preparedness Hector Ocaranza

San Antonio Regional Campus

Pain Trends in the Elderly Daniel Ayala Active Living Amanda Merck Mind. Exercise. Nutrition. Do It! Benjamin Silva Piloting the PRISm Intervention Nadia Silva Dental Public Health Armia Zaki

STEER: South Texas Environmental Education & Research

Community Outreach Christine Binkley Health on the Texas-Mexico Border Lauren Fanty

Public Health on the Texas-Mexico Border Rebbeka George

Public Health on the Border Rutger Gunther Health on the Texas-Mexico Border Alison Kimura

STEER: Public Health on the Border Sierra Mitchell

Out-of-School Time Opportunities

Teaching a lesson on on My Food Plate, during the camp’s “Health and Wellness” week.

Photo Credit: Pricilla Sanchez

Practicum Highlights

Andy Roddick Foundation: Expanding Learning Opportunities • Teaching students about “My Food Plate”, healthy eating By: Mandy Ackerman portions and how to plan a creating community partnerships My main responsibility at the Andy nutritious meal! and developing administrative Roddick Foundation was to assist • Watching the students procedures. The summer program the programs team with the develop and grow throughout served over 70 low-income children development and implementation the summer, especially in their in grades K-5th at Pecan Springs of the Foundation’s pilot of the 5- literacy, relational and health Elementary School in East Austin week summer learning program knowledge skills completely free of charge. Many focusing on STEM themes, physical of the children attending the fitness, healthy eating, relationship school would have not have been building and literacy. In order for able to afford a high quality the camp to run, I played a huge summer learning program role in scheduling activities, otherwise.

Public Health Significance Inform, educate and empower: Advice for Future students and families through Over half of the achievement gap comprehensive health and STEM Students between lower- and higher-income focused curriculum students can be explained by • When helping launch a unequal access to out-of-school Evaluate: effectiveness, opportunities. As a result, low- accessibility and quality of out-of- brand new youth program, income students are less likely to school programming flexibility and open- mindedness are both key graduate from high school or enter Research: insights and innovative qualities. college (Alexander et al, 2007). It is solutions to how to target summer therefore essential to expand out- learning loss • Take advantage of of -school learning opportunities in opportunities to network order to promote positive health, Develop policies and plans: that and partner with other social and educational outcomes, support students and community community organizations health through out-of-school especially for low-income children. and nonprofits. programs

Summer 2014 ● Mandy Ackerman ● Andy Roddick Foundation● Out-of-School Opportunities

KEEP AUSTIN BREASTFEEDING

In addition to many health benefits from Special Project- breastfeeding, it has been • estimated that if 90% of US Created a card to distribute infants were exclusively to Austin moms to help breastfed for 6 months, the them assess if they need US would save $13 breastfeeding help with billion/year in healthcare phone numbers and costs. (Pediatrics, 2010) websites for assistance

• 6,000 cards will be printed to distribute to safety net clinics and hospitals in English & Spanish Graphic Courtesy of

http://www.foodandhealth.co m/clipart.php/view/170/

Lessons Learned- IT TAKES A VILLAGE TO SUPPORT BREASTFEEDING MOMS • Say yes to every opportunity By : Amy Brandes during your practicum for the best, most unique For my practicum, I worked with the clinics & produced online education experience. Austin/Travis County Health and for the clinics. • In public health, our job is Human Services Department in the I worked on marketing tools & a never complete--which Chronic Disease area. Specifically, I communication plan. I prepared a makes it hard to leave the worked on one objective as part of the card for clinics to give moms to work behind on weekends Community Transformation Grant. That determine if she needs breastfeeding and evenings. objective was for health clinics to help and who to call if she does. I also • It’s important to find a way support patients with breastfeeding up created a pamphlet to advertise the to leave it behind for your to 1 year. online education to clinics & created a own well-being. I was the 4th UTSPH student to PowerPoint summarizing our work for participate in this practicum. The the Breastfeeding Summit in Austin this others initiated a work group, created August. a sample policy & guideline for the

HELPING MOMS MEET THEIR FEEDING GOALS

At this point in the project, most of the PowerPoint to educate their own work done on the breastfeeding associates on how to care for portion of the Community breastfeeding moms.

Transformation grant is assuring a The card created helps the clinics competent public health & personal know where to send moms for health care workforce. additional breastfeeding help.

Austin/Travis County is looking for Sometimes being competent means Breastfeeding is best for the opportunities to educate the safety net knowing where to send a client for environment too—no clinics regarding the benefits of more assistance. packaging, no water used & breastfeeding and the role the clinics no waste. The Austin/Travis County Health have to support breastfeeding moms. Department is committed to helping all Austin/Travis County will present at the moms meet their own breastfeeding Graphic Courtesy of Breastfeeding Summit in hopes of goals. http://www.amadori.org/breastfe motivating clinics to adopt breast- edingart/html/frames/framesetall. feeding supportive policies & to use the htm

Summer 2012 ● Your Name ● Practicum Site ● Practicum Topic Summer 2014-Amy Brandes-Austin/Travis County-Breastfeeding

Improving Nutrition in Migrant Camps

Special events

• Successfully obtained ration cards for 30 individuals • Conducted workshops on pre- natal care,

reproductive health, and nutrition and farming • Enrolled 10 girls in primary and secondary school

Nutrition video from UNICEF which I used in my lesson about nutrition.

Advice for Future Improving Nutrition in Migrant Camps in Rural India through Students Education

By: Magdalena Hernandez • Working with government I also worked with government officials officials in India is very I worked on helping improve the to discover government schemes complex, especially in rural nutrition in rural migrant camps in which could help improve the areas where there is a lack Northern India. nutritional status in the camps. of personnel for the various As a community development I worked with the individuals in the services. I would tell future organization, I worked with other interns camps to register them for ration cards interns to just be patient, to conduct a basic health assessment which provided with cheaper food, sometimes some things work in the camps, which showed a lack of such as rice, beans, and flour. out, and others don’t. knowledge of basic nutrition, pre-natal and post-natal care, and reproductive I also conducted various health health. education workshops in the camps, which were highly enjoyed due their technology component.

Public Health Significance

My practicum contributed to the public health by diagnosing the needs Through the support of my organization I was able to empower the individuals in health education, inform and educating the community, and linking in camp to seek governmental services individuals to services. which are offered to them. It was really rewarding to go through Through the survey that I conducted I the tiring process of obtaining ration was able to understand which health cards for the migrants, which topics we as an organization needed contained a lot of problems since they to discuss within the migrant camps. were migrants. Thankfully everything Through the use of videos and hands- Demographics displayed at worked out and now they have access on activities I was able to fully engage Chief Medical Officer Office to cheaper food, which should help in all members of the community in at Zonal Hospital in improving nutrition among the camps. discussion of these topics- some which Dharmshala, Himachal are a bit controversial, such as Pradesh. reproductive health.

Summer 2014 ● Magdalena Hernandez ● Himachal Pradesh, India ● Nutrition

Outdoor Advertising/ Public Health Research

Special events/ duties during your

practicum

• Completed several community visits to compare and contrast media outlets. • I learned how to use two new computer programs, ArcGIS and FileMaker Pro.

Advice for Future

Source: “Fast Food Targeted Marketing, 2012-2013”. Yale Rudd Center for Food Policy & Obesity. Web. 27 July Students 2014.

Outdoor MEDIA (Measuring & Evaluating the Determinants • Take the initiative to reach

& Influence of Advertising) II out to those who work in your field of interest. Every year, BILLIONS of dollars are spent to (Texas) as well as Merced and Santa Clara • advertise unhealthy products including fast (California). The study aims to determine No one is born an expert, food, alcohol and tobacco products to the whether fast food, alcohol, and tobacco take the time to learn about public. While recent research has shown that media advertisements differ by county? the topic(s). fast food, alcohol and tobacco advertising in Race/ethnicity? And socioeconomic status? • Don’t be afraid to ask for periodicals and television are linked to help. As a graduate research assistant, my duties overweight, obesity and other harmful health • Stay organized and be included: conducting literature reviews, behaviors, there is limited research that attending project meetings, preparing aware of deadlines. investigates the influence of outdoor media progress reports, supervising undergraduate advertising on health status. research assistants, and composing/revising a The Outdoor MEDIA II project will document data collection tool to be used for future data This is me at the Prevention Research Lab. point of sale ads in three counties: Austin collection on outdoor advertising.

Public Health Significance

My practicum experience related to the The Prevention Research Lab at the following Essential Services of Public University of Texas at Austin conducts Health: research focusing on health and risk

behaviors among adolescents and  Monitors health status to identify college age students. community health problems. Research findings from this study can be  Informs, educates, and used to produce cost-effective and empowers people about health sustainable public health policies and issues. programs.  Assures a competent public Overall, health research can lead to health and personal health care improvements in healthcare and public workforce. health by providing important  Researches for new insights and information about disease trends and innovative solutions to health risk factors, outcomes of public health problems. interventions, and more.

Summer 2014 ● Ana Herrera ● The Prevention Research Lab at The University of Texas at Austin ● Public Health Research

Refugees and Recreational Needs

Highlights

• The privilege of hearing the stories of newly arrived refugees and being welcomed into their homes.

• A picnic for staff, volunteers, and research study participants at Mueller Lake Park.

Bhutanese Nepali

Community in Austin. www.marykang.com Advice for Future Students Recreational Needs & Barriers Experienced by Refugees By: Amy Hoskins • Create a detailed timeline Explore ATX program that matches a and stick to it. Don’t forget Texas is the top destination for refugees refugee with a volunteer to assist them to build in time for arriving to the U.S., and Refugee in exploring the Austin community. unexpected delays. Services of Texas (RST) provides • Choose a practicum site resettlement services to many of them. First, I conducted a literature review RST asked me to study the recreation and developed an interview guide. where you’d like to work. You might receive a job needs and barriers experienced by Then I interviewed adult refugees from newly arrived refugees residing in Bhutan, Burma, and Iraq and gathered offer. Austin. RST recognizes that recreation is data on their recreational experiences. an important component of Lastly, I created a report on the findings community integration, health, and and made recommendations for the well -being. They recently created the Explore ATX program.

Public Health Significance

T his practicum was related to the summer, study participants attended a following Essential Services of Public picnic in their community. They met volunteers at their apartment Health: research, educate, and empower. The majority of my complexes and traveled together on

practicum involved research. This the bus to the park. Ideally, the park included developing, implementing, visit and bus training will empower clients to travel to the park on their own and analyzing one-on-one interviews that obtained both quantitative and in the future.

qualitative data on a subject that was RST provides other essential public lacking research. Upon completion of health services. These include the Refugee Services of Texas logo. www.rstx.org interviews, I educated clients on following: mobilize community recreational activities in their partnerships and action, link people to neighborhoods. At the end of the needed personal health services, and assure a competent workforce.

Summer 2014 ● Amy Hoskins ● Refugee Services of Texas- Austin ●Refugees and Recreational Needs

Acute pesticide exposures in Texas

Non-occupational pesticide exposures reported in Texas, a descriptive analysis.

By: Katherine Kantzes My final product was a descriptive I worked for the Texas Department analysis which examined age, of State Health and Human severity, and other variables related Services, in the Epidemiology and to pesticide exposures in Texas. The Toxicology section. Specifically, I majority of calls were regarding worked with the Department’s PEST children, yet an even greater Program to address a gap in their majority (over 90%) could be knowledge. Occupational classified as “non-serious” events. exposure to potentially-toxic pesticides has been documented, Special events/ but non-occupational calls to the Texas Poison Control Network had duties/highlights not been examined. during your I worked with two senior-level practicum epidemiologists and a partner with - I networked with senior level the TPCN to tabulate and examine state employees differences within the non- - I learned how to use Microsoft Children can easily get into occupational exposures, and household chemicals (photo provided a report at the end of the Access to create complex courtesy of babyworld.co.uk). project. queries

Public Health Significance Advice for Future Practicum Students Embrace ambiguity. This project did not have clearly The Public Health Essential Service(s) (PHES) that most defined scope or steps at the beginning. I found that if I kept closely relates to my practicum experience is research the overall goal and purpose of the project in mind, I was and investigation of a potential public health able to take small steps each day towards a rewarding problem. experience and a quality report for my practicum site. My project in particular looked at an issue that is widely assumed in the public to be highly toxic and threatening - acute pesticide exposure. I investigated who was exposed, in what situations, and whether or not these exposures represented a serious public health problem and to whom. Descriptive analyses of problems like these are common in DSHS, and are efforts to direct resources towards public health issues if warranted. In this case, my analyses might actually help to dissuade fears Caption describing picture or graphic. Include source. about acute pesticide exposures, as so few of the calls resulted in serious consequences.

Lessons Learned [OR] Advice for Although few exposures resulted in severe outcomes, Futureit’s still Students important to protect kids from potentially fatal harm by appropriately labeling and storing chemicals. (photo courtesy of healthykids.org).

Summer 2014 ● Katherine Kantzes● Texas DSHS ● Pesticide Exposures 2000-2013

Project Development/Creating

Change

Special events

• The IT’s TIME TEXAS SUMMIT brought together health advocates in a 2-day inspirational and educational conference • The Summit was a great opportunity to see the reach of the organization throughout Texas

Promoting health in a community near you. Healthy Choices for Life. (2014). Canadian Cancer Society. Retrieved from: https://secure3.convio.net/ccssk/site/SPageServer/?pagename=MARCH_living_resources

Advice for Future Students Provid e a descriptive TITLE here (What would the article title be?) By : Kelli Lovelace • I’d recommend jumping in head first and taking The projects at ITT address nutrition and IT’s TIME TEXAS (ITT) is a non-profit in initiative at your practicum – Austin whose mission is to empower physical activity in both youth and the practicum is a chance people to live healthier lives and build adults to get real world work healthier communities. The organization has built and continues to The project I worked on during my experience in a field that grow their cause by bringing together practicum was the development of a you see yourself in. Take full mobile phone app that will be a community of empowered advantage! individuals and organizations to create instrumental in helping to grow the and support a social change social movement among individuals in movement throughout Texas. Texas communities. The app will help to link users with opportunities to be healthy nearby and hopefully increase demand for such activities

Public Health Significance

My practicum gave me experience change. An educated, informed and with the Essential Public Health Services empowered public, mobilized for a

to “inform, educate and empower” as common cause can have great power well as to “mobilize”. These functions of to influence both corporate and public health are very closely related governmental policies that, in turn, to the mission of IT’s TIME TEXAS – the provide the structure for a healthier mission, to create a cause, is a unique community. and extremely valuable one in the field of public health because social IT’s TIME TEXAS has successfully built empowerment and education link the relationships with organizations such as research and diagnostics involved in H-E-B and Blue Cross Blue Shield of defining disease to policy change. As a Texas. It has been very valuable for me student of health promotion I find this to see the ways in which these It’s Time Texas Logo. (2014). to be the most thrilling and crucial step important relationships are nurtured Retrieved from: to effectively making public health and maintained. www.itstimetexas.org

Summer 2014 ● Kelli Lovelace ● IT’S TIME TEXAS ● Project Development

Communication is Key

A map showing the 8 regions of health Special events/ departments in Texas duties during my

practicum

• I was able to travel all over

Texas and meet multiple https://www.dshs. leaders of the field. state.tx.us/upload • I took part in the weekly edImages/Conte “Epi conference call” which nt/Regional_and_ discusses current outbreaks Local_Health/rls/rl hs-map-big.jpg

Advice for Future Students An Epidemiology Coordination Plan for the Ages

By: Blaine Mallon • Never be afraid to jump into is extremely important. This plan also the unknown and make phone The state of Texas is one big state, eases the burden of surge capacity, so calls to organizations or health therefore a three tier system is in place when a department needs help during departments with your direct for health departments (local -> region a major outbreak, they know who to - > state). Even though we have so interests in public health. Most call and what resources are available. many health departments, every all are welcoming and appreciative of help on a department has their own methods to We had a total of four meetings across achieve the same result. the state with many representatives project that would work for you from various health departments. Each practicum. Be proactive! This coordination plan was designed to meeting built upon the last in regards be used as a guideline so that to what should be in the plan. everyone is on the same page. Lessening the time gap for information

Public Health Significance

This practicum was highly involved in developing a new plan to coordinate food/waterborne, respiratory, vaccine preventable, etc. all efforts regarding infectious disease epidemiology of health departments This coordination plan could be a very withi n the state. important resource to health I worked in the Emerging and Acute departments. The key to coordination Infectious Diseases branch, specifically is good communication, especially in the Infectious Disease Control Unit. during a large outbreak where time is of the essence. A healthy Texas is a This unit monitors all infectious diseases and deploys resources as requested by happy Texas! regional and local health departments. Vibrio, one of many infectious biological agents under the Ther e are many different genres of surveillance program. infectious diseases including www.enfo.agt.bme.hu/drupal/ sites/default/files/Vibrio cholerae.jpg

Summer 2014 ● Blaine Mallon ● Texas DSHS IDCU ● Epidemiology Coordination Plan

After -School Program in Uruguay

Special events/ duties

• Students also worked on a mural project during the after-school program, and it was wonderful to experience the planning process as well as student involvement with painting! Classroom • Having a hands-on role with

this program and getting to Photo courtesy of interact with students was Irene Parobii. very special.

Increasing Physical Activity and Preventing Tobacco Use Lessons Learned Among Adolescents • It is okay to be flexible! There By: Irene Parobii are many elements to public While in Montevideo, Uruguay, I a week. Students also wore health work that require assisted with the implementation of an accelerometers for a week during patience and flexibilty,

after -school program for middle- the implementation of the program. especially when adapting a school aged youth. This program took In addition to aiding facilitators with program in a global setting. place in 2 different schools and the activities, my duties also involved facilitator-led physical included initializing accelerometers activities, icebreakers, and activities to and distributing/collecting them build connections between students. from students. I also helped with the

distribution of self-report surveys on Student physical activity was physical activity and tobacco use. In measured before the start of the addition, I am working to enter and program by the use of analyze accelerometer and survey accelerometers, which were worn for data that will be used to evaluate the program. Public Health Significance My practicum experience was part also contributing largely to the of a larger grant-funded research Public Health service of research. project, “Activate Ya!”, so one Furthermore, my practicum site essential Public Health service that aimed at mobilizing community my practicum site provided was partnerships in Uruguay to identify Student mural; photo courtesy research for solutions to health and solve health problems in a of Irene Parobii problems. The host organization in sustainable way, in this case, Uruguay that worked in preventing youth smoking by collaboration with the research increasing physical activity, school project was The Center for the connectedness, and supervised Investigation of the Epidemiology time after school. of Tobacco (CIET), an organization

Summer 2014 ● Irene Parobii● Montevideo, Uruguay ● After-school Program in Uruguay

Perinatal Hepatitis B Prevention

Practicum Make sure to Highlights check your hepatitis B status • I identified over 30 when you are pregnant women who pregnant. Protect were not already in your baby. the perinatal hepatitis Source: Captionhttp://www.acph describing B program. Provide caption pictured.org/perinatal - • My response rate from hepb.aspxdescribing the healthcare image/photo. providers was above Include source. 90%.

Identification of Pregnant Women Diagnosed with Hepatitis B By: Hailey Rucas

In my practicum, I worked with the labs are coded to designate the Infectious Disease Control Unit within person is pregnant, but many others the Texas Department of State Health are not. My job was to call the Services to identify pregnant women healthcare providers listed for the who tested positive for hepatitis B and positive lab results with no information refer them to the perinatal Hepatitis B about pregnancy to determine the Advice for Future program through the state. pregnancy status of the women. The list of women was given to the perinatal Hepatitis B is a reportable disease in the program. Practicum Students state of Texas so any labs that come back positive are put in a database at After, I looked into the trends of the • Take every opportunity to the health department. Many of the data. sit in on meetings or learn what it is like to have the job you want to have to Public Health Significance see if it is something you could see yourself doing The Public Health Essential Service the spread of disease to protect the (PHES) that aligns the closest with what and enjoying. population. If the baby develops I did at my practicum are monitor and chronic hepatitis B, which is much more link. Since I identified pregnant women likely the younger hepatitis B is throughout Texas, I was helping to contracted, he or she will have the identify community health problems. By opportunity to spread it to other referring the pregnant women to the people and have to suffer from chronic perinatal hepatitis B program, I was hepatitis B. “linking” them with the services they needed in order to prevent the The Infectious Disease Control Unit is transmission of hepatitis B to their responsible for monitoring infectious children. diseases and investigating outbreak s to prevent transmission within the state It is important to public health to stop of Texas.

Summer 2014 ● Hailey Rucas ● Texas Department of State Health Services ● Hepatitis B Positive Pregnant Women

Special Olympics - Special Smiles

Volunteers at Special events/ Special Olympics duties during your Special practicum Smiles event teaching • how to I had the opportunity to properly meet with Dr. Steve Corbin, brush. a major influence within Source: Special Olympics, and one http://resources.spe cialolympics.org/To time Chief of Staff for the pics/Healthy_Athlet es/Disciplines/Speci Surgeon General al_Smiles.aspx • Also, meeting with Dr. Timothy Shriver, he is the son of Eunice Kennedy Shriver, the founder of Special Olympics, and one of the

Addressing the Lack of Adequate Oral Care in the leaders within the organization. Intellectually Disabled Population Advice for Future By : Bhumit Shah Students My internship this summer was at as well as partnering with dental care Special Olympics International. The providers to provide treatment for the Persistence is the key to focus of my project was on the issues detected during the screenings. I success. On the same token evaluation of the oral health program evaluated the cost benefits of the you have to avoid being called Special Smiles. The program is program, and I found that the money obnoxious. Also, build conduct ed all across the United States. that can be saved by providing the relationships before you need The oral health issues among the free screenings, and basic tips on help. People are more likely to intellectually disabled are greater than proper brushing leads to potentially help when you know you. among the general population. Due to millions of dollars in savings. The results this disparity, Special Olympics provides show that investing in health promotion free screenings during sporting events and prevention can lead to savings.

Public Health Significance

The Public Health Essential Services play an environment that supports change an important role in the work that I do that may reduce the disparities with

at Special Olympics. Of the 10 main the intellectually disabled population. services the following are the ones that Mobilizing community partnerships to play a significant role. Monitoring the solve health problems is also a major health status of the intellectually role played by Special Olympics. For disabled community is one of the major example, partnering with roles of the organization. It helps to medical/dental care providers to offer guide the advocacy and free services. Research and evaluation programming efforts of the play an important role as well where I organization. Informing, educating, worked during my internship. We work Volunteer providing dental and empowering both the to collect and analyze information, services during a Special Smiles intellectually disabled and the general and then use it to offer solutions and event. population. These efforts help to create guidance. Source:http://specialolympicsblog.wordpr ess.com/2011/11/21/free-dental-care-at-a- day-for-special-smiles/

Summer 2014 ● Bhumit Shah ● Special Olympics International ● Oral Health

Patient Handoff Research

Does standardizing the handoff process help? By: Daniel Thomas I joined the Patient Handoff Team at hit a few snags along the way. My Seton Family Healthcare. Their goal final product for the Handoff Team is to promote a standardized is a document listing the work done handoff tool called DRAW. My task to date on the project including the was to conduct seminal research in proposal and all documentation the field of patient handoffs. once authorized. I am continuing my work with the team to complete Miscommunication during patient the research post practicum. handoffs lead to patient safety

issues and is a concern nationally. The belief is that standardizing the Special events/ handoff process will limit these duties/highlights adverse outcomes. during your This summer I hoped to conduct research highlighting the effects of practicum • First-hand experience with standardization on handoffs. My role was to develop and take a change management proposal from conception to • Networking opportunities Photo Courtesy of Daniel Thomas fruition. As with most research, we among stakeholders in the hospital

Public Health Significance Lessons Learned & Advice for Future Practicum Students My practicum covered many of the essential public health services: You can plan all you want, but many times events occur • A purpose of the handoff team is to diagnose that are unexpected. This is true of the public and private and investigate patient safety issues caused sector. The key is to roll with the punches and continue by poor handoffs. working hard. • The handoff team also educates all new associates on the use of DRAW.

• They assure that associates are knowledgeable and equipped with DRAW.

• Another goal of the organization is to evaluate the effectiveness of the tool.

• This is where my research came into the picture. My goal is to provide one of the first studies that show quantifiable evidence that standardizing the patient handoff impacts the ability to provide an adequate handoff.

• These essential services provide the patient Photograph of a Baton Handoff. N.p., population a reduction in the incidence of n.d. http://www.worshipmatters.com/tag/worshipgod09/ adverse health outcomes due to CaptionWeb.21 describing July. 2014. picture or graphic. Include source. miscommunication between healthcare providers. Patient handoffs are similar to a baton handoff. When transferring care of one patient to another, healthcare professionals must exchange a breadth of information to ensure that the patient has a safe experience.

Summer 2014 ● Daniel Thomas ● Seton Family Healthcare ● Patient Handoff Team

Special event during my

practicum

• I attended “Ladders of

Opportunity” an event hosted by Brownsville Mayor Tony Martinez and Photo credit: http://www.fns.usda.gov/nslp/national-school-lunch-program-nslp the City Commission where government Feeding Low-Income Children Across America officials from the U.S. Department of Agriculture By: Ileana Chapa District. My preceptor was Dr. Rose (including Audrey Rowe -

This summer I had the Gowen, one of Brownsville’s City Administrator of Food and opportunity to experience the process Commissioners at large who is very Nutrition Services) were of implementation and promotion of involved in the promotion of health present to discuss two of U.S. Department of Agriculture’s programs and events for the city. partnerships to improve child nutrition programs- The Summer Food Service Program (SFSP) and the I contributed with feedback and the SFSP coverage as well Seamless Summer Option (SSO-for suggestions in order to increase program as to discuss and learn school authorities only). coverage for children next year and about federal programs to

provided feedback on the school’s assist business owners, During this experience, I summer menu in order to create farmers, ranchers, children worked closely with the Food and awareness about the advantages as Nutrition Service Director of the well as areas of improvement regarding and others. Brownsville Independent School school meals.

Public Health Significance

reach children through their summer The mobilization of community programs; UT School of Public Health Lessons Learned partnerships and action to identify and Brownsville Regional Campus- to solve health problems was the essential increase awareness through media • It is difficult to get everybody public health service that I relate to advertising and City Commissioner to cooperate fully in helping most from my experience. In order to Rose Gowen to encourage support ensure that children in need are being from other local authorities; among programs such as these. targeted and that healthy meals are others. • The school district being provided, local authorities and administrators are willing to community organizations need to be make changes if enough aware of the issue low -income support is provided from the children and teens are facing and community and create partnerships to promote health by providing free healthy meals. organizations. Some of BISD’s partnerships include: Parks and Recreations- to

Summer 2014 ● Ileana Chapa ● Summer Food Service Program

Mosquito Trap Database !

! Practicum Highlights

• Attended an American Red Cross Shelter Fundamentals

Mosquito Trap Database. Consists of trap training course to prepare on locations,! what types of trap were used, how to operate, maintain, and times traps were set up, types of mosquito close a shelter during a disaster. species! caught, how many of each mosquito! species were caught, and ! graphs to show patterns in mosquito • Attended the South Texas population.! Hurricane 2014 Conference to !! network and interact with DSHS, Photo Credit: http:// !www.iconarchive.com/show/ios7-icons- ARC, TCEQ, Fire and City Health by-icons8/Animals-Mosquito-icon.html Departments and http://www.iconarchive.com/show/ !mac-folders-2-icons-by-hopstarter/Folder- Advice for Future Mac-icon.html ! Students A Database to Quantify and Identify Mosquito Species in • Always ask questions to ! several public health !Cameron County for the Past Decade professionals and community

By: Angel Guevara leaders to expand your knowledge and resources My! practicum site was the Cameron a quantitative and identification of • Network and communicate County! Department of Health and mosquito species from ten years of trap !Human Services under the guidance of records and lab results of possible with as many public health !the Chief Epidemiologist and Public mosquitoes carrying diseases from May organizations for opportunities Health Preparedness Program Director. 2014 - July 2014. • Remember to have fun and ! that everything is an The public health issue I addressed was By creating a mosquito trap database, experience the need of creating an electronic the department will be able to identify mosquito! trap database after Cameron patterns, alert the community of County! had a Dengue Fever outbreak in potential mosquito born diseases, and !November of 2013 . enter/edit new data more efficiently. The final product is a mosquito trap database I! began to create a mosquito trap that can continue to built upon. database at the department by detailing Public Health Significance !My practicum experience relates to the 4. A research tool for analyzing !following Essential Services of Public emerging mosquito-borne disease Health: outbreaks locally and how they relate ! to national mosquito-borne disease 1. Monitoring mosquitoes by year, ! outbreaks and research potential month, species, and amount present vaccines. ! across the county based on traps set ! weekly. In addition, know if this is local Utilizing my database, public health ! or a travel acquired disease. professionals can analyze the quantitative and identification of 2. Diagnose and investigate cases of mosquito species to a specific time individuals who may have mosquito- ! period. If there’s a significant rise in a A mosquito gravid trap. borne diseases. ! mosquito population, we can alert the Another type of trap yet 3. Inform, educate, and empower the public early to take precautions and rarely used by the Health ! Department was a light population on how to prepare, prevent an outbreak. trap. Photo Courtesy of prevent, and understand mosquito- Angel Guevara borne diseases.

Summer 2014 ● Angel Guevara ● Cameron County Department of Health and Human Services ● Mosquito Trap Database!

Parent Wellness and Health

Special events/ duties during your

practicum

This is an invitation for • Organizing the MEND IDEA Public Schools 5K3, the 3rd annual 5K program to begin in our and Health Fair. The lower RGV region event was hosted this • Understanding the habits of year in Lyford, TX IDEA parents through their Parent Choices in Health and Wellness at IDEA completed parent surveys.

By : Alessandra Jiménez

but demonstrable changes are Advice for Future IDEA Public Schools has recently made an effort in improving the health and anticipated in scheduled assessment Students wellness of students and the for the upcoming school year. community at large. Evaluation of parent health habits • Be very focused when expressing your practicum’s To extend the goals of this organization resulted in the following of parents parent health habits were assessed, surveyed. goals. It will give your time purpose and your success health activities, recommendations on 1. 17.5% exercised with their how to improve health habits were children three or more times a measureable. included in weekly newsletters, and week IDEA worked in partnership with community organizations to adopt a 2. 7.4% parents consumed family obesity reduction program vegetable three or more times called MEND. a day Post implementation progress was not 3. 35.6% of parent drank no sodas measured to assess change overtime, in the week the survey was completed

Public Health Significance

Monitor/ Evaluate: Time spend at IDEA Public Schools was spent appropriate and included in the summer wellness magazine. monitoring the health habits of parents and sought to change the Mobilize: A program was adopted

habits by including to help with identified problem of recommendations and activities in childhood obesity in schools by the weekly parent newsletter providing classes to parents and Inform Education and Empower: families that would improve their Lists of activities that could be health and that of their children. Picture was taken by Elizabeth done in school and in the Parents participated in the health Garcia a parent of IDEA students community were provided in the and Farmer at IDEA Frontier in fair and 5K scheduled in March weekly newsletters and a summer 2014. Brownsville, TX. IDEA parents, activity list that were regionally children, faculty and staff routinely participate in farm activities

Summer 2014 ● Alessandra Jimenez● IDEA Public Schools ● Parent Health and Wellness

Gay City Health Project

Side projects and other tasks

 Assisted with medical records data analysis and reporting to King County

Public Health.

Located in Seattle, WA, “Gay City Health Project is a multicultural gay men’s  Attended collaborative health organization and the leading provider of HIV and STI testing in King meetings with King County County.” Their stated mission is “to promote wellness in LGBT communities by Public Health to provide providing health services, connecting people to resources, fostering arts, and input on potential building community.” implementation of - GayCity.org electronic kiosk system for registering Wellness Center clients.

 Researched HIPAA-

Wellness Center and community mobilization projects compliant web-based By James Bowen client self-scheduling software to improve I worked on three projects: demand between 5-6 pm is exceeding health care accessibility supply. These insights should improve 1) Quality assurance survey and preserve privacy. scheduling, the client reminder system, This will be used to gather Wellness and client access to care. Center client feedback. 3) Community mobilization Advice for future 2) Client utilization study Gay City is currently using a community practicum students I analyzed Wellness Center client mobilization grant from King County  Because my practicum utilization by entering appointment Public Health to fund their was self-designed, my scheduling data into Stata (no-shows, #myHIVmoment social media intended final products cancellations, peak times, campaign. I gathered and organized appointment types, etc.). Major hundreds of photographs and changed dramatically findings: clients that schedule online comments from everyday individuals after I arrived at Gay City are less reliable than clients that for use in the campaign. The campaign Health Project and was schedule via phone; and appointment can be found at myHIVmoment.org. better able to assess the needs of the organization.

While this initially worried Essential public health services rendered me, my faculty sponsor 1) Quality assurance survey Link people to needed personal health provided reassurance services and assure the provision of that modifying one’s Evaluate effectiveness, accessibility health care when otherwise goals is fairly common and quality of personal and unavailable. after arrival at a population-based health services. practicum site. 3) Community mobilization Assure a competent public health and personal health care workforce. Inform, educate and empower people about health issues. 2) Client utilization study Mobilize community partnerships to Evaluate effectiveness, accessibility identify and solve health problems. and quality of personal and population-based health services.

Gay City photo from GayCity.org Caduceus graphic from ipharmd.net/images/caduceus-medical-logo-rainbow.png

Summer 2014 ● James Bowen ● Gay City Health Project ● Wellness Center and Community Mobilization

Can Pediatricians Help Prevent Bullying?

Practicum Goals

• Learn about public health insurance for children in TX, including CHIP and Medicaid Caption describing Provide caption picture • Learn methods for describing qualitative research image/photo. Picture courtesy of Paradigm Malibu, an adolescent treatmentInclude center source. • Analyze data and for teens struggling with all types of behavioral challenges. help write manuscript for study- Can http://paradigmmalibu.com/teen-bullying-8-sneaky-signs-its-occurring/ Pediatricians Prevent

Bullying? A Collaborative Approach to Bullying Prevention By: NIA JONES

This summer, I worked on a qualitative the methods of qualitative research research project in the Division of and applying that knowledge to actual General Pediatrics at UT Southwestern. data sets. By the time the summer Lessons Learned The project focused on analyzing data was over, I was able to finish a draft of from focus groups conducted with the the results section of the manuscript • Tackle projects that are parents of adolescents. 3 groups of and a draft of the introduction section intimidating. I was both parents were interviewed: parents of of the manuscript. Also, at the excited and intimidated bullies, parents of victims, and parents of conclusion of my time, I felt well at the thought of writing children uninvolved with bullying. I spent equipped to conduct qualitative parts of the manuscript, most of my time on 2 tasks: learning research in the future. but it turned out to be a

great learning Public Health Significance experience. The Public Health Essential Service prevent bullying. This insight may help that most closely relates to my shape guidelines for how pediatricians • Ask for help when you experience is “research for new approach the subject with families. need it. Your community insights and innovative solutions to preceptor is there to health problems.” This is directly The research done in the Division of help you, and it will save related to my project because my General Pediatrics is at the you time in the long run. goals were to learn about and intersection of medicine and public contribute to research. For example, health. Many of the physicians the results of the study I worked on conducting research in this division will add insight on what parents think are both clinicians and principle pediatricians should be doing to investigators for various studies.

Summer 2014 ● Nia Jones ● UT Southwestern Medical Center Division of General Pediatrics ● Bullying Prevention

The BVM Effect

Practicum Highlights

 Worked as an integral member of the research team in all steps of the project. • Actively applied multiple disciplines of public health (particularly biostatistics) The bag-valve mask appears to be the during the length of the most effective airway adjunct in out-of- practicum. hospital cardiac arrest. http://www.phecit.ie/PHECC/Publications_and_Resources/Newsl etters/Newsletter_Itmes/Spring_2012/Cardiac_First_Response.aspx Lessons Learned

The BVM Effect: Airway Management in Out-of-hospital Cardiac Arrest  Be flexible and adapt to Christopher Leba unforeseen circumstances. Do not get discouraged if survival is improved in those patients The most appropriate airway obstacles arise. Stay the receiving bag-valve mask (BVM) management strategy in the treatment course! ventilation rather than advanced of out-of-hospital cardiac arrest airways. (OHCA) remains to be determined. We reviewed recent literature regarding This “BVM effect” appears to persist the association between the types of despite variations in geographical airway management used in OHCA region, patient population, and CPR and survival to hospital discharge. quality. We recommend that a prospective randomized study be The majority of the research reviewed conducted in the prehospital setting in regarding the care of the patient order to explore this finding and its suffering from OHCA indicates that causation.

Public Health Significance

This project related to several of the implemented in prehospital cardiac components of the Essential Services of arrest in different communities. Public Health. We hope our findings will be As a research project, the practicum instrumental in promoting further experience endeavored to reach new research and possibly future changes insights into OHCA airway in prehospital guidelines that can management, particularly the improve OHCA patient survival. presence and nature of the "BVM The BVM is a basic airway Through its widespread presence, the effect." adjunct capable of "BVM effect" is a significant ventilating a patient This was a vehicle to evaluate the phenomenon that warrants further quickly and effectively. effectiveness of different airway investigation and analysis. http://commons.wikimedia.org/wiki/File:Amb management adjuncts currently being u_Bag_valve_mask.jpg

Summer 2014● Christopher Leba ● Parkland Emergency Department ● The BVM Effect

Tobacco Cessation in Dallas

Studying the Effectiveness of Mobile Apps to Special events/

Increase Smoking Cessation Rates duties/highlights By: JIESU LEE during your During this summer, I worked to practicum reduce tobacco smoking in the • Screening and talking Dallas community. I completed with patients the Parkland my practicum at the Businelle Hospital Tobacco and Kendzor lab studying the Cessation Clinic effectiveness of a mobile phone • Learning to start my own app in reducing smoking relapse. databank, work with My job included screening for SPSS, perform data eligible participants, collecting analysis and present the final outputs to others. data, and performing data analyses for previous studies in Lessons Learned regards to tobacco cessation and health behaviors. [OR] Advice for The final product I will produce Future Practicum will be a poster and perhaps a Smoking is the number 1 preventable cause of Students research paper that talks about death in the US. Much work can be done to the effect that sleep quality at reduce smoking rates. • I came into medical quit date has on the smoking school wanting to Schwartz, Nanci. "Smoking Cessation Video Helps become an relapse rate at weeks 4 & 12 after Doctors Encourage Patients to Quit." PRWeb. The ophthalmologist but this quitting. It seems that better CommConnection, 27 June 2012. Web. 18 July 2014 experience has been quality sleep is correlated with great to broaden my higher probability of success in horizons and opinions. quitting smoking.

Public Health Significance My practicum experience was related to monitoring the general health statuses of the Dallas community, informing/educating & empowering people about tobacco cessation, linking people to needed tobacco cessation and health services, evaluating effectiveness of different cessation interventions as well as researching for new insights into tobacco cessation. Most essentially, this practicum showed me how clinical research is used to assess whether a new tobacco cessation intervention The lab studied the effectiveness of multiple program increases the success rate such that physicians and tobacco cessation therapies- including the tobacco cessation professionals can gain useful tools to help their provision of small financial incentives (black patients more effectively. Furthermore, no single intervention will line) based on abstinence status which turned be successful for all individuals. Multiple diverse therapies need to out to be helpful in promoting tobacco be available to reach a broad and large range of people who cessation in addition to regular Parkland need help in quitting cigarette smoking. therapies (broken line).

It was great to see how research is used to gather data that will Businelle, Michael S., Darla E. Kendzor, Anshula Kesh, later be used to provide new education materials to those who Erica L. Cuate, Insiya B. Poonawalla, Lorraine R. want to quit. Reitzel, Kolawole S. Okuyemi, and David W. Wetter. "Small Financial Incentives Increase Smoking Cessation in Homeless Smokers: A Pilot Study." Addictive Behaviors 39.3 (2014): 717-20. Web.

Summer 2014 ● Jiesu Lee ● UTSPH Health Promotions & Behavioral Sciences Lab ● Tobacco Cessation

The Agape Clinic:

Strategic Planning News: • July 8: After teaming up with Dr. Mitschke from UT Arlington, we received IRB Stephanie Bohan, approval for our patient survey.

Agape’s Executive July 29: We have a total of Directive, and I are 70 completed patient ready to get down to • surveys in English and Spanish. business. Advice for Future Students: • It takes several reiterations to create a survey. It is key to start early, so the survey is written at an appropriate Planning for the Future: A Free Clinic Story grade level for patients, By: Leigh Anna Logsdon translated into the appropriate languages, The mission of The Agape Clinic lesions, present my findings to is to provide quality health care services attending dermatologists, assist in asks the right questions,

to the underserved. Regardless of a procedures, recruit volunteers, organize and obtains IRB approval. • patient’s race, ethnicity, gender, sexual the inventory, and keep the inventory Everybody can teach you orientation, religion, disability, or social up-to-date. As a public health student, I something. While class, Agape’s doors are open to all. have developed a patient survey and working at your performed a dermatology chart review. practicum, listen to the In order to help the clinic plan for the future, I joined their Strategic This combined experience has patients’, nurses’, and Planning Committee. In this position, allowed me witness patient needs first- staffs’ experiences. This is I’ve had both clinical and public health hand as well as through surveys and essential for community- responsibilities. As the medical student charts. These patient needs will help us based research. manager for the Dermatology Suite, I decide the future areas of growth for the take dermatological histories, examine clinic.

Public Health Significance The clinic and my project share The dermatology chart review two main goals: (1) understanding how allows us to understand the patterns of to link people to needed personal health patient’s place of birth, diagnosis, services and (2) assuring the provision procedure, biopsy result, prescription,

of health care when otherwise and follow-ups. This data helps us unavailable. I’ll elucidate how my provide more culturally competent care, responsibilities at the clinic are based prepare for future care, and stock the upon these goals. most needed medications.

Our patient survey was While working in the designed to assess patients’ medical Dermatology Suite, I am directly

needs, medical coverage, preventative involved in providing free care to health, demographics, use of clinic underserved patients. All of these I’m standing next to our services, and overall satisfaction of the aspects of my summer have been very Dermatology Suite, where clinic. This survey will help us fulfilling. I hope that they have helped we see 12-17 patients each determine the barriers and unmet the clinic and its patients. Saturday. medical needs of our patients.

Summer 2014 ● Leigh Anna Logsdon ● The Agape Clinic● Strategic Planning

Nutritional Literacy and Knowledge

Assessing Nutritional Knowledge and Literacy Among Food-bank Participants in the City of Dallas By: Antonio Lopez Studies show that people with low health literacy have a higher risk of developing chronic illness and malnutrition. The goal of the project was to assess the baseline nutritional literacy (NL), nutritional knowledge (NK), and health/weight perception of food-bank clients from Crossroads Community Service and North Dallas Shared Ministries in the city of Dallas.

Three surveys were administered to each participant. The results show that food bank clients have low NL and NK. There are no differences between Food North Dallas Shared Ministries’ Pantry Stamp Participants vs Non- – http://www.ndsm. org/food-pantry participants (P= .068 for NL and P= .962 and NK). There were no differences when clients were Practicum compared in terms of previous Highlights nutrition classes (P= .565 for NL and P= .332 for NK). • Had the opportunity to create and translate surveys.

• Learned the IRB approval Public Health Significance process. • Developed long term Diagnose and investigate: a complete characterization of food- relationships with bank clients in general, and Food Stamp Program/Supplemental community partners. Nutrition Assistance Plan participants in particular had yet to be conducted with regards to nutritional knowledge and literacy.

Monitor: health and weight perception of food-bank clients from Crossroads Community Service (CCS) and North Dallas Shared Ministries (NDSM) in the city of Dallas was measured. Advice for Future Crossroads Develop policies and plans: thanks to this study a nutrition Community Practicum Students Services – education program would be created. We not only will base it on the results obtained, but also on the resources available at each http://www.ccsdall • If you are starting a of our partner sites. Information was also collected with regards to as.org/Pages/defa project form scratch the types of nutritional programs some of our participants had ult.aspx make sure you complete receive at other organizations, this information can provide us all the necessary with some examples for methods to avoid. paperwork for IRB approval on time.

Summer 2014 ● Antonio Lopez ● CCS and NDSM ● Nutritional Literacy and Knowledge

C HILDHOOD OBESITY

PRACTICUM HIGHLIGHTS

• The practicum allowed me to really be immersed in the community. It was fun interacting with the parents

and seeing the kids react positively to our healthy recipes. • I enjoyed learning about the research process starting at survey development to statistics. BrighterBites provides 30 lbs of fresh produce weekly to each participating families. Source: Salud America!

ADVICE FOR FUTURE THE BRIGHTERBITES PROGRAM: A Fruit and Vegetable Intervention STUDENTS By: Saundra Nguyen

For my practicum, I worked with distribution of fresh produce, along • One thing that I learned about public health is to be the BrighterBites pilot program in with corresponding education and Dallas: learning about program a “fun food experience”, ultimately flexible and to take planning and implementation, helping to curb the childhood ownership! Things will not go coordinating a food drop site at a obesity epidemic. as you expect, and nothing local community church, and My duties included attending will be handed to you on a conducting a program evaluation meetings with BrighterBites and the silver platter. It is a lot of to assess the impact of the 7-week North Texas Food Bank, preparing work but it is meaningful! summer progam. weekly recipes, developing a BrighterBites is a fruit and vegetable survey, and evaluating the impact program that aims to impact of the program. eating behavior among

predominantly low-income families by introducing them to a routine

P UBLIC HEALTH SIGNIFICANCE

The BrighterBites Program seeks to Texas Food Bank) to identify and inform , educate and empower solve health problems, specifically low-income families about the the problem of food access and nutritional health benefits of fruits nutrition. BrighterBites works with and vegetables. The schools and the food bank to get donated community sites that they partner produce (or produce at heavily with are required to implement a reduced prices). By reducing nutrition education curriculum (i.e. barriers (cost and availability) and the CATCH program), and a empowering the community with bilingual handbook is provided to nutrition knowledge, fruit and the parents weekly. vegetable consumption behavior can be positively impacted. In addition, the program mobilizes community partnerships (the North A variety of donated fruits and vegetables are distributed weekly at community sites.

Summer 2014 ● Saundra Nguyen ● BrighterBites Dallas ● Childhood Obesity

Sickle Cell Disease Research

Practicum Highlights

• Seeing patients with a genetic disease being cured.

• Meeting scientists Caption describing Provide caption working at the world picture renowned National describing Institutes of Health. image/photo. Include source.

The National Library of Medicine, world's largest collection of medical literature. Photo credit: National Institutes of Health

Myocardial Iron Overload in Sickle Cell Disease (SCD) By: Hellen Oduor

I worked at the National Heart, Lung & My duties included abstracting Blood Institute (NHLBI) in the Sickle medical records, contacting other

Mortality Prevention Lab, under the healthcare institutions, literature review, supervision of Courtney Fitzhugh, MD. and compiling reports of my findings to present to my lab. I wrote a manuscript My project entailed documenting the and presented my findings on a poster. effects of excess iron [from chronic Lessons Learned blood transfusions] on the heart in Outside of my project, I attended patients with SCD, as well as clinical grand rounds and meetings, [OR] interventions to reverse these effects. I saw patients at the clinic alongside my did a retrospective analysis on a few mentor, attended research Advice for Future patients at the NIH. conferences, and participated in a journal club. Practicum Students

Public Health Significance • Write down your objectives. Articulate The two Public Health Essential Service(s) what you want to get out (PHES) that most closely relate to my I am contributing to a body of scientific of your practicum from practicum experience are: evidence that can be applied in the very beginning. Be clinical practice. • Inform, educate and empower proactive. people about health issues. My host organization as a whole • Research for new insights and contributes to public health by serving innovative solutions to health as the biomedical research nerve problems. center for the US. Among the many innovations at the NIH, the lab I worked The findings from my project are useful in with has found a cure for a genetic that they inform and educate illness. healthcare professionals on a topic surrounded by controversy and anecdotal reports. Through my project,

Summer 2014 ● Hellen Oduor ●National Institutes of Health ● Cardiac Iron overload in SCD

Fever Phobia in Community Care Clinics

Duties during Practicum

• Researched and gathered data on parents’ knowledge of fever management at Taking your child’s temperature community clinics. and calling the primary care • Provided recommendations

physician is one method of fever on how to better educate management. families on fever and fever

Picture drawn by Reema Patel management.

Addressing Fever Phobia and Fever Management Among Parents Advice for Future By: Reema Patel Practicum Students

During my practicum, I interviewed 30 Emergency Department (ED) for fevers and what methods they use in parents whose children are patients at • Be patient. Much of communicating to patients about three different MyChildren’s clinics that research involves waiting fevers. are associated with Children’s Medical and you might not get the

Center Dallas. I inquired about parents’ data you want right away. knowledge, beliefs, and concerns After interviewing patients and • There is always room to add about fever along with what available physicians, I analyzed qualitative data questions you want to ask resources are used for fever for the development of public health management. initiatives and provided during interviews. These recommendations for how to better additional questions will help Physicians at the clinics were also address fever phobia and fever you get the most out of your interviewed and were asked why they management in primary care clinics. research. believe parents tend to utilize the

Public Health Significance

illnesses by providing educational My practicum experience relates to the Public Health Essential Services (PHES) in materials to parents and physicians on terms of informing and educating fever management. patients and conducting research. Research is the main service that Educational materials include relates closely to my practicum since I displaying Fever Posters in patient collected data on fever knowledge waiting rooms, streaming short videos in physicians’ clinics that depict ways from patients and physicians. parents can treat fevers at home, and

developing a smartphone or tablet Children’s Medical Center Dallas The Injury Prevention Department at app that parents can use to answer Emergency Department Children’s Medical Center Dallas is medical questions. These working to understand fever phobia Picture taken from The Office of the recommendations will better address and reduce ED visits on non-urgent home management of fever in Governor http://governor.state.tx.us/disabilities children. /awards/apa_gcpd_accessibility_aw ards/ Summer 2014 ● Reema Patel ● Children’s Medical Center Dallas: Injury Prevention Department ● Fever Phobia

Preventing Childhood Obesity

Healthy Bite, Future Bright! Go BrighterBites!!

By: Patil Shilpa Our duties –

We served Brighter Bites is a project partnered with the North Texas Food Bank to • Over 200 families per week bring healthy choices into the homes, minds and mouths of the • Families enrolled in children and their families in the summer programs with Dallas county area. children from ages 4 – 16 Brighter Bites serves the low income • On an average, pou families of the Dallas communities population was 90% by providing 30 lbs of fresh Hispanic and 7-8 % African produce per week for 8 weeks. American Along with the produce, we provide nutritional information and recipes for healthy snacks which were provided to the children Lesson learned every week. Such features are thought to be helpful in curbing • Having a lofty goal is better obesity rates in these communites. than having none. As a site coordinator, I take care of Nutritional Information Handout- the activities like selecting and Every week children receive. • Good thought with procuring produce, bagging and persistant efforts can become a reality for the distribution. Additionally, I am better community. involved in the program planning for the upcoming school year 2014- 2015. Final results of the level of impact Brighterbites had on communities is being determined.

Public Health Significance

BrighterBites has substantial Public Health significance, as it is rooted in the belief that if we provide children with something better to “munch on”, they will. And the life they lead will be as vibrant as the food they crave for. Lisa Helfman, one of the founders of BrighterBites realised that by informing children with healthier choices, we can educate and empower them. This is one of the healthier way to prevent childhood obesity, which is a pressing issue in U.S. The program primarily target children in the age groups, who attend elementary or middle school. This is believed to be a perfect age to shape NTFB Truck Delivering Fresh Produce their thoughts. Providing proper information and education along with fresh at the Casa Linda Project Site – Shilpa Patil produce can empower them. Such behavioral lessons make them self- efficacious which will enable them to make correct choices in the future. BrighterBites attempts to does this by removing the socioeconomic barriers of access to quality fresh produce. The program partners with NTFB and Schools to target the issue of obesity and tries to bridge the gaps in the broken food system. Food banks supports in mobilizing sources and the schools enable outreach to the children in ‘food desert’ regions. With help of these partners; program planning, implementation and evaluation becomes possible.

Summer 2014 ● Shilpa Patil ● Dallas County ● Preventing Childhood Obesity

Childhood Obesity and Nutrition

Special events/ duties during your

practicum

Watching Fed Up (2014) had a • Viewing and discussion of shocking impact the documentary, Fed Up on the kids. While • Conducting a focus group watching, they with their caregivers stopped drinking their sodas and eating popcorn. CBC News

Lessons Learned Evaluating impact of KidsEat! program on nutritional knowledge, attitudes, and self-efficacy • Find a project or work site that you’re passionate By: Nessa Philip about, instead of worrying To evaluate the program, I adapted I worked at the South Dallas Cultural about convenience. This pre- and post-test surveys and Center to evaluate the KidsEat! experience can help you conducted a focus group to determine program, a nutrition intervention in whether the program increased discover what you love which educational activities inspired nutritional knowledge, attitudes, and about public health and participant-written theater self-efficacy. Results showed that the create lasting partnerships performances by Soul Children’s adolescents had improved attitudes and community networks to Theater Company. and self-efficacy toward healthy help you in future projects. This program was aimed at curbing eating after the program. childhood obesity in southern Dallas I created an oral presentation, neighborhoods through hands-on abstract, executive summary, and activities dealing with healthy eating. poster as part of my work.

Public Health Significance

My experience with the KidsEat! potential to multiply its impact by program matches the 9th Essential connecting nutrition education of its participants with the peer-to-peer Public Health Service: to evaluate health services, by determining the education tool of theater.

effectiveness of an intervention Even though South Dallas Cultural combining nutritional education and Center does not focus on public health t heater, which has not been previously issues, they developed the KidsEat! studied in the literature. program to address the issue of limited food access in southern Dallas My project contributes to public health by demonstrating the effectiveness of neighborhoods, which leads to reliance South Dallas Cultural Center an innovative solution targeted to a on unhealthy options served at empowers the community well -known issue, that of childhood convenience stores and fast food through local partnerships obesity. The KidsEat! program has the restaurants, to increase awareness of and arts programs. the issue and provide education. Dallasculture.org/SDculturalc enter

Summer 2014● Nessa Philip● South Dallas Cultural Center● Nutrition Program Evaluation

Public Health Syndromic Surveillance

The Houston S pecial Events/ Duties Department of Health & Human during practicum Services • Helped prepare Informatics headquarters presentation for the dept.

where I was • Helped analyze data for rash & located during salmonella outbreak my practicum, • with me & my Learned how data is sent to knowledg eable health dept. from hospitals mentor (Mr. • Toured Houston lab facilities Wesley McNeely, • Led conference calls with tech MS, MPH on right). & customer service reps, Photo taken by: learning about HL7 messages. Alina Perez

(secretary of division)

Secondary Uses of Syndromic Surveillance in Public Health By: Romero Santiago

As a Bureau of Epidemiology intern at websites to ascertain the various Source: the Houston Dept. of Health & Human categories of drugs, all classes besides http://www.who.int/workforcealliance/members partners/member list/isds logo gif Services, I was responsible for building opiates used as exclusion criteria. For Sequel (SQL) database code consisting our MERS query, about 25 admissions of search parameters that I used to remained where MERS could not be Lessons Learned query the database of emergency ruled out. • Jurisdiction is critical department admissions for rash, MERS, • Meaningful use criteria I created MERS and opiate overdose and opiate overdose. For MERS, we first spurring expansion of data code that can be utilized and refined looked at CDC’s SAS code written for sharing networks (EHRs & as case definitions become more Biosense (their surveillance system) as a hospitals coming on board) starting point to identify MERS- specific. I presented my work to the • Informatics critical to public indicative search terms. For opiate group and wrote a short paper about health’s progress to predictive overdose, we looked at articles & secondary uses of syndromic surveillance (original use: bioterrorism). analytics • Introducing myself to dept.

Public Health Significance members helped me involve My main syndromic surveillance fortunate to observe a few outbreak myself in a breadth of projects directly relate to PHES #1 investigations. These cases are divided activities to understand public (Monitoring health status) as queries between the Foodborne, Vector health practice are constantly being run with the SQL borne, and Zoonotic teams. code built to see if there are any unexpected increases in conditions According to the CDC, MERS is such as “Rash” or that are categorized associated with a 30% mortality rate as Neurological, GI or Respiratory within and has spread to numerous countries a particular area, using zip code data. via travelers. Also, drug overdose is now the highest cause of mortality in the However, this nicely parallels traditional U.S., most of these related to opioid surveillance methods utilized in overdose. Thus, syndromic surveillance outbreak investigations (PHES #2 – is important in that real-time data can Diagnose and Investigate). be used to detect outbreaks before

Epidemiologists contact numerous traditional surveillance, allowing control Source: case patients per day and I was http://www.cdc.gov/mmwr/preview/mmwrhtml measures to be mobilized earlier. /figures/su5301a3f.gif

Summer 2014● Romero Santiago ● Houston Dept. of Health & Human Services● Public Health Syndromic Surveillance

ill

Tac tical Emergency Medical Support (TEMS)

Practicum Events and Duties

• Research the history, utility, and popularity of TEMS. • Train to operate within potentially hostile environments, while I (left) practice applying a tourniquet to a fellow rendering medical aid to classmate (middle) during a tactical first aid combat casualties. course. The instructor looks on (right). Photo taken

by Defensive Mindset. L essons and Advice for Future Students

• TEMS is a relatively new and P roviding TEMS to Law Enforcement Operations dynamic field of emergency By : Thomas Schaeffer medicine, requiring Second, I attended several training dedication and a desire to My practicum involved the provision sessions in the DFW and San Antonio help those who serve. of pre-hospital medical care to law areas that taught me basic tactical • Do not choose a practicum enforcement officers during tactical strategies in regards to caring for simply because it is operations. Three aspects allowed me patients in austere environments. available. Pursue something t o become better acquainted with this that genuinely interests you, unique theory and practice. Finally, I rode along with members of the Dallas PD, allowing me to observe even if you have to create First, I conducted research, the challenges that law enforcement an experience from scratch. producing summaries of approximately officers face on a daily basis. 30 academic manuscripts that my m entor and I hope to use to compose Law enforcement is a dangerous a review article of our own. job, requiring unique medical support.

Public Health Significance

Tactical law enforcement officers constantly being evaluated. The provide communities with an important research that I conducted this summer service. In order for medical personnel will hopefully be used to inform public to keep operators fit and healthy, health officials as to the current status several essential public health services of TEMS, its growing popularity, and must be realized. potential areas for improvement.

Community partnerships must be The responsibilities of TEMS personnel mobilized. This typically includes cross include providing tactical teams with Logo representing Tactical Combat training medical personnel (physicians, preventative medicine and Casualty Care (TCCC) and Pre- paramedics, etc.) so that they may emergency treatment in hostile Hospital Trauma Life Support, key support law enforcement operations. situations and coordinating plans and aspects of TEMS. Retrieved from: First Response Training Group, LLC. strategies with hospitals and traditional The policies and plans developed http://www.firstresponsetraininggro EMS. These serve to maintain the by tactical medical personnel are up.com/naemt-courses.html operational integrity of the team.

Summer 2014 ● Thomas Schaeffer ● UTSW/Dallas PD ● Tactical Emergency Medical Support (TEMS)

Chemical Contamination of Ecosystems

UTSPH Dallas Environmental

Health Research

• Arnold Schecter, MD, heads up the research division for environmental health at the Dallas Regional Campus • My responsibility this summer was to help synthesize several manuscripts for publication in journal Barrels of Agent Orange at Johnson Atoll circa 1976 (source Wikipedia)

Lessons Learned Epidemiological Investigations of Biopersistent Exposures By: Justin Stuart • Performing epidemiological research as part of a Human activities have always worldwide team is difficult been found to essentially never released waste into the environment, because of competing decompose, and traces of it can be but in the last century with the advent goals among individual found in all foods. of advanced organic chemical researchers. synthesis methods, novel chemicals A similar compound is dioxin, a • To survive in research such with unknown effects contaminate the contaminant of the Agent Orange as this, a practicum student herbicide that was sprayed during the world’s ecosystems at alarming rates. has to be patient, flexible, Vietnam War.  One harmful chemical that has been and willing to compromise. in the news is DDT, an insecticide first The newest environmental contaminants include BPA, a type of synthesized in 1874 that was sprayed in large amounts throughout the world for plasticizer, and PCBs, a type of flame malaria and typhus control. DDT has retardant used in electronics.

Public Health Significance

 For most countries in the world, a chemical can be manufactured, sold, of Agent Orange, recently agreed to pay $93 million in fines as a result of and used freely so long as no adverse health effects can be demonstrated. contamination, although they still deny their chemical has any link to birth The burden for chemical exposure defects. then becomes the responsibility of  environm ental epidemiologists who BPA has been voluntarily removed from the plastics used in baby bottles. seek to link chemical exposures to health effects, sometimes require PCBs are still used in almost all decades of follow-up before a computer circuit boards, and PCB dust Birth Defects Presumably Caused chemical is removed from the market. has been found to be present in nearly by Intrauterine Dioxin Exposure. everyone’s residence. PCB is a Monsanto Corporation, manufacturer (Source: Lovacore Del Munco suspected estrogen disruptor.

Summer 2014 ● Justin Stuart ● Dallas Regional Campus ● Chemical Contamination

Society, Community and the Individual

Sugary Beverage Educating the Education at Jose Public on Sugary Damian Elementary Beverages School. I presented education on Photo Source: sugary beverages to Jeffrey Mohlman approximately 100 third

graders and 100 fourth graders. Students also listened to each other’s’ hearts using stethoscopes.

Researching Breast Public Health’s Significance in Medical Practice Cancer in the

By: Jeffrey Mohlman Hispanic Population

During my time in the Society, My Public Health Projects: • Because of my time learning Community and Individual course at epidemiology and the Paul L. Foster School of Medicine I • Food Day event to provide learned the importance of public education to elementary students biostatistics in this course I health in the practice of medicine. I about sugary beverages. was able to research Breast now know how culture, family and the Cancer in the Hispanic community can impact an individual’s • An original epidemiological Population and will be health. I also understand epidemiology research project about breast presenting the research in and biostatistics better. Finally, I can cancer in the Hispanic population. Tampa, FL at a conference. now converse a bit easier in medical Spanish. My time in the course • El Paso Immunization Coalition- prepared me to apply what I learned social media organization. to various projects.

Public Health Significance

My practicum, the Society, triple what they were one generation Community and Individual course and ago, I hope activities like this can make my projects relate to the essential a difference for our nation’s health. services of public health in various By establishing the social ways. First of all, my research in breast media websites for the El Paso cancer has allowed me to investigate Immunization Coalition, I mobilized health problems in the El Paso community partnerships to identify and community. I learned that it takes solve health problems. We are striving team -work and hard-work on the to link the community to useful individual’s part to take an observation education and resources to have a and turn it into quality research that is healthy, immunized community. presentable. I hope that I can continue I am thankful for the to enjoy researching important information learned during the course Caption describing picture or medical and public health topics. and practicum. I am glad I had the graphic. Include source. The sugary beverage opportunity to apply some of the education course we presented to the principles and essential services of elementary school students allowed public health in my projects and plan The Breast Cancer Ribbon me to inform, educate and empower Source: graysanatomycast.info people. With childhood obesity rates to do so in my future career. Summer 2014 ● Jeffrey Mohlman ● Paul L. Foster School of Medicine ● Society, Community and the Individual

INFLUENZA TYPES IN EL PASO

Practicum Highlights

• Summarize secondary surveillance data on OR ? flu in El Paso Caption describing Provide caption • Analyze flu data by picture type and describing demographics in El image/photo. Paso Include source.

• Summarize mortality Is It Swine or Bird flu? Source: World Health Organization rates by flu types

EXAMINING FLU TYPES & TRENDS IN EL PASO: 2012-2014 SEASONS

By: Alice Nyakeriga My responsibilities involved but were not During this summer 2014, I was doing my limited to summarizing the flu data into practicum with the City of El Paso tables and graphs based on theoretical Department of Public Health, (ELPDPH) epidemiological knowledge that I have garnered during the MPH training. I worked on summarizing Influenza data from the past two surveillance flu seasons: I was able to summarize the data into a 2012-2013 & 2013-2014. report, which I submitted to my community Advice for preceptor, Dr. Gonzalez. The ELPDPH provided me with flu data Future collected by the epidemiology section to The main flu types experienced in the analyze and summarize. county were types A, being responsible for Practicum 48-61% and type B (47.8-34.5%) of all flu Students cases in 2012-2013 and 2013-2014 flu Public Health Significance seasons, respectively. Younger children suffered the highest impact from flu; with • If possible, make Any one season may present various types mortality being mainly due type A prior arrangements of flu and this may vary from season to season. The surveillance of flu helps in the and/or visits to the understanding of the information needed esteemed practicum for action for various services of Public Through surveillance of flu in the site before the Health including: county, the DPHELP is able to prepare practicum time in readiness to provide the necessary begins. This helps in • Assess flu status through diagnosis advice and services to contain flu in El understanding any • To define objectives for action and Paso including: other prerequisites priorities • Diagnosis & monitor flu types that are necessary • and must be met To timely inform the public • Identify and evaluate control before one embarks • Application of data to prevent and measures- provision of flu shots on the practicum control flu/disease. and treatment, itself. • To evaluate interventions & • To monitor isolation activities, if programs in PH practice, and needed provide info to plan & conduct • Disseminate data on flu status research.

Summer 2014 ● Alice Nyakeriga ● City of El Paso Department of Public Health ● Influenza Types and Trends in El Paso

Public Health Preparedness

D uring My Practicum

• As a student, I felt welcomed and I was able to demonstrate what I have learned during my academic studies to other members of the Department. of Public Health • Being proactive and helpful without limitations was beneficial during my practicum experience.

Advice for Future Courtesy of the City of Columbus, Office of Emergency Preparedness. Students http://columbus.gov/publichealth/programs/emergency-preparedness/

• Be part of the team you are Public Health Preparedness Plans assigned to, every person City of El Paso, TX Department of Public Health within the team is important and always learn something By: Hector I. Ocaranza from every person you encounter. At my practicum site I was introduced and imperative to update current plans to bring • Look for a way to contribute assigned to a key element of public health them up to speed with times and threats. something to the team!! preparedness: The Planning. I actively participated in the revision of The existing plans for the City of El Paso current plans and was involved, along with Public Health Preparedness required the division personnel and higher revisions which were aimed at providing a management, in the updating process of fresh perspective as well as incorporating such plans to bring them up to date. contemporary elements into the existing plans. I would like to share that no matter how you prepare, there is always room for Current times bring new threats to the improvement and lessons to learn from community and new challenges as how to adverse events that would lead to a approach a specific situation, therefore it is continuum disaster management circle.

Public Health Significance Influenza Virus Colored Electron Microscopy Picture. The City of El Paso Department of Courtesy of CDC.gov Public Health performs all 10 essential The plan that I enjoyed the most was services of public health; however the Crisis and Emergency Risk each of the division within the Communication (CERC). This plan was department performs one or several of redesigned and expanded focusing the services. on delivering specific information during an emergency, paying The preparedness division, particularly particular attention to how to reach my practicum experience evolved certain population with special needs. within the development of policies and plans, much needed as guidance in case of a disaster of any nature.

Summer 2014 ● Hector I. Ocaranza ● City of El Paso Department of Public Health ● Preparedness

Pain Trends in the Elderly

In the community… Pain as a multifaceted process. • Pain lectures were given at various senior centers in the WebMD. (2012). San Antonio area. Chronic Pain Causes and Solutions. http://www.webmd.co • Elderly community members m/pain- filled out surveys on pain management/ss/chroni c-pain-causes-solutions management and pain beliefs

Pain study in the elderly reveals current pain myths

By : Daniel Ayala Advice to future students… Literature on pain management has management and beliefs particularly in described several pain myths present in the elderly population. the population. For example, one myth • Have fun! Though some Preliminary data reveals that pain is that pain is a normal part of aging aspects may be tedious, the myths remain widespread and, which is simply not true. Pain is due to importantly, is common in many of the work that is being done to pathological processes, which though participants that were hurting the most. learn and/or help our may occur at higher incidence as one communities is well worth ages, is not a result of aging per se. A Though a larger data set is needed, the the effort. few other pain myths include that pain relationship between inadequate pain medication is inherently bad, that the management and underlying pain elderly cannot reliably report pain, and myths should be further explored. that pain is “all in the head”. A second phase of the study involves An objective of this study was to utilizing an intervention and studying its discover current trends in pain effect on the study population.

Public Health Significance: Essential Services

Key aspects of the 10 essential public A lecture was given at each site as an health services relevant to include: educational service to the community, Investigating health problems, to both give an overview of pain informing, educating and empowering management and to help dispel pain

people about health issues, and myths. Several community members performing research to discover new had questions during and after the insights and innovative solutions to lectures, showing the level of interest in

public health issues. this area.

This project was useful in investigating Finally, research in this area is useful to CDC. 10 Essential Public and uncovering underlying belief gain insight which may lead to relevant Health Services. systems in the elderly population that interventions that could potentially perhaps are contributing to mitigate inappropriate pain http://www.cdc.gov/nphpsp/ess inadequately managed pain. management in the elderly population. entialservices.html

Summer 2014 ● Daniel Ayala ● San Antonio, TX ● Pain Trends in the Elderly

Active Living

Speak Out for Healthy Living with the Active Living Council Special events By: Amanda Merck

• Developed Speak Out for My practicum experience was Healthy Living town hall with the Active Living Council of • Assessed and compiled San Antonio (ALC). Working with findings into a summary the Mayor's Fitness Council report (MFC), and with support from the San Antonio Food Bank and the • Analyzed event and Witte Museum, we developed created a toolkit for the inaugural Speak Out for future events Healthy Living town hall event. • Attended ALC and MFC The purpose of this and future meetings events are to gain public • Attended the Public opinion/input regarding issues Health and the Built that discourage or encourage Environment Conference healthy living in their • neighborhoods in order to apply Attended TEDxSA Food Policy Salon. strategies from relevant societal sectors of the Active Living Plan June 2014 Speak Out for Healthy Advice for Future for a Healthier San Antonio to Living Breakout Discussion Groups. address those issues. I Source: Esparza, Laura. Active Living Practicum Students developed and analyzed Council. interactive surveys in addition to • Become very familiar with public input; I compiled data into the Active Living Plan for a report to be shared with the a Healthier San Antonio. public and with stakeholders; and I created a toolkit to be used in planning future Speak Out events.

Public Health Significance

Through community partnerships, the Speak Out event served to educate people about healthy living opportunities in San Antonio while identifying community health barriers, in order to develop community health plans and policies. My experience most closely relates to the following Essential Public Health Service: inform, educate and empower people about health issues, not only the general public, but also stakeholders and policymakers. The ALC contributes to public health by facilitating and supporting positive change in policy, infrastructure, and attitudes to increase Example of sticker board opportunities for active living. interactive survey method. Source: Esparza, Laura. Active Living Council.

Summer 2014 ● Amanda Merck ● Active Living Council ● Speak Out for Healthy Living

Mind. Exercise. Nutrition. DO IT!

Special events/ duties during your

practicum  Being a part of the first

Project MEND program in the Rio Grande Valley was an honor – not to mention a bit of a sweaty task! Children and their  My first one-on-one families participate interviews as a “researcher” in interactive MEND classroom sessions. showed me the more personal side of community Courtesy of the interventions. MEND Foundation

School of Public Health and community partners help Lessons Learned families fight childhood obesity [OR] Advice for By : Benjamin Silva Future Students Whether I was preparing supplies, Brownsville –I had the privilege to work participating in active play at alongside the faculty and staff at the intervention sites, or interviewing  When delivering community- UT School of Public Health and various parents to help design recruitment based interventions, be groups such as IDEA Brownsville to flyers, I was fully immersed in the prepared for anything! Your implement Project MEND. This process of community lifestyle role may change from day intervention offers teaching, guidance, intervention delivery. to day, but adapt and you’ll and practice to overweight and obese children and their parents on how they My recruitment poster design and be glad you did. can live fitter, healthier, and happier parent interviews will serve to enable lives. the SPH to expand Project MEND here in Cameron County for years to come! From day one, my task list was full!

Public Health Significance

Throughout my practicum experience, I healthier choices throughout their day. was able to participate in providing two of the 10 Essential Public Health The MEND team and I were able to Services. train and equip community partners to

The MEND team and I informed, deliver the Project MEND intervention educated, and empowered children to those they serve. One of my tasks and their families in Brownsville. The was to draft a memorandum of Project MEND intervention offers understanding between the School of Public Health and the Brownsville families education and information about healthy food choices and Independent School District. This task exercise habits. This classroom was among many that were served instruction is followed by active play, these two essential public health which empowers children to make services in the Brownsville community. Courtesy of the MEND Foundation http://www.mendfoundation.org

Summer 2014 ● Benjamin Silva ● UT School of Public Health - Brownsville ● Project MEND

Piloting the PRISm Intervention

Practicum Highlights

This experience allowed me to: • Take part in primary data collection • Explore a different side of Preliminary research took medicine place at the • Understand the practical uses Audie L. Murphy of public health and how to VA Hospital in San apply it in my future career Antonio, Texas.

http://www.southte xas.va.gov/

Advice for Future Piloting the Physician Relationship, Improvising, and Students Sensemaking Intervention

All students: Search hard for By: Nadia Silva something that really interests physicians relate to one another, make The health care system is aimed at you. This can be a fun and sense of what is happening, and improving patient outcomes and enriching opportunity! improvise in uncertain situations. It is increasing accessibility. The purpose of specifically directed at briefings before this practicum and research was to MD/MPH students: Don’t be rounds, debriefings after rounds, and afraid of developing your own evaluate the role of physician teams in the use of STICC (Situation, Task, Intent, practicum. Use this impacting patient outcomes. Concern, Calibrate) framework. opportunity to really explore We began preliminary work in piloting how you can apply public Initial data analysis has shown the PRISm (Physician Relationships, health in your future. implementing the PRISm intervention Improvising, and Sensemaking) may actually reduce rounding times. intervention. PRISm is a communication We are looking forward to the results of tool designed to improve how patient outcomes.

Public Health Significance

The 10 Essential Public Health Services The research focused on improving the efficiency and effectiveness in which as used by the National Public Health Performance Standards Program to health care is delivered to patients. This has important implications for public structure the way health systems are evaluated. health, as it offers a simple tool that is free to use, easily adopted, and is

Developing the research topic at hand widely applicable. required implementing the 1st (monitor) Physician teams play a key role nd Beyond this particular clinical research and 2 (diagnose and investigate) in patient outcomes. Working in project, the VA Hospital System is essential services. However, my a high uncertainty environment involvement with this practicum involved in numerous research projects requires elements of centere d on the 10th essential service: across the nation. The outcomes of the sensemaking, improvising, and research. research done here helps to lay the learning to develop these foundation for many public health effective relationships. initiatives. Image courtesy of Dr. Luci Leykum

Summer 2014 ● Nadia Silva ● Audie L. Murphy VA Hospital ● Piloting the PRISm Intervention

Dental Public Health

Texas Oral Health Metrics Summit

At the summit, I met and interacted with many professionals; dentists, public health professionals, policy makers and dental researchers. It was great to learn that Public Health involves a diverse select of professionals to work on Department of Comprehensive Dentistry (Comprehensive Dentistry) concurrent issues in the http://compdent.uthscsa.edu/ society.

Access to Dental care is Impacted by Insurance Coverage Lessons Learned

By: Armia Zaki Through Diversity, different proven effective to use to learn about I am working with my community opinions and professional a health issue on a short notice, and to preceptor, Dr. Cappelli, and his staff, at advice highlight the success of direct further research to resolve the the UTHSCSA Comprehensive Dentistry Public Health in facing the issue. department, on a research project health issues we have in the exploring the barriers to accessing My involvement in the project will society. dental care with the focus on dental continue even after I finish my insurance coverage. practicum at the end of the summer, and I might get a thesis opportunity in The project has allowed me to apply the same research track of the project! research methods that I learned at school into a real life issue in our society. These research methods have

Public Health Significance

Oral and dental cares are essential for 2. Diagnose and the whole body health. Neglecting the investigate health problems proper dental hygiene could result in many complications in the mouth and and health hazards in the the rest of the body. community.

Dental Public Health focuses on the 3. Evaluate effectiveness, community and works on enhancing accessibility and quality of the oral health in our society. personal and population- Some of the essential public health based health services. services involved in my practicum: 4. Research for new insights and 1. Monitor health status to identify innovative solutions to health Dentists Study Defects to Save community health problems. problems. Faces (225 Years) http://www.225.pitt.edu/story/dentists

-study-defects-save-faces

Summer 2014 ● Armia Zaki ● UTHSCSA Comprehensive Dentistry Department ● Dental Public Health

STEER

South Texas Environmental Education and Research (STEER) immerses health

professions students and faculty in the unique culture and environment of the

Texas-Mexico Border. Our purpose is to reunite Medicine and Public Health.

Each summer, MD/MPH students from San Antonio head to Laredo and Harlingen

to experience first-hand the intersection of public health and medicine through a real world study in environmental health. Read the summaries below to learn about

the STEER program through the experiences of UTSPH students.

http://steer.uthscsa.edu/index.aspx

Community Outreach

A defaced sign posted at the Donna Reservoir, Highlights an EPA Superfund Site, which warns • Meeting and discussing the local fishermen implications of public health from eating the fish as an example in the medical field with Dr. Joseph McCormick, MD, MS of the challenges that arise in • Going to Green Valley attempts to Farms to meet members of promote public the local community and heath. Courtesy of learn of their struggles first- Dr. Noe Garza, DDS, MPH hand

Advice for Future Students Overcoming Environmental Obstacles through Public Health • Be sure to bring a journal community and learn about the with you so you can jot The STEER program, which is short for varying roles of public health research, down interesting things you the South Texas Environmental community outreach programs and learn and see. There are so Education & Research Program, policy in action in the promotion of many different interlacing provides an integrative overview of public health. public health relative to environmental themes that by the end of the month, you’ll be so factors specific to the Lower Rio What stood out from the practicum Grande Valley. most prominently was the necessity of grateful for a written record offering a solution to the community of your experiences! In this practicum, we had the instead of only taking away the opportunity to delve into the problem, like in the case of the Donna complicated web of environmental Reservoir, where local fishermen relied factors that influence the health of a on their livelihood.

Public Health Significance

STEER illustrates how a community uses that people face in the lower Rio all ten of the Essential Public Health Services to effectively assess and Grande Valley in the form of socioeconomic hardships, lack of overcome adverse environmental factors. services, and pollution. To this end, the essential service of For my own project, I was able to informing, educating and empowering expand on the topic of air pollution from tire burnings on the US/Mexico people about health issues most closely relates to the STEER experience. border to provide my colleagues and leaders from the community further We had the opportunity to talk to insight and awareness of the problem An overarching theme of the severa l leaders in the local community and potential solutions. STEER program captured on about the environmental risk factors the program’s t-shirt. Photo courtesy of Dr. Noe Garza, DDS, MPH

Summer 2014 ● Christine Binkley ● Harlingen, Texas ● STEER

Special Events • Intimate conversations with people facing difficulties obtaining health care • A glimpse into life in the colonias • Personal meetings with the Director of Public Health of the City of Brownsville Volunteering with • Exploration of zoonotic Proyecto Azteca to help rebuild a diseases seen on the border ho use. • Lectures from border patrol Source: Dr. Noe • Visits to waste Garza. management and recycling centers

Incorporating Cultural and Environmental Factors into Healthcare • Hurricane preparedness conference By : Lauren Fanty Advice for Future Our lecturers ranged from local Participation in the STEER Program in Harlingen, Texas this summer doctors to concerned parents in Students helped me gain an understanding the area, giving us an introduction • Be open minded and willing of how different aspects of living on to a variety of perspectives. Many to explore the vibrant the border make it an exciting and days we also stepped out of the culture found on the challenging place to practice classroom and into the community- border. public health. In order to more fully we helped sort papers at a • You have the unique experience the South Texas culture recycling plant, assisted an elderly opportunity to hear the and lifestyle, we traveled to a woman in home repairs and obstacles this community variety of work sites such as helped out in other places where faces—listen! colonias, recycling centers and we were needed. community centers. My final research project and We discussed the challenges of presentation addressed the public providing health and health impact of tire piling on the implementing policy in an area border, an issue I had never viewed where communication with as important before participating in STEER. My experiences this summer another country is paramount to success. have helped me become aware of the importance of blending Public Health Significance environmental and cultural awareness with the clinical Assuring a competent public health and personal health care presentation of the illness while workforce. treating a patient. As a future physician and public health worker, Steer sought to increase our critical I feel these qualities will greatly thinking skills and knowledge base enhance my ability to providing by having us consider how competent care to the environmental conditions could be communities I serve. contributing to health concerns.

We were challenged to explore a Visiting a state park that is often different culture and set of beliefs used as a crossing point into the of the people in the area. United States.

Source: Dr. Noe Garza.

Summer 2014 ● Lauren Fanty ● Harlingen, TX ● Border Health

! Public Health on the Texas-Mexico Border

!! ! Practicum Highlights

• Visit the City Public Health Department

• Visit community health centers and meet with STEER participants Promotoras helping out with Caption!describing!a home repair for Help build or repair a Provide!caption! • picture!Proyecto! Azteca home in collaboration describing! with a community image/photo.!! organization Include!source.! • Learn about Border ! Public Health from local public health Border! Public Health: Culture and Environmental Impacts on Health leaders By:!!! Rebbeka George • Visit a Curandero, and !At STEER I had the opportunity to learn This practicum covered a very broad learn about the role of more about the public health issues along spectrum of public health topics that alternative medicine the Texas-Mexico Border. I was able to were specifically relevant to the Texas- with respect to the meet with several public health officials, Mexico border. My duties involved culture and community health workers and attending seminars and volunteering leaders about what they are doing to time to help the community. At the end • Visit the Colonias mitigate many of the health issues. I was of my experience I partnered with also privileged with the opportunity to visit another STEER participant and created a a Colonia, and learn more about their presentation on Migrant Farmworker Advice for Future struggles and achievements in receiving Health. This was a relevant topic as there access to adequate public health is a large population of migrant Practicum Students infrastructure. I was immersed in the farmworkers living in this region. We culture and learned a lot about the found that this population is very • For future STEER students I importance of understanding and underserved, and is still lacking in would like to encourage connecting with the community members adequate healthcare and despite this you to approach every to make a significant impact. knowledge there is little research on this experience and population regarding their health. interaction with Public Health Significance community members with The! two essential public health services The STEER program makes an impact on an open and eager that the STEER program catered to were public health in the community in the mind. Learn as much as informing, educating and empowering sense that we volunteered our time to you can from them, the community, as well as mobilizing the help the community and also visited with because understanding community. This program partners up with members in the community to learn more the members in the many of the researchers to identify health about them and their needs. community and learning problems in the area and works with Specifically, we helped sort through community health workers, Promotoras, to about their culture will material for recycling at the Harlingen help educate the community about how help you to understand Recycle site and also assisted Proyecto to fix these health issues. There is also great how to best approach Azteca with home repairs for a family in partnership with community organizations their public health issues. need. whose missions are to improve the public health infrastructure as evidenced by our volunteer work with Proyecto Azteca.

Summer!2014!●!Rebbeka!George!●!UTHSCSA!STEER9!RAHC!Harlingen,!TX!●!Texas9Mexico!Border!Health!!

Public Health on the Border

Unique The STEER team Experiences helping out a home renovation  We were able to visit a as part of curandera and experience Proyecto Azteca. first-hand some of her People in need alternative medicine can attain brand new homes healing techniques. through sweat equity. • Going to a detention center and seeing the Photo taken by resources required to Ali Kimura support such a system was truly eye-opening.

“Pearl of Wisdom”

Discovering the many faces of public health Be sure to bring a By : Rutger Gunther notebook with you so you can jot down Examples include the border wall, A small group of students with diverse small notes on your backgrounds in public health, such as community health centers, the port of social work and medicine, were able to Brownsville, recycling centers, the daily adventures. work with the Regional Academic landfill, the zoo, and many others. That way you can Health Center at Harlingen in order to While no specific project was review it later and learn more about health issues on the completed, the focus of the program remember how border. was to educate students in a broad each experience Our educational experience lasted spectrum of public health domains. We affected you. only a month but we were able to see came away from STEER with a much many elements of public health that better understanding of health on the were previously unknown to us. border and public health as a whole.

Public Health Significance

When relating STEER to the 10 essential In the coming years, it will become its public health services, it successfully own independent school of medicine incorporated each and every one of further establishing its role in providing them. I think it was incredibly successful better health services to the valley. in its goal to educate young students The Rio Grande Valley is one of the on many public health issues on the most medically underserved areas in border. Texas and in the United States. The The Regional Academic Health Center RAHC plays an enormous role in trying (RAHC) is a sister organization to the to revitalize the community with both main UT Health Science Center of San research and education of future Student practicing CPR on Antonio. Its enormous academic value doctors. I look forward to seeing the patient in brand new state-of- in the Rio Grande Valley makes it a hub future work that will come out of this the-art simulation hospital at for research and education. rapidly growing institution. the RAHC.

Photo taken by Dr. Noe Garza

Summer 2014 ● Rutger Gunther ● Harlingen STEER ● Public Health on the Border

Health on the Texas-Mexico Border

Special events/ duties during your

practicum

• Visit a detention center and learn about an individual’s experience there before deportation • Meet parents raising children with Autism The Regional Academic Health Center, Harlingen, Texas Spectrum Disorder and learn about their challenges http://library.uthscsa.edu/2011/10/ramirez-library/

Lessons Learned [OR] Advice for Health, Hope and Hot Days: Lessons from the Field Future Students By: Alison Kimura engaged with physicians, public health A team of 8 students, including • Be open and receptive to officials, community health workers, medical students, MPH students and a everything you are exposed and members of the RGV community social work student, spent one month in to. Relish this opportunity to gain a holistic view of what life in the the Rio Grande Valley (RGV) studying because it is a great Rio Grande Valley truly means. the environmental aspects of public preparation tool for our health in this region of Texas. At the end of the month, we prepared future careers. a presentation regarding a significant We were introduced to a wide range public health issue in the RGV. These of public health programs and policies presentations ranged from migrant unique to this area, gaining an farm worker inequities to Dengue fever. appreciation for the challenges that the RGV community faces. We

Public Health Significance

The STEER program aims to expose firsthand how health and immigration students to as many aspects of border are intimately intertwined. We were reminded how important the health as possible. Throughout our time, we learned the importance of enforcement of laws and regulations collaboration in both diagnosing, can be in protecting the health of investigating, and treating a public wellbeing of a community; and how hard the balance between protection health problem. We also learned, through meeting with program and compassion can often be. directors, how important policy and Among many other lessons, one of the law can be in their approach to public most profound was about health disparities and the consequences that health mobilization. Through meetings Harlingen, TX is located on the arise from inequities and injustice in with border patrol and advocates of border between Texas and immigrant health, we witnessed health care. We were empowered to Mexico be change agents for better health. http://www.go-texas.com/Harlingen-Travel- Information-DMO/

Summer 2014 ● Alison Kimura ● Harlingen, TX ● STEER

STEER: PUBLIC HEALTH ON THE BORDER

Discovering the link between environment and public health

By: Sierra L. Mitchell For four weeks, a group of peers and I prohibition of fishing which supplies food for participated in STEER Harlingen, which low-income families. We also visited colonias focuses on exposing the environment of the and saw firsthand the unhealthy living border and its effect on public health. There conditions that many families experience. were two main aspects of the environment Lastly we explored the ecological that seemed to have the most impact- the consequences of the border wall and how it cultural and physical environments. has interfered with the migration of local To understand how the culture impacts the wildlife. One of the most shocking discoveries many aspects of public health, we visited a was the reports of multi-drug resistant tuberculosis and outbreaks of dengue on the Maria, one of the daughters of Ms. Castro, local curandera and experts of the Latino border. With limited access to care and standing in front of their home in a local colonia, culture to learn the many influences that resources, there are obvious challenges that Green Valley Heights. Photo taken by Scott impacts their health. Additionally we explored need to be overcome. Dalton/Zuma Press for ABC News. the physical environment by visiting and learning on how its pollution has enforced Public Health Significance STEER Highlights The significant prevalence of various morbidities on the border has fired up the community in addressing the health needs of the • Visiting a local curandera and learning how she uses natural remedies to community. Throughout the STEER experience, it was apparent which cure ailments of members of her community. of the Essential Public Health Services were being addressed and how • Touring the colonias and hearing the compelling story of Ms. Castro and they were going to address them. Firstly, the School of Public Health her family. (Refer to top photo) has been instrumental in the diagnosing and investigating of the health problems of the community. For example, there was a large survey • Learning of the impact of city-wide initiatives in Brownsville designed done in the city of Brownsville in which data analysis was performed to according to research done by the local School of Public Health. help create programs to increase public health education. A large portion of these programs have seen success because of promotoras, A Pearl for Future Students local community health volunteers, who educate their community and During your time in Harlingen, take advantage of volunteering with local in turn empower. We had the opportunity to do a house visit with a organizations of interest. It adds so much value to the experience to be promotora and see firsthand the acceptance they receive in the homes. able to give your time and efforts for the betterment of the border community. W e witnessed neighborhoods band together such as Proyecto Juan Diego which started as a dilapidated colonia and has transformed to a proactive community that advocates for their rights, education, and health. Working through these communities allow for a larger support base when it comes to sparking changes in health behaviors. One of the most exciting developments as a MD/MPH student was the learning of the opening of the new medical school of the Rio Grande Valley. This will not only attract more healthcare professionals to the area, but also increase the availability and accessibility of healthcare services for the community. There is also an impressive clinical research facility that holds biological samples which will serve to attract medical researchers who can work to answer questions that the particular community has such as why is diabetes so prevalent in the Hispanic community and what impact does the environment have in the cognitive and emotional development of the community. Knowing these answers will shape the future of public health.

While their efforts are tremendous and commendable, there is still so Rebekah George (left) and I (right) working on a home with Proyecto Azteca, a much that needs to be done. However, I am encouraged by the sense of community and inspired by those who have dedicated their lives in grass roots organization committed to helping low-income families build serving a much forgotten population and environment. sustainable homes. Photo taken by Lexie Evan.

Summer 2014 ● Sierra L. Mitchell ● STEER: Harlingen ● Border Health

For more information regarding The University of Texas School of Public Health, Office of Public Health Practice and the practicum program, please visit: https://sph.uth.tmc.edu/practicum/