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Past Events

Assessing the Impact of Enhanced Primary Care on Health System Performance. A Modeling Study in Singapore

Friday, September 30, 2022  |  9:00 – 10:00 am EDT

John P. Ansah, PhD

Assistant Professor, Center for Community Health Integration
Case Western Reserve University, School of Medicine

Many countries are rapidly aging.  Because chronic conditions are more prevalent with age, the percentage of the population living with chronic diseases has grown.  Many of these conditions, left unmanaged, become complex, leading to increased healthcare demands.  The US-based Institute for Healthcare Improvement has advocated focusing efforts on achieving an optimal mix of services that are individually, and in aggregate, effective, patient-centered, fulfilling for providers, and financially sustainable.

This research presents a comprehensive study in Singapore that aims to assess the impact of enhanced primary care on the quadruple aim of healthcare using a system modeling framework. The study involves the synthesis of the existing international evidence on enhanced primary care through a systematic review, gathering and analyzing epidemiological data to categorize the population into health and social services needs groups, elicitation of patients’ and providers’ preferences for alternative venues of care and a modeling study, that incorporates outcomes from a systematic review, epidemiological research and preference study, to simulates the impact of different policy scenarios on population health, cost of healthcare, patients satisfaction and provider satisfaction. 

Biography

John P. Ansah is an Assistant Professor in the Center for Community Health Integration, School of Medicine, at Case Western Reserve University. His research focuses on the use of computational modeling—with Systems Thinking and System Dynamics Method— as the foundation, to better understand complex health systems issues and inform policy and interventions to improve population health with active stakeholders’ participation.

His research emphasizes the development of simulation models—that are rigorous, evidence-based, and customized to the optimal use of stakeholders— to address strategic and operational health and social care challenges, as well as evaluate health system-wide impacts of complex health and social care interventions to inform intervention development. Broad areas of interest are primary care, chronic diseases, health and social care for the elderly, population health, and health workforce planning. 

Updates from MetroHealth’s Center for Health Care Research and Policy (CHRP) - Speed rounds of research in CHRP

Presentations by Faculty of the Center for Health Care Research and Policy

Friday, June 17, 2022  |  9:00 – 10:00 am EDT

New Hybrid Option: Please join by Zoom as noted above or you are invited to join in person at MetroHealth Medical Center, Rammelkamp Bldg., Conference Room R219.

MetroHealth at this time requires visitors to wear masks. For MetroHealth employees, masking is optional for those who have a "No Mask" sticker (indicating vaccination), otherwise masking is required.


Treatment of Intimate Partner Violence:  Perpetrators & Survivors

Gunnur Karakurt, Ph.D., LMFT

Associate Professor, Department of Psychiatry
Case Western Reserve University

Friday, June 10, 2022  |  9:00 – 10:00 am EDT

Description: IPV is composed of aggressive and violent, physical, sexual, verbal, and psychological acts by an intimate partner. IPV sustained over time may be associated with lasting physical, behavioral, and cognitive consequences.

There exist many treatment models for the prevention and treatment of IPV. Different studies work with different groups of participants and apply different combinations of treatment models in terms of the interventions they use, related co-morbidities such as substance use issues and trauma, and psycho-social outcomes. 

The purpose of this presentation is to investigate the effectiveness of different batterer intervention programs in reducing violence against male IPV perpetrators as well as interventions designed to alleviate the effects of violence on survivors of IPV. 

Biography: Gunnur Karakurt, Ph.D. is a faculty member in the Department of Psychiatry at  Case Western Reserve University. Dr. Karakurt's research focuses on intimate partner violence (IPV), with particular emphasis on the characterization, prevention, and treatment of its physical and mental health consequences. Intimate partner violence is a complex problem that intersects issues from the biological level to larger societal issues interconnecting individuals and families. 

Over the last twelve years, Dr. Karakurt has established numerous research projects to study this important public health problem and has actively sought out and developed collaborative, multi-disciplinary partnerships. She also engaged with community partners to raise awareness and develop strategies to prevent IPV and alleviate its consequences and published her research finding

New Hybrid Option: Please join by Zoom as noted above or you are invited to join in person at MetroHealth Medical Center, Rammelkamp Bldg., Conference Room R219. However, this speaker will be doing a virtual presentation and will not be present.

MetroHealth at this time requires visitors to wear masks. For MetroHealth employees, masking is optional for those who have a NM sticker, otherwise masking is required.


Exploring How to Achieve Health Equity in Cardiovascular Research

Carolyn Harmon Still, PhD, MSM, AGPCNP-BC, CCRP, FAAN

Assistant Professor, Frances Payne Bolton School of Nursing
Case Western Reserve University

Friday, April 22, 2022  |  9:00 – 10:00 am EDT

Description: Discuss explorations of health equity in cardiovascular disease and self-manage research. Explore best practices for adopting health equity approaches.

New Hybrid Option: Please join by Zoom as noted above or you are invited to join in person at MetroHealth Medical Center, Rammelkamp Bldg., Conference Room R219. However, this speaker will be doing a virtual presentation and will not be present.

MetroHealth at this time requires visitors to wear masks. For MetroHealth employees, masking is optional for those who have a NM sticker, otherwise masking is required.

 


The Influence of Socioeconomic Status on Health Trajectories Among Older Long-term Cancer Survivors (Part 1)

Minzhi Ye, PhD

Department of Sociology, Case Western Reserve University

Understanding Disparities in Breast Cancer in Northeast Ohio (Part 2)

Kirsten Eom, PhD, MPH

Postdoctoral Scholar MetroHealth Cancer Center and Population Health Research Institute, The MetroHealth System

Friday, April 22, 2022  |  9:00 – 10:00 am EDT

Description: This two-part presentation by Dr. Ye and Dr. Eom will introduce various ongoing projects that investigate demographic, socioeconomic, and neighborhood-level factors associated with cancer prevention, diagnosis, mortality, and survivorship. Dr. Ye will present on the influence of socioeconomic status on health status among older long-term care survivors and Dr. Eom will present her ongoing work in evaluation of the BREAST/Amigas program, a community-based breast cancer screening program, as well as in understanding influences of neighborhood-level factors and race on triple negative breast cancer. 

 


The Effect of Insurance Status on Inter-Facility Transfers of Trauma Patients: Evidence from the Affordable Care Act's Dependent Coverage Provision

Joseph (JT) Tanenbaum, MD, PhD

Resident, Department of Orthopaedic Surgery, Northwestern Memorial Hospital

Friday, April 15, 2022  |  9:00 – 10:00 am 

Description: Organized trauma systems reduce trauma patient mortality by an estimated 20%. One proposed mechanism is the timely transfer of injured patients to high level trauma centers. However, inter-facility transfers, especially overtriage or the inappropriate transfers of minimally injured patients, impose a substantial and preventable burden on the trauma system.

Observational studies report that under-insurance is associated with greater likelihood of inter-facility transfer. We hypothesize that policies that expand insurance eligibility could reduce inter-facility transfers of trauma patients. The present study leverages the implementation of the Dependent Coverage Provision of the Affordable Care Act to determine whether insurance status drives these inter-hospital transfers.

Presenter Biography: Joseph "JT" Tanenbaum is a current second year resident in orthopaedic surgery at Northwestern, in Chicago, Illinois. A graduate of the MD-PhD program at Case Western Reserve University in 2020, JT studied epidemiology and biostatistics under the mentorship of Metro's own Drs. Randy Cebul, Doug Einstadter, Thomas Love, and Mark Votruba.

Since graduating from CWRU, he has worked under the mentorship of Dr. Anne Stey, a trauma surgeon at Northwestern and faculty member of the Surgical Outcomes and Quality Improvement Center at Northwestern Memorial Hospital. His research interests lie at the intersection of health policy and surgery, with an emphasis on how health insurance influences decision making for surgical patients.

 


 

What’s Cooking? The Role of the Kitchen in Fighting Climate Change and Premature Deaths

Dr. Ther Wint Aung

Environmental Health Scientist

Friday, April 8, 2022  |  9:00 – 10:00 am  

Description:  An estimated 2.6 billion people lack access to clean cooking fuels and technologies, and cook with solid fuels (wood, charcoal, crop residues, and coal) in open fires or poorly vented cookstoves. This results in emission of household air pollution, which is associated with climate impacts and 2.5 million premature deaths, primarily in low and middle-income countries (LMIC).

Aung will present results from a randomized controlled study where she evaluated climate and health co-benefits from the first carbon-financed cookstove intervention in India. She will also share her experiences leading a National Geographic Society funded study where she initiated citizen science air monitoring activities in urban Myanmar. She will share ideas on how knowledge and lessons learnt from LMICs can be applied to future research in other contexts, including disadvantaged communities, in North America.


Stepped Wedge Designs in Practice: What Should We Think Hard About?

Thomas E. Love, Ph.D. 

Professor of Medicine, Population and Quantitative Health Sciences
Case Western Reserve University School of Medicine

Director, Biostatistics and Data Science Division
Population Health Research Institute, The MetroHealth System 
Center for Health Care Research & Policy
Case Western Reserve University at MetroHealth Medical Center

Chief Data Scientist, Better Health Partnership

Friday, April 1, 2022  |  9:00 – 10:00 am  

Description:  Stepped wedge designs are a form of cluster randomized trial that involves the sequential transition of clusters (hospitals/groups/communities) from control to intervention conditions in a randomized order, and are becoming increasingly popular.

The stepped wedge allows us to do a randomized evaluation which otherwise would not be possible due to policy or other constraints, and in some cases, the stepped wedge is the only feasible design because the intervention requires the roll-out of a scarce resource. Dr. Love will discuss some key concerns when doing cluster-randomized trials in general, and in designing stepped-wedge studies in particular.


Updates from MetroHealth’s Center for Clinical Informatics Research and Education (CCIRE)

Eric Kim, MD, PhD

Clinical Informatics Fellows and Family Medicine Physician
The MetroHealth System/Case Western Reserve University

David C Kaelber, MD, PhD, MPH
Professor of Internal Medicine, Pediatrics, Population and Quantitative Health Sciences The MetroHealth System/Case Western Reserve University

Nicholas Riley, MD, PhD
Assistant Professor of Family Medicine
The MetroHealth System/Case Western Reserve University

Ruba Hossain, MD
Senior Clinical Informatics Fellow and Emergency Medicine Physician 
The MetroHealth System/Case Western Reserve University

Friday, March 25, 2022  |  9:00 – 10:00 am


An Unexpected Journey: A Hedgehog in Academia

David C. Aron, MD, MS 
Emeritus Professor of Medicine, Case Western Reserve University
Director, Clinical Program Research and Evaluation | Louis Stokes Cleveland VA Medical Center

Friday, March 11, 2022  |  9:00 – 10:30 a.m.

Description: Those of us who have toiled in the field of health care delivery and its improvement have had a tough road to hoe – rocky soil, tools not fit for purpose, pests, and a changing climate. Yet, we carry on, reveling in every harvest however meager. Why is the soil so rocky and the tools so unfit? Who or what are the pests and how can we deal with a changing climate while improving the soil and tools and getting rid of the pests?

I have spent my career doing what I could to address each of these, a journey I never expected to take when I started medical school, completed residency and fellowship, and began my first job as a faculty member learning to do basic science research. This journey depended on many contingent events and teachers, some from whom I learned and revered and some from whom I learned and rejected totally.

I have been fortunate to learn a few things along the way and notwithstanding the frustrations, I have had quite a bit of fun. I offer some stories of successes and failures that may appeal and resonate and some that may send you screaming into the night – your choice, but it has been a heck of ride.

Presenter Bio: David Aron was the former Director of Clinical Program Research and Education at the Cleveland VA Medical Center. He is a clinical endocrinologist, health services researcher, and was the leader of the VA Quality Scholars Fellowship Program, a training program in quality improvement.  

He is Emeritus Professor of Medicine and Epidemiology and Biostatistics at the School of Medicine, Case Western Reserve University. He was previously Adjunct Professor of Organizational Behavior at the Weatherhead School of Management where he teaches a class on Managing Complex Systems. He is the author of a recent book entitled Complex Systems in Medicine: A Hedgehog’s Tale of Complexity in Clinical Practice, Research, Education, and Management. 

A former (reformed?) laboratory bench researcher, Dr. Aron’s current research interests are eclectic and have included health services and implementation research related to quality measurement and improvement, especially diabetes-related, and most recently, applications of principles of complex systems. He is currently writing another book – An Insider’s Guide to Academic Medicine. However, as has often been the case in the past, exactly what he will be working on, even in the not too distant future, cannot be predicted with any certainty. 


Improving VTE Prophylaxis via the Electronic Health Record

Michael B. Rothberg, MD, MPH
Vice Chair for Research, Community Care
Director, Center for Value-Based Care Research
Cleveland Clinic

Friday, March 4, 2022  |  9:00 – 10 a.m.

Description: Venous thromboembolism (VTE) is a common cause of hospital-acquired morbidity. Chemoprophylaxis can reduce the incidence of VTE if applied to the right patients, but physicians often overestimate patients’ risk of VTE and overuse prophylaxis.

In this talk, Dr. Rothberg will describe his team’s development of a VTE risk model, its incorporation into the electronic health record and what happened when they tested the model in a randomized controlled trial.

Presenter Bio: Michael B. Rothberg, M.D., M.P.H. is the Vice Chair for Research in Cleveland Clinic Community Care and Professor of Medicine at Case-Western Reserve University. He practices general internal medicine and directs the Center for Value-Based Care Research. His research examines quality of care and decision making for common medical conditions, with an emphasis on tailoring treatment to patients based on individual risk and preferences.

His methods include large observational studies, risk modeling, and cost-effectiveness analysis. His areas of interest include pneumonia and influenza, venous thromboembolism, coronary artery disease, and public reporting of healthcare quality.

The goal of his research is to help physicians and patients make better healthcare decisions in order to improve outcomes and control costs. Dr. Rothberg completed a research fellowship in Medical Informatics from the National Library of Medicine and has received research funding from AHRQ, NHLBI, the Doris Duke Charitable Foundation, and the Informed Medical Decisions Foundation. Dr. Rothberg received his M.D. from New York University and his Master’s in Public Health from Harvard University. 


Predictors of Engagement in a Web-Based Brief Intervention for Alcohol Misuse Among National Guard Members: Secondary Analysis of a Randomized Controlled Trial*

Richard A. McCormick, PhD
Consultant, Clinical Psychologist

Friday, February 4, 2022  |  9:00 – 10:00 a.m.

Description:  eHealth interventions that use computers and smart phones to deliver brief interventions show promise for changing a variety of health behaviors. Fostering engagement in the intervention is an ongoing challenge. Little is known about the factors related to engagement, including the modality of delivering the intervention and demographic and psychosocial variables of the participants. A secondary analysis of a large successful eHealth intervention for reducing hazardous drinking among National Guard members was conducted to provide a better understanding of the factors associated with engagement, and their practical implications.

Presenter Bio: Richard McCormick Ph.D. is a clinical psychologist. He retired from VA as the Director of Mental Health for the VA Healthcare System of Ohio and subsequently served as a member of the Department of Defense Mental Health Task Force charged with improving mental health and substance abuse services for military members. He is part of a research group, centered at the University of Michigan, investigating eHealth interventions to reduce hazardous alcohol use among National Guard members. He has been associated with the Center for Health Care Research and Policy for many years.


Legal Epidemiology and Health Equity

Megan Douglas, JD 

Assistant Professor in the Department of Community Health and Preventive Medicine | Director of Research and Policy in the National Center for Primary Care | Morehouse School of Medicine

Presented Friday, January 28, 2022  |  9:00 – 10:00 a.m.

Description:  This presentation will include an introduction to the emerging field of Legal Epidemiology and discuss how legal epi approaches are being used to advance health equity. The presenter will share some of her work related to behavioral health insurance laws and highlight opportunities for future research and collaborative studies.

Presenter Bio: Megan Douglas is an Assistant Professor in the Department of Community Health and Preventive Medicine and the Director of Research & Policy in the National Center for Primary Care at Morehouse School of Medicine. She is a licensed attorney and her research focuses on studying how laws and other policies improve population health and advance health equity.

She has a strong interest in advancing the field of legal epidemiology, which uses scientific methods to study the effects of laws on health outcomes and Professor Douglas has used this approach to study behavioral health, developmental disabilities, digital health tools, and structural racism.

She also teaches students, residents, communities and practicing health professionals about advocacy and how to engage in the policymaking process. She loves talking policy and helping others navigate the process to make their voices heard and improve the health of their communities.


Inconsistent Medicaid Coverage is Associated with Negative Health Events for People with Epilepsy*

Wyatt Bensken

PhD Candidate in Epidemiology & Biostatistics | Case Western Reserve University

Friday, January 14, 2022  |  9:00 – 10:30 a.m.

Meeting ID: 945 3232 8533  |  Passcode: 867012

Description: There has long been attention to gaps in Medicaid coverage, often referred to as churning when an individual moves in and out of coverage. People who have Medicaid gaps often have delays in preventive screening, higher rates of hospitalization for ambulatory care sensitive conditions, and higher expenditures.

Epilepsy is a neurological condition that affects an estimated three million adults and nearly 500,000 children in the United States alone; it is a condition well poised to illuminate the impact of gaps in coverage on health outcomes.

For people with epilepsy (PWE) lapses in coverage of prescriptions or follow-up care could mean experiencing a breakthrough seizure—risking physical injury or death, and importantly decreasing the quality of life for that patient.

PWE experience a number of social challenges including challenges in school, social relationships, employment, transportation (losing driving privileges due to recent seizures), independent living, and stigma.

Taken together, these considerations make it clear that epilepsy provides a salient condition through which to understand the impact of gaps in coverage on health outcomes, and who is most at risk for those gaps.

In this study, we examined the impact of gaps in Medicaid coverage on negative health events, including hospitalizations and emergency department visits, for PWE, and identified factors associated with gaps to inform potential interventions.

Presenter Bio: Wyatt Bensken is a PhD candidate in Epidemiology and Biostatistics at Case Western Reserve University, working under the mentorship Dr. Siran Koroukian. Wyatt’s research interests center on disparities in health and health outcomes.

Wyatt’s dissertation focuses on disparities and inequities in health for people with epilepsy on Medicaid, with a goal of identifying potential points of intervention to improve health outcomes. His dissertation is funded by an F31 Pre-Doctoral Fellowship from the National Institute on Minority Health and Health Disparities.


Students Teaching Students About Stroke*

Agnieszka Ardelt, MD, PhD, MBA
Chair, MH Department of Neurology

Julie Fisher MHA, BSN, RN
Project Lead Ohio Coverdell Stroke Program

Alice Liskay, MPA, BSN, RN
Nurse Consultant, Ohio Coverdell Stroke Program

Tiffany Short, MS, SPHR
Director, Culture and Organizational Effectiveness

Salethia Coles
Secondary Education Specialist

Presented Friday, January 7, 2022 |  9 – 10 a.m.

*Description: A collaborative project with MetroHealth and Lincoln-West High School to: 1) teach students about stroke risk factors and stroke symptoms; 2) teach students to become teachers to others; and 3) determine if student-generated presentations are more effective than standard presentations.


The MetroHealth Food As Medicine Clinic: Early Findings*

Shari Bolen MD, MPH
Associate Professor of Medicine
Director, Population Health Research Institute
Director, Center for Health Care Research and Policy
Case Western Reserve University at The MetroHealth System

Kevin M. Chagin, MS
Strategic Data Analyst, Population Health Innovation Institute
The Institute for H.O.P.E.TM
The MetroHealth System

Jennifer Bier, MS, RD, LD
Manager of Ambulatory Nutrition
The MetroHealth System

Presented Friday, December 10, 2021 |  9 – 10 a.m.

Description: Health systems are increasingly implementing programs to identify and address social determinants of health, including food insecurity which remains one of the top social needs identified on screening surveys.

Addressing food insecurity in a tailored way within health systems has the potential to assist in preventing and better managing chronic conditions through improved dietary behaviors and increased engagement with the health system.

In this seminar, we present early findings from our Food As Medicine clinic at The MetroHealth System and discuss future directions for this program. 


Environmental Hazards and Reproductive Health: Applications of Policy-Relevant Epidemiology

Mary D. Willis, Ph.D., M.P.H.

Postdoctoral Scholar
College of Public Health and Human Services
Oregon State University

Presented Friday, December 3, 2021 |  9:00 – 10 a.m.


Is a Trauma-informed Community the Key to Health Resilience: A Multidisciplinary Partnership Pilot

Sarah Hendrickson, M.Ed, CReC
Director, Centers for Trauma Recovery and Health Resilience*
The MetroHealth System

Katie Kurtz, MSW LISW-S
Educator & Trainer, Center for Health Resilience
The MetroHealth System

Mary Breslin, MPH 
Program Advisor, Center for Health Resilience
The MetroHealth System

Presented Friday, November 12, 2021  |  9:00 – 10:00 a.m.


Lead and Child Well-being – Tracking Conditions and the Effects of Community Initiatives in Cleveland

Rob Fischer, Ph.D. 

Associate Professor & Co-Director, Center on Urban Poverty & Community Development  |  Jack, Joseph and Morton Mandel School of Applied Social Sciences  |  Case Western Reserve University

Presented Friday, October 29, 2021  |  9:00 – 10:00 a.m. 

Description:  In 2021, major efforts are underway to reduce the risk of childhood lead poisoning in Cleveland. This presentation will summarize the Poverty Center’s foundational research on the conditions of lead risk and the downstream results of lead exposure for Cleveland’s children. In addition, the work of the Lead Safe Auditor will be described in tracking the implementation of the City’s Lead Safe ordinance for rental properties.  


Investigating Socioeconomic Disparities in Slow and Fast Aging: Exploiting Residual Blood Samples to Examine Sociomedical Risk and Resilience in a Pediatric Analytic Cohort

Kristen Berg, PhD, CRC

Research Scientist, Center for Health Care Research and Policy  |  The MetroHealth System  |  Case Western Reserve University

Presented Friday, October 22, 2021  |  9:00 – 10:00 am

Description: This pilot project investigates how young people’s biological aging may unfold at different rates across different neighborhood socioeconomic environments. Research suggests that individuals who live in more socioeconomically disadvantaged neighborhoods tend to show worse health and faster biological aging over time when compared to individuals of the same chronological age who live in neighborhoods that are more socioeconomically advantaged.

This study will look at over 7,000 MetroHealth patients ages 6 to 21 and their biological aging, measured by markers of their immune-hematological functioning collected from routine blood testing, to better understand how neighborhood environments may become internalized early in life even after accounting for chronological age. In addition, this study will engage community members and clinical experts about how to share findings with youth and families within their schools and communities.

The study findings will expand our understanding of biological aging and what it means for underserved youth to “grow up fast”. Findings will aid in developing longer-term intervention that focus on engaging youth in thinking critically about the significance of their environmental and social conditions. 


Population Health:  Major Opportunities for an Evolving Field

Marc N. Gourevitch, MD, MPH
Muriel and George Singer Professor of Population Health and Chair
Department of Population Health
NYU Grossman School of Medicine

Presented Friday, October 1, 2021  |  9 – 10:30 a.m. ET

Description: Ever-increasing attention is being paid to improving population health and health equity in communities across the country. Yet gains in life expectancy in the United States stalled even prior to COVID-19, and the pandemic has only further widened already-stark disparities. What approaches hold the most promise for population health researchers and practitioners seeking to advance health, equity and well-being? How does healthcare delivery improvement fit into the picture? Dr. Gourevitch will explore responses to these core challenges to our field, drawing on his experience at NYU Grossman School of Medicine building and leading one of the earliest and now largest departments of population health at an academic medical center.


Center for Reducing Health Disparities Overview (brief speed rounds of research at Center)

Friday, September 17, 2021 |  9 – 10 a.m. ET

Ashwini Sehgal, MD
Introduction

Erika Hood, MEd
Community Members as Reviewers of Medical Journal Manuscripts

Elodie Nonguierma, MPH
Pain and Immobility After Breast Cancer Surgery

Jacqueline Dolata, MBA
Investigator Development Core

Anne Huml, MD
Barriers to Care for Patients With Failing Kidney Transplants

Daryl Thornton, MD, MPH
Promoting CPAP Adherence Among African Americans With Obstructive Sleep Apnea


Social Determinants of Health from a Feedback Perspective: Insights and Opportunities for Advancing Health Equity, from Local to Global

Presented Friday, September 10, 2021

Peter S. Hovmand, PhD, MSW
Professor of General Medical Sciences
Professor of Biomedical Engineering, and inaugural Pamela B. Davis MD PhD
Professor of Medicine,Case Western Reserve University

Description: Social determinants of health are inextricably linked with the underlying social, economic, political, and ideological systems driving distributions of resources, exposures, prevention, and access to quality health care.

Several approaches have been used to characterize the system level effects and build community and research capacity in using systems science to advance equity. Community Based System Dynamics (CBSD) is a participatory systems science method that has been applied across global and local settings to understand social determinants of health across a variety of health outcomes from obesity and mental health to cancer prevention and treatment.

The talk summarizes what has been learned from applying CBSD to understand social determinants of health and highlights emerging opportunities to significantly advance scientific understanding of social determinants of health from a feedback perspective for advancing equity. The talk concludes with a call for the study of global equity science


Questions of Faith: Religious Affiliations and Suicidal Ideation and Attempts Among Sexual Minority Adolescents and Young Adults*

Presented Friday, July 2, 2021

Susan M. De Luca, PhD
Assistant Professor, The Steve Hicks School of Social Work
Core Faculty, Center for Women's and Gender Studies
Research Associate, Population Research Center
The University of Texas at Austin

Description: Death by suicide among adolescents and young adults is at its highest point in nearly 20 years (Miron, Yu, Wilf-Miron, & Kohane, 2019). Recently, there has been a 51% increase in female adolescents presenting to ED’s with suicide attempts since the pandemic began (Yard, Radhakrishman, Ballesteros, et al, 2021).

Among the more than 10 million adults in the U.S. who reported ideation pre-pandemic, the prevalence of ideation among young adults is four times higher than those aged 50 or older (SAMHSA, 2018). In Cleveland, high school students reported higher rates of hopelessness and ideation than the national average in 2019. 

But even more striking was that reported suicide attempts were double the rate for females (22%) and males (15%) residing in Cleveland than the national average (11%) and (7%) respectively (CDC, 2020).  Adolescent suicide is such a public health concern that just last week the American Medical Association (2021) adopted new policies to address the recent increase in youth suicide and to identify evidence-based interventions and other factors to reduce risk. 

Pre-pandemic reports found that adolescents who identified as lesbian, gay, or bisexual expressed higher ideation (47%) and attempts (23%) compared to their heterosexual peers (15% ideation; 6% attempt) (CDC, 2020). Many studies elucidate risk and protective factors related to ideation and attempts among sexual minorities (Haas et al., 2010), yet few examine self-reported religious affiliation and levels of religiosity.

Religion may function protectively for sexual minorities as it does for heterosexuals if sexual minorities can find affirming religions (Rosenkrantz, Rostosky, Riggle, & Cook, 2016; Rostosky, Riggle, Brodnicki, & Olson, 2008).

Consequently, understanding the nuances among different denominations, how sexual minority adolescents are connected to their religious affiliation and how it plays a role in their identity, but also how faith-based organizations can offer welcoming messaging, will help to disentangle the complexity of how religion is related to suicidal risk.


Population Studies of Urologic Cancer Health Disparities

Presented Thursday, July 1, 2021

Ken Batai, PhD
Research Assistant Professor
Department of Urology, College of Medicine
University of Arizona


High-Risk Infant Follow-Up: What, When, and How?

Presented Friday, June 25, 2021

Samudragupta Bora, PhD
Associate Professor; Group Leader, Neurodevelopmental Follow-Up and Outcomes
Mothers, Babies and Women’s Health Program
Mater Research Institute, Faculty of Medicine, The University of Queensland
Australia

Description: Recent advances in healthcare have considerably improved the survival of high-risk infants, particularly those born prematurely or with congenital heart disease. Nonetheless, their increased risk of neurodevelopmental morbidities is a pressing challenge, imposing a significant burden on families, communities, and the healthcare and education systems.

Consequently, the focus of research has broadened from reducing mortality to improving neurodevelopmental outcomes and enhancing the quality of life. This presentation discusses Dr. Bora's research profiling long-term neurodevelopmental outcomes of high-risk infants and the roles of neurological and social variables impacting these outcomes.

Challenges to accessing neurodevelopmental follow-up care associated with individual, family, and neighborhood factors within social determinants of health framework is also discussed.


Disparities in Video Visit Uptake and Satisfaction in an Urban Academic Medical Center

Presented Friday, June 18, 2021

Jessica Ruff, MD, MA, MSPH 
Clinical Informatics Fellow
Center for Clinical Informatics Research and Education
The MetroHealth System


Unravelling Assumptions and Breaking Down Barriers to Achieve Vaccine Equity: Lessons from a Safety-Net System

Presented Friday, June 11, 2020

Brook Watts, MD, MS
Senior Vice President and Chief Medical Officer, Community & Public Health
The MetroHealth System
Professor of Medicine
Case Western Reserve University


Building Community Partnerships to Investigate Climate Change's Impact on Human Health

Presented Friday, June 4, 2021

Daniel Smith, PhD, MS, RN, CNERobert Wood Johnson Foundation Future of Nursing ScholarClinical Instructor, Nell Hodgson Woodruff School of NursingEmory University


Better Health Partnership: Regional Health Improvement Updates*

Presented Friday, May 21, 2021

Description: This seminar includes an overview of the regional population health improvement initiatives facilitated by Better Health Partnership in collaboration with northeast Ohio health systems, social service agencies, payers, academia, government, and other community-based organizations.

With Ohio’s ranking of 47th in health outcomes across the US and with Cleveland ranked as having the highest poverty rate amongst the largest US cities, there is ample room for improvement and a for an enhanced focus on health equity. Please join us to learn and explore more ways we can take our collaborative efforts to new levels for greater impact. 


Knowledge, Experiences, and Perceptions of Evidence-Based Smoking Cessation: Gaps and Opportunities*

Presented Friday, May 14, 2021

Sarah Koopman Gonzalez, Ph.D.
Research Scientist, Department of Population and Quantitative Health Sciences
Director of Training and Professional Development, Prevention Research Center for Healthy Neighborhoods
Adjunct Instructor, Master of Public Health Program, Department of Population and Quantitative Health Sciences
Case Western Reserve University

Description: This presentation describes the perceptions of and barriers to smoking cessation by current and former smokers in Greater Cleveland.

Experiences with and attitudes towards evidenced-based smoking cessation resources is discussed.

This presentation focuses on findings from in-depth qualitative interviews with 75 current and former tobacco users from a study funded by the Case Comprehensive Cancer Center.


05/07/21 Embracing Community Health and Health Equity in a Large, Integrated Healthcare System*

Presented Friday, May 7, 2021

Nazleen Bharmal, MD, PhD, MPP
Associate Chief, Community Health & Partnerships 
Cleveland Clinic Community Care 
Staff Physician, Dept of Internal Medicine

Description: Cleveland Clinic’s community health strategy + learnings from other major health care institutions and facilitated discussion on the challenges and opportunities with data and research.


04/23/21 An Introduction to Structural Equation Modeling for Health Services Research*

Presented Friday, April 23, 2021

Douglas D. Gunzler, Ph.D.
Associate Professor of Medicine and Population and Quantitative Health Sciences Center for Health Care Research & Policy
Case Western Reserve University at MetroHealth Medical Center

Adam T. Perzynski, PhD
Associate Professor of Medicine and Sociology for Center for Health Care Research and Policy
Director of The Patient-Centered Media Lab, The MetroHealth System
Case Western Reserve University at MetroHealth Medical Center

Adam Christopher Carle, MA, PhD
Associate Professor
James M. Anderson Center for Health Systems Excellence
Department of Pediatrics
Cincinnati Children's Hospital Medical Center
University of Cincinnati College of Medicine
Department of Psychology
University of Cincinnati College of Arts and Sciences
Cincinnati, OH

Description: Structural equation modeling (SEM) is a multivariate technique that allows relationships among variables to be examined. SEM is often used in practice to model and test hypothesized causal relationships among observed and latent (unobserved) variables, including in analysis across time and groups. It can be viewed as the merging of a conceptual model, path diagram, confirmatory factor analysis and path analysis. In this seminar we introduce basic concepts and SEM vocabulary and give real-world examples relevant for health services researchers.


04/16/21 How Total Quality Management Came to Healthcare: Ten Life Lessons from Duncan for All of Us to Emulate

Presented April 16, 2021

J. Edward McEachern, M.D.
Executive Vice President and Chief Medical Officer, PacificSource Health Plans 
University of Utah School of Medicine
Associate Professor, David Eccles School of Business, University of Utah
Master in Population & Health Systems Management Founder/Faculty, Boise State University

Co-sponsored by 
The Center for Health Care Research and Policy and
The Center for Reducing Health Disparities
MetroHealth Medical Center | Case Western Reserve University


03/19/21 Highlights from Cancer Population Science Efforts in 2021: Case Comprehensive Cancer Center*

Presented Friday, March 19, 2021

Highlights from Cancer Population Science Efforts in 2021:

Case Comprehensive Cancer Center*

Jennifer Cullen, PhD, MPH

The James T. Pardee – Carl A. Gerstacker Professorship in Cancer Research, School of Medicine
Associate Professor, Department of Population & Quantitative Health Sciences, School of Medicine
Associate Director for Cancer Population Sciences, Case Comprehensive Cancer Center
Case Western Reserve University

Description: This presentation provides an overview of current efforts in cancer population science at the Case comprehensive cancer center, opportunities for engagement with PHRI-MH, and an example of funded work that will provide insight into health disparities in prostate cancer aggressiveness.


03/12/21 Mechanisms of Racism Structuring Food Security and Community Nutrition*

Presented Friday, March 12, 2021

Darcy Freedman, PhD, MPH
Swetland Professor in Environmental Health Sciences
Director, Mary Ann Swetland Center for Environmental Health
Professor, Department of Population and Quantitative Health Sciences 
Case Western Reserve University, School of Medicine

Description: Racism has been declared a public health emergency structuring health opportunity for African Americans and other racialized populations.

This presentation examines how to assess racism and racialized experiences among African Americans from two neighborhoods in Cleveland and Columbus, Ohio, and will evaluate how experiences of racism structure food security and diet quality. The goal of the presentation is to enliven discussions about underlying mechanisms of racism that may be modulated for health equity.


02/12/21 Quality Strategy for Today’s Medicaid Managed Care Health Plan*

Presented Friday, February 12, 2021

Dale J. Block, MD, MBA
Market Chief Medical Officer, Ohio
CareSource Insurance

Description: Quality strategy for today’s Medicaid Managed Care Health Plan is very prescriptive due to federal and state regulatory and credentialing requirements. Alignment with federal and state stakeholders is key to having an evidence-based high performing quality assurance and performance improvement strategy.


02/05/21 Care in Context: A Patient- and Family-Centered Approach to Learning from Practice Innovation*

Presented Friday, February 5, 2021

Sarah D. Ronis, MD, MPH  
Center for Child Health and Policy
UH Rainbow Babies & Children's Hospital
Case Western Reserve University School of Medicine

Description: Patient- and family-centered care (PFCC) — care that is respectful of and responsive to individual patient culture, social context, preferences, needs, and values  —  is a fundamental domain of health care quality.

PFCC requires health care teams to explicitly incorporate multiple stakeholders, address context, and account for prior experience when collaborating with patients in the creation and implementation of care plans.

This talk presents an iterative model for such collaborative decision-making, illustrated using data collected by the UH Rainbow Center for Child Health and Policy as part of a multi-year study designed to elicit regular input by patients and families into the development and implementation of interventions to support PFCC in a medical home for women and children.


01/29/21 Adapting Clinical Research to COVID-19 Pandemic: Insights from a Rapid Study of SARS-CoV-2 among First Responders*

Presented Friday, January 29, 2021

Nursing and Research Coordinator Team: 

  • Lisa Humbert MSN, RN, CCRC, Cynthia Newman BSN, RN
  • Julie Nichols RN, Kristine Russ MS, and Kimberly Schach 
  • Cleveland EMS Paramedic and Cleveland Association of Rescue Employees (Union) Treasurer Dave Jockers

Description: Team Discussion with faculty Adam Perzynski, Yasir Tarabichi, Brook Watts and Thomas Collins, research nurses Lisa Humbert, Kimberly Schach, Cynthia Neuman, Kristine Russ, Julie Nichols Cleveland EMS Paramedic and Cleveland Association of Rescue Employees (Union) Treasurer Dave Jockers and other members of the study team that conducted a community-based longitudinal study with nearly 300 participants providing biological samples in just 6 weeks!

This was also the first ever study at MetroHealth to utilize a virtual, e-consent process. The study has been published in  PreHospital Emergency Care . We will provide a brief description of the scientific findings, but the focus of this session is on innovations in teamwork and clinical research procedures.

Our hope is that this sharing session can expand the way we all think about possibilities for research and partnership with other organizations during the pandemic and beyond.

Additional contributors to the study were: Brook Watts, Thomas Collins, David Margolius, Douglas Gunzler and Ann Avery. The project was principally funded by The MetroHealth System and was made possible through the cooperation of EMS and Fire at the City of Cleveland.


01/08/21 How to Conduct Research on the Health Impacts of Climate Change*

Presented Friday, January 8, 2021

Ashwini Sehgal, MD
Duncan Neuhauser Professor of Community Health Improvement
Co-Director, Center for Reducing Health Disparities
Case Western Reserve University
Associate Editor, Annals of Internal Medicine
Division of Nephrology
MetroHealth Medical Center

Dr. Ashwini Sehgal is the Duncan Neuhauser Professor of Community Health Improvement and Co-Director of the Center for Reducing Health Disparities at Case Western Reserve University and a nephrologist at MetroHealth Medical Center. He is currently developing a new graduate course on Climate Change and Health.

Description: This talk will provide a framework for thinking about research on the health impacts of climate change. Topics to be covered include an overview of climate hazards and their health impacts, phases of research, examples of research related to heat waves, and challenges in conducting research on climate change.


12/18/20 "It's a Vicious Cycle": Understanding Tobacco Use Disparities through the Lens of Food Insecurity

Go to Recorded Presentation

Presented Friday, December 15, 2020

Jin E. Kim-Mozeleski, PhD
Assistant Professor, Department of Population 
and Quantitative Health Sciences
Core Faculty, Prevention Research Center for Healthy Neighborhoods
Case Western Reserve University, School of Medicine

Description: This presentation discusses current research on the intersection of tobacco use and food insecurity. The presentation features empirical findings from two studies, including a population-based quantitative study using data from the Panel Study of Income Dynamics, and an in-depth qualitative interview study of current and former smokers experiencing food insecurity.

The presentation concludes with a discussion of ongoing research activities in the Food Security, Tobacco Cessation, and Health (FETCH) Project (PI's NIDA-funded career development grant), and discuss directions for future population-based and intervention research.


11/13/20 Innovative Data Driven Approaches to Lead Testing Using Community Health Workers*

Presented Friday, November 13, 2020

Christopher Mundorf, MPH, PhD
Director of Data Analytics and Reporting
Better Health Partnership

Jonathan S. Lever, MPH, NRP
Program Manager
Better Health Partnership

Description: Exposure to lead at an early age can, if left untreated, can harm a child’s development and increase the risk of negative health outcomes. Lead tests are required at ages 1 and 2 for children receiving federal Medicaid benefits, yet despite these rules, only 50% of these Cuyahoga County children are tested at age 1 and only 34% are tested at age 2.

In this webinar, representatives from Better Health Partnership discuss a project they are piloting which aims to improve lead testing through two approaches. First, they are analyzing data across 5 health systems and Federally Qualified Health Centers to identify best practices in the management of lead testing.

Then, leveraging those results, they will utilize Community Health Workers through the Pathways HUB Model to offer case management support for families in need of lead testing. This project aims to connect children in our community to needed treatment, and improve prevention through data-informed decision making.


11/06/20 Health-Related Social Needs and Increased Hospital Readmission*

Presented Friday, November 6, 2020

Wyatt P. Bensken, BS
Ph.D. Candidate, Epidemiology and Biostatistics
Department of Population and Quantitative Health Sciences
Case Western Reserve University

Description: The strong relationship between health-related social needs (HRSN), the individual-level correlates of the social determinants of health, and health outcomes widely recognized, and in recent years we have seen this relationship become more explicit and quantified.

As a result of this deepening understanding of how HRSN such as food insecurity, social isolation, and housing instability impact health, most hospitals report screening patients for social factors and interventions are being developed. In addition to limited training for providers on HRSN, including screening and documentation, interventions and documentation for HRSN are presently not reimbursable leading to a challenges in data quality and the ability to conduct robust studies.

However, with the introduction of ICD-10 in 2015 came a new class of diagnostic codes aimed at capturing these HRSN in a standardized fashion. In this presentation, Dr. Bensken discusses findings from a study we undertook, using a large and nationally representative dataset, to understand the use of these codes for HRSN as well as their association with an important health outcome and quality metric: 30-day readmission.

This study does more than solidify the important relationship between HRSN and readmission, but calls attention to the strengths and limitations of a burgeoning methodological opportunity to capture and understand HRSN.


10/23/20 MetroHealth’s Center for Clinical Informatics Research and Education (CCIRE) Overview

Presented October 23, 2020

Peter Greco, MD
Associate Professor of Internal Medicine
The MetroHealth System/CWRU

David Kaelber, MD, PhD, MPH
Professor of Internal Medicine, Pediatrics,
and Population and Quantitative Health Sciences
The MetroHealth System/CWRU

Yasir Tarabichi, MD, MS
Assistant Professor of Internal Medicine
The MetroHealth System/CWRU

Jessica Ruff, MD, MS, MS
Clinical Informatics Fellow
The MetroHealth System/CWRU


10/16/20 The Impact of the Implementation of a Sepsis Early Warning System in the Emergency Department Setting: A Randomized Controlled Quality Initiative

Presented October 16, 2020

Yasir Tarabichi MD, MSCR
Director of Clinical Informatics for Research Support
Associate Director of Clinical Informatics for Medical Subspecialties
The MetroHealth System
Assistant Professor of Medicine, Department of Medicine, 
The MetroHealth System, CWRU


10/09/20 Building a Culture of Community Health in Old Brooklyn: The Intersection of Community Development & Public Health*

Recorded October 9, 2020

Amber Jones, MPH, CHES
Director of Community Health
Old Brooklyn Community Development Corporation

Hope Fierro, BS
Community Health Coordinator
Old Brooklyn Community Development Corporation

Britiny Hubbard, BA
AmeriCorp VISTA and Old Brooklyn Farmers Market Coordinator
Old Brooklyn Community Development Corporation

Description: A person’s health is defined by more than the medical care they receive — it’s where they live, work, play. Old Brooklyn Community Development Corporation utilizes their knowledge of neighborhood conditions and applies a Social Determinants of Health lens to their work to improve the quality of life for their residents. In this webinar, they discuss their process, current and future strategies, as well as the importance of Community Health (the intersection of community development and public health).

They would also like to hear from you — what are challenges you experience on behalf of your patients that are tied to community conditions? By forming partnerships in unlikely areas, OBCDC hopes to challenge traditional ways of thinking to say that health is more than a hospital. 


09/18/20 Health, Opportunity, Partnership and Empowerment: Taking Action on Social Determinants of Health

Recorded September 18, 2020

Susan Fuehrer, MBA  President, Institute for H.O.P.E.™
President, Center for Social Determinants of Health & Health Equity
The MetroHealth System

Karen Cook, MPH
Director, Healthy Families & Thriving Communities
Institute for H.O.P.E.™