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Pilot Project Program

2019-2020 Pilot Project Awardees

Jyotsna S. Jagai, MS, MPH, PhD and Molly Scannell Bryan, MPP, PhD
Breast cancer risk: The intersection of structural violence, environmental inequalities, and family history

Project Description: Breast cancer is the most commonly diagnosed cancer in American women, and women of color bear a disproportionate burden of breast cancer morbidity and mortality. Breast cancer risk is influenced by structural violence, environmental inequality, and familial history, but the independent effects of each explain less than half of the breast cancer diagnoses. Combining these distinct risk domains is expected to improve the ability to predict breast cancer, but few studies have collected data that will allow for assessment of combined risk factors in each domain. We propose a secondary data analysis of data gathered from women who underwent a mammography screening and answered questionnaires about family history of cancer (N=3300 women screened). After informed consent is obtained (n=600 expected to consent by June), we will assess the relationships between neighborhood-level indicators of structural violence, ecological indicators of environmental exposures, and clusters of high familial risk of cancer. Further, we will characterize how structural violence, familial risk, and environmental exposures are associated with breast density, which will be extracted from mammography notes using Natural Language Processing. The project goals will be revised over quarterly meetings with our partner organization Sisters Working It Out (SWIO), and SWIO will facilitate dissemination neighborhoods with traditionally low mammogram rates. Additionally, this project will aim to provide preliminary data that will support a planned R01 application in the winter of 2020. This project will provide a foundation for future funding to help develop the independent careers of MPIs Dr. Scannell Bryan and Dr. Jagai.

Angelica C. Scanzera, OD
Telemedicine Diabetic Retinopathy Screening in an Urban Setting: Population Characteristics

Project Description: Diabetic retinopathy (DR) is a leading cause of blindness in the U.S., and early detection and treatment can prevent vision threatening problems.1 Yet, DR still causes 12,000-24,000 new cases of blindness annually.2 Unfortunately, racial and ethnic minorities have higher rates of diabetes related complications compared to non-Hispanic whites.3 Patients with diabetes are recommended to have a dilated fundus examination or posterior pole image screening annually. As the need in diabetic patients within the UI Health System are not met, other options are necessary. An alternative option to increasing specialists within clinics is a telemedicine DR image screening provided within the primary care provider’s clinic.

A joint telemedicine DR image screening program between the Department of Ophthalmology and Visual Sciences and Department of Internal Medicine was recently implemented to assist in increasing access to eye care. The specific aim of this project is to better understand racial/ethnic and residential influences predictive of participation, ocular complications diagnosed on screening, and to gain a better understanding of specific barriers to care through key informant interviews. We hypothesize that racial minorities from low socioeconomic status neighborhoods will have poorer adherence to follow-up and are diagnosed at later stages of DR. Our community partner for the proposed project is the Lions of Illinois Foundation, and co-investigators include Dr. Paul Chan, MD, MSc, Dr. Nita Valikodath, MD, and Dr. Jonathan Radosta, MD. This pilot program could assist in determining the need for expansion of a diabetic telemedicine diabetic retinopathy screening to other UI Health sites.

Rohan D. Jeremiah
Quad Cities Refugee Men’s Health Initiative Pilot Study

Project Description: The goal of this project is to advance the scientific knowledge about the health and well-being of ethnic minority refugee men in the United States, by theoretically explaining how they cope with migration trauma and daily stressors during resettlement. Recent statistics estimate the global refugee population at about 65 million at the end of 2017, with 1 of every 113 people in the world fleeing their home because of war conflict, or fear of persecution. Many refugees are at a disadvantage during resettlement when they are mitigating daily stressors including unfamiliar social and cultural norms of their adopted communities. This proposed study augments ongoing research within the Chicago Refugee Men’s Health Initiative that is studying the health and well-being of ethnic minority refugee men in the United States. Using a qualitative study format, we will recruit thirty (30) African Great Lakes (Burundi, Central African Republic and Democratic Republic of the Congo, Rwanda, Sudan and South Sudan) that have resettled into the Quad Cities Region on the border of Illinois and Iowa into time-lapse in-depth life narrative interviews and participant observations. The qualitative data will be used to build a theoretical explanation of their migration trauma and daily stressors during resettlement and identify social-ecological perspectives of their social networks. This pilot study lays the foundation for a NIMHD R21 application that will address the long-term psycho-social effects of trauma that emerge in ethnic minority refugee men’s coping strategies.

2018-2019 Pilot Project Awardees

Aaron Gottlieb, PhD and Robert Wilson, PhD
The Effect of Police Contact on Hopelessness and Educational Outcomes of Urban Youth

Project Description: Because police departments have increasingly relied on “proactive policing” and schools have increasingly employed uniformed school resource officers, police contact has become a form of structural violence that is quite common in the lives of urban boys of color. We propose to address 1) Examining whether arrests, police stops not resulting in arrest, and vicarious police contact are associated with chronic school absenteeism and college expectations among urban adolescents; 2) Examining several factors that may mediate the association between police stops and our two educational outcomes of interest; and 3) Examining whether the effects of police contact on school absenteeism and college expectations are particularly pronounced for boys of color and whether the mediating pathways are the same or different for this group.

Sarah Abboud, PhD
Toward the development of a community-based and youth-focused sexual violence prevention intervention for Sexual and Gender Minorities (SGM) in underserved Arab Communities in Chicago

Project Description: Using a community-based participatory action approach guided by the socio-ecological and structural violence frameworks,our main objective is to evaluate the cultural adaptation of an existing youth-focused evidence-based violence prevention intervention, Safe Dates. We will also identify the unique characteristics that define and prevent intimate partner sexual violence within the Arab youth community in Chicago and that can be targeted at early ages.

Amber Hathcock, MD, MPH
Reaching Out of the System: HIV Care Where You Are

Project Description: This study aims to evaluate and further characterize barriers to care and to assess needs for PLWH who are lost to care in Chicago. We will use a combination of spatial analysis to identify neighborhoods with the most PLWH out of care and qualitative analysis to identify greatest barriers to care and feasible care options for PLWH. Using this data, we will develop an innovative care model known as Reaching Out of The System: HIV care where you are (ROOTS) to reach patients who would otherwise be unable to access treatment.

2017-2018 Pilot Project Awardees

Dr. Uchechi Mitchell
“Holding on to Hope: An Analysis of Structural Risk Factors and Resilience Facilitators among a Racial Diverse Population of Older Adults” 

Project Description: Despite its association with poor physical and mental health and with an increased risk for death, research on the social and structural determinants of hopelessness among older adults is virtually nonexistent. Experiences of discrimination may contribute to feelings of hopelessness in old age, particularly among older African Americans who have been disproportionately exposed to this stressor over the life course. This project examines the relationship between discrimination and hopelessness among a racially-diverse and nationally representative population of older adults, and seeks to identify modifiable, social factors that protect against the adverse effects of discrimination and hopelessness.

Dr. Mary Dawn Koenig
“Mitigating the effects of structural violence on maternal iron status: a randomized controlled pilot study of probiotic supplementation in at-risk pregnant Black women.” 

Project Description: Interventions that can mitigate the physiologic effects of chronic stress from structural violence have the potential to improve maternal-infant iron status that translates to positive maternal-infant health outcomes in at-risk women. This study will pilot test the feasibility and tolerability of the probiotic LP299v and explore effects on maternal stress and maternal-infant iron status in at-risk Black women. This project will also build a sustainable university-community partnership to promote lifestyle and dietary approaches to mitigate the effects of chronic stress from structural violence for at-risk pregnant Black women in Chicago.

Dr. Anne Elizabeth Glassgow
“The Effect of Neighborhood Disorganization on Engagement in Health Care, Mental Health, and School Attendance of Children with Chronic Health Conditions”

Project Description: The proposed pilot study aims to examine structural violence among a large cohort of urban children with chronic conditions who are living in poverty. Research from this study will advance our understanding of the impact of structural violence on health, mental health, and social outcomes in a large group vulnerable children with known health disparities.

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