Embark KU Wichita is published by KU School of Medicine-Wichita. Contact us at wicpa@kumc.edu or 316-293-2635.
All changes of address, undeliverable copies and other correspondence should be sent to this address. The views presented in this publication do not necessarily reflect the opinions of the administration of the university or Embark sta . Embark does not endorse and is not responsible for any of the services or merchandise advertised. The entire issue is copyrighted and no part may be reproduced without permission. Patient photos are used with permission.
2
To support our work for a healthy Kansas, please visit kuendowment.org/MedWichita.
Population health education programs prepare graduates for careers in medicine, community health and beyond. Here there and everywhere
59 1721
Where are they now?
Explore what some of our graduates are doing with their degrees in sidebars throughout this issue. In-depth and additional spotlights can be found using the QR code.
Compassionate care for addiction
Funding from opioid lawsuits helps prepare physicians to better treat substance use disorders.
A bright spot from a dark time
The pandemic paves the way for additional educational opportunities.
Fix
the bridge first
If you had a damaged bridge and people were falling o , what would you do? Throwing life preservers would help save the people who had fallen, but fixing the bridge would have prevented them from falling in the first place. Personal health is like tossing them life preservers, but public, or population health would be equivalent to fixing the bridge.
This is the analogy S. Edwards Dismuke, M.D., MSPH, used to describe the di erence between personal health and population health during his tenure as the first chair of Preventive Medicine in Wichita, a new department created in 1991 by the University of Kansas for the School of Medicine. The initial goal of the department was to create a Master of Public Health program, which was to be jointly administered with Wichita State University. The program also integrated preventive medicine into the medical school curriculum.
Personal health and population health are equally important to all communities and serve unique needs, but population health isn’t as well
recognized. Most people see health as, “I need a doctor because I’m ill.”
Personal health is a one-on-one physician/patient relationship.
Population health tries to prevent illness. For example, when there’s an outbreak of some infection or an increase in a symptom that doesn’t appear in another location, doctors don’t have a sta — or their own time — to investigate and answer questions like why is this happening, how is it being transmitted, why did it appear at this time and what environmental issues are leading to the spread.
Public health partners with other advocates and provides education to change behaviors. It doesn’t compete
with the individual physician/patient relationship but provides another layer that improves individuals’ health by addressing the population through policy making and legislative changes.
As you will read in the following articles, in addition to having a component of population health in our medical curriculum, we have current and upcoming degrees for those who want a more well-rounded knowledge, who want to set themselves apart as a resident or fellowship candidate, or who want to enhance their
opportunities for a public health profession — all with the goal of preventing disease and infection to alleviate their risk factors.
Dean Garold Minns, M.D.
One sought the “mental boost” and confidence of an MPH before applying to KU School of Medicine-Wichita and following her dream of becoming a doctor. A fertility specialist pursued an MPH to learn more about biostatistics but has concluded that studying social factors a ecting patients’ health was the greatest benefit. Another MPH recipient practices evidence-based family medicine in his rural clinic, and now also puts his knowledge to work as the state’s chief medical o cer.
From the Centers for Disease Control and Prevention to county and state health departments to leaders of medical school departments to those preparing to apply for medical school, residency or fellowship, graduates of programs o ered by the Department of Population Health at KU School of Medicine-Wichita have a wide range of purposes and careers.
But the graduates share a common skill set: Looking at health from the
Paul Ndunda, M.D., MSCR assistant professor Internal Medicine
Population Health programs include a Master of Public Health, a master’s in clinical research and a research class for medical students. They prepare graduates for med school, residency, fellowships and a wide range of public health careers.
“No matter where someone ends up going, this is a skill set you can use for the rest of your life,” he says.
Becoming masters of public health and clinical research
The two-year, 42-credit MPH program is the Department of Population Health’s largest, with 60 to 70 students per year across campuses.
perspective of groups of people instead of single patients and becoming more skillful researchers.
One of them, former internal medicine faculty member Paul Ndunda, M.D., recently completed a cardiology fellowship, several years after earning his Master of Science in clinical research.
Students roughly fall into three categories, says Melissa Armstrong, Ed.D., M.A., director of MPH. First are those looking to build skills to successfully enter medical school, residency or fellowship. Second are those seeking public health careers in epidemiology, program evaluation, health education or other areas. Finally, “there's this hodgepodge group that comes from just about anywhere,” such as schoolteachers looking to expand knowledge or move up the pay scale, or non-clinicians working in hospitals or quality improvement.
Melissa
Armstrong, Ed.D., M.A.
education assistant professor MPH director Population Health
We really think of it as an opportunity for us to give these future clinicians a glimpse into what public health and population health are. They can use their time in the MPH program to get some good research experience and really stand out.
Melissa Armstrong, Ed.D., M.A., education assistant professor, MPH director
The in-person program has emphases in epidemiology or public health practice, while the online one o ers a public health generalist degree. All students complete an internship and a capstone project. Required classes include epidemiology, public health administration, management of public health data, and community health assessment, intervention and advocacy.
“Medical schools are always seeking the best and brightest,” Armstrong says. “What we hear from MPH students trying to get into medical school is they’re told to continue their personal and professional development and come back and apply again.
One of the things they suggest is to get an MPH degree, because it's very complementary to the clinical world.
“For foreign medical graduates, they are in a very competitive residency match process, and they're vying for a limited number of spots,” she says. “With an MPH, they get research opportunities, and it really shows a dedication to being here in this community and contributing to its overall health.”
The department’s Master of Science in clinical research program is much smaller than the MPH one, with just one to three students often graduates of the internal medicine residency at a time focusing on the research skills sought by fellowship programs.
Requiring fewer credit hours — 33 — “it takes out a lot of the traditional public health courses like administration and social behavioral health, and adds in more epidemiology, more biostatistics,” Armstrong says.
“It focuses on grant writing, scientific writing and clinical trials. It has primarily attracted students who need to show a track record of research and publication. So far, our graduates have gotten almost exclusively cardiology fellowships, but there’s also been a couple of nephrology fellowships.”
In addition to its degree program, the department o ers three online graduate certificates for those wanting to pursue careers in public health. The 12-credit-hour programs focus on essentials of public health, epidemiology, and public health policy, practice and management.
Teaching population health and research to medical students
Medical students aren’t left out by the department, as they can take a four-credit elective, Clinical and Population-Based Research, from Professor Elizabeth Ablah, Ph.D., MPH, CPH.
Students begin with two weeks of classroom work followed by eight weeks of summer sessions. Since 2020 the class has been fully online, where students can wear their jammies but must always turn on the camera and participate. They formulate research projects, work with mentors, analyze data, learn research-writing styles and produce two things: a publishable paper and an oral or poster presentation.
The topics range widely, with recent topics including transgender surgery complications, vaccine e ectiveness, EMS data on behavioral health problems and continuous blood glucose monitoring. “It’s all across the board, and it’s really fun,” Ablah says.
“It’s a wonderful opportunity for the student to understand what evidencebased research is, which is often an ethereal concept. They understand how the research process occurs and what needs to happen,” Ablah says. “They’ll be more cognizant of what
evidence-based medicine is about. They can study the best approach for a patient rather than just going o a hunch and wishing for the best.”
The course has grown in popularity, with nearly 50 students across three years, numbers that ticked up after the Step 1 test, one of a three-step examination for licensure in the U.S., became pass/fail and future residency candidates sought to build skills and resumes, Ablah says. “It’s been a good opportunity for students to demonstrate they are strong candidates for residency and can conduct their own studies.”
Putting population health to work
Whether studied in a medical school class, learned through a degree program, or put to work in a doctor’s o ce or public health agency, there’s a core element to population health. It’s the belief in stepping back — taking the view from the balcony — and looking at the lives of many to obtain information and lessons that, person by person, can improve health and lives.
David Grainger, M.D., MPH, chair of the Department of Obstetrics & Gynecology, is a fertility specialist, but the skills and perspective he gained through his MPH translate across many fields, locations and professions.
Throughout this issue of Embark, look for stories of how he and others put their degrees and knowledge to use.
A better understanding of population health, epidemiolog y and biostatistics helps me paradoxically — better care for patients.
— David Grainger, M.D., MPH, professor
MPH: The fertility doctor
David Grainger, M.D., MPH, is a professor, chair of the Department of Obstetrics & Gynecology and a longtime Wichita infertility specialist. He earned an MPH in 2000, a decade after completing his fellowship in reproductive endocrinology and infertility. He’s since been involved in numerous clinical studies, including for uterine fibroids and endometriosis, and Wichita is a test site for many medical devices.
“My MPH has been very helpful in dealing with industry with regards to study design and implementation,” he says. “If an individual is contemplating medical research at any level, the MPH program is invaluable.”
Exposed to biostatistics during his fellowship, it initially sparked his interest in the MPH degree. Over time the focus of his appreciation shifted.
“Today I believe that the most valuable classes were those related to social determinants of health,” he says. “The MPH program encourages a ‘bigger picture’ approach to medicine. This type of learning is especially helpful in exposing and addressing our own unconscious bias. I believe I can communicate better with my patients as a result of my deeper understanding of socioeconomic barriers.”
In-depth and additional spotlights can be found using this QR code.
10.2M
Adults in the U.S. have co-occuring mental health and substance use disorders.
Substance Use Disorder Mental Illness
Preparing physicians to treat addiction
Statistic from nimh.nih.gov
Substance use disorders are the focus of training, new fellowship
“Drawing out an undiagnosed substance use disorder may be more than many physicians are ready to tackle. But it’s not from a lack of caring.”
Elizabeth Ablah, Ph.D., MPH, CPH, professor
“When you are dealing with someone who has a substance use disorder, this is not going to be generally an easy conversation and they’re generally not going to be enthusiastic about changing behaviors,” said Elizabeth Ablah, Ph,D., MPH, CPH, professor and vice chair in the Department of Population Health at the University of Kansas School of Medicine-Wichita.
“It can be draining for a lot of providers when they’re already tight on time. Some providers are feeling like ‘we don’t have the time to get into this, so why would I screen for something?’ It’s challenging, I think, for folks when they fear there will be pushback or resistance.”
Nevertheless, it’s a problem of epidemic proportions: Nearly 18% of Kansans 18 years and older have a substance use disorder, according to a recent survey. Nationwide, it’s estimated that 16.5% of Americans have a substance use disorder, yet 94% receive no treatment for it.
Preparing physicians
A multilayered e ort called Preparing Physicians to Treat Addiction is trying to better prepare physicians to treat addiction disorders while increasing access to such care in Sedgwick County. Launched last November, PPTA is funded from Kansas’ share of national opioid lawsuit settlements.
Ablah’s part of the work centers around physician awareness and education. Rachel Brown, her co-principal investigator on the grant, is overseeing the development of an addiction medicine fellowship that’s another part of PPTA. Brown, MBBS, M.Phil., is also professor and chair of the Department of Psychiatry & Behavioral Sciences.
Ablah started by gathering information: interviews with 26 local physicians, residents and medical students; and a survey of Sedgwick County Medical Society members. The results tallied with medical literature on the topic, Ablah said. “Physicians have many barriers to intervening with people who have a substance use disorder, including stigma. It’s a big issue.”
‘A 10-minute conversation’
For physicians seeing patients in 15-minute increments, PPTA promotes an approach known as SBIRT, for Screen, Briefly Intervene, Refer and Treat. It starts with a two-question screening tool that a patient can complete in seconds, allowing the physician to assess the risk of substance use disorder. If they screen positive, there is an 8-10 item survey for the physician to better understand the risk. The physician then conducts a brief intervention to discuss risks and, if the patient is interested, risk reduction strategies. The physician o ers to help
“That’s very exciting,”Ablah said of the fellowship. “It will be accredited and rolling in 2025.”
the patient, without expressing judgment. If the patient agrees, the physician provides treatment and/or refers to substance use disorder services.
Ablah said even a brief intervention can be e ective. “A 10-minute conversation with a physician is a lot. If it’s done in a way where somebody doesn’t feel they’re being judged or being attacked, they often will have a conversation where they’re not trying to defend themselves, they’re willing to open themselves up with someone they trust.”
50% of people 12+ have used illicit drugs at least once.
Statistic from NCDAS (2023). drugabusestatistics.org
Treatment could range from medication to prevent opioid cravings to “motivational intervening” and “harm reduction” remedies that Ablah called a “bold act.”
For instance, she said, a physician might suggest to a patient that “instead of drinking five liters of vodka a day, how about a 12-pack?”
PPTA also encourages physicians to change the way they may talk and think about substance use. On a webpage set up for the program, physicians are encouraged to use “person-first, medically appropriate language” in this area. For instance, instead of thinking of and/or referring to a patient as an “abuser,” “addict” or “substance abuser,” physicians should refer to the patient as a “person with a substance use disorder.”
‘Be the LIGHT’ PPTA has produced and distributed a short video built around the idea that physicians can be the “LIGHT” for people with a substance use disorder. LIGHT stands for language, intervention, guidance, help and treatment.
Also as part of PPTA, Dan Warren, M.D., one of the county’s addiction medicine specialists, and Chad Harmon, CEO of Substance Abuse Center of Kansas, have made presentations to members of the medical community, usually with the help of someone recovering from substance use disorder.
Ablah called the county’s lack of addiction medicine specialists “really a problem” and one the grant will help address.
board-certified addiction medicine specialists in Sedwick County 4
Fellowship on way
Another of the county’s specialists, Ashley Haynes, M.D., is helping develop the fellowship program. Fellows likely will rotate among several recovery centers, an opioid treatment clinic and community providers such as Comcare, as well as the VA during their year in the program, Haynes said.
Haynes said addiction medicine is evolving much as other specialties did. It has become a board-certified specialty requiring a fellowship in the past decade, whereas previously a physician could become certified after amassing experience in the field.
Haynes, who did her fellowship in toxicology, was drawn to addiction medicine after seeing e ects of the
Daniel Warren, M.D., physician
K2 synthetic marijuana epidemic, which claimed clusters of lives in communities across the United States. “I wondered why would (K2 users) keep doing this to themselves?” She practiced in Dallas — where one of the deadly clusters had occurred — before returning to Wichita, where she has worked at a local opioid treatment program, residential treatment centers and hospital consultation.
Haynes said she has always enjoyed “the challenging cases that were not straightforward and seeing the changes in (a patient’s) life and that improvement was very rewarding.”
There’s no question the county could use more specialists, she said, noting that she “had to turn down opportunities because I don’t have the time to work everywhere that needs a person.”
“We have not seen a decrease in opioid use disorder,” she said. “There’s probably a lot of people who are untreated or undertreated. And we need people willing to treat the adolescents and pregnant and the higher-risk patients. We really need several more in our community.”
Ablah noted that the state recently approved the construction of a new psychiatric hospital to be located in south central Kansas, addressing a severe need exacerbated by patients with substance use disorders.
“If you think about the psychiatric hospital coming in a couple of years, we are not prepared. So, I am thrilled that we are in a place where we can start developing that capacity.”
“A lot of times, people who have a substance use disorder find themselves walking on a dark path alone,” said Elizabeth Ablah, Ph.D., MPH, CPH, “We ask the physician to be the light that walks with the patient and brightens that path.”
MPH: The future doctor
Growing up in Wichita, Saniya Ahmed, MPH — a second-year medical student — always wanted to be a doctor. As the child of immigrants whose family was uninsured or underinsured, she helped her parents navigate the health system and receive care at a safety net clinic.
Ahmed had to make the financial and health choices around doctor’s visits and getting lab work. She’s volunteered with the JayDoc Community Clinic and the county health department and worked at the International Rescue Committee for refugees, which exposed her to medicine, underserved populations and the type of doctor she strives to be.
“I’ve always wanted to be the kind of physician and person that is known first and foremost as an advocate,” she says.
Although interested in medicine, she was more interested in the natural world. She majored in health sciences at Wichita State but, “terrified of the MCAT,” instead entered the MPH program. The experience provided the “mental boost” for medical school.
From seeing motivational interviewing in action to an elective rural rotation in Dodge City, “convinced me to be a family medicine physician for life.”
“It’s really important for anyone who goes into primary care to know about public health work, to be mindful of public health professionals, to listen and to collaborate.”
Environmental experience provides valuable content for
health classes
With a career that started during the 1970s when the Environmental Protection Agency was formed, KU School of Medicine-Wichita research instructor Jack Brown, R.S., MPA, has a wealth of experience to share with students who take the required environmental health course in the Master of Public Health degree program.
Jack Brown, R.S., MPA, research instructor Population Health
“I’ve taught the class since the beginning of the MPH program (in 1997) and it’s always focused on all aspects of the environment, particularly from a practitioner’s standpoint,” said Brown, whose achievements range from having served as the project manager of a Wichita groundwater cleanup e ort that led to the building of one of the nation’s most innovative treatment centers to developing recommendations to help ensure safe water for Kansans using private household wells.
When Brown joined the KUSM-Wichita faculty in the mid-1990s, he was still involved in leading the Wichita-Sedgwick County environmental health department, the state’s largest such department. He retired from that position in 2003.
Environmental law is one of the key areas of his class because “it establishes standards for everything we do in the country in terms of air quality, water quality and hazardous waste disposal. All of these you find in government environmental
programs, and they impact the general population,” Brown explained.
“My career started around the same time the EPA was created and that was a new and exciting thing because it became a very active time for environmental law,” said Brown, who was one of the first environmental health practitioners in Kansas to earn the designation of registered sanitarian.
“While there’s a lot of regulation, there is still a lot of work to be done. It would be misguided to think that everything’s cleaned up now.”
With more work to be done, it’s important for public health practitioners to understand the concepts of environmental health.
As part of the class, Brown includes “field experiences where we go out and observe what we’ve talked about in class related to the practices we’ve talked about.”
One of the field trip destinations is the Wichita Area Treatment Education Remediation (WATER) Center,
“I’ve always wrapped in the practical experience I have from working in local government and public health, particularly as it relates to the environment, because a lot of public health work is done through local, state and federal organizations.”
Jack Brown, research instructor which opened in 2003 in Herman Hill Park in south Wichita and has a two-fold purpose: cleaning up polluted groundwater extracted through 14 wells in a four-square-mile area in central Wichita and educating the public about how reclaimed water can be used.
The Herman Hill water treatment facility at 101 E.
Street in Wichita cleanses 1.2 million gallons of water daily and is devoted to water-specific ecology issues.
Established in 1970, the EPA conducts environmental assessment, research and education. It has the responsibility of maintaining and enforcing national standards under a variety of environmental laws, in consultation with state, tribal and local governments.
Pawnee
Water pollution can cause infections, diseases and other health problems, such as cancer, cardiovascular and respiratory conditions.
Unsafe water kills more people each year than war and other forms of violence.
Statistic from nrdc.org
“In the field of environmental health, the goal is to preserve the environment and protect the health of current and future generations, which is why it is important to include the topic in MPH degree curriculum.”
Jack Brown,
research instructor
Allison Honn, MBA, program manager Population Health
Brown oversaw the building of the center, where solvents and other compounds are removed from the water. The reclaimed water is then used in the center’s fountains, water pools, a fish observatory and gardens. The project won several awards, including top honors from the American Academy of Environmental Engineers and the American Council of Environmental Engineering.
The work that was done in the various groundwater contamination areas in Wichita helped shape national policy on how to deal with contaminated sites and redevelop them, according to Brown.
Brown was also involved in setting up a water monitoring and sampling plan for the Arkansas River, which has helped inform the public about the safety of the river for recreational activities. That project led to an Ark River summit that drew hundreds of participants and a major study of the river’s potential pollution sources. The annual volunteer cleanup of the river is another outcome of the project.
Brown also encourages his students to attend public meetings when environmental health issues are on the agenda to see that part of the process.
But regulations aren’t the only thing that Brown teaches his students.
As public health initiatives have evolved to include community health and wellness, he’s started adding additional material, like pedestrian and bicycle safety programs and creating access to healthy activities like hiking.
“Those are things that everybody can really identify with,” Brown said.
Another highlight of Brown’s career was being part of a research team — which also included KUSM-Wichita population health professor and department vice chair Elizabeth Ablah, Ph.D., MPH, CPH (a former student of
Jack Brown and Elizabeth Ablah
Brown’s) and population health program manager Allison Honn, MBA, — that developed recommendations for making water from private wells safer for drinking, cooking and other household uses.
While the recommendations were created to address the lack of standards in Kansas, the researchers said the recommendations could be useful for other communities and states according to an article published in Environmental Health Perspectives in 2020. The research was funded with a grant from the Kansas Health Foundation.
Upcoming publications mark milestones in Hayrettin Okut’s career
In just a few months, Hayrettin Okut, Ph.D., will experience one of the most significant highlights of his personal and professional life. He anticipates that a new book exploring the complex relationships between genetics and health will reach publication by the end of 2024. He is the book’s academic editor.
“Agreeing to be the editor of this book embodies my lifelong passion for biostatistics and my commitment to understanding the intricate ways in which genetic variations impact health outcomes,” Okut says of the work, titled “Genetic Variations — Unraveling Causalities.”
A professor in Population Health for the University of Kansas School of Medicine-Wichita, Okut has also co-written one of the book’s chapters with a colleague in the O ce of Research, Rosey Zackula, M.A., statistician. Additionally, Okut will write a two-page introduction for the book.
“The book is important for the study and advancement of population health as it bridges the gap between genetic research and practical health applications,” says Okut. “It highlights how understanding genetic variations can lead to more e ective prevention strategies, personalized treatments, and ultimately, a reduction in health disparities.”
This milestone in Okut’s career is unfolding as he continues his work as the co-author of the upcoming fourth edition of “Epidemiology: Study Design and Data Analysis.” The new edition will serve as an invaluable textbook for students studying statistics and epidemiology, as well as a standard reference for practicing epidemiologists.
Okut earned his Doctor of Philosophy degree in biometry-biostatistics in 1992 from the University of Ege-Izmir, Turkey, and completed courses for his degree at the University of Minnesota-Twin Cities. Since then, he has worked as a researcher in genetics, biometry and biostatistical methodology at various universities and centers, including Yuzuncu Yil University-Van-Turkey, the University of Wisconsin, Oregon Research Institute, University of Nebraska, University of Palermo-Italy and Wake Forest School of Medicine. He has served at KUSM-Wichita since 2018.
His work in the Department of Population Health relies heavily on big data to better understand and predict health outcomes.
“In essence,” he says, “by developing better predictive models and understanding complex health data, we can make significant strides in preventing diseases and personalizing treatment, ultimately enhancing the overall health of populations.”
TH E IMPACTS OF
FEAR FACTS NOT TOCONTINUE
A federal grant used for several community health initiatives has ended but should continue to benefit several of Wichita’s minority populations.
Amanda Aguila-Gonzalez, Ph.D., MPH, post-doctoral fellow Population Health
KU School of Medicine-Wichita began serving as the administrator for the Facts Not Fear ICT project in April 2023.
Facts Not Fear ICT had four main goals: improving health literacy, engaging Wichita communities, improving patient-provider communication, and improving access to COVID-19 testing and vaccinations. Although open to anyone 18 years and older, the priority populations for FNFICT were Wichita adults who were Black or African American, Hispanic or Latino, American Indian or Alaska Native, and Asian or Asian American.
In response to mental health needs shared by the community at large and FNFICT priority populations, an intervention was developed to improve mental health literacy, mental health care access, and the mental health workforce. FNFICT partnered with Mental Health America of South Central Kansas and Communities Organizing to Promote Equity to develop a training for individuals, especially from FNFICT priority communities, to become community mental health workers. Part of the grant was used to recruit and train community mental health workers.
Four cohorts totaling 60 participants completed 40 hours of training, each over a four-week period. Amanda Aguila-Gonzalez, Ph.D., MPH, lead evaluator at KU School of Medicine-Wichita, described trainees as “folks who were interested in serving the community and doing this one-on-one work with community members” in the area of mental health. Most were women, with an average age of 45.
The training included how to assess clients’ needs, how to develop a client care plan, mental health and wellness, and preparing trainees on how to interact with individuals with a mental illness. The intent was to improve mental health literacy and prepare trainees to join the mental health workforce. Organizations such as Guadalupe Clinic, MHASCK and COMCARE joined the final day of training to share information about open positions and possible roles and responsibilities for trainees. Angela Scott, COPE community health worker field supervisor, helped train the community mental health workers. In addition to preparing those people for entry-level jobs, she said, Facts Not Fear impacted the priority populations.
“I think the e ect has been that we provided education and knowledge that people didn’t have before, specifically in regard to mental illnesses, and how to help and connect people with mental illnesses to resources,” Scott said. “That’s the feedback we got.”
“We have already heard back from some folks who have been able to make connections and find employment opportunities after completing their training,” Aguila-Gonzalez said.
During the last three years, Facts Not Fear ICT hosted community sessions at several locations, including the Urban League of Kansas, Atwater Neighborhood Center, and the Evergreen and downtown branches of the library. These sessions were intended to promote healthy habits and improve health literacy to promote positive health outcomes. Each session focused on a di erent health topic including: physical activity and nutrition, stress and mental health, health visits and screenings, COVID-19 and prevention, and substance use disorder.
“Folks were interested in serving the community and doing this one-on-one work with community members.”
Angela Scott, COPE community health worker field supervisor
More than 1,000 people attended the sessions, which were presented in English and Spanish by community health facilitators. FNFICT provided interpreters at sessions to address language barriers for those who speak English, Spanish, Vietnamese, Thai and Lao. Content from the interactive sessions will be made available at factsnotfearict.com in English, Spanish and Vietnamese.
Facts Not Fear ICT also partnered with community organizations to host mobile vaccine clinics. This year alone, Aguila-Gonzalez said, more than 200 people from the grant’s priority populations were vaccinated along with others outside those populations. Interviews with more than 200 community members around the topics of substance abuse and mental health were also conducted.
Facts Not Fear ICT utilized information shared by community members in those interviews to inform other project e orts such as training to improve providerpatient communication and the assessment of 16 clinic and community organization patient/client-facing materials in Wichita. Facts Not Fear ICT supported these sites by providing recommendations and translation of materials to improve access to, use of and understanding by priority communities.
“We share some of our lessons learned,” Aguila-Gonzalez said. “We share evidence-based strategies for health literacy, we share cultural considerations and we share evidence-based communication strategies that have been proven to be e ective to improve communication and interactions between providers and patients within the FNFICT priority communities and others.”
“I appreciated that this training was taught by people outside academia who spoke from real life experiences. The role playing with specially trained ‘clients’ was great practice for future interactions at my job.” — Mark Calvin, site director, Haysville Learning Café
Mark Calvin, site director at Haysville Learning Cafe, includes what he learned during the community mental health training sponsored by Facts Not Fear ICT to help advise Kathleen Faber on potential career courses.
BACKGROUND
Community members’ health at the core throughout its evolution
Though COVID-19 was the seed from which Facts Not Fear ICT grew, the initiative has progressed with the changing needs of our community. Population health experts began by helping Wichitans identify COVID-19 misinformation and access care. They promoted testing and eased fears about vaccinations.
The grant was designed to improve health outcomes and address health disparities exacerbated by COVID-19 in Wichita by improving health literacy. Four priority populations disproportionately impacted by COVID-19 in Wichita were: Black or African American, Hispanic or Latino, Asian or Asian American, and American Indian or Alaska Native adults.
This initiative continued to develop as community needs were identified. The expansion included disseminating messaging and education programs in addition to COVID-19 on topics including nutrition, stress and mental health, health visits and screenings, and substance use disorder. These programs were designed by Population Health colleagues at KUSM-W led by Elizabeth Ablah, Ph.D., MPH, CPH, professor, and team members Amanda Aguila-Gonzalez, Ph.D., MPH, and Allison Honn, MBA.
There is more collaboration with clinics and community service organizations to improve communication between physicians and their patients. Community members are receiving state-certified training to contribute to an entry-level mental health workforce. The community at large is receiving detailed information to improve mental health literacy, using campaigns and short videos in multiple languages that provide tools and resources addressing the signs and symptoms of common mental illnesses.
Ablah and her team will continue to address attitudes and behaviors to empower people to be successful and achieve their goals.
Allison Honn, MBA, program manager Population Health
MPH: The state’s chief medical o cer
Dereck Totten, M.D., MPH, sees his role as Kansas’ chief medical o cer as “the icing on the cake” of his upbringing in the state; education in KU’s university, medical school and residency programs; and nearly a decade of rural practice.
Totten and his wife, Kysha Nichols-Totten, M.D., have practiced full-spectrum family medicine, including obstetrics, in Colby since 2016. He’s nurtured and put his background in population health to work as Thomas County medical o cer and providing evidence-based care at his group practice.
“We can look at, say, hemoglobin A1C, and examine trends so we can start to move the needle on outcomes. It’s not just taking the same recommendation but really looking at what’s unique to that area and population,” Totten says.
Totten is still learning what the CMO role entails, with duties that mix policy, preparedness and consulting on individual medical cases or potential disease outbreaks.
“I jump in when there’s a medical question, like an odd tuberculosis case they need advice on. Or consulting on policy questions on family planning,” Totten says.
“I’m someone with a rural health background, and one of my biggest honors is to bring that perspective to the conversation.”
may help address preventable di erences in health outcomes.
3:40 2:25
Michelle Redmond, Ph.D., M.S. associate professor
Population Health
While new grant opportunities are allowing KU School of
Medicine-Wichita
Associate Professor of Population Health Michelle Redmond, Ph.D., M.S., to expand research methods, the real catalyst behind her work is finding innovative and user-friendly options to help improve health outcomes for vulnerable communities.
“When I was writing this grant, I thought of how this could have helped my aunt who died from complications from diabetes,” Redmond said about creating an online and easily accessible resource for diabetes self-management. “I could see her getting on her computer, using this information and really trying to figure out how to manage her diabetes.”
The eDECIDE portal for diabetes self-management, found at edecide.org, is one of two digital health interventions that Redmond has undertaken in the past few years. In spring 2024, she started collecting survey data to create a music therapy intervention program to help reduce every day and situational stressors among pregnant and postpartum women.
While anyone can end up having complications from diabetes or a stressful pregnancy, statistics show that non-white populations often encounter more challenges, with many of them coming from outside influences — known as social determinants of health — that have led to disparities or gaps in health care.
Applying new skills
Redmond, who earned her doctorate in community psychology from Wichita State University in 2006 and completed a three-year postdoctoral National Institutes
of Health fellowship at the University of Michigan, Ann Arbor, has had a longtime interest in researching health disparities.
She has extensive experience conducting program evaluations for community-based and local government organizations along with expertise in developing and designing community-based research projects.
“She’s amazing in what she does,” said Joyea Marshall-Crowley, a program director with the Kansas Breastfeeding Coalition and founder of the Wichita Black Breastfeeding Coalition. “She’s making a huge mark in representation and improving health care and that’s important.”
In 2018, Redmond received a five-year career development award of more than $500,000 from the National Heart, Lung and Blood Institute. The purpose of career
development grants, according to the NIH, is to provide financial support that allows the researcher to have dedicated time to engage mentors and further develop their research skills and experience. In Redmond’s case, she initially sought out Tracie Collins, M.D., MPH, MHCDS, who was chair of the Department of Preventive Medicine & Public Health. After Collins’ departure from KUSM-Wichita in 2019, Nicole Nollen, Ph.D., from KU Medical Center in Kansas City became Redmond’s mentor.
To dive into developing her digital intervention skills, Redmond worked with Barbara Chaparro, Ph.D., a human factors professor with expertise in user experiences ranging from gadgets to websites. Chaparro had run a usability research lab at Wichita State before leaving for Embry-Riddle Aeronautical University in 2017.
You want to create interventions that can help people and improve their lives. With digital interventions, perhaps we can reach more people.
— Michelle Redmond, Ph.D., M.S., associate professor
There’s a body of research that indicates music has therapeutic e ects that help relieve pain, reduce stress and improve one’s sense of well-being.
A portal for diabetes self-management
According to May 2024 numbers posted on the Centers for Disease Control and Prevention’s National Diabetes Statistics Report website, 38.4 million Americans of all ages, or 11.6% of the population, have diabetes; about 95% of those diagnosed have Type 2 diabetes.
Diabetes, caused by the body’s inability to either produce or use its own insulin e ectively, is also a deadly disease; the CDC says it’s the seventh leading cause of death in the U.S.
Uncontrolled diabetes can lead to serious health complications, including heart disease, stroke, blindness, diabetic neuropathy, amputation and kidney failure.
In many cases, behavioral changes like eating a healthier diet, doing more physical activity and applying better diabetic self-management skills can help improve one’s quality of life.
That’s where eDECIDE can help, Redmond said. Adapted from a traditional and successful intervention program initially created by a Johns Hopkins researcher for African Americans in the Boston area, eDECIDE is one of the first web-based platforms that can help adults manage their
Type 2 diabetes, according to the eDECIDE website. DECIDE® stands for Decision-Making Education for Choices in Diabetes Everyday.
Most interventions that help those with diabetes learn problem-solving skills to manage their disease tend to be done in group or one-on-one settings.
With eDECIDE, an adult with diabetes can have access right at their fingertips. The program includes sessions on topics such as managing stress, increasing physical activity, staying compliant with medications and even talking to one’s provider.
Feedback from the current participants in eDECIDE’s pilot study is helping Redmond and her research team determine how to further tweak and improve the site.
“What really excites me is the opportunity to provide an additional tool to people who need to manage their diabetes,” Redmond said.
About 20 of the 100 screened participants have enrolled or have completed the eDECIDe program. At least one participant has indicated they’ve lost weight through using the techniques in the program.
Soothing sounds
There’s a growing body of research that indicates music has therapeutic e ects, including releasing endorphins— hormones that help relieve pain, reduce stress and improve one’s sense of well-being.
Stress during pregnancy can lead to unhealthy outcomes for mom and baby, including low birth weight or even worse.
“Currently there’s not a lot of literature out there around interventions during pregnancy, particularly for African American women,” Redmond said. “We’re interested in African American women because of the high infant mortality and maternal morbidity and mortality rates.”
A study of maternal death rates for 1999-2019, published in 2023 in the Journal of the American Medical Association, showed Kansas has consistently high maternal mortality rates among African American mothers, especially when compared to rates among all other women in the state.
The state also has had a consistently higher infant mortality rate among non-Hispanic Black babies, according to the Kansas Department of Health
and Environment, which publishes an annual report on infant mortality since it’s an indicator of community health. The rate has remained at least 2.5 to 3 times that of non-Hispanic white births for most years from 2002 to 2021, the latest report said.
In 2021, the rate for non-Hispanic Black infants was 13.6 deaths per 1,000 births, well above the 4.5 rate among non-Hispanic white births and 5.2 rate among Hispanic births.
About half of the women in Redmond’s current study are African American women while the remaining half include Hispanic and white women.
Participants were asked open-ended questions about whether they experience discrimination (i.e. what forms and frequency), what coping strategies they use for relieving stress and tension and how
those are working, and if they were to use music to reduce everyday stressors, how would they want that intervention delivered (i.e. through a music app or self-generated playlists or already-curated playlists).
For this study, funded by an internal grant from Frontiers Clinical & Translational Science Institute at KU, Redmond is collaborating with Rebecca Lepping, Ph.D., an assistant professor of neurology with KU’s Hoglund Biomedical Imaging Center, and Deanna Hanson-Abromeit, Ph.D., MT-BC, an associate professor of music therapy and music education with KU. The three met at a Kansas Birth Equity Network meeting.
Once Redmond and her research team have compiled data from the survey responses, they will apply for additional funding to create and test the pilot intervention.
MSCR: A big step toward cardiology
Paul Ndunda, M.D., MSCR, has always been fascinated by the interaction between social determinants of health and cardiovascular disease. His interest grew as he cared for underprivileged patients with rheumatic heart disease in rural Kenya and witnessed a growing coronary artery disease epidemic in more a uent Nairobi. “My mother’s complete heart block needing emergency pacemaker implantation during my residency cemented my desire to pursue cardiology.”
“KU provided the perfect opportunity to do what I love, caring for critically ill patients, working with medical students and residents, and conducting research while pursuing the MSCR program,” he says.
Ndunda says the MSCR program empowered him as a clinician, researcher and leader by broadening his understanding of population health, statistics and research methods. This enabled him to critically appraise evidence in clinical practice, take a broader view in the care of his patients and e ciently develop and execute research plans.
“ Clinical research is very rewarding and gives me the opportunity to make an impact on personal and global levels. I love the fact of adding to the body of knowledge of cardiovascular medicine, and contributing to something that will outlive us,” he says.
Melissa Armstrong, Ed.D., M.A., education assistant professor MPH director
Population
Health
In the aftermath of the COVID-19 pandemic which brought increased attention to the importance of public health new education pathways were created within the KU Medical Center public health degree program: an online Master of Public Health degree option and three graduate certificates.
And there could be more to come.
The Department of Population Health is exploring o ering the Doctor of Public Health. The Dr.PH is an advanced terminal professional degree that prepares public health professionals for leadership roles and emphasizes fieldwork and practice, in contrast to a Doctor of Philosophy degree which focuses on advancing research.
“O ur alumni want it, our community wants it and we want it,” said Melissa Armstrong, the longtime site director for the Master of Public Health degree program at KU School of Medicine-Wichita.
The department is creating an advisory group of faculty and MPH alumni to help strategize and make recommendations for a Dr.PH program at KUMC.
That move is the first step in the lengthy process of starting a new degree program, which involves designing a curriculum with courses focused on enhancing the skills of mid-career professionals. It can take more than two years of review to gain final approval from the Kansas Board of Regents.
It would also need accreditation by the Council on Education for Public Education. While the CEPH sets core
competencies for a Dr.PH program, schools determine their own approach in crafting the degree program.
“While we’ll look at best practices, the guiding star will be what works best for Kansas.”
—
Melissa Armstrong, assistant professor
“Because Kansas and much of the region don’t have access to this terminal professional degree program, we want to make sure that what we o er will be the most pertinent to public health practice,” said Simon Craddock Lee, Ph.D., MPH, who became chair of the Department of Population Health at KU School of Medicine in 2022.
Currently, the nearest Dr.PH programs in the region are at the University of Colorado and the University of Nebraska while none exist in Missouri, Oklahoma or Iowa.
Ahead of its time
When the University of Kansas moved to create the Department of Population Health in 2019 by integrating two existing departments within its medical school, it was making a strategic decision with an eye to the future.
“If you look back over the last few years, you see academic medical centers — meaning medical schools and their a liated health systems — around the country creating departments or divisions of population health within medical schools,” Lee said, citing numbers from an organization he leads, the Population Health Leaders in Academic Medicine. Statistics from PHLAM, an a liate of the Association of American Medical Colleges, show a quadrupling in the number of population health departments or divisions within medical schools, going from only 11 in 2016 to well over 40 in 2022.
“ This has been a deliberate e ort on the part of medical schools to attend to public health issues and to integrate the role of medicine in e orts to address social determinants of health but not lose the tie to the health systems where our clinicians practice.”
— Simon Craddock Lee, chair
The mission of both the medical school and the population health department has been tied to improving the health of Kansans, whether it be to provide doctors or strengthen public health programs across the state.
Simon Craddock Lee, Ph.D., MPH, chair Population Health
“We had several adult learners who wanted to retrain, further educate themselves or switch over to public health.”
Melissa Armstrong, Ed.D., M.A., education assistant professor MPH director
“One of the things I find so exciting about the MPH program here at KUMC is how … (our alumni) are really concerned about the health and health care in their communities and they want to stay in Kansas,” Lee said. “So, we have a responsibility to build the skill sets of people who are going to serve our state.”
That’s why it’s been important for the department to identify new opportunities to reach adult learners as it has done in recent years, he said.
“We want to make sure Kansans who want to promote and work in public health have an opportunity to get that education through accredited programs,” Lee said.
Going online
While the MPH program included online class options before COVID-19, the pivot to online-only class instruction during the pandemic lockdown brought a new pathway for the MPH degree.
“Because we have a rural population in Kansas, I had been saying we needed to have a fully online degree option,”
Armstrong said. “We showed we could do that successfully during the pandemic, so we decided to continue this new modality while still serving our campus-based students.”
The online generalist MPH degree option was rolled out in September 2021. About 15 of KUMC’s 75 MPH students are taking advantage of earning their degree fully online, Armstrong said.
Of the remaining students, about 35 are enrolled in the MPH program through the Kansas City campus and about 20 are enrolled through the Wichita campus.
Being able to o er the MPH degree online has helped meet a slight uptick in student demand for MPH degrees following the pandemic, said Armstrong.
The online degree option also has the potential to appeal to another important demographic: rural physicians. For example, if a physician has several patients who are dealing with a similar issue, the competencies they’ve gained from an MPH degree could help in implementing e ective, evidence-based interventions to reach more patients at one time, Armstrong said. The MPH also positions clinicians to better partner with community-based organizations and state and local government agencies.
Adding credentials
The pandemic also identified another way the department could capitalize on its track record of working with adult learners: by providing shorter-term certificate programs focused on specific topics and skill sets within public health.
“It’s a wonderfully complementary degree to the M.D.,” Armstrong said. “The MPH allows (the practitioner) to think about patient issues, whether those are health care or mental health issues, in a population-based manner.”
At th e same time it rolled out the online MPH degree option, KUMC’s Department of Population Health also launched three new 12-hour certificate programs in epidemiology, essentials of public health, and public health practice, policy and management.
Each certificate consists of four required courses and can be completed in two semesters.
“For some people, an added credential can open up a new career path without having to complete a full degree,” Armstrong said.
To date, 14 students have completed at least one of the certificate programs with some students opting to complete two at the same time. Currently, there are 15 active students in these graduate certificate programs.
By expanding its educational o erings in public health and continuing to do relevant research, the Department of Population Health is showing its commitment to improving the health of Kansas citizens and in training the health care workforce, Lee said.
“As much as our faculty are engaged in advancing the science of population health through research at multiple levels across multiple communities and settings, we all feel a sense of responsibility to equip the next generation of professionals in evidence-based practice,” he said.
As Kipchoge Vanhoose looks to a bright future, he acknowledges financial aid helped make it possible
After completing his degree in the Master of Public Health program earlier this year, Kipchoge Vanhoose has landed a position where he’s convinced he can make a di erence. That was crucial to his job hunt.
“I just want to be of help to as many people as possible,” says Vanhoose, 25, who will be a health educator with the Fairfield, Ohio, County Health Department. “I see this as a chance to further my knowledge while being able to engage with, assess and evaluate health education programs.”
Vanhoose’s educational journey at the University of Kansas School of Medicine-Wichita wasn’t easy, financially. For one, he shoulders a lot of the responsibility for caring for family members. He also didn’t anticipate some of the expenses related to his research and internship. But with assistance from the Lawrence A. Weller Family Research Fund, Vanhoose was able to surmount those challenges.
“The scholarship presented itself at an especially di cult time for me and provided the assistance that allowed me to focus on my internship and capstone,” he says. “I saw financial aid as a way to bet on myself and help generate the confidence and drive I needed to complete my degree.”
Elizabeth Ablah, Ph.D., MPH, CPH, professor in the Department of Population Health, is one of Vanhoose’s strongest advocates. She, too, is thankful for the financial aid that allowed him to pursue his educational goals.
“He’s so extremely bright and curious,” says Ablah, who has encouraged Vanhoose to earn a doctoral degree next. “He loves evaluating programs to help determine whether they are e ective, and there are loads of public health roles where that is so important.”
Down the road, Vanhoose has another big passion — to hold elective o ce so he can make as big an impact as possible in the field of population health.
A HEA LTHY KANSAS S TARTS HERE
A airs
1010 N. Kansas Wichita, KS 67214-3199
The University of Kansas prohibits discrimination on the basis of race, color, ethnicity, religion, sex, national origin, age, ancestry, disability, status as a veteran, sexual orientation, marital status, parental status, gender identity, gender expression and genetic information in the university's programs and activities. Retaliation is also prohibited by university policy. The following person has been designated to handle inquiries regarding the nondiscrimination policies and is the Title IX coordinator for all KU/KUMC campuses: Associate Vice Chancellor for Civil Rights and Title IX civilrights@ku.edu, 1000 Sunnyside Avenue, Dole Human Development Center, Suite 1082, Lawrence, KS 66045, 785-864-6414, 711 TTY.
