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Public Health-Cubed fall 2015 awardees

The Institute for Public Health has awarded Public Health-Cubed (PH3) grants of $15,000 to eight projects this fall. PH3 is a rapid seed funding mechanism to support cross-disciplinary projects from the Institute’s Faculty Scholars. Funding for fall 2015 projects were awarded to:

Fatal Interactions with Police Study (FIPS)

Team: Cassandra Arroyo-Johnson, PhD, MS; Melody S. Goodman, PhD, MS; Odis D. Johnson Jr., PhD

Using a mixed-methods approach to build a unique database from crowd-sourced and investigative reporting data, this team will examine the impact of race on officer-related shootings and other fatal interactions with the criminal justice system in the United States. One of the aims of this project is to determine if there is an association between whether the officer’s actions were ruled legally ‘justified’ and the race of the victim. Another aspect of the project is to look into the number of officers who are being prosecuted on official charges in instances where an officer has killed a civilian. The team hopes that this analysis will provide a way of better understanding of how racism may be operating at the criminal justice system level to impact health outcomes among people of color.

Availability and Characteristics of Electronic Cigarettes in Guatemala

Team: Patricia A. Cavazos, PhD; Joaquin Barnoya, MD, MPH; Ana Garces, MD, MPH, Francisco Marroquin University, Guatemala

This team will examine the electronic nicotine delivery systems (ENDS) being sold in various retail stores throughout Guatemala City. Specifically, they will describe the retailers selling/marketing ENDS, the variability of these business, ENDS product characteristics, and sales prices. They will also describe fine-grained details about the ENDS including types of ENDS available, brands of these products, manufacturers, flavors of e-liquids, concentrations of nicotine in the ENDS and e-Liquids. The team is ultimately planning to study the impact of various marketing tactics on the ENDS attitudes and use behaviors of Guatemalan youth. In addition, the projects will generate baseline data ENDS that can be used to inform tobacco regulation activities to deter youth from nicotine addiction.

Parenting for Growth and Development: A New Intervention Approach in Haiti

Team: Lora Iannotti, PhD; Patricia Kohl, PhD; John Constantino, MD

This project aims to create and preliminarily test an innovative nutrition and parenting intervention to promote healthy growth and development among young children in an urban slum of Haiti. While there is substantial evidence linking under-nutrition and impaired child development, few studies have tested integrated, holistic strategies to prevent the two associated public health problems. The team will design an integrated child development and nutrition intervention that is premised on Haitian social, environmental, and demographic factors, and take existing parenting behaviors into account as well. This project brings together three disciplines—nutrition, social work, and psychiatry—to create a new approach to child nutrition and development.

Effects of Insurance on Medication Adherence for HIV Prevention

Team: Timothy McBride, PhD, MS; Aimee James, PhD, MPH, MA; Rupa Patel, MD, MPH, DTM&H

Pre-exposure Prophylaxis for HIV (PrEP) is an intensive strategy for HIV prevention among high risk individuals. It is over 92% effective, and real world implementation needs to be studied. PrEP implementation in a Medicaid non-expansion state has not been evaluated in the Midwest. This team will examine the insurance and cost variables associated with PrEP care and medication adherence at Washington University’s Infectious Disease Clinic’s PrEP Program, and then potentially expand portions of this project to PrEP project site partners in in Providence, Rhode Island and Jackson, Mississippi. The investigators will study the correlation of medication adherence and insurance status, and also conduct cost studies related to PrEP use and make inferences about barriers related to insurance status when looking PrEP care across three sites.

Do Citywide Bicycle Path Networks Differ by Socioeconomic Status in Bogota, Colombia?

Team: Diana Parra, PhD; Ross Brownson, PhD; Luis Fernando Gomez, MD, MPH, Universidad Javeriana, Colombia

The public network of bicycle paths in Bogota, also known as “Cicloruta,” is one of the largest in Latin America, with approximately 376 kilometers of bicycle paths distributed throughout the city. The Cicloruta increases bicycle use in the city, but there are some concerns regarding disparities in the design and distribution of the routes, with lower-socioeconomic status areas having fewer routes and poorer design. This situation has not been systematically evaluated. This project aims to document the spatial distribution of the public network of bicycle paths in Bogota, assessing differences by neighborhoods’ socioeconomic status. There is evidence that lower income populations in Bogota have a higher tendency to use the bicycle as a means of transportation, mostly due to economic reasons. Unfortunately the rate of injuries involving bicyclists remains high in the city, and lower income populations could bear most of the burden if the design and distribution of bicycle paths are unequally distributed.

Evaluation of Social Apps for HIV Prevention Research Recruitment among Men Who Have Sex with Men in St. Louis

Team: Rupa Patel, MD, MPH, DTM&H; Douglas Luke, PhD; Aimee James, PhD, MPH, MA

Young adult minority men who have sex with men (MSM) are one of the highest risk groups most likely to get new HIV infections in St. Louis. This population has also not adequately been engaged in HIV prevention research and, consequently, interventions. The project team will use social network analysis to determine ad placement for HIV prevention research on social apps. The study will include a survey component to solicit direct feedback about the advertising from users. Based on data gathered regarding high risk venues, affiliation networks using social network analysis will be generated in order to create a more accurate picture of effective study recruitment methods among minority MSM.

Neighborhood Significance in Breast Cancer Mortality among West African Immigrants in Paris, France

Team: Carolyn Sargent, PhD; Sarah Gehlert, PhD, MSW, MA; Pierre Chauvin, MD, PhD, MPH, University of Pierre et Marie Curie, Paris, France

Washington University faculty have formed an alliance with French physician and social epidemiologist Dr. Chauvin to establish breast cancer mortality differences by immigrant/refugee status in France. The group has developed research questions to advance research on breast cancer and health disparities in France and in the US, and intends to collect data at the neighborhood level to identify mortality disparities. They will focus on the neighborhoods of St. Denis and Montreuil, which have significant French speaking West African immigrant populations from the country of Mali, to determine whether breast cancer mortality increases with West African ancestry when other salient factors are taken into account. This cannot be determined definitively with existing data, because in France, morbidity and mortality by neighborhood is buried in larger sector demographic and epidemiological data.

Differences in Breast Cancer Treatment in a Low-Middle-Income Country, Guatemala

Team: Joaquin Barnoya, MD, MPH; Adetunji Torioloa, MD, PhD, MPH; Edward Gharzouzi, MD, Instituto de Cancerología, Guatemala City, Guatemala

Standard of care for locally advanced breast cancer (LABC) requires neoadjuvant treatment to downstage tumors prior to surgery. However, many low/middle income country patients cannot afford this treatment due its high cost. At Cancer Institute Guatemala, an estimated 50% of these patients never begin or complete treatment. For hormone receptor positive (HR+) breast cancer, neoadjuvant endocrine therapy with tamoxifen (TMX) has proven effective at a much lower cost. This study evaluates the feasibility, adherence, and efficacy of neoadjuvant TMX in a low-resource setting in Guatemala.