IMPACT The Research Magazine of The Ohio State University School of Public Health
Inside this issue: • Cervical Cancer in Appalachia • Ohio Center for Public Health Preparedness • Helping hard-core smokers quit • Latest faculty research news
|
2006
IMPACT The Research Magazine of The Ohio State University School of Public Health
|
2006
Inside this issue:
Table of Contents 1 Dean’s message
• Cervical Cancer in Appalachia • Ohio Center for Public Health Preparedness • Helping hard-core smokers quit • Latest faculty research news
Editorial Staff Christine O’Malley, Communications Director Alicia Ritchey, Communications Intern
2 A research leader for public health 3 New faculty
Lisa Lopez Snyder, Contributing Writer Liane Egle, Contributing Writer Publication design by The Drawing Room
4 A new day for Appalachian women
Photo credits: Page 2 – 3, 19 University Photography; pages 4, 5, 10, American Cancer Society. Back Cover: A view from the Olentangy River Wetland Research Park at The Ohio State University. Photo by University Photography.
7 Why minorities get sicker 10 Friends to help hard-core smokers quit
New research leader, page 2
Impact Magazine is published annually by the OSU School of Public Health for the alumni, faculty, students, staff and friends of the school. This is the first issue. Copyright 2006. Permission to reprint any portion must be obtained from the School. Contact: School of Public Health Communications Office, 320 W.
12 Ready to ‘reach and teach’ Ohio’s professionals 14 Faculty news
10th Ave., Starling-Loving A332, Columbus OH 43210. Phone: (614)293-9406. On the web at http://sph.osu.edu “Advancing Knowledge. Improving Life.”
16 Student research
Cervical cancer and Appalachian women, page 4
19 Champions of Public Health Awards 21 Faculty publications, grants and contracts
Student research projects, page 16
How is great research like great jazz? Louis Armstrong was an extraordinary musician. He had the technical skill and the passion to be great. He could keep up with the rhythm, with the improvisation of his art. But most of all, he made an impact that set in motion fundamental changes in his field and the culture at large. The impact of public health research can be just as enduring. If you want to be great, and make a lasting impact, you need Louis Armstrong’s brand of commitment and passion. That means the skill to do the work and the passion to get it done. And you need to keep up when the rhythm changes. Our highest priority as a School of Public Health is to fulfill our promise to our students, our university and our community. We prepare students for the challenges of leadership and service in public health and related professions, add to knowledge through basic and applied research, and improve the health of the public through sharing that knowledge. I believe that the caliber of our faculty, our expanding research programs, and our activities in service and outreach merge to offer students a wonderful education in public health. We have a very bright future. In 2005, Ohio State moved into the Top 10 public research universities ranked by the National Science Foundation on the basis of funded research, and sixth in the country among all universities for industry-sponsored research. It is deeply satisfying to be part of a university that puts a high priority on research to fulfill its mission to educate and serve the public. The research being conducted today in all of our colleges, and the future generations of researchers we are training, are the promise of tomorrow. The School of Public Health’s research program is in a period of rapid growth. This expansion is driven partly by additions to our faculty, including appointing Mary Ellen Wewers as our new associate dean of research and faculty development, and in part by our current veteran faculty. As you may know, we recently hired three new division chairs. The possible dark cloud on the horizon of research is a shrinking of traditional funding sources. The two primary sources of research funding for the School is the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). The two of these agencies combined represent nearly two-thirds of our research funding. However, both those agencies will have their budgets slashed severely this year. We believe this budget reflects misguided priorities, but we also know that complaining about it won’t improve our situation. We need to be more creative in finding sources for our research. We have added the School’s first full-time development director to build a fund-raising program that attracts support from corporations, foundations and individuals. Additionally, our research expenditures for the first 6 months of the current fiscal year are more than double that figure for the same period a year ago. This is a testament to the growing strength of our new and current faculty. We have the vision and the passion to make a long-lasting impact in our field, our country and the world.
Advancing Knowledge. Improving Life.
Dean’s Message
Dean Stanley Lemeshow
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Impact Research Magazine
A research leader for public health Wewers takes helm as school’s first associate dean for research By Liane Egle Contributing Writer As a girl growing up, Mary Ellen Wewers imagined herself becoming a lawyer. “I pictured myself arguing my case, defending my position,” she says. Now many years later, having been named October 1, 2005, as associate dean for research and faculty development in the OSU School of Public Health, she admits that her career is really not too far off that track. While her arena is not a courtroom, she does spend a great deal of her professional life developing a case for what she wishes to research and then doggedly defending it in pursuit of funding to carry out the project. Had Wewers chosen a career in law, she would likely have achieved great success as a litigator; however, the field of public health would be absent a national leader and would have missed out on significant research particularly in the area of tobacco control. Mary Ellen Wewers’ roots in public health began in intensive care nursing. Fresh out of nursing school she worked in a Respiratory Intensive Care Unit in a hospital in Little Rock, Ark., where she witnessed first hand the debilitating effects of tobacco-related illnesses. This experience seems to have had an impact on Wewers and set the course for significant work in the area of tobacco control. From patient care she moved on to researching the impact of nicotine dependence and addiction on the brain of rats. Wewers cites this particular research as among the most meaningful of her career. Eventually she was drawn back to people and patients and began doing community-based tobacco cessation research. Her work in this area is extensive and much of it has focused on studying effective cessation strategies with the more vulnerable groups of smokers that are all too often ignored. Wewers describes smoking as a class issue.
“It is the disadvantaged who are more likely to smoke in our society,” she states. “People who smoke are often those with less control in their lives and use smoking to manage life’s challenges.” While she is concerned that society may have become complacent about individual tobacco use, she regards tobacco cessation research of marginalized groups as an issue of social responsibility. To that end, her research has included studies of smoking patterns among Southeast Asian immigrants and smokers in rural Appalachia. Recently Wewers received an award from the American Academy of Nursing for a Tobacco–Free Nurses web site. The web site was developed as part of a collaborative project with University of California at Los Angeles and University of California at San Francisco. The site serves as both a resource for nurses to encourage cessation among their patients as well as a link and support system for nurses who wish to quit smoking themselves. Wewers regards her move to the School of Public Health as both logical and exciting. She has worked collaboratively on research with colleagues from the School of Public Health since 1990, and tobacco remains a critical public health issue. She sees this as a time of growth for the school and is encouraged by Dean Stanley Lemeshow’s interest in expanding the school’s emphasis on research. As associate dean, she looks forward to supporting faculty in both their career development and their research endeavors. She’ll also continue with her own research, writing grants and building and defending her work. “I work hard,” says Wewers “and I get a lot of satisfaction from my work.”
“People who smoke are often those with less control in their lives and use smoking to manage life’s challenges.”
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Catherine Alfano
Brian Focht
Mei-Ling Ting Lee
Catherine Alfano joined SPH’s Division of Health Behavior and Health Promotion as an assistant professor. She is also an associate member of the Comprehensive Cancer Center at Ohio State. Her areas of expertise include: cancer prevention through risk factor change; bio-behavioral interventions for people with cancer to improve rehabilitation, manage symptoms, maintain quality of life, promote health and optimize survival. She comes to us from the University of Washington and the Fred Hutchinson Cancer Research Center. Dr. Alfano received her PhD from the University of Memphis. Brian Focht joined SPH’s Division of Health Behavior and Health Promotion as an assistant professor. His areas of expertise include exercise psychology, physical activity and aging, physical activity in pain management, and theoretical models of exercise participation. He comes to us from East Carolina University’s Department of Exercise and Sport Science. Dr. Focht received his PhD from the University of Florida. Mei-Ling Ting Lee joined SPH’s Division of Biostatistics as chair and professor. She is a biostatistician with a wide range of research interests in statistical modeling, methods and applications, including survival and time-to-event studies, threshold regression models, and nonparametric methods for clustered data. Her areas of medical application include cancer, occupational risk, the environment, epidemiology, microbiology, pharmacokinetics, genomics and proteomics. She was among the first to demonstrate the importance of replication in microarray studies and the need for assessing sample size and power for these kinds of studies. Dr. Lee is the founding editor and editor-in-chief of the international journal Lifetime Data Analysis, the only international statistical journal that is specialized in modeling
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New faculty and staff
Bo Lu
time-to-event data. She comes to us from Harvard University’s Medical School and School of Public Health. She received her PhD from the University of Pittsburgh. Bo Lu joined SPH’s Division of Biostatistics as an assistant professor. His research interests include observational study, causal interference, missing data, statistical analysis for cancer diagnostic methodology, and health economics. He comes to us from Brown University’s Center for Statistical Sciences. Dr. Lu received his PhD from the University of Pennsylvania. Kurt Stevenson joined SPH’s Division of Epidemiology as an associate professor. He holds a primary appointment with Internal Medicine. His interests include healthcare epidemiology in rural communities, antimicrobial resistance, and clinical infectious diseases. He comes to us from Qualis Health, a nonprofit organization, and held affiliate academic appointments at Boise State University, the University of Washington, and the University of Utah. Dr. Stevenson received his MD from the University of Utah and his MPH from the University of Washington. James Azzaro joined the School of Public Health as its first full-time director of development. He comes to us from The Ohio State University College of Mathematical and Physical Sciences. At the School of Public Health, he will direct fundraising operations and build sophisticated annual and major-gifts programs. He earned his PhD in higher education administration in 2004. His scholarly interests include institutional advancement, leadership, and high performance organizations.
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Impact Research Magazine
A new day for Appalachian women School of Public Health researchers fight cervical cancer in at-risk population By Lisa Lopez Snyder Contributing Writer
The Pap test is recognized as one of the most revolutionary gains in women’s reproductive health. Since the 1950s, when women began having Pap tests, the number of deaths from cervical cancer has dropped dramatically, by about 70 percent, according to the American Cancer Society. But cervical cancer is still killing Ohio’s Appalachian women. In the southern and eastern parts of the state, the incidence and death rates among these women are almost 50 percent higher compared with women living outside of Ohio’s 29 Appalachian counties, according to the Ohio Department of Health. The American Cancer Society reports that Ohio Appalachian women smoke more and have fewer Pap tests than their non-Appalachian female peers, lifestyle behaviors that put them at increased risk of cervical cancer. Public health cancer researchers, a colleague from the University of Michigan and a team of other multidisciplinary practitioners hope to change that scenario. With a five-year, $7.5 million grant from the National Cancer Institute, they will explore why Appalachian Ohio women suffer from such a high rate of this disease and what community interventions will help prevent its occurrence and reduce death from what investigators say is a preventable disease. “No woman should die of cervical cancer,” says Electra Paskett, a professor in SPH’s Division of Epidemiology and principal investigator of the study. Interventions that tackle the three known risk factors for cervical cancer – smoking, the presence of the human papilloma virus (HPV) and lack of appropriate Pap testing – will go a long way toward saving Electra Paskett 4
women’s lives, she says. But efforts will also need to address additional environmental factors that put women in Appalachian communities at greater risk of cervical cancer, say Paskett and her colleague, co-principal investigator Mary Ellen Wewers, a professor in SPH’s Division of Health Behavior and Health Promotion. Wewers is also the School’s associate dean for research and faculty development. Initial interviews and focus groups with these women found that most have a high school education or less, are poor, lack health care insurance and access to health care, and often do not trust local doctors. In addition to cigarette smoking, alcohol abuse and risky sexual behaviors are more common, a combination that creates a higher risk for cervical cancer. “We hope to understand how to overcome those barriers and see if the use of lay health advisors, trusted and trained women from the community, can help,” says Paskett, who is also the Marion N. Rowley Designated Chair in Cancer Research and director of the Center for Population Health and Health Disparities at the OSU Comprehensive Cancer Center. The population center is one of eight National Institutes of Health-funded centers designed to support cutting-edge research to understand and reduce differences in health outcomes, access and care. Paskett also chairs the national steering committee of these centers this year. To address these issues, the study, called Community Awareness Resources and Education (CARE), will focus on three major projects: • Home-based educational sessions and lay health educator outreach to increase Pap smear screenings; • A series of 8-week programs that will monitor smoking quit rates among women participating in one of two smoking cessation groups; and • An analysis of a random sample of Pap tests to determine what variables, such as HPV status, sexual behavior and
and is in desperate need of intervention. The study helps us understand not only why there’s an access problem, but also the best way to intervene.” – Stanley Lemeshow, Dean
tobacco use, may lead Appalachian women to have a higher risk of developing cervical abnormalities than nonAppalachia women. Paskett is leading the first CARE project. Her research team is working to recruit more than 1,600 women in 17 counties to participate in educational sessions about the importance of annual Pap smears. The home sessions will use lay heath advisors to convey the importance of early detection through screenings and to help increase women’s awareness of the disease. Early interviews of Ohio Appalachian women noted that barriers such as transportation, the cost of health care services and distrust of medical providers are among the key obstacles for
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“We know this population has a high disease burden
these women. “We hope to understand how to overcome those barriers and see if these lay advisors can help,” Paskett says. For example, she notes, “we also know that people in underserved areas of Ohio don’t have the same access to health services as those in more urban areas do,” she says. Wewers, who is overseeing the second CARE project, is studying what makes Appalachian women smoke and what will help them stop. Her team is studying the quit rates among women in clinics in 17 counties who are enrolled in two different interventions: one involving eight weekly face-to-face counseling sessions with lay health advisors, including use of a nicotine patch
Who are Ohio’s Appalachian citizens? Most Ohioans live less than a three-hour drive to the closest Appalachian county. But how many of the state’s population understand these communities? Statistics give us some compelling profiles. For example, of Ohio’s 88 counties 29 are Appalachian, nine of which are considered economically distressed by federal standards. But did you know that Appalachian Ohio also has a 1995 population of 1,436,723, making it the fourth largest “city” in Ohio? Here are other features that distinguish communities in Appalachia Ohio, according to Loyal Jones, scholar and co-founder of the Berea College Appalachian Center. Appalachians value: • Individualism and self-reliance, and prefer to not be beholden to others; • Religion, and believe that outside factors control one’s life; • Neighborliness and hospitality, but are suspicious of strangers; • Family solidarity, with a deep loyalty; • Love of home or place; • Modesty and not putting on airs; • Sense of beauty, displayed through folk songs, poems, arts and crafts; • Sense of humor; and • Patriotism, which goes back to Civil War times. Source: Ohio Appalachian Center for Higher Education (www.oache.org), 5
Impact Research Magazine
Average Annual Age-Adjusted Cancer Incidence and Mortality Rates and Percent Difference by Site/Type for Appalachia versus Non-Appalachia Ohio, 1997 – 2000 1,2 American Cancer Society, “Ohio Cancer Facts & Figures 2003”
INCIDENCE CANCER SITE
Appalachia Rate
Non-Appalachia
MORTALITY Percent Difference
Appalachia Rate
Rate
Percent Difference
Rate
All Sites/Types
479.7
470.6
+1.9
223.0
214.8
+3.8
Lung & Bronchus
83.9
75.7
+10.8
68.0
62.4
+9.0
Colon & Rectum
65.4
56.8
+15.1
27.0
23.6
+14.4
Female Breast
123.9
134.1
-7.6
29.3
29.8
-1.7
Cervix
12.8
8.6
+48.8
4.0
2.8
+42.9
Prostate
136.5
148.2
-7.9
28.2
34.1
-17.3
replacement and another that will rely on a personalized letter and other printed material from their doctor stressing the importance of stopping smoking. Wewers is also working with researchers who are collecting baseline data on behavioral patterns among the women who smoke, including data on possible environmental influences such as stress levels, depression, community norms and indoor air bans. “We understand a lot of what prompts people to persist in smoking, but we want to see if there is there anything different in Appalachian communities for why people smoke,” Wewers says. The lay health advisors completed their training and started working with women in 2005. They meet with participants in locations that the women feel most comfortable, including homes, voter registration sites, and through the OSU Extension Program, which is a study partner. Many of the project’s lay health advisors have been doing this work for 10 years, Wewers notes, and they are all female because they need to ask the patients sensitive questions. They check in each week with a nurse to discuss any issues that may arise. The lay health advisor model is one that takes advantage of limited resources in the community and builds trust with women in the community. In fact, Wewers notes, most of the lay health advisors are ex-smokers, which helps build a common bond between them and the women they’re serving. “These [lay health advisors] understand what it’s like.” The researchers will analyze results at 3, 6 and 12 months.While community participants will self-report their progress, they will also provide a saliva sample, an indicator of whether the woman has used tobacco recently. The third CARE project, led by Mack Ruffin, MD, PhD, an epidemiologist and family practice physician in the department of family medicine at the University of Michigan, will examine 6
Non-Appalachia
Fact box: The incidence of and death from cervical cancer among Ohio’s Appalachian women are almost 50 percent higher compared with Ohio women living outside of that region. Pap test samples from the participating Ohio study clinics to compare risk factors among women with and without cervical abnormalities. Ruffin’s goal: To determine the potential risk factors, including biological, behavioral, and psychosocial, that may contribute to Appalachian women’s high risk for cervical cancer. The CARE projects will offer critical information for public health practitioners and the public, says Stanley Lemeshow, PhD, biostatistics professor and dean of the School of Public Health. “We know this population has a high disease burden and is in desperate need of intervention,” he says. “The study helps us understand not only why there’s an access problem, but also the best way to intervene,” he says. For Paskett and Wewers, who have extensive experience in community-based interventions among underserved communities, the study is an opportunity to have even greater impact for all women in the United States. “I think we as a country have to do a better job and recognize the opportunities to improve services for women,” Wewers says. “This project aims to do just that.”
To support this or another program in the School of Public Health, contact James Azzaro, director of development, (614) 293-7628, jazzaro@sph.osu.edu
Figuring out why minorities get sicker and what to do about it
Advancing Knowledge. Improving Life.
Leveling the field
By Alicia Ritchey SPH Communications Intern
After a heart attack, patients who are smokers need to quit During one of his presidential campaigns, Franklin Roosevelt said, “Nothing can be more important to a state than its public smoking in order to reduce the risk of subsequent cardiac health; the state’s paramount concern should be the health of events. However, according to the U.S. Department of Health and Human Services, the proportion of elderly Medicare its people.” With advances in medicine and technology, people today are beneficiaries hospitalized for acute myocardial infarction who healthier than ever. Yet, ethnic, racial and cultural minorities are received smoking cessation counseling was lower among black and Hispanic elderly compared with finding themselves on unequal footing non-Hispanic white elderly. when it comes to disease incidence and Ann Scheck McAlearney, assistant medical care. professor in our HSMP Division, is “Addressing this issue is important involved in a study designed to improve because everyone should have the cardiovascular care for minority same chance for health their education Americans. Her research is part of the level, race and income,” said Sharon Expecting Success program, a major Schweikhart, associate professor in SPH’s initiative of the Robert Wood Johnson Division of Health Services Management Foundation focused on both quality and Policy (HSMP). improvement and reducing health The National Cancer Institute defines disparities. disparities in health as “differences in – Sharon Schweikhart, associate “The major goals of this study are the incidence, prevalence, mortality, and professor in SPH’s Division of Health to improve cardiovascular care for burden of cancer and related adverse Services Management and Policy minorities and to reduce disparities health conditions that exist among in care, while increasing awareness of specific population groups in the United States.” However, disparities in health may also be apparent disparities as an important health issue,” said McAlearney. McAlearney is part of a team of experts in quality between groups when compared on the basis of income or improvement, evidence-based practice, survey and sampling insurance status. Some examples of medical conditions that affect ethnic/racial methodologies, and collection of race and ethnicity data. groups in unequal proportion include cancer, cardiovascular The team is applying quality improvement methods to disease, diabetes and obesity. For example, one report from the improve care for all patients with cardiovascular disease, while Centers for Disease Control and Prevention (CDC) noted that investigating the nature of disparities in care that may exist in the age-adjusted prevalence of hypertension is 40.5 percent the participating hospitals. Ten hospitals are part of the project, and McAlearney’s role among non-Hispanic blacks compared to 27.4 percent among includes working to each hospital to assess its institutional non-Hispanic whites. Patients from different racial and ethnic backgrounds are readiness for change. She will be helping the hospitals to not reaping the full benefits of technological advances in create site-specific Cardiovascular Improvement Plans that will guide quality improvement activities aimed to improve cardiac care.
“Everyone should have the same chance for health despite their education level, race and income.”
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Impact Research Magazine
Cancer deaths per 100,000 people per year for colorectal cancer: Non-Hispanic white men: 23.2 Black men: 33.4 Non-Hispanic white women: 43.9 Black women: 51.8
cardiovascular care and reduce disparities care. The causes of health disparities can be complex and varied. “There are many hypotheses about the origin of disparities in U.S. health care. One is that there may be subconscious discrimination, evidenced when providers offer differing health care advice to patients based on perceptions of potential patient compliance, understanding, or ability to pay for treatment. For example, language barriers create a major challenge in many U.S. hospitals, and because some hospitals have insufficient interpreter services, clinicians may be saying or doing different things when they are unable to clearly
communicate with their patients,” said McAlearney. In many regions, ethnic, racial and economic minority groups are more likely to have lower incomes, lower insurance coverage levels, and less education when compared to the dominant population. Statistics released in 2005 from the U.S. Census Bureau, tell the troubling story of income and medical coverage for certain minority groups. • White, non-Hispanic households have a median income of $48,977. Black households have a median income of $30,134. • Estimates are that 11.3% of non-Hispanic white households are not insured compared to 20% of black households. • The bureau also reports that 30.6 percent of non-Hispanic white people had bachelor’s degrees, compared to 17.6 percent of African Americans.
Racial disparities in health and economic status 50
35
50000
30
40
40000 25
30
30000
30
20
20000
20
20
15
10
10
10
10000
5
0
Age-adjusted prevalence of hypertension Non-Hispanic whites: 27.4% Non-Hispanic blacks: 40.5%
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0
0
Median Income Non-Hispanic white households: $48,977 Black households: $30,134
0
Non-insured Non-Hispanic white households: 11.3% Black households: 20%
Bachelor’s degree or higher Non-Hispanic whites: 30.6% Blacks: 17.6%
Statistics are an integral part in determining factors in health disparities. According to Lei Shen, assistant professor in SPH’s Division of Biostatistics, the kind of statistics used in studies of health disparities varies from study to study. When using statistical methods for health disparities, information collected
from the dominant group is compared with information of the minority group. These statistics include comparisons of disease incidence and prevalence, survival rate once a disease is contracted and quality of life. There are two kinds of problems that require appropriate statistical methods. “There are the questions of, is a
Socioeconomic status has real effects on health and medical care. Low-income Americans run the highest risk of being uninsured. Census bureau figures show that 24.3 percent of people with incomes below $25,000 were uninsured, almost triple the rate of 8.4 percent for people with incomes over $75,000. Low-income and uninsured populations are more likely to suffer from cardiovascular disease, infectious diseases, cancer and dental disease. Cost-effective operations may result in practices that create real or perceived barriers to low-income individuals. Policies with regard to the treatment of uninsured patients have a selective effect on the care of minorities when these populations have lower rates of insurance coverage. “For example, a provider might make a decision about treatment based on what he or she predicts about patient compliance. If you think a patient won’t get follow-up care, you might do more at the time you see them. Alternatively, if you think a patient does not have enough money to buy an expensive drug, you might prescribe a different medication,” said McAlearney. Schweikhart echoes this sentiment. “Sometimes it is difficult to gain access, but once access is granted, there are still inequalities. Cultural competence is a problem that must be addressed because sometimes health care must be tailored to cultural needs,” she said. The 2004 National Healthcare Disparities Report from the U.S. Department of Health and Human Services reported that from 1992 to 2001, rates of late stage colorectal cancer were higher among blacks compared with whites. “Persons of any racial group, including whites, who are poor, have a lower level of education, and/or have inadequate health care coverage, are more likely to have higher incidence and/or higher mortality rates associated with cancer,” said
certain observed disparity a real phenomenon, or simply a spurious observation? And can it be explained by some factors such as differing rates of some genetic mutation or different typical socioeconomic levels?” said Shen.
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How to measure health disparities
Michele Shipp, Research Assistant Professor in the SPH’s Division of Health Behavior and Health Promotion. Shipp conducted a study in Alabama exploring how disparities in colon cancer are affected by race, ethnicity and socioeconomic status. She examined differences in incidence, stage at diagnosis, and method of therapy between blacks and white men and women diagnosed with colorectal cancer in that state. Shipp said colorectal cancer (CRC) is the second most common cause of cancer death in the United States. However, incidence and mortality are highest among African American men and women in the U.S. She hopes that the findings will contribute to the understanding of variations in stage at diagnosis, treatment and survival associated with CRC in white and black patients and the extent to which race and socioeconomic status may affect these outcomes. CDC has indicated that the future health of the nation will depend on how effectively the U.S. reduces health disparities. Success in closing these gaps could result in greater economic productivity and a better-informed public. These possibilities are just becoming apparent. “Awareness of and sensitivity to health disparities is relatively recent, and this has become more urgent because of recent studies showing that this is a big problem. However, the issue of health disparities is a long-term problem and we have only begun to study it,” said McAlearney.
To support this or another program in the School of Public Health, contact James Azzaro, director of development, (614) 293-7628, jazzaro@sph.osu.edu 9
Impact Research Magazine
Change the messenger, not the message Using friends and confidantes to help hard-core smokers quit By Liane Egle Contributing Writer For tobacco prevention advocates, the times they are achangin’. Over a 12-month period, 13 municipalities in Central Ohio, including Columbus, have adopted smoke-free indoor air regulations. They follow the lead of Toledo which was the first large Ohio city to adopt such a regulation in 2001. Designed to protect individuals from the harmful effects of environmental tobacco smoke, these regulations require smokers to step outside to light up. While there are variations among these regulations, the bottom line is that there are fewer places to smoke in public. Further with the recently adopted tax increase on tobacco in Ohio, it is not only less convenient to smoke but also more expensive. Tax increases, in particular, are considered to have a potent impact on encouraging people to quit as the cost of the addictive habit becomes prohibitive. For some smokers, however, neither of these factors is enough for them to smoke their last cigarette. Nearly 21 percent of Ohioans are daily smokers, the fourth-highest rate in the nation. Who are these hard core smokers? Phyllis Pirie, chair of SPH’s Division of Health Behavior and Health Promotion, and Amy Ferketich, assistant professor in the Division of Epidemiology, are both conducting separate tobacco cessation research. They agree that the smokers are often among the more socially disadvantaged. “Smoking may be one of few pleasures in their lives,” Pirie said. She notes that these indeed are the hard core and the most resistant smokers, a fact that underscores the importance of the innovative research underway. Pirie joined the faculty in the School of Public Health in 2004. Once here, she established a research site at OSU for a project she initiated at the University of Minnesota. “The Baby Steps Program” is a Robert Wood Johnson Foundation project that encourages pregnant women to quit smoking.
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Particularly unique about the Baby Steps project is its focus on who delivers the messages about quitting. The program is based on the premise that pregnant women typically have one or more female supporters on whom they depend for pregnancy advice. Often the pregnant woman perceives the female supporter to be more credible than her spouse and nearly as influential as her physician. Designated as “health confidantes,” these individuals are at the center of Baby Steps, relying on them to intervene with the pregnant women and influence their tobacco use. Thirty pregnant women have been enrolled in Baby Steps through the OSU Obstetrics Clinic. Most participants are young, of low-income and face a number of life challenges. Once recruited, the women are asked to identify who would best serve as their health confidante. Project staff then work with the confidantes on how to encourage reduction or elimination of tobacco use. Part of the project is having the pair work together on a Baby Steps scrapbook that chronicles the pregnancy and includes tobacco cessation worksheets. The goal of the project is a 15 percent quit rate. This is lower than the 20 percent average success rate of most cessation programs, but Pirie recognizes that participants are very addicted, resistant smokers. She anticipates that many of the participants will go back to smoking even if successful at reducing or quitting during pregnancy. This is less than ideal but quitting during pregnancy is essential in order to reduce the incidence of miscarriage, low birth-weight babies, and Sudden Infant Death Syndrome (SIDS). Pirie is anxious to see the impact of the health confidante model. “Use of people in the social environment as a way to impact health behavior is an interesting approach that may have broader implications with other health behavior issues,” she states. In a somewhat similar vein, Amy Ferketich, assistant professor
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“Use of people in the social environment as a way to impact health behavior is an interesting approach that may have broader implications with other health behavior issues.”
Wewers, and others, they are conducting in SPH’s Division of Epidemiology, is a pilot study to see how responsive a co-investigator on a study, led by Dr. individuals are to a cessation program Mary Ellen Wewers, that is examining when offered prior to or just after having the effectiveness of lay health advisors been screened for lung cancer. in encouraging women in Appalachia Regarding the future of tobacco to quit smoking. As an off-shoot of the cessation research, both Ferketich and larger study of cervical cancer among Pirie anticipate significant opportunities women in Appalachia (see page 4), this well into the future. Despite success project draws participants from 16 health with nicotine replacement therapies, clinics in Appalachia. The incidence of governmental regulations and taxes, smoking among women in Appalachia is incidence rates seem to have plateaued 30 percent, compared with 19.5 percent as those that quit are replaced by new overall for women in Ohio. The need for smokers many of whom are society’s an innovative approach in this region more vulnerable individuals. is essential. Marie Collart served as co-chair The project, which began in spring – Phyllis Pirie, chair of SPH’s Division of SmokeFree Columbus, the grass 2005, relies on lay health advisors who of Health Behavior and Health roots coalition instrumental in the are from the area and many of whom are Promotion passage of Columbus’ and several other former smokers themselves to provide municipalities’ smokefree indoor air support and encouragement to women through personal home visits. It is hoped that these lay health ordinances. She also serves as executive director of the Central advisors will be perceived as understanding and credible and Ohio Breathing Association, an organization providing tobacco cessation programming to nearly 1000 persons annually. will therefore have a positive impact on cessation rates. Collart reiterates the importance of research in supporting Ferketich is also a co-investigator on a separate study among male and female smokers in Appalachia to determine people’s efforts to quit smoking and indicates that it is essential the effectiveness of an interactive video in prompting them for community based, non-profit organizations. “We have the passion, we have the dedication,” she states. to discuss tobacco cessation with their physician (PI: Dr. Mary Ellen Wewers). The video is designed to empower the “What we need is the scientific evidence of what is most patient in their relationship with their physician who is also effective to guide our efforts,” she adds. Both Pirie and Ferketich look forward to contributing considered to be influential in conveying messages about to that body of evidence. Through their work they hope to tobacco cessation. In addition to considering who delivers the message about assist vulnerable individuals in giving up their cigarettes and cessation, Ferketich is also studying what may be the best ultimately reducing the number of persons who die annually timing to offer smoking cessation interventions. Working with as a result of tobacco related illnesses. Dr. Michael Knopp in the College of Medicine, Dr. Mary Ellen 11
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Prepared to act School’s center ready to ‘reach and teach’ Ohio’s professionals By Lisa Lopez Snyder Contributing Writer
Portion of a mobile tent hospital designed by a participant in the School’s public health leadership institute. The horror of Sept 11, 2001, and the tragedy of Hurricane Katrina seem beyond the realm of what could happen in Ohio, but the catastrophes underscore the critical role that preparedness plays in local, state and national responses to natural and man-made disasters. Now, thanks to federal grant dollars awarded post-Sept 11, communities nationwide are working to strengthen their capacity to prevent and manage such disasters, and the Ohio Center for Public Health Preparedness (OCPHP) is positioned to play a key role in that effort. Housed in the School of Public Health’s (SPH) Office of Workforce Development, OCPHP was established in 2004 by a $5.6 million grant from the Centers for Disease Control and Prevention in cooperation with the Association of Schools of Public Health, as one of 40 such centers nationwide. The centers were created to improve the capacity of front-line public health professionals through education and training. One of three centers in the state, each with its own focus, OCPHP is the only entity in Ohio designated to provide training and experience to public health practitioners statewide, says Frank Holtzhauer, PhD, director of the Office of Workforce Development and clinical assistant professor in the School, the first and only school of public health in Ohio. Holtzhauer cites several key developments that characterize the Center’s growth and impact thus far: • Full-time staff of 24, made up of seasoned academic and practicing public health professionals; • Certificate in Epidemiology Program; • Five practice-based preparedness courses taught by experts in the field; • Staff person who spends 50 percent of his time with the Ohio Department of Health. • Monthly Public Health Grand Rounds series that provides opportunities to discuss preparedness issues; • Development of a public health model of the National 12
Incident Management System (NIMS) command and control structure; • Ohio Public Health Exercise Portal; and • Ongoing collaborations with faculty and other practitioners in the Office of Workforce Development’s Ohio Public Health Leadership Institute (OPHLI), a professional development program for public health leaders. The practice-based courses are a strategic investment, says Holtzhauer, who was a former assistant health commissioner for the city of Columbus. The discipline-specific courses, offered for undergraduate and graduate credit, focus on epidemiology, environmental health, public health leaders, health education and nursing. “We’re much better prepared to identify and respond to emerging and unusual diseases like the avian flu, severe acute respiratory syndrome (SARS), and other emerging infections
Bioterrorism & Emergency Readiness: Competencies for All Public Health Workers (Source: CDC) • Being able to describe the public health in emergency response; • Being able to describe the communication roles in emergency response; • Being able to describe the chain of command for emergency response; • Being able to locate the agency emergency response plan; • Describing individuals’ roles in response; • Regularly participating in drills; • Understanding personal limits in knowledge, skill and authority; • Recognizing potential emergencies and describing the appropriate action; and • Being creative in developing solutions
– Frank Holtzhauer, director Ohio Center for Public Health Preparedness. This mobile tent hospital is similar to those used in the aftermath of Hurricanes Katrina and Rita. Shown is a small portion of the mobile hospital.
and terrorists-initiated events that professionals will be trained to look for,” Holtzhauer says. The program has trained almost 40 individuals. The Ohio Public Health Exercise Portal, devoted entirely to public health exercises in Ohio, will house training models, exercise dates, documents and other communications that can be shared across the seven homeland security regions within the state. For example, OCPHP is taking the lead nationwide in developing a simulation training model of the National Incident Management System (NIMS). A model is already in place for emergency first responders, such as police officers and firefighters. The new model will be customized for public health professionals and will post the training dates on the portal. The NIMS simulation model, a virtual “whose in charge” effort, details Ohio localities’ command structure during an emergency or threat.
Ohio Centers for Public Health Preparedness Center for Terrorism Preparedness – University of Findlay School of Environmental and Emergency Management http://seem.findlay.edu/ Center for Emergency Preparedness – Cleveland State University Division of Continuing Education http://www.csuohio.edu/ce/Oldpgms/cemergprep.html Northeastern Ohio Consortium for Biopreparedness – Kent State University http://cphp.kent.edu Ohio Center for Public Health Preparedness – Ohio State University School of Public Health School of Public Health Office of Workforce Development http://sph.osu.edu/cphp
“We’re filling a need,” Holtzhauer says of the NIMS training. Today more than ever, the crux of public health practitioners’ readiness relies on key competencies, says J. Mac Crawford, RN, PhD, assistant professor in SPH’s Division of Environmental Health Studies. “Public health has always been involved in response, but that role is now more front and center,” he adds. Crawford, who teaches a seminar on public health preparedness and a new course for undergraduates, notes that public health emergency responders must be proficient in at least nine core competencies, as outlined by the CDC (see inset). All this activity prompts the need to explore practitioners’ needs, says Timothy J. Buckley, PhD, associate professor and chair of SPH’s Division of Environmental Health Sciences. Buckley is working with OCPHP faculty on a proposal that will explore issues from a research perspective. “This will span the entire spectrum,” he says, “from basic bench-type research to applied research and ultimately, what practitioners will need in order to respond to these kind of disasters.” OCPHP has already proven a powerful resource. After Hurricane Katrina, OCPHP trained 40 staff from the Ohio Department of Health who were leaving for the Gulf region. The OCPHP also offered to help the Columbus Health Department process any evacuees headed to Ohio. In another preparedness move, OPHLI graduate Mike Ottaway, public health emergency response coordinator in Hamilton County, and his colleagues created the concept of using a 210-bed mobile tent system to create a comprehensive alternative care center, thought to be the largest portable civilian modular field hospital in the nation. The tent was held in reserve for use following Hurricane Rita. Steve Wagner, JD, MPH, assistant division chief of the Bureau of Public Health Preparedness, applauds OCPHP’s efforts in providing public health professionals ready access to preparedness training, and in creating an atmosphere of collaboration among the other university-based centers. Indeed, today’s environment offers opportunities and challenges for public health professionals, Holtzhauer says. If anything, he says, it means “everybody’s job has changed.”
Advancing Knowledge. Improving Life.
“We’re much better prepared to identify and respond to emerging and unusual diseases like the avian flu, SARS, and other emerging infections and terroristsinitiated events.”
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Impact Research Magazine
Faculty news
Health risks probed for police, firefighters John “Mac” Crawford, assistant professor in SPH’s Division of Environmental Health Sciences, is leading a study titled “The Health of Ohio Police Officers and Firefighters” on the occupational health risks of members of the Ohio Police and Fire Pension Fund (OP&F). Police officers and firefighters face a multitude of health risks from responses to emergencies, such as high-speed pursuits, and subtle, invisible environmental exposures, such as combustion byproducts and microwave radiation. OP&F would like to know more about the risks their members face from their work environments. They will use the information to make more equitable decisions about granting disability due to occupational exposures. In order to better understand the occupational health risks to OP&F members, Crawford will use the occupation and industry data fields of the Ohio Cancer Incidence Surveillance System. He will undertake a general mortality study of the police officers and firefighters by linking with publicuse death certificate data available through the Ohio
Department of Health, which has occupational data fields for 10 years of death certificates. In firefighters, Crawford may see excess occurrence of death and disease due to certain cancers, such as colon, bladder, and kidney, and death from cardiovascular disease. Among police officers he may see excess deaths from testicular and prostate cancer, as well as from cardiovascular disease. “I hope to have an understanding of how the occupations of firefighting and law enforcement are associated with the incidence of various cancers by analyzing (cancer registry) data. I also hope to have an understanding of how these occupations influence occurrence of death,” said Crawford. – by Alicia Ritchey, SPH Communications Intern
Hay fever may keep brain cancer at bay Judith Schwartzbaum, associate professor in SPH’s Division of Epidemiology, has completed research showing that asthma, hay fever or another allergic condition may reduce the risk of developing one fatal form of brain cancer. Her study is the first to include a genetic component in addition to participant selfreports of asthma and allergy. The findings appeared in the journal Cancer Research. New evidence for this relationship between allergies and cancer is found in the normal variation of two genes. “Variations in certain genes may make a person more prone to develop asthma or allergies and those same variations may protect adults against the most common kind of brain cancer,” said Schwartzbaum. Glioblastoma multiforme (GBM) affects three out of 100,000 people, a rate that quadruples to 13 out 100,000 among people who are 65 and older. The average five-year survival rate from the time of diagnosis for GBM is only 3.3 percent, and is lower for people 65 and older. The current study supports several years’ worth of research by other scientists who have suggested an inverse relationship
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between asthma, allergies and GBM. But those studies were based only on information that participants gave about their history of asthma and allergies, not on information from DNA testing. “We needed an objective way to measure the accuracy of allergy self reports, one that isn’t affected by the presence of a brain tumor” Schwartzbaum said. “Looking at genetic variation is one way to do this.” – from an article by Holly Wagner, OSU Research Communications
NetWellness web site rated tops by journal NetWellness.org was rated as one of the best consumer health websites by Medicine on the Net, a national journal that is published by HCPro. NetWellness.org is a consumer health web site operated by three health-related schools in Ohio, including The Ohio State University’s School of Public Health. Now in its 10th year, NetWellness.org provides a wide range of free health information for those with medical questions. The site has more than 30,000 pages of information on numerous health topics. Phyllis Pirie, chair of SPH’s Division of Health Behavior and Health Promotion, is NetWellness.org’s program director at Ohio State. “NetWellness is a unique resource which is used by a worldwide audience, but it is particularly relevant to Ohioans – it provides responses from health care professionals from leading Ohio institutions and includes links to Ohio healthrelated resources. We hope that by allowing people to get their questions answered by reputable health professionals, they will be able to make better choices about protecting and improving their health,” said Pirie. NetWellness.org is operated by The Ohio State University School of Public Health, the University of Cincinnati College
of Medicine and Case Western Reserve University College of Medicine. The site features an “Ask an Expert” section that includes information on 100 different topics and questions answered by medical experts from the three universities. Users can also submit questions that will be answered by a real doctor.
MDs often give addictive meds for sleep problems Rajesh Balkrishnan, associate professor in SPH’s Division of Health Services Management and Policy, is the lead author on a study showing that doctors frequently prescribe potentially addictive medications for sleep disorders. Balkrishnan has a joint appointment with the College of Pharmacy. “The drugs, called benzodiazepines, are often a cheaper alternative to some newer types of medicines that don’t have the same potentially addictive side effects,” said Balkrishnan. Benzodiazepines are typically effective for a short time when used to treat insomnia but addiction can quickly develop. A person can acquire a strong psychological and physical dependence on these drugs and experience severe withdrawal symptoms once they stop taking the medication. The study includes data from 94.6 million office visits in the US over six years. Patients included in the data set sought help for sleep-related difficulties in outpatient physician offices. Balkrishnan and his colleagues gathered outpatient office visit data from 1996 to 2001 from the National Ambulatory Medical Care Survey. They analyzed the treatment patterns of patients 18 and older and found nearly two-thirds of those visits resulted in medication prescriptions for sleep problems. Three-quarters of those prescriptions were for a benzodiazepine. “Overall, the study suggests that some physicians do consider other options before jumping to prescribe a drug to treat sleep problems,” he said, “But many health care providers don’t take public health insurance.” 15
Impact Research Magazine
Patients with Medicare or Medicaid coverage and patients age 65 and older were more likely to receive prescriptions benzodiazepines. “There needs to be a move toward a more uniform prescription system – at least for certain types of medications,” said Balkrishnan. – from an article by Holly Wagner, OSU Research Communications
Professor studies exposure to insecticides during pregnancy J.R. Wilkins, professor in SPH’s Division of Epidemiology, is currently studying the effects of perinatal exposure to various insecticides. The three classes of toxicants being examined are chlorpyrifos (CP), other organophosphate (OP) insecticides and pyrethroids (PYR). Wilkins is recruiting 176 women in their second trimester of pregnancy and will follow healthy, full-term newborns. Wilkins’ team began recruiting women in 2002 for the study and completed recruiting in fall of 2005. “We then must follow the babies until they are 2 years of age, so the study will continue on for at least another two to two-and-a-half years,” he said. Each woman is interviewed about her exposure to insecticides, other toxicants, maternal demographics and other family-based factors. After birth, additional information is obtained from the mother when the child is 3, 12 and 24 months. At 3 months, information will be obtained on the infant by administrating the Bayley Scales of Infant Development-II (BSID-II), a framework used to diagnose mental, motor and behavior scales. At 12 months, control data on potential confounders will be acquired, in addition to data on breastfeeding and parental IQ. At 24 months, the information will be gathered by repeat administration of the BSID-II, in addition to a one-time administration of Ireton’s Child Development Inventory (CDI). “Basically, we want to contribute to the growing body of scientific evidence that addresses the question of pre- and post-natal exposure to OP’s and the potential neurotoxic effects of these environmental chemicals,” he said. – by Alicia Ritchey, SPH Communications Intern
To support this or another program in the School of Public Health, contact James Azzaro, director of development, (614) 293-7628, jazzaro@sph.osu.edu
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MPH student Mark Lehman works with a Maasai man to screen goats for subclinical mastitis.
Tanzania practicum illustrates zoonotic link in public health Mark Lehman is a public health officer in the Air Force who pursued public health after becoming dissatisfied with private practice in veterinary medicine. Public health gave him the opportunity to do everything he enjoyed about veterinary medicine, and his work has an impact that reaches all the way to Africa. He started working on his Master of Public Health (MPH) degree at Ohio State in the fall of 2004 and plans to graduate in the summer of 2006. For his practicum, Lehman worked with the Christian Veterinary Mission, part of World Concern, on a detection study checking for subclinical mastitis in goats and sheep in Tanzania. Though mastitis literally means inflammation of the breast, in subclinical mastitis there is no swelling of the udder and other than a possible reduction in milk production, the milk appears to be normal. The objective of the study was to detect and develop a prevention strategy at the subclinical stage of disease. Early detection prevents a disruption of milk supply and prevents the disease from being passed to humans. “Mastitis reduces the amount of milk produced by the animals, which leads to malnutrition of the people. Also, most of a family’s worth is based on their livestock. If you sell a sick animal at market you won’t get as much money as a healthy one. For me it was important to test and evaluate these animals because many of the diseases we saw have been eradicated from the US,” he said. Lehman worked with a veterinarian who had been an army reservist. Besides testing animals for mastitis, they also tested some for Brucellosis, a disease that can cause severe infections of the central nervous system among other things. “The most unusual disease I came across was East Coast Fever, a disease specific to Africa, caused by a blood parasite.
By Alicia Ritchey SPH Communications Intern
Advancing Knowledge. Improving Life.
Students reap benefits of research program
Maasai children tending the goats.
From Africa to Ohio, SPH students expand their experience, skills and horizons through practice placements and residencies. All of our students are given the opportunity for hands-on application of new skills learned in the course of their studies. These profiles represent just a handful of our students’ experiences. It has a high mortality rate among cattle. Basically you infect the cattle and treat them, and hope not too many will die. So far it has been successful and the locals accept a few deaths from the immunization because they realize they have more losses when they don’t immunize,” he said. Lehman’s African experience reaffirmed his belief that public health advances knowledge which improves the lives of whole communities, not just individuals. “One of the goals of public health should be to empower communities through education. Once they have the knowledge and accept ownership of a program, the entire community benefits,” Lehman said.
PhD student has personal link to cancer research on Amish Ross Kauffman, a second-year PhD student in epidemiology, has more than a scientific interest in his public health research on the Ohio Amish community. Two of Kauffman’s greatgrandparents were Amish and left to join the Mennonite
church. Kauffman did his undergraduate work at Eastern Mennonite University in Harrisonburg, Va., studying biology and environmental science. Kauffman spent the past two summers working on the Ohio Appalachia Cancer Behavioral Lifestyle Studies, which examines cancer in Holmes County, the largest Amish settlement in the world. He worked primarily with SPH faculty Amy Ferketich and Mira Katz on the studies. “The study was of particular interest to me due to my own Amish roots… It was a valuable opportunity for me to learn the art of interviewing, and an excellent introduction to the world of epidemiologic studies,” said Kauffman. The study was a follow-up to The Amish Lifestyle Behavior Study which found a lower incidence of cancer among the Amish when compared to non-Amish. The goal of the project was to determine the prevalence of cancer-related behaviors in the Holmes County Amish community. “The preliminary study did not seem to indicate a genetic cause for the lowered risk. This pointed to lifestyle factors as the mechanism of decreased risk. The goal of the Amish Lifestyle Behavior Study was to examine which characteristics of the Amish life protect them from cancer,” said Kauffman. The Amish community is governed by strict behavioral and moral codes. The choice to refrain from using many modern technologies leads to lower consumption of processed foods, higher uses of traditional food preservation methods and decreased exposure to many chemicals. Monogamous sexual practice, low usage of tobacco, alcohol and other drugs, and high exercise rates also may influence the community’s health. To better understand the information collected from the Amish, comparison data would be needed. The Ohio Appalachia Cancer Behavioral Lifestyle Studies was initiated to collect information on the non-Amish in the same region. Both studies consisted of face-to-face surveys, each 17
Impact Research Magazine
approximately two hours in length, covering a wide range of questions. Topics studied included demographics, health and cancer history, food storage, diet and exercise, medication and supplement use, and work history.
OSU students benefit from health survey Students at The Ohio State University may notice health and wellness programs that fit more closely to their interests thanks to research done by Laura Peterson. For Peterson, her practicum with the Student Wellness Center represented a confluence of knowledge gained from her full-time job and her studies in the School of Public Health. Peterson is an MPH student in the School’s Program for Experienced Professionals (PEP). This program is for individuals already in the work force who want to pursue a master’s degree in public health. She began her graduate studies in the School of Public Health in 2004 with a specialization in Health Behavior and Health Promotion. For her practicum, Peterson developed a survey for the Student Wellness Center (SWC) to assess the types of traditional and alternative health services students are currently using as well as what students would like to be offered. Peterson’s full-time job as a project manager for the Stress and Immunity Cancer Projects in the Department of Psychology helped her in the survey development for SWC. As project manager, she supervises the accrual, assessment, and follow up for more than 300 participants in several multidisciplinary research projects. The SWC survey focuses on integrative health services, health behaviors and wellness. Peterson’s studies in public health were put to use in the survey development. “Public health approaches are needed to assess health service usage patterns among different demographic groups as well as comparison of these treatments to each other,” Peterson said. The specific aims of this survey are to examine the OSU student demographic information including education, income, race, and ethnicity with type of health service use; investigate the relationship between traditional and complementary alternative medicine services and psychological variables such as wellness, conscientiousness, depression, social support and stress; and assess student interest in services at the wellness center. “The public health emphasis on interdisciplinary research 18
and collaborating with different groups was helpful in coordinating these activities. The wealth of research experience I gained was invaluable,” she said.
Webber’s work shortens wait for patients in docs’ offices If you find yourself spending less time in your doctor’s waiting room, people like Sara Webber may be responsible. Webber, a second-year MHA student in the School of Public Health, did a residency at the Ohio State University Primary Care Network and helped implement a process improvement project. She received her undergraduate degree in athletic training from Ohio State. “One unique aspect of the MHA program is the opportunity to participate in clinical rotations within the hospital. This experience allows one to see the healthcare system from the perspective of the physician and care team,” she said. At the Primary Care Network, Webber had a chance to develop her skills in health administration primarily through various tasks, troubleshooting and projects concerning efficiency improvements. The projects entailed an initial analysis and time study in three different areas in the office. Specifically, referrals, chart locations and timeliness in seeing patients. Webber collected information on these sectors, analyzed the problems and developed solutions. Offices were evaluated based upon how often the first patient of the day was seen on time, how readily available patient charts were, and how quickly referrals were scheduled. After initial data was collected and evaluated, individualized improvement strategies were designed for each office and implemented over the course of several weeks. “The project that I worked on will decrease wait time for patients who are being seen in the clinic.” Currently, a follow up study is being implemented to test the effectiveness of the changes made. If they are found to be effective, they will be recommended to the larger network.
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A day of champions School honors three who made a difference for Ohio
Last fall, the School of Public Health presented its first Champion of Public Health Awards. These awards will become an annual event for the School every fall. The School presented three awards in 2005. Approximately 150 people attended the event, which also celebrated the School’s 10th anniversary. Kathryn Peppe, RN, MS, was chosen in the Community Leader category, for her work improving the health of Ohio’s children as chief of the Division of Family and Community Health Services at the Ohio Department of Health; Maurice “Mo” Mullet, MD, was selected in the Public Health Practitioner category, for his work as a national, state and local leader during his 30 years as health commissioner of Holmes County; The Ohio Chapter of the American Academy of Pediatrics earned the award in the Organization category, for working closely with state legislators on a law requiring school-age children to be immunized against chicken pox, the greatest vaccine-preventable killer of children in the U.S. The School is now accepting nominations for the 2006 awards. Nominees should be an individual or organization who has made a significant contribution to the health of Ohioans. We encourage nominations from all fields of public health. Nominees will be notified in writing that their names have been submitted for consideration. The nominations committee will make a decision by Aug. 31. The winner(s) will be notified and invited to attend the awards presentation in October. The Ohio State University School of Public Health was formed in 1995 and is fully accredited by the Council on Education for Public Health. It is the first and only school of public health in Ohio. While an independent unit within the university, the School is an integral part of OSU’s comprehensive health sciences campus.
Kathryn Peppe, RN, MS, left, receives the Champion of Public Health Award, Community Leader category, from Dr. Antoinette Eaton, former interim dean.
Dr. Maurice Mullet, left, receives the Champion of Public Health Award, Public Health Practitioner category, from Dr. J. Nicholas Baird, director of the Ohio Department of Health.
Dr. Bill Cotton accepts the Champion of Public Health Award, Organization category, from Anne Harnish, assistant director of ODH. Dr. Cotton was representing the Ohio Chapter of the American Academy of Pediatrics. 19
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2006 Champions of Public Health Awards
Nomination Form Sponsored by The Ohio State University School of Public Health
We invite you to identify and nominate worthy individuals who, through their professional achievements, volunteer service or civic involvement, personify the mission of the School of Public Health to advance knowledge and improve lives. • Nominees must be an individual or organization who has made a significant contribution to the health of Ohioans. • Individuals may be nominated posthumously, but the committee prefers nominees who are living at the time of nomination. • Individuals may come from all fields of public health. • Submit this nomination form and a one-page nominating statement.
I nominate
• You may include up to two letters of support. Letters of support are limited to one 8 ½” x 11” page each, singlespaced. Please attach your nomination to this form and mail to: Champions of Public Health Awards Committee OSU School of Public Health A332 Starling Loving Hall 320 W. 10th Ave. Columbus OH 43210 All nominations packets must be postmarked no later than June 15. Additional forms are available by emailing comalley@sph.osu.edu.
(full name)
for the Champions of Public Health Award in the category (community leader, public health practitioner, or organization)
Nominee street address city/state/zip phone number Nominator your name street address city/state/zip phone number email address
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Fann, Jesse, R; Alfano, Catherine, M; Burington, Bart, E; Roth-Roemer, Sari; Katon, Wayne, J; Syrjala, Karen L. Clinical presentation of delirium in patients undergoing hematopoietic stem cell transplantation. Cancer. 103(4): 2005. 810-20. Sieck, Winston R.; Arkes, Hal R.. The Recalcitrance of Overconfidence and its Contribution to Decision Aid Neglect. Journal of Behavioral Decision Making. 18(1):2005. 29-53. Balkrishnan R, Rasu RS, Rajagopalan R. Physician and patient determinants of the pharmacological treatment of sleep difficulties in outpatient settings in the United States. Sleep. 28(6):2005. 715-719 Cayce KA, Krowchuk DP, Feldman SR, Camacho FT, Balkrishnan R, Fleischer AB. Healthcare Utilization for Acute and Chronic Diseases of Young, School-age Children in the Rural and Non-rural Setting. Clinical Pediatrics. 44(6):2005. 491-498. Barshes ND, Lee TC, Balkrishnan R, Karpen SJ, Carter BA, Goss JA. Orthotopic Liver Transplantaton for Biliary Atresia: the US Experience. Liver Transplantation. 11(10):2005. 1193-1200. Thevarajah S, Balkrishnan R, Camacho FT, Feldman SR, Fleischer AB. Trends In Prescription Of Acne Medication In The US: Evidence For Effects Of Microbial Resistance On Prescribing Behavior. Journal of Dermatological Treatment.16(4):2005. 224-228. Balkrishnan R, Camacho FT, Pearce DJ, Kulkarni AS, Spencer L, Fleischer AB, Feldman SR. Factors influencing prescription of ultra high potency topical corticosteroids for psoriaisis treatment in US outpatient settings. Journal of Drugs in Dermatology. 4(6):2005. 699-706. Rasu R, Shenolikar RA, Nahata MC, Balkrishnan R. Physician and Patient Factors Associated With Prescribing of Sleep Disorder Medications in United States Outpatient Settings: An Analysis of the NAMCS 1996-2001. Clinical Therapeutics. 27(12):2005. 1970-1979. Hite, R Duncan; Seeds, Michael, C; Bowton, David, L; Grier, Bonnie, L; Safta, Anca, M; Balkrishnan, Rajesh; Waite, B Moseley; Bass, David A Surfactant phospholipid changes after antigen challenge: a role for phosphatidylglycerol in dysfunction. American Journal of Physiology. Lung Cellular and Molecular Physiology. 288(4):2005. L610-7.
Carroll, Christie, L; Balkrishnan, Rajesh; Feldman, Steven, R; Fleischer, Alan B Jr; Manuel, Janeen C The burden of atopic dermatitis: impact on the patient, family, and society. Pediatric dermatology. 22(3): 2005. 192-9. Balkrishnan, Rajesh The importance of medication adherence in improving chronic-disease related outcomes: what we know and what we need to further know. Medical Care. 43(6):2005. 517-20. McCall, Brian, P; Horwitz, Irwin, B; Feldman, Steven, R; Balkrishnan, Rajesh Incidence rates, costs, severity, and work-related factors of occupational dermatitis: a workers’ compensation analysis of Oregon, 1990-1997. Archives of Dermatology. 141(6):2005. 713-8. Balkrishnan, Rajesh; Nelsen, Linda, M; Kulkarni, Amit, S; Pleasants, Roy, A; Whitmire, J Timothy; Schechter, Michael S Outcomes associated with initiation of different controller therapies in a Medicaid asthmatic population: a retrospective data analysis. The Journal of Asthma: Official Journal of the Association for the Care of Asthma. 42(1):2005. 35-40. Chapin AR; *Rule; AM; Gibson KE; Buckley TJ; Schwab KJ: The isolation of airborne multi-drug resistant bacteria from a concentrated swine feeding operation: a concern for human exposure. Environmental Health Perspectives. 113:2005. 137-142. Gilliland F; Avol E; Kinney P; Jerrett M; Dvonch T; Lurmann F; Buckley T; Breysse P; Keeler J; McConnell R. Air pollution exposure assessment for epidemiologic studies of pregnant women and children: lessons learned from the centers for children’s environmental health and disease prevention research. Environmental Health Perspectives. 2005. Apelberg BJ, Buckley TJ, White RH: Socioeconomic and racial disparities in cancer risk from air toxics in Maryland. Environmental Health Perspectives. 113(6):2005. 693. Matsui, Elizabeth, C; Simons, Elinor; Rand, Cynthia; Butz, Arlene; Buckley, Timothy, J; Breysse, Patrick; Eggleston, Peyton A. Airborne mouse allergen in the homes of inner-city children with asthma. The Journal of Allergy and Clinical Immunology. 115(2):2005. 358-63. Sapkota, Amir; Symons, J Morel; Kleissl, Jan; Wang, Lu; Parlange, Marc, B; Ondov, John; Breysse, Patrick, N; Diette, Gregory, B; Eggleston, Peyton, A; Buckley, Timothy J. Impact of the 2002 Canadian forest fires on particulate matter air quality in Baltimore city. Environmental Science & Technology. 39(1):2005. 24-32.
Breysse, Patrick, N; Buckley, Timothy, J; Williams, D’Ann; Beck, Christopher, M; Jo, Seong-Joon; Merriman, Barry; Kanchanaraksa, Sukon; Swartz, Lee, J; Callahan, Karen, A; Butz, Arlene, M; Rand, Cynthia, S; Diette, Gregory, B; Krishnan, Jerry, A; Moseley, Adrian, M; Curtin-Brosnan, Jean; Durkin, Nowella, B; Eggleston, Peyton A. Indoor exposures to air pollutants and allergens in the homes of asthmatic children in inner-city Baltimore. Environmental Research. 98(2):2005. 167-76.
Advancing Knowledge. Improving Life.
2005 Publications
Sapkota, Amir; Williams, D’Ann; Buckley, Timothy J. Tollbooth workers and mobile source-related hazardous air pollutants: how protective is the indoor environment? Environmental Science & Technology. 39(9):2005. 2936-43. Han CH, Ding H, Casto BC, Stoner GD, and D’Ambrosio SM. Inhibition of the growth of premalignant and malignant human oral cell lines by extracts and components of black raspberries. Nutrition and Cancer. 51:2005. 207-217. J. Mac Crawford, Joanne Pearsol, John Rule, Shirley Funt, Kathleen Koechlin. Epidemiology Training and Public Health Workforce Development in Ohio Public Health Reports. 120:2005. 685-687. Freud, Aharon, G; Becknell, Brian; Roychowdhury, Sameek; Mao, Hsiaoyin, C; Ferketich, Amy, K; Nuovo, Gerard, J; Hughes, Tiffany, L; Marburger, Trent, B; Sung, John; Baiocchi, Robert, A; Guimond, Martin; Caligiuri, Michael A. A human CD34(+) subset resides in lymph nodes and differentiates into CD56bright natural killer cells. Immunity. 22(3):2005. 295-304. El-Sayed, Osama; Magorien, Raymond, D; Orsini, Anthony; Ferketich, Amy, K; Leier, Carl V. Advancing immunosuppression therapy to counter the progression of cardiac allograft vasculopathy. Journal of cardiac failure. 11(2):2005. 137-41. May, Kenneth F. Jr; Roychowdhury, Sameek; Bhatt, Darshna; Kocak, Ergun; Bai, Xue-Feng; Liu, Jin-Qing; Ferketich, Amy K.; Martin, Edward W. Jr; Caligiuri, Michael A.; Zheng, Pan; Liu, Yang. Anti-human CTLA-4 monoclonal antibody promotes T-cell expansion and immunity in a hu-PBL-SCID model: a new method for preclinical screening of costimulatory monoclonal antibodies. Blood. 105(3): 2005. 1114-1120. Blaser, Bradley W.; Roychowdhury, Sameek; Kim, Daniel J.; Schwind, Noah R.; Bhatt, Darshna; Yuan, Weifeng; Kusewitt, Donna F.; Ferketich, Amy K.; Caligiuri, Michael A.; Guimond, Martin. Donor-derived IL-15 is critical for acute allogeneic graft-versus-host disease. Blood. 105(2):2005. 894-901. 21
Impact Research Magazine
Dierksheide, Julie E.; Baiocchi, Robert A.; Ferketich, Amy K.; Roychowdhury, Sameek; Pelletier, Ronald P.; Eisenbeis, Charles F.; Caligiuri, Michael A.; VanBuskirk, Anne M.. IFN-gamma gene polymorphisms associate with development of EBV+ lymphoproliferative disease in hu PBL-SCID mice. Blood. 105(4):2005. 1558-1565. Raman, Subha V.; Cook, Stephen C.; McCarthy, Beth; Ferketich, Amy K. Usefulness of multidetector row computed tomography to quantify right ventricular size and function in adults with either tetralogy of fallot or transposition of the great arteries. American Journal of Cardiology. 95(5):2005. 683-686. Ali N, Mekhjian H, Kuehn L, Bentley T, Kumar R, Ferketich AK, Hoffmann S. Specificity of computerized physician order entry has a significant effect on the efficiency of workflow for critically ill patients. Critical Care Medicine. 33:2005. 110-114. Ferketich AK, Pohorence Ferguson J, and Binkley PF. Depressive symptoms and inflammation among heart failure patients. American Heart Journal. 150:2005. 132-136. Ferketich AK and Binkley PF. Psychological Distress and Cardiovascular Disease: Results from the 2002 National Health Interview Survey (NHIS). European Heart Journal. 26:2005. 1923-1929. Winpisinger KA, Ferketich AK, Berry RL, and Moeschberger ML. Study of house fly (Diptera: Muscidae) populations in rural communities surrounding very large poultry facilities. Journal of Medical Entomology. 42:2005. 732-738. Roychowdhury S, Blaser W, Freud AG, Katz K, Bhatt D, Ferketich AK, Bergdall B, Kusewitt D, Baiocchi RA, Caligiuri MA. IL-15 but not IL-2 rapidly induces lethal xenogeneic graft versus host disease. Blood. 106:2005. 2433-2435. Focht, B. C., Brawley, L., Rejeski, W. J., & Ambrosius, W. T.. Effects of lifetime physical activity and traditional exercise therapy programs upon health-related quality of life among older adults in cardiac rehabilitation. Annals of Behavioral Medicine. 28:2005. 52-61. Focht, B.C., Rejeski, W.J., & Rejeski, A.F. Treating obesity in patients with knee osteoarthritis. Journal of Musculoskeletal Medicine. 22:2005. 491-502. Focht, Brian, C; Rejeski, W Jack; Ambrosius, Walter, T; Katula, Jeffrey, A; Messier, Stephen P. Exercise, selfefficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis. Arthritis and rheumatism. 53(5):2005. 659-65. Gray, D.L. The Role of the Toxicologist in Toxic Torts, OSBA CLE Institute Reference Manual, 20th Annual Environmental Law Seminar, 2005. Harris, Randall E. Does the dose make the poison? Science. 308(5719):2005. 203. Randall E. Harris, Joanne Beebe-Donk, Hani Doss and Deborah Burr Doss: Aspirin, ibuprofen, and other non-
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steroidal anti-inflammatory drugs in cancer prevention: A critical review of non-selective COX-2 blockade (Review). Oncology Reports 13:2005. 559-583. Linnan LA, Ferguson YO, Wasilewski Y, Lee AM, Yang J, Solomon F, Katz ML. Using community-based participatory research methods to reach women with health messages: Results from the North Carolina BEAUTY & Health Project. Health Promotion Practice. 6:2005. 164-173. Pasche, Boris; Knobloch, Thomas, J; Bian, Yansong; Liu, Junjian; Phukan, Sharbani; Rosman, Diana; Kaklamani, Virginia; Baddi, Lisa; Siddiqui, Farida, S; Frankel, Wendy; Prior, Thomas, W; Schuller, David, E; Agrawal, Amit; Lang, Jas; Dolan, M Eileen; Vokes, Everett, E; Lane, William, S; Huang, Chiang-Ching; Caldes, Trinidad; Di Cristofano, Antonio; et al.. Somatic acquisition and signaling of TGFBR1*6A in cancer. JAMA :The Journal of the American Medical Association. 294(13):2005. 1634-46. Lee, Mei-Ling Ting; Whitmore, G, A; Bjorkbacka, Harry; Freeman, Mason W. Nonparametric methods for microarray data based on exchangeability and borrowed power. Journal of Biopharmaceutical Statistics. 15(5):2005. 783-97. Lee, M-L T, Gray RJ, Bjorkbacka H, Freeman MW. Generalized Rank Tests for Replicated Microarray Data. Statistical Applications in Genetics and Molecular Biology. 4(1):2005. http://www.bepress.com/sagmb/ vol4/iss1/art3 Saul, A.N., Oberyszyn, T.M., Daugherty, C., Kusewitt, D., Jones, S., Jewell, S., Malarkey, W.B., Lehman, A., Lemeshow, S. & Dhabhar, F.S. Chronic stress and susceptibility to skin cancer. Journal of the National Cancer Institute. 97(23):2005. 1760-1767. McGuire L, Heffner K, Glaser R, Needleman B, Malarkey W, Dickinson S, Lemeshow S, Cook C, Muscarella P, Melvin WS, Ellison EC, and Kiecolt-Glaser JK (2005) Pain and Wound Healing in Surgical Patients. Accepted for Publication in Annals of Behavioral Medicine. Kiecolt-Glaser JK, Loving TJ, Stowell JR, Malarkey WB, Lemeshow S, Dickinson S, Glaser R (2005) Hostile Marital Interactions Influence Proinflammatory Cytokine Production and Wound Healing. Accepted for Publication in Archives of General Psychiatry. Wewers MD, Lemeshow S, Lehman A, Ckanton TL, Diaz PT (2005). Lung CD4 Lymphocytes Predict Survival in Asymptomatic HIV Infection. Chest. 128(4):2005. 2262-7 Shapiro CL, Phillips G, Poznak CH, Jackson R, Leboff MS, Woodard S, Lemeshow S. Baseline bone mineral density of the total lumbar spine may predict for chemotherapy-induced ovarian failure. Breast Cancer Research and Treatment. 90(1):2005. 41-6. Lu, B. Propensity Score Matching with Time Dependent Covariates. Biometrics. 61:2005): 721-728. Zanutto E, Lu B, Hornik R . Using Propensity Score Subclassification to evaluate a National Anti-Drug
Media Campaign Journal of Educational and Behavioral Statistics. 2005. McAlearney, Ann Scheck; Reeves, Katherine, W; Tatum, Cathy; Paskett, Electra D. Perceptions of insurance coverage for screening mammography among women in need of screening. Cancer. 103(12): 2005. 2473-80. Ann Scheck McAlearney. Organizational and physician perspectives about facilitating handheld computer use in clinical practice: results of a cross-site qualitative study Journal of the American Medical Informatics Association: JAMIA. 12(5):2005. 568-75. McAlearney, AS; Hoshaw SA. The potential for handheld computers in LTC settings Long-Term Care Interface. 6(4):2005. 36-40. Reeves, KW, McAlearney, A.S., Tatum, C., Paskett, E. Cost as a Barrier to Screening Mammography. Cancer Epidemiology, Biomarkers, and Prevention. 14(2):2005. 549. McAlearney, A.S. Exploring Mentoring and Leadership Development in Health Care Organizations: Experience and Opportunities. Career Development International 10(6/7):2005. 493-511. McAlearney, A.S., Fisher, D., Heiser, K., Robbins, D., Kelleher, K. Developing Effective Physician Leaders: Building Skills and Changing Cultures. Hospital Topics. 83(2):2005. 11-18. Chisolm, D.J., Young, R.R., McAlearney, A.S. Implementation of a Touch-Screen New Patient Registration System: A Case Study. Journal of Medical Practice Management 21(3):2005. 159-162. Mutti, Donald, O; Mitchell, G Lynn; Jones, Lisa, A; Friedman, Nina, E; Frane, Sara, L; Lin, Wendy, K; Moeschberger, Melvin, L; Zadnik, Karla. Axial growth and changes in lenticular and corneal power during emmetropization in infants. Investigative Ophthalmology & Visual Science. 46(9):2005. 3074-80. Blitstein, J.L., Murray, D.M., Lytle, L.A., Birnbaum, A.S., Perry, C.L. Predictors of violent behavior in an early adolescent cohort: similarities and differences across genders. Health Education & Behavior. 32(2):2005. 175-194. Voorhees, C.C., Murray, D.M., Birnbaum, A.S., Ribisl, K.M., Welk, G., Johnson, C.C., Saksvig, B., Pfeiffer, K., Jobe, J. The role of peer social networks and physical activity in adolescent girls. American Journal of Health Behavior. 29(2):2005. 183-190. Blitstein, J.L., Hannan, P.J., Murray, D.M., Shadish, W.R. Increasing the degrees of freedom in existing group randomized trials: The df* approach. Evaluation Review. 29(3):2005. 241-267. Blitstein, J.L., Murray, D.M., Hannan, P.J., Shadish, W.R. Increasing the degrees of freedom in future group randomized trials: The df* approach. Evaluation Review. 29(3):2005. 268-286.
Michielutte R, Sharp PC, Foley KL, Cunningham LE, Spangler JG, Paskett E, Case LD. Intervention to Increase Screening Mammography Among Women 65 and Older. Health Education Research Theory and Practice. 20(2):2005. 149-62. Hensley, Martee, L; Dowell, Jeannette; Herndon, James E 2nd; Winer, Eric; Stark, Nancy; Weeks, Jane, C; Paskett, Electra. Economic outcomes of breast cancer survivorship: CALGB study 79804. Breast Cancer Research and Treatment. 91(2):2005. 153-61. Chlebowski, Rowan T.; Chen, Zhao; Anderson, Garnet L.; Rohan, Thomas; Aragaki, Aaron; Lane, Dorothy; Dolan, Nancy C.; Paskett, Electra D.; McTiernan, Anne; Hubbell, F. Alan; Adams-Campbell, Lucile L.; Prentice, Ross. Ethnicity and breast cancer: Factors influencing differences in incidence and outcome. Journal of the National Cancer Institute. 97(6):2005. 439-448. Polyp Prevention Study Grp; Hartman, Terryl J.; Albert, Paul S.; Snyder, Kirk; Slattery, Martha L.; Caan, Bette; Paskett, Electra; Iber, Frank; Kikendall, James Walter; Marshall, James; Shike, Moshe; Weissfeld, Joel; Brewer, Brenda; Schatzkin, Arthur; Lanza, Elaine. The association of calcium and vitamin D with risk of colorectal adenomas. Journal of Nutrition. 135(2):2005. 252-259. Dunn CL, Pirie PL. Empowering youth for tobacco control. American Journal of Health Promotion. 20(1):2005. 7-10. Pirie PL, Rhodes K, Daly K, Davey C. Feasibility and acceptability of an intervention to reduce the prevalence of risk factors for otitis media in a Minnesota American Indian population: The Little Ears Study. The IHS Primary Care Provider. April 2005. 95-99. Michael J. Pompili. Public Environmental Health in Ohio -Where do we go from here? Part 1 -Our Past and Our Heritage -Having a sense of where your roots came from. Ohio Journal of Environmental Health. 55(3):2005. 27-29. Michael J. Pompili. Public Environmental Health in Ohio: Where Do We Go From Here?- Part 2 Who We Are! Environmental Health Atlas - Personnel Ohio Journal of Environmental Health. 55(4):2005. 10-14. Schwartzbaum, Judith; Ahlbom, Anders; Malmer, Beatrice; Lonn, Stefan; Brookes, Anthony, J; Doss, Hani; Debinski, Waldemar; Henriksson, Roger; Feychting, Maria. Polymorphisms associated with asthma are inversely related to glioblastoma multiforme. Cancer research. 65(14):2005. 6459-65. Schwartzbaum, Judith; Jonsson, Fredrik; Ahlbom, Anders; Preston-Martin, Susan; Malmer, Beatrice; Lonn, Stefan; Karin, Soderberg; Feychting, Maria. Prior hospitalization for epilepsy, diabetes, and stroke and subsequent glioma and meningioma risk. Cancer Epidemiology Biomarkers & Prevention. 14(3):2005. 643-650.
Wrensch M, Fisher JL, Schwartzbaum JA, Bondy B, Berger M, Aldape KD. Molecular epidemiology of adult glioma. Neurosurgical Focus. 19(5):2005 .E5. Edwards CG, Schwartzbaum JA, Lonn S, Ahlbom A, Feychting M. Exposure to Loud Noise and Risk of Acoustic Neuroma. American Journal of Epidemiology. 2005. Stone, Tamara, T; Schweikhart, Sharon, B; Mantese, Annamarie; Sonnad, Seema S. Guideline attribute and implementation preferences among physicians in multiple health systems. Quality Management in Health Care. 14(3):2005. 177-87. Weber, Frank; Shen, Lei; Aldred, Micheala, A; Morrison, Carl, D; Frilling, Andrea; Saji, Motoyasu; Schuppert, Frank; Broelsch, Christoph, E; Ringel, Matthew, D; Eng, Charis. Genetic classification of benign and malignant thyroid follicular neoplasia based on a three-gene combination. The Journal of Clinical Endocrinology and Metabolism. 90(5):2005. 2512-21. Sarquis MS, Weber F, Shen L, Borelsch CE, Jhiang SM, Zedenius J, Frilling A and Eng C. High Frequency of Loss-of-heterozygosity in Imprinted Compared to Non-imprinted Genomic Regions in Follicular Thyroid Carcinomas and Atypical Adenomas, The Journal of Clinical Endocrinology and Metabolism. 2005. Shipp MP, Desmond R, Accort N, Wilson RJ, Fouad M, Eloubeidi MA. Population-based study of the geographic variation in colon cancer incidence in Alabama: relationship to socioeconomic status indicators and physician density. Southern Medical Journal. 98(11):2005. 1076-1082. Jones AR, Shipp M, Thompson CJ, Davis MK . Prostate cancer knowledge and beliefs among Black and White older men in rural and urban counties. Journal of Cancer Education. 20(2):2005. 96-102. Steinman, Kenneth, J; Wright, Valerie; Cooksey, Elizabeth; Myers, Linda James; Price-Spratlen, Townsand; Ryles, Ron. Collaborative research in a faithbased setting: Columbus Congregations for Healthy Youth. Public Health Reports. 120(2):2005. 213-6. Steinman KJ. Drug selling among high school students: related risk behaviors and psychosocial characteristics. Journal of Adolescent Health. 36(1):2005. 71.e1-8. Samore MH, Bateman K, Alder SC, Hannah E, Donnelly S, Stoddard GJ, Haddadin B, Rubin MA, Williamson J, Stults B, Rupper R, Stevenson K. Clinical Decision Support and the Appropriateness of Antimicrobial Prescribing: A Randomized Trial. The Journal of the American Medical Association. 294:2005. 2305-2314. Stevenson KB, Barbera J, Moore JW, Samore MH, and Houck P. Understanding Keys to Successful Implementation of Electronic Decision Support in Rural Hospitals: Analysis of a Pilot Study for Antimicrobial Prescribing. American Journal of Medical Quality. 20:2005. 313-318
Loeb M, Smith S, Brazil K, Lohfield L, Walter S, Xiwu L, McGeer A, Simor A, Stevenson K, Zoutman D. Effect of Multifaceted Intervention to Reduce Antimicrobial Prescriptions for Urinary Indications in Residents of Nursing Homes: A Randomized Trial. British Medical Journal. 331:2005. 669. Tanenbaum, Sandra J. Evidence-based practice as mental health policy: three controversies and a caveat. Health Affairs. 24(1):2005. 163-73. Tanenbaum, Sandra J. Uncertainty, consultation, and the context of medical care. British Medical Journal 330(7490):2005. 515.
Advancing Knowledge. Improving Life.
Stevens, J., Murray, D.M., Catellier, D.J., Hannan, P.J., Lytle, L.A., Elder, J.P., Young, D.R., Simons-Morton, D., Webber, L.S. Design of the Trial of Activity in Adolescent Girls (TAAG). Controlled Clinical Trials. 26:2005. 223-233.
Tanenbaum, Sandra J. Evidence-Based Knowledge, Psychotherapeutic Culture and Managed Mental Health Care in the U.S. International Journal of Knowledge, Culture and Change Management 4. 2005. http://ijm. cgpublisher.com/product/pub.28/prod141. J Li, P Muscarella, S H Joo, TJ Knobloch, WS Melvin, CM Weghorst and M-D Tsai. Dissection of CDK4binding and Transactivation Activities of p34SEI-1 and Comparison between Functions of p34SEI-1 and p16INK4A. Biochemistry. 44(40):2005. 13246-13256. B Pasche, TJ Knobloch, Y Bian, J Liu, S Phukan, D Rosman, V Kaklamani, L Baddi, W Frankel, TW Prior, DE Schuller, A Agrawal, J Lng, ME Dolan, EE Vokes, WS Lane, C-C Huang, T Caldes, A Di Cristofano, H Hampel1, IM Nilsson, G von Heijne1, R Fodde, V.V.V.S. Murty, A de la Chapelle, CM Weghorst. Somatic acquisition and signaling of TGFBR1*6A in cancer. Journal of the American Medical Association. 294:2005. 1634-1646. Sarna, Linda; Bialous, Stella Aguinaga; Wewers, Mary Ellen; Froelicher, Erika Sivarajan; Danao, Leda. Nurses, smoking, and the workplace. Research in Nursing & Health. 28(1):2005. 79-90. Groner, J., French, G., Ahijevych, K.L., Wewers, M.E. Process evaluation of nurse-delivered smoking relapse prevention program for new mothers. Journal of Community Health Nursing. 22:2005. 157-167. Andrews, J. Felton, G., Wewers, M.E., Waller, J., Humbles, P. Sister to sister: Assisting low-income women to quit smoking. Southern Online Journal of Nursing Research. 1(6):2005. www.snrs.org. Xiang, Huiyun; Smith, Gary, A; Wilkins, J R 3rd; Chen, Guanmin; Hostetler, Sarah Grim; Stallones, Lorann. Obesity and risk of nonfatal unintentional injuries. American journal of Preventive Medicine. 29(1):2005.41-5. Atrubin, David; Wilkins, J R 3rd; Crawford, J Mac; Bean, T L. Self-reported symptoms of neurotoxicity and agricultural injuries among Ohio cash-grain farmers. American Journal of Industrial Medicine. 47(6):2005. 538-49.
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Impact Research Magazine
Grants and Contracts ARKES, HAL “EITM: Collaborative research: Reference point adaptation and mental accounting: Dynamic extensions of prospect theory,” National Science Foundation Social, Behavioral and Economic Sciences, $176,285 (2004-2006 ARKES, HAL “Collaborative research: The reluctance to use decision aids,” National Science Foundation, $170,000 (2003-2006) ARKES, HAL (Co-I) “Collaborative research in team versus individual play,” National Science Foundation Social, Behavioral and Economic Sciences, $132,744 (2005-2008), Award PI: John Kagel CASWELL, ROBERT “Public health traineeship,” Bureau of Health Professions/ Health Resources and Services Administration, $142,566 (1996-2006) CRAWFORD, JOHN “The health of Ohio police officers and firefighters,” Ohio Police and Fire Pension Fund, $40,935 (2005-2006) FERKETICH, AMY (Co-I) “Prevention of post-transplant lymphoproliferative disorder,” Leukemia and Lymphoma Society, $200,000 (2005-2008), Award PI: Michael Caligiuri FERKETICH, AMY (Co-I) “Iron and atherosclerosis,” National Heart, Lung and Blood Institute/ National Institutes of Health, $224,250 (2005-2007), Award PI: Subha Raman FERKETICH, AMY (Co-I) “Cytokine production, gene polymorphisms and PTLD,” National Cancer Institute/ National Institutes of Health, $149,500 (2004-2006), Award PI: Anne VanBuskirk GRAY, DEBORAH “Connecting Ohio hospitals to the Real-Time Outbreak and Disease Surveillance System,” Ohio Department of Health, $282,000 (2005) HOLTZHAUER, FRANK “Public health workforce curriculum development and implementation program,” Ohio Department of Health, $397,000 (2005-2006) HOLTZHAUER, FRANK “Public health workforce scholarship program,” Ohio Department of Health, $368,280 (2005-2006) HOLTZHAUER, FRANK; Pearsol, Joanne (Co-I) “Center for Public Health Preparedness,” Centers for Disease Control and Prevention, $2,220,884 (2004-2009)
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HOLTZHAER, FRANK; Pearsol, Joanne (Co-I) “Ohio Public Health Leadership Institute,” Association of Schools of Public Health/ Centers for Disease Control and Prevention, $55,742 (2004-2008)
MOESCHBERGER, MELVIN (Co-I) “Clinical research curriculum,” National Heart, Lung and Blood Institute/ National Institutes of Health, $1,200,000 (1999-2006), Award PI: Karla Zadnik
HOLTZHAUER, FRANK ”Pennsylvania and Ohio Public Health Training Center,“ Health Resources and Services Administration, $490,717 (2002-2010)
PASKETT, ELECTRA “Ohio Patient Navigation Program,” American Cancer Society, Dollar Amount Pending (2005-2006)
HOLTZHAUER, FRANK; Crawford, John (Co-I); Gray, Deborah(Co-I); Pearsol, Joanne (Co-I) “Ohio State University Center for Public Health Preparedness,” Centers for Disease Control and Prevention, $628,015 (2002-2005)
PASKETT, ELECTRA “Cancer control and prevention earmarks,” Centers for Disease Control and Prevention, $148,800 (2005-2006)
HOLTZHAUER, FRANK (Co-I) “Bioterrorism training and curriculum development program,” Health Resources and Services Administration, $844,625 (2003-2005), Award PI: W. Frederick Miser KATZ, MIRA “Patient activation to increase colon cancer screening,” National Cancer Institute/ National Institutes of Health, $135,108 (2005-2010) LEMESHOW, STANLEY (Co-I) “Eliminating barriers to effective training in clinical investigation,” National Institute of Child Health and Human Development/ National Institutes of Health, $669,785 (2005-2010), Award PI: Philip Binkley LEMESHOW, STANLEY (Mentor) “The obese critical III: Process and outcome disparities,” National Heart, Lung and Blood Institute/ National Institutes of Health, $130,248 (2005-2009), Award PI: James O’Brien LEMESHOW, STANLEY (Co-I) “Stress, the immune system and basal cell carcinoma,” National Cancer Institute/ National Institutes of Health, $760,300 (20052008), Award PI: M. Ronald Glaser LEMESHOW, STANLEY “Comprehensive program for the prevention, detection and treatment of lung cancer,” Ohio Department of Development, $153,904 (2003-2007), Award PI: Michael Caligiuri. LEMESHOW, STANLEY (Co-I) “Biochemical/ psychosocial risks for low back disorders,” National Institute of Occupational Safety and Health/ Centers for Disease Control and Prevention, $846,835 (2001-2006), Award PI: William Marras MCALEARNEY, ANN “Improving cardiovascular care for minority Americans: Assessing organizational readiness to change,” Robert Wood Johnson Foundation, $64,999 (2005-2006)
PASKETT, ELECTRA “Appalachian Cancer Center Network,” National Cancer Institute, $253,329 (20052006) PASKETT, ELECTRA “Grandma’s hands program,” Susan G. Komen Breast Cancer Foundation Columbus, $32,108 (2004-2005) PASKETT, ELECTRA “Reducing cervical cancer in Appalachia,” National Cancer Institute/ National Institutes of Health, $4,491,435 (2003-2008) PASKETT, ELECTRA “Springfield regional cancer screening program,” Public Health Service, $447,225 (2003-2006) PASKETT, ELECTRA; Alfano, Catherine (Co-I) “Breast cancer prevention through nutrition program,” The Breast Cancer Research Foundation, $999,999 (2002-2006) PASKETT, ELECTRA “Cancer and Leukemia Group B cancer control and health outcomes committee chair support,” National Cancer Institute, $190,884 (20022006) PASKETT, ELECTRA “Cancer and Leukemia Group B special prevention member support,” National Cancer Institute, $206,984 (2002-2005) PASKETT, ELECTRA “The effect of phytonutrients on reducing breast cancer risk,” The Breast Cancer Research Foundation, $220,412 (2002-2005) PASKETT, ELECTRA “Soy supplementation and prostate cancer prevention,” United States Department of the Army, $209,503 (2002-2005) PASKETT, ELECTRA (Co-I) “Gynecological cancer center for health disparities,” Henry M. Jackson Foundation for the Advancement of Military Medicine, $847,990 (20042006), Award PI: Jeffrey Fowler PIRIE, PHYLLIS “OAT special projects: Netwellness,” Health Resources and Services Administration, $426,916 (2002-2006)
WEWERS, MARY ELLEN (Co-I) “Menthol, ethnicity and nicotine dependence,” National Institute of Drug Abuse/ National Institutes of Health, $261,625 (20052008), Award PI: Karen Ahijevych
SCHWARTZBAUM, JUDITH “Allergic condition biomarkers and glioma risk,” National Cancer Institute/ National Institutes of Health, $141,853 (2003-2005)
WEWERS, MARY ELLEN “Comprehensive program for the prevention, detection and treatment of lung cancer,” Ohio Department of Development, $284,681 (2003-2007) Award PI: Caligiuri.
SHEN, LEI “Connecting Ohio Hospitals to Real-Time Outbreak and Diseases Surveillance System,” Ohio Department of Health, $99,500 (2005-2006) SHEN, LEI (Co-I) “Interrogating epigenetic changes in cancer genomes,” National Cancer Institute/ National Institutes of Health, $2,862,114 (2004-2009), Award PI: Tim Huang SHEN, LEI (Co-I) “Stromal gene expression during pulmonary sarcoidosis,” National Heart, Lung and Blood Institute/ National Institutes of Health, $411,125 (20042006), Award PI: Elliott Crouser
WEWERS, MARY ELLEN “Tobacco use and cessation among Ohio Appalachian women,” National Cancer Institute, $900,000 (2003-2008) WILKINS, JOHN “Adherence to NAGCAT and injury risk reduction,” National Institute of Occupational Safety and Health/ Centers for Disease Control and Prevention, $1,083,875 (2003-2006)
WILKINS, JOHN; Moeschberger, Melvin (CoI); Weghorst, Christopher (Co-I) “Biomarkers and neurobehavioral effects of perinatal exposure to insecticides,” Environmental Protection Agency, $1,251,458 (2001-2006)
Advancing Knowledge. Improving Life.
POMPILI, MICHAEL “Public participation/community involvement activities project for local and state environmental health programs,” Charles F. Kettering Foundation, $63,000 (2004-2006)
WILKINS, JOHN (Co-I) “Ohio Regional Center for Agricultural Disease and Injury,” National Institute of Occupational Safety and Health/ Centers for Disease Control and Prevention, $1,714,433 (2003-2006), Award PI: Thomas Bean
*This list includes grants and contracts from external sponsors which were active in the School of Public Health in 2005. Amounts include total award to date.
SHIPP, MICHELE “What accounts for racial disparities in colon cancer,” National Cancer Institute/ National Institutes of Health, $228,511 (2004-2006) STEINMAN, KENNETH “Health behavior among religiously active black youth,” Association of Schools of Public Health/ Centers for Disease Control and Prevention, $903,194 (2003-2006) TANENBAUM, SANDRA “Evidence and empowerment among consumers in the public mental health system,” Ohio Department of Mental Health, $33,222 (2005-2008) WEGHORST, CHRISTOPHER “Chemopreventive agentresponsive genes in oral cancer,” National Institute of Dental and Craniofacial Research/ National Institutes of Health, $373,750 (2004-2006) WEGHORST, CHRISTOPHER (Co-I); Casto, Bruce (Co-I) “Apoptotic mechanisms in NSAID chemoprevention,” National Cancer Institute/ National Institutes of Health, $236,210 (2005-2009), Award PI: Steven Dambrosio WEWERS, MARY ELLEN “Testing the effects of interactive computer programs for smoking cessation,” Walther Cancer Institute, $12,834 (2005-2006) WEWERS, MARY ELLEN “Tobacco Free Nurses,” Robert Wood Johnson Foundation, $105,060 (2003-2006)
Get to know us better To learn more about the School of Public Health and its activities, please visit the following web sites: The Ohio State University School of Public Health http://sph.osu.edu Dean: Stanley Lemeshow, PhD Center for Health Outcomes Policy and Evaluation Studies http://sph.osu.edu/hopes Interim Director: Mary Ellen Wewers, PhD Ohio Center for Public Health Preparedness http://sph.osu.edu/cphp Director: Frank Holtzhauer, PhD Office of Workforce Development http://sph.osu.edu/workforcedevelopment/ Director: Frank Holtzhauer, PhD Master of Health Administration http://sph.osu.edu/mph Program Director: Sharon Schweikhart, PhD Columbus Congregations for Healthy Youth http://sph.osu.edu/cochy Principal Investigator: Kenneth Steinman, PhD 25
School of Public Health The Ohio State University M116 Starling-Loving Hall 320 W. 10th Ave. Columbus OH 43210