Active Projects/Grants Managed in the SSW

Healthy Michigan Plan CMS Evaluation FY19

October 2018 - September 2019

An interdisciplinary team of researchers from the Institute for Healthcare Policy and Innovation has partnered with MDHHS to conduct the evaluation of Michigan's Medicaid expansion, known as the Healthy Michigan Plan (HMP). Per the Centers for Medicare and Medicaid Services, IHPI will carry out evaluation in seven domains: 1) an analysis of the impact of Medicaid expansion on uncompensated care costs borne by Michigan hospitals; 2) an analysis of the effect of HMP on the number of uninsured in Michigan; 3) the impact of HMP on increasing healthy behaviors and improving health outcomes; 4) the viewpoints of beneficiaries and providers of the impact of HMP; 5/6) the impact of HMP's contribution requirements and MI Health Accounts on beneficiary healthcare utilization; 7) the cost effectiveness of the Marketplace Option.

Genetic Contributions to Smoking and Internalizing Problems in Adolescence

August 2015 - August 2020

This Career Development Award (K01) will provide the candidate with the necessary skills to develop an independent research program focused on integrating genetic methodologies to the candidate's already strong longitudinal modeling skills to explore and clarify the etiology of the interplay between cigarette use and internalizing problems during adolescence. Despite decreases in prevalence of smoking during adolescence in the past two decades, adolescence continues to be the developmental period of greatest risk for cigarette use onset and increase in internalizing problems. Clarifying the complex etiological pathways involved in the co-occurrence between cigarette use and internalizing problems during this vulnerable time requires using multiple methodologies. The overall aim of the current proposal is to test increasingly complex longitudinal models that explore the degree to which the co-occurrence between adolescent cigarette use and internalizing problems are influenced by genetic and environmental factors and to include measured genetic variants. The training plan will be completed at the Virginia Institute for Psychiatric and Behavioral Genetics at Virginia Commonwealth University and is designed to provide the candidate with skills in genetic epidemiology, quantitative genetics, and molecular genetics. The candidate will acquire the knowledge and skills to a) conduct univariate, bivariate, and multivariate genetically informed studies to identify the genetic and environmental risk factors in smoking initiation, progression t heavier smoking, nicotine dependence, and internalizing problems; b) conduct longitudinal genetically informed studies to clarify the causal pathways involved in cigarette use and internalizing problems by exploring the degree to which genetic and environmental factors explain the covariance between the behaviors; and c) conduct genetically informed ecological momentary assessment studies of adolescent twin pairs to explore the causal pathway between these problems behaviors. These skills will be developed through a combination of formal coursework, mentored research projects, and didactic training. The proposed research program involves a combination of analysis of existing longitudinal studies of adolescent twins and an original data collection pilot project. The existing longitudinal studies of adolescent twins inclue the Swedish Twin Study of Child and Adolescent Development, the Minnesota Twin and Family Study, the Virginia Twin Study of Adolescent Behavioral Development, the National Longitudinal Study of Adolescent Health, the GEDI (Genes, Environment, Development Initiative part of NIDA's Genetics Consortium). In the pilot project, the candidate will collect momentary cigarette use and mood data of 16- and 17-year-old adolescent twin pairs recruited from a population-based twin registry comprised of over 50,000 twins. Training activities and results will be used to develop a R01 proposal for a prospective momentary assessment and genotyping study of 14 to 17 year old adolescent twins.

OCCUPATIONAL SAFETY AND HEALTH EDUCATION AND RESEARCH CENTERS (T42)

October 2018 - June 2023

The University of Michigan Center for Occupational Health and Safety Engineering (COHSE), a NIOSH Education and Research Center (ERC), has been continuously funded by NIOSH since its establishment in 1982. Our Center has a distinguished legacy, building on NIOSH Trainee Program grants in the early 1970s, the Institute of Industrial Health founded in 1951, and may other milestones dating back to the establishment of the Laboratory of Hygiene in 1888. The mission of the Center is to serve the region, nation and world as a center of excellence for graduate education and research in occupational health and safety. We maintain outstanding Master’s, doctoral and research programs in Industrial Hygiene, Occupational Health Nursing, Occupational Safety Engineering and Ergonomics, and Occupational Epidemiology. Our academic and research programs provide broad-based interdisciplinary academic training to ensure that graduates are qualified to pursue careers and assume leadership roles in the practice of occupational health and safety, and to help ensure an adequate supply of well-trained researchers. Complementing the academic programs, our suite of Research-to-Practice projects, Continuing Education programs, and Outreach activities are aimed at transferring state-of-the-art knowledge to professionals and practitioners in occupational health and safety and allied disciplines. As a NIOSH Education and Research Center, we serve a number of constituencies, including: (1) NIOSH; (2) industry, labor and professional interests in our region and beyond; (3) academic units within the University of Michigan that provide critical teaching and research resources necessary for Center success; and (4) our students. The broad goals of the Center are to: • Promote excellence in our professional training and research training programs in each core program; • Increase the financial resources needed to improve the number, quality and diversity of graduate students in each core area; • Enhance the quality of our continuing education courses and other service and outreach activities; • Increase external research funding to improve our research infrastructure, expand opportunities for research training, and promote interdisciplinary research related to occupational health and safety; • Provide an organizational structure to coordinate and promote interdisciplinary educational activities for all core programs; • Promote awareness and education of occupational health and safety in undergraduate and graduate courses in other departments and schools; • Utilize a variety of research-to-practice (R2P) mechanisms, including our Visiting Partners Program, to develop skills and capabilities of mid-career occupational health and safety professionals; and • Assist Center programs and affiliated academic units in recruiting, promoting and retaining faculty

Comprehensive Community Assessment of Detroit's Older Adults

April 2018 - May 2019

The proposed Detroit Area Older Adult Comprehensive Community Assessment will update the 2002 assessment data on older Detroiters in the context of a post-bankrupt Detroit along with rapidly gentrifying pockets of the city where displacement of seniors continues. Thus, this is a crucial time to collect data on the contributions and needs of seniors in Detroit’s changing environment and make recommendations to stakeholders and community-based agencies. Given the city’s leadership (Councilpersons’ Mary Sheffield and Casteneda-Lopez), and collaborating city departments (Health Department, Department of Transportation, Parks and Recreation, Disability Department) in this project, key stakeholders have expressed the benefit of this project for the future of the city, given the absence of a Senior Citizens Department at this time.

Preventing HIV/STI in Urban Adolescents via an mHealth Primary Care Intervention

February 2017 - January 2021

HIV/STI remain significant public health concerns in the United States and adolescents are disproportionately affected. Adolescents engage in HIV/STI risk behaviors, including drug use and condomless sex, which increases risk for HIV/STI infection. At-risk adolescents, many of whom are racial minorities, experience HIV/STI disparities. Despite the facts that: (a) At-risk adolescents are disproportionately affected by HIV/STI risk behaviors, and infections, and (b) while CDC recommends routine HIV/STI testing in adolescents, relatively few adolescents report having ever been tested for HIV/STI. With expected increases in health clinic visits as a result of the Affordable Care Act, combined with technological advances, health clinics and mobile-health (mHealth), including apps, provide innovative contexts and tools to engage at-risk adolescents in HIV/STI prevention programs. Yet, a dearth of efficacious mHealth interventions delivered in health clinics to prevent/reduce both condomless sex and drug use and increase HIV/STI testing in at-risk adolescents exists. To address this gap in knowledge, we developed a theory-driven, culturally congruent mHealth intervention (hereon referred to as S4E) that has demonstrated feasibility and acceptability in a clinic setting. A next important step is to examine the preliminary efficacy of S4E on adolescent HIV/STI testing and risk behaviors. This goal will be accomplished by two aims: AIM 1 is to develop a cross-platform and universal version of S4E. The cross-platform and universal version of S4E will be compatible with both IOS and Android operating systems, and multiple mobile devices, aimed at providing adolescents with ongoing access to the intervention once they leave the clinic, and AIM 2 is to evaluate the preliminary efficacy of S4E, relative to Usual Care control condition, in preventing/reducing drug use and condomless sex, and increasing HIV/STI testing in a clinic sample of at-risk adolescents aged 14 – 21 living in Southeast Michigan. One-hundred adolescents recruited from a youth-centered community health clinic will be randomized via a blocked randomization with random sequence of block sizes to one of two conditions: S4E mHealth intervention or Usual Care. Theory-driven and culturally-congruent, S4E is a mHealth adaptation of the face-to-face Storytelling for Empowerment, which is registered with the Substance Abuse and Mental Health Services Administration National Registry of Evidence Based Programs and Practices.

A Community-University Approach to Preventing HIV

March 2018 - March 2019

HIV remains a significant public health concern in the US, and African American youth residing in Flint, Michigan, are disproportionately affected. Few HIV prevention programs have been developed and tested with this vulnerable population. To address these HIV prevention concerns, we collaborated with community-based organizations via NIDA funding to develop and pilot test, Storytelling 4 Empowerment (S4E), a theory-driven, mobile-health (mHealth) HIV prevention program that delivers targeted and tailored prevention messaging to youth. Our pilot study demonstrated the feasibility, acceptability, and preliminary efficacy of S4E in a clinic setting with at-risk youth. The overarching goal of the proposed community-university research is to advance scientific knowledge of technology-based, HIV prevention, and improve public health by establishing the feasibility and acceptability of an innovative mHealth prevention program for at-risk African American youth. We will accomplish these goals with two specific aims. Employing the principles of CBPR, we will establish and mobilize a community steering committee to inform all aspects of the research process. We will test the feasibility and acceptability of S4E by: a) enrolling at-risk African American youth (N = 20) at water distribution sites in Flint, Michigan; b) delivering the S4E intervention by peer health educators (N=2); and c) measuring uptake of HIV testing. The primary outcome will be feasibility and acceptability of S4E (e.g., enrollment rates). The secondary outcome will be uptake of HIV testing immediately post-intervention. Our S4E approach is innovative in linking at-risk youth at water distribution sites to an mHealth intervention to improve HIV testing.

Mood-Lifters: a novel approach to mental wellness

Approximately 57% of adults in the United States will develop a mental illness during their lifetime and 32% of adults live with a mental health condition at any given time. This has significant costs to society, government and industry with lost wages and disability payments estimated at $217 billion. There are over 55 million adults in the USA with a mental illness not receiving any treatment and millions of others receive substandard care. We created a program that shifts the paradigm in how wellness care in delivered from a clinic-based, clinician-run structure, to a scalable paraprofessionally administered, community-based, educational, wellbeing program called Mood Lifters. Mood Lifters is a 15-week self-referral program, where facilitators, who are not trained clinicians but rather professionals in a number of fields, are certified specifically in the psychoeducation provided by Mood Lifters to be inexpensive to deliver, scalable and evidence-based mental health care. Up to 15 participants per group will participate in weekly meetings that cover the teaching of evidence-based techniques that fall within five domains known to influence mental health - biology, cognitive, emotion, social processes, and behavior including evidence based treatments such as Cognitive Behavior Therapy for Insomnia (CBTi), Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy (CBT) and character Strengths (positive psychology). Clients are given a targeted set of goals (homework) for incorporating new wellness activities associated with the covered material into their lives and receive “points” for self-reported wellness behaviors during the intervening week. Mood Lifters has the potential to be used by multiple groups that work on wellness such as employers, social service providers, local Ys, community centers, schools or prisons. Unlike online programs, such as Mood Gym, Mood Lifters has social interaction and peer support, two essential components to successful self-referral programs. In addition the points manual that is used by participants has the essential component of using self-management to track their own behavior and outcomes while at home and at work. This grant will help us to take the the model program from the lab in the community as well plan to run 24 adult groups and 4 child groups next year testing the efficacy of the program.

Michigan Institute for Clinical and Health Research (MICHR) - KL2 Award

June 2017 - February 2022

The University of Michigan (U-M) and the Michigan Institute for Clinical and Health Research (MICHR) are strongly dedicated to the education of a competent clinical and translational research workforce. To this end, MICHR’s educational programs cater to members of the clinical and translational research workforce within four broad roles: 1) pre-doctoral students, 2) post-doctoral fellows, 3) faculty, and 4) staff. The “crown jewel” of our educational offerings is the KL2 program, which has attracted and developed exceptional scholars. Collectively, over the last 10 years, the MICHR KL2 Scholars have published more than 1000 peer-reviewed publications and received over $155,385,534 in grant support as principal investigators (more than $4 million per scholar). Importantly, 100% of the KL2 Scholars have remained in clinical and translational research and 68% have been successfully promoted since program completion. One of our main priorities going forward is to expand the program, use creative methods to increase the number of KL2-like trainees that we influence, and create pathways of access to our KL2 offerings for the many other categorical K-12 scholars at U-M. Additionally, we aim to focus on mentor training for both the mentee and the mentor, using the curriculum developed by the National Research Mentoring Network (NRMN). Creation of the MICHR Career Development Academy will provide education on critical skills for professional development that are often not taught. Through purposeful integration of our KL2 Scholars, along with our TL1 students, other MICHR Scholars, and community partners, we will provide the opportunity for our KL2 Scholars to gain “hands on” experience in mentoring and patient engaged research. Through development of an individualized learning plan, each Scholar will work with their mentoring team to successfully complete their research project and training plan. Monitoring of KL2 Scholar progress will take place through instruction and creation of eportfolios which will allow mentors ready access to each scholar’s work and formative reflective thoughts. Lastly, creation of a greater network or supportive research community surrounding our KL2 Scholars will be accomplished though purposeful integration with a diverse group of clinical and translational scientists as well as other Scholars within institutional training programs.

Promise Indiana Rewards Card Study

February 2018 - April 2019

The Center on Assets, Education, and Inclusion (AEDI) proposes to conduct a rapid-cycle randomized control trial to test the impact of providing rewards cards (vs. no rewards cards) to families of students with Children’s Savings Accounts (CSAs). Reward cards provide a rebate up to 5% on all grocery store and pharmacy purchases. At the time of purchase the rebate is ear marked to be deposited into a child’s CSA. By transforming spending into saving, rewards card programs have the potential to allow even the poorest CSA participants to begin building assets to help pay for college, even when purchasing goods with food stamps.

Kickstart to Career Newaygo County Program Evaluation

April 2019 - December 2022

Kickstart to Career is designed as a 10-year cohort program scheduled to enroll students through 2027. The program will conclude upon the graduation of the last cohort, class of 2041. The 2018-2019 initial cohort includes kindergarteners from eight schools (approximately 700 students). Approximately 7,000 students will receive accounts and financial literacy lessons within that timeframe.

Removing Barriers to Recovery: Community Partnering for Innovative Solutions to the Opioid Crisis

November 2018 - December 2020

Removing Barriers to Recovery: Community Partnering for Innovative Solutions to the Opioid Crisis