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UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE

KNOWLEDGE TO

S AV E A L I F E HELPING WITH HYPERTENSION

DIABETES PREVENTION AND

MANAGEMENT

BRIDGING

TH E DIV IDE

connecting people to social services to improve health


WE ARE DEDICATED TO IMPROVING AND PROMOTING THE HEALTH OF INDIVIDUALS AND COMMUNITIES IN ALABAMA AND THE REGION THROUGH LEADERSHIP IN MEDICAL EDUCATION AND PRIMARY CARE; THE PROVISION OF HIGH QUALITY, ACCESSIBLE HEALTH CARE SERVICES; AND SCHOLARSHIP.

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A MESSAGE FROM THE DEAN

F A LFLA L2L0 1290 1 9

A journey to

A

excellence

t about this time last year, I stepped into the role of interim dean of the College of Community Health Sciences at The University of Alabama. I previously served, since 2013, as director of the UA Family Medicine Residency, and as chair of the CCHS Department of Family, Internal, and Rural Medicine. I am honored and quite humbled to have been chosen in July as the permanent dean of CCHS. I am excited to begin this permanent role, and I am particularly excited about continuing the work that we began in the interim period. I look forward to building upon the successes of our College’s education, patient care, research and outreach programs. I hope you will join me in our commitment to further elevate the distinction of our medical student education and residency, the care of our patients at University Medical Center, and the translation of our research and discovery into improving the health of Alabama. In fact, we are about to embark upon a new strategic planning process for the College. The previous dean and his team developed our last strategic plan in 2014. The College did a fine job of keeping up with the vision and goals established over the last five years, but it is time to take a careful look at where we are now and where we want to go during the next decade. We hope to have a finalized and College-wide approved new strategic plan in early spring of 2020. This planning will certainly be an opportunity to align the College more closely with The University of Alabama

strategic plan, finalized earlier this year, and begin to prepare for the next decade, which will be full of challenges, including an ever-changing health care regulatory environment, new quality reporting requirements, an evolving landscape in academic medicine and higher education, new degree offering opportunities, creating a culture of philanthropy within the College, continuing to foster a positive and impactful relationship with our community partners, particularly those in rural and underserved areas, creating a culture of diversity and inclusion within CCHS and, finally, creating a culture of excellence and accountability in all that we do. Now, as we move to close out one fiscal year and begin a new one, I want to provide you with some updates about our recent efforts. We had one of our strongest years ever in faculty and clinician recruitment. We added numerous faculty in nearly all of our academic and clinical departments, including physicians specializing in family medicine, pediatrics, endocrinology and obstetrics and gynecology, as well as seasoned doctoral-level researchers in our Institute for Rural Health Research. We significantly expanded the size and scope of our University Hospitalist and Neuro Hospitalist Group, 23 physicians and four nurse practitioners who care for our patients when they are hospitalized, and we have seen, through the high-quality care delivered, those patients spend less time in the hospital and have fewer readmissions once discharged. Our University Medical Center location in Demopolis, C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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DEAN’S MESSAGE

Alabama, continues to experience significant growth and that success means we have a practice model that can be replicated in similar Black Belt and medically underserved Alabama communities. We are currently working with several rural communities that understand not every rural community will have a hospital in the future. The regulatory environment and escalating costs will just not support existing hospital models without significant changes to the current reimbursement model. Many of our resident physicians have gone on to practice in these rural areas with passion and enthusiasm to provide excellent care. Unfortunately, the same challenges that we are seeing across the country in regard to rural health – declining populations, older and sicker patients and lower reimbursement for providers - have impacted our graduates’ decisions to leave rural Alabama communities. Many of our graduates and family medicine physicians from across the state have come to us looking for solutions. Our growing and successful medical practice in Demopolis gives us a sustainable model that can be replicated across the state. We are working hard to continue to refine and study this model for the future. Our College’s focus on external research funding continues to drive change throughout CCHS. Both number of grants and monetary awards are up substantially as compared to the same time last year. This growth has created additional and important opportunities for our learners at all levels. Additional resources have been given to the Institute for Rural Health Research and that team has responded in tremendous fashion. We are working on other initiatives across campus that will naturally create 2

we ARE READY TO BUILD oN OUR

SUCCESSES

more opportunities for our MD and PhD faculty. I look for this endeavor to continue to drive growth in this important area of the College’s mission. We have added emerging and important areas to our degree programs and curricula offerings, including master’s degrees in population health and rural community health, and certification in global health. Our initial institutional effectiveness review placed these programs in the top 10% of all degree programs at The University of Alabama. What an awesome accomplishment! This speaks to the highquality work we do on a regular basis. We also continue to bring health care resources directly to people in communities, including through “social work hubs” in Tuscaloosa and health-related projects in Pickens County. The College of Community Health Science has accomplished much during the past fiscal year and we are ready to build on our successes as we move into the next decade. We are presented with a tremendous opportunity for ongoing and continual growth within the College. We will create a culture of excellence throughout all of our programs as we approach future challenges in health care, higher education and research. Hold on, buckle up and join us on our journey to excellence.

-DR. RICHARD FRIEND

DEAN, COLLEGE OF COMMUNITY HEALTH SCIENCES


WINTER 2018

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TABLE OF CONTENTS 1

Dean's Message

4

News

10

12 14

DEAN

Dr. Richard Friend

EDITOR

Leslie Zganjar, MPA

Q&A with Dean Friend

ASSOCIATE EDITORS Kaylin Bowen Erin Tech

Save a Life Training BRIDGING THE DIVIDE

16

Comcare Program

18

A Bridge to Mental Health Care

19

Transitioning the ACTION Program

22

Caring for Foster Children

CREATIVE DIRECTOR Erin Tech

WRITERS

Leslie Zganjar, MPA Kaylin Bowen Kathryn Fish

DESIGNERS

24

Social Work Student Field Education

27

Laura Beth Brown Persistent About Solutions

31

Christmas in July

32

Reaching Out to Educate the Community

33

Building the Bridge

34

Diabetes Education from an Expert

37

The Rising Burden of Insulin

39

Helping with Hypertension

43

Snapshots

47

New Faculty

53

New Faculty Roles

56

Accolades

Kaylin Bowen Nicholas Jones Erin Tech

COVER PHOTOGRAPHER Greg Randall

PHOTOGRAPHERS Kaylin Bowen Greg Randall UA Photography

ON THE COVER The University Medical Center Office of Case Management and Social Services is working to reduce the impact of social determinants of health in Alabama (page 14).

On Rounds is a semiannual publication of The University of Alabama College of Community Health Sciences. Please send address changes and correspondence to Erin Tech, College of Community Health Sciences, The University of Alabama, Box 870326, Tuscaloosa, AL, 35487 or erin.tech@ua.edu.

C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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N EWS

Dr. Robert Sheppard and Dr. Charles Lehman

U N I V ER SITY HOSPITALIST GROUP

CARING FOR HOSPITALIZED PATIENTS Doctors who practice hospital medicine work within hospitals, caring for patients from the time they are admitted to the time they are discharged and providing much of the hospital care once handled by patients’ primary care physicians. The College of Community Health Sciences in recent years has significantly expanded the size of its hospitalist group. Starting in 2003 with two hospitalists, today 23 physicians comprise University Hospitalist Group and work primarily at DCH Regional Medical Center in Tuscaloosa. DCH is a tertiary-care facility with more than 580 beds, an advanced trauma unit and advanced services in cancer, cardiology, robotic and minimally invasive surgery, critical care pulmonology, gastroenterology and nephrology. University Hospitalist Group physicians provided more than 52,320 patient care visits for University Medical Center and other patients hospitalized at DCH in 2018. The College operates UMC, which has locations in Tuscaloosa, Northport and Demopolis. Hospital medicine has quickly become one of the largest medical specialties in the US. The 4

number of practicing hospitalists is currently estimated at 30,000 and demand for hospitalists remains high. The growth of the specialty has been fueled by several trends, the main one being that the demands on office-based physicians’ time have significantly increased and many have less time to travel to facilities where their patients are hospitalized. Research also suggests greater satisfaction among hospitalized patients who are cared for by hospitalists. “Hospitalists are there all day” said Dr. Robert Sheppard, associate professor of family, internal, and rural medicine at the College and a hospitalist with University Hospitalist Group. Sheppard also founded in 2006 and currently directs the College’s University Hospitalist Fellowship, the first in the nation for family medicine physicians seeking additional experience practicing medicine within hospitals. There are currently four physicians in the fellowship program. Sheppard said hospitalists can immediately answer questions of hospitalized patients, meet with the family and follow up on tests. Traditional


H OS P I TAL I ST FE LLOW S H I P office-based physicians often find it difficult to split their time throughout the day with the office and hospitalized patients, so hospitalists help them do a better job in the office because their focus can remain there, he said. “But hospitalists are more than fill-ins for physicians who no longer round in hospitals,” said Dr. Richard Friend, dean of CCHS. “Today, hospitalists are the key drivers of many of the metrics hospitals need to be financially successful – length-of-stay indexes, readmission rates and patient satisfaction – since many hospital reimbursement incentives and penalties are directly tied to their daily work.” In fall 2018, the College realigned its contract with University Hospitalist Group to shift the focus to quality goals rather than visits per provider and, as a result, has seen hospital readmission rates and length-of-stay indexes fall for UMC patients hospitalized at DCH. While the 30-day readmission rates continue to rival those of any hospital system in the country, the length-of-stay index continues to be a challenge, Friend said. “Hospital readmission rates are trending down nicely,” Friend said. “This has been strong work, helping both DCH, patients and the community. I think this demonstrates the commitment of DCH and UMC to quality patient care. Hospital readmissions and length-of-stay are very complex problems that do not have easy solutions. We study the literature constantly to see what others are doing to try to help us make decisions that will yield better, quality care.”

The College of Community Health Sciences offers a hospitalist fellowship for family medicine physicians seeking experience practicing medicine within hospitals and caring for patients from admission to discharge. There are currently four fellows participating in the University Hospitalist Fellowship, founded in 2006 and the first hospitalist fellowship in the nation for family medicine physicians. To date, 20 family medicine physicians have received training through the fellowship. The yearlong fellowship is housed and offers training at Tuscaloosa’s DCH Regional Medical Center, a tertiary-care facility with more than 580 beds and an advanced trauma center. DCH offers a variety of specialty units and advanced services that include cancer, cardiology, robotic and minimally invasive surgery, critical care pulmonology, gastroenterology and nephrology. The fellowship offers one-on-one supervision from a hospitalist attending physician for the College, with backup from a large academic hospitalist service of board-certified physicians. It was founded and is directed by Dr. Robert Sheppard, associate professor of family, internal, and rural medicine for the College and a practicing hospitalist. Once fellows complete the program, they are prepared to take the necessary exams to become board certified in hospital medicine.

C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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NEWS

FAST GROWING

UMC-DEMOPOLIS

BRINGING MUCH NEEDED PRIMARY CARE TO THE COMMUNITY In August 2017, University Medical Center added a permanent location in Demopolis, Alabama, and in the two years since, the practice there has experienced significant growth. In the beginning, UMC-Demopolis was comprised of six exam rooms in the outpatient facility adjacent to the now Whitfield Regional Hospital and physicians from UMC’s main location in Tuscaloosa traveled to Demopolis several days a week to provide family medicine and prenatal care. The practice saw four patients during that first month. Today, UMC-Demopolis is still in the same location, but the number of exam rooms has increased to nine, pediatric and obstetrical services have been added, and patients are seen by the same three UMC physicians who are there five days a week. UMC-Demopolis now averages 575 patient visits and approximately 10 newborn deliveries each month. “We’re getting very busy down there really fast,” said Dr. Richard Friend, dean of the College of Community Health Sciences, which operates University Medical Center and its three locations, including Demopolis. “We have invested heavily in establishing a presence in Demopolis. We will continue to provide the Demopolis practice what it needs to provide excellent patient care and to fill a community need. The community needs us, and we feel we are doing good work there. The initial feedback we have received from the community is very positive and encouraging.” 6

The move to a permanent location in Demopolis, situated in Alabama’s rural Black Belt region, began as a temporary response to an immediate need to help the only local physician still providing prenatal care cover his practice in his absence, and following the closure of the hospital’s obstetrical unit in 2015. When the physician retired shortly thereafter, it became apparent to the College that there was a significant and growing need for family medicine and prenatal care in Demopolis and the surrounding communities. Currently, CCHS is “working with the hospital administration to establish obstetrical services for that community,” Friend said. “Besides providing a muchneeded clinical service to the community and the hospital, we also hope to establish that practice as a teaching site in the future.” Today, the temporary coverage has transitioned into UMC-Demopolis, the third location for UMC along with a main location in Tuscaloosa and a second location in Northport. UMC is the largest multi-specialty community medical practice in West Alabama. Meanwhile, administrators from the UAB Health System are working with leaders of Whitfield Regional Hospital (member of the UAB Health System) to continue to develop strategies to improve the hospital’s financial operations and viability, and CCHS is assisting in those efforts. “We’ve partnered with the hospital and UAB to continue to bring primary care to Demopolis,” Friend said.


3 9 +

FULL-TIME PHYSICIANS

EXAM ROOMS

575 10

AVERAGE NUMBER OF PATIENTS SEEN PER MONTH NUMBER OF NEWBORN DELIVERIES PER MONTH

OBSTETRICAL AND PEDIATRIC SERVICES ADDED

DR. BRITTNEY ANDERSON has a special interest in rural medicine.

She earned a bachelor’s degree in psychology from Duke University in Durham, North Carolina, and completed a master’s degree in rural and community health as a Rural Medical Scholar at The University of Alabama. She received her medical degree from the UA School of Medicine and completed her residency training at the UA Family Medicine Residency, which is operated by UA’s College of Community Health Sciences. Anderson is also an assistant professor of family, internal, and rural medicine for the College, which operates UMC-Demopolis, and spends time teaching the College’s family medicine residents and medical students.

DR. CONNIE LEEPER provides both family medicine and obstetrics care

for patients at UMC-Demopolis. She graduated cum laude from Duke University in Durham, North Carolina, with a bachelor’s degree in biology. She earned her medical degree and a Master of Public Health degree from the University of Alabama School of Medicine. Leeper completed a family medicine residency at the Ventura Family Medicine Residency in Ventura, California, where she served as chief resident. She also completed an obstetrics fellowship at Natividad Medical Center in Salinas, California. In addition, Leeper is an assistant professor of family, internal, and rural medicine for the UA College of Community Health Sciences, which operates UMCDemopolis, and assists in teaching the College’s family medicine residents and medical students.

DR. ASHLEY WAMBOLT STEINER

is a graduate of Cape Breton University in Nova Scotia, where she was an Academic All-Canadian volleyball player. Prior to graduation, she spent seven years in the Canadian Armed Forces, reaching the rank of Lieutenant Navy. Steiner earned her medical degree from Saba University School of Medicine in the Caribbean Netherlands and completed her residency training at The University of Alabama Family Medicine Residency, which is operated by the UA College of Community Health Sciences. She also completed an obstetrics fellowship at the College. Steiner has a passion for women’s health, and she provides obstetrics care for patients in addition to family medicine care. Steiner is an assistant professor of family, internal, and family medicine for the College, which operates UMC-Demopolis, and also assists in teaching the College’s family medicine residents and medical students. C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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NEWS

NEW FELLOWSHIP COLLEGE CREATES PEDIATRIC FELLOWSHIP FOR FAMILY MEDICINE PHYSICIANS

PEDIATRICS The College of Community Health Sciences has created a Pediatric Fellowship for family medicine physicians that is believed to be the first such training program in the country. The fellowship will provide comprehensive instruction for family medicine physicians seeking additional skills in pediatric care. Dr. Sara Phillips, fellowship director and assistant professor of pediatrics for the College, said the year-long program offers a variety of experiences in both primary care and tertiary care settings, including at Children’s of Alabama, a Birmingham-based hospital that provides specialized medical care for ill and injured children. Fellows will also receive dedicated research time and financial support for continuing medical education activities. Phillips said while the Pediatric Fellowship is grounded in a primary care setting, it also provides important exposure to pediatric care in hospitals

8

and with specialists. “If you have primary care physicians with pediatrics experience, they can intubate, start lines on pediatric patients, whatever they might have to do.” She said there is a scarcity of pediatric care in rural areas, so equipping primary care physicians with pediatric care skills can help with the shortage of care that currently exists. The Pediatric Fellowship can currently accommodate one fellow. Interviews will begin in fall with a start date of July 2020. The addition of the Pediatrics Fellowship brings to seven the number of fellowships offered by CCHS, which include behavioral health, emergency medicine, geriatric medicine, hospital medicine, obstetrics and sports medicine. CCHS operates The University of Alabama Family Medicine Residency, one of the oldest and largest family medicine residencies in the country, and it provides the clinical years of education for a portion of UA School of Medicine students.


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FRIEND NAMED DEAN OF CCHS

Dr. Richard Friend, a physician with extensive administrative experience in family medicine at two universities and who also spent 10 years in private practice, was named dean of The University of Alabama College of Community Health Sciences July 15. Friend has served as interim dean and professor in the College for the past year. “Dr. Friend’s extensive qualifications and familiarity with the University will serve the campus well as he leads CCHS,” said Dr. Kevin Whitaker, UA executive vice president and provost. “Our College of Community Health Sciences will strongly support UA’s research initiatives, particularly those related to life research. The College also plays a vital role in rural health initiatives in the state and impacts medical student education by serving as a regional campus of the University of Alabama School of Medicine.” Friend joined CCHS in 2012 as director of the UA Family Medicine Residency, which the College operates, and as associate professor of family medicine and vice chair of the CCHS Department of Family Medicine. He was later named director of the Family Medicine Clinic within University Medical Center, also operated by CCHS, and chair of the College’s Department of Family, Internal, and Rural Medicine. Friend came to UA from the LSU School of Medicine, where he served as assistant residency program director

beginning in 2006, and then as program director from 2007 to 2012. In addition to his administrative experience, Friend brings substantial clinical experience, including inpatient and ambulatory medicine, endoscopic procedures and extensive emergency room experience. He serves as an emergency medicine physician at Choctaw General Hospital in Butler, Alabama, as a family medicine physician at DCH Regional Medical Center and at Rush Foundation Hospital in Meridian, Mississippi. He previously served as an emergency medicine physician at DCH’s Northport Medical Center and Fayette Medical Center. He has also served as a medical director for nursing homes, a home hospice and a home health company. He has been awarded millions of dollars in grant funding, authored published articles and given invited presentations. Friend graduate from Louisiana State University School of Medicine with honors and completed his residency at LSU Health Sciences Center in Shreveport. He earned his undergraduate degree, with honors, from Tulane University. He is a member of the American Academy of Family Physicians, the Association of Family Medicine Residency Directors and the Alabama Academy of Family Physicians, and he serves on the Alabama Academic Family Medicine Council.

Dr. Richard Friend talks with guests at his Dean’s reception on August 8, 2019.

C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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Q A and

with

Dean Friend

Where did you grow up? What inspired you to study medicine? My family relocated from Illinois to New Orleans when I was 11 years old and at that time my great-uncle was a pediatrician in New Orleans who used to make house calls. He was the first physician in Louisiana to use penicillin. He really inspired me to become a physician.

Where did you go to medical school and what were those years like? I went to undergrad at Tulane University and earned a BS in psychology. I graduated with honors and then I went to medical school at LSU School of Medicine in New Orleans. I graduated there and then went on to do my residency training at LSU (Health Science Center) in Shreveport. LSUHSC was a level-one trauma center so I also learned how to manage very sick patients. When I was in medical school, the old Charity Hospital was still there, before Katrina. We had great experiences as medical students. We did everything from registering patients to drawing blood. There were lots of opportunities for procedural training, lots of babies being delivered. That whole system was very dependent on students and residents to function, so it was a great training experience.

When did you know that you wanted to specialize in family medicine? I decided that I really enjoyed the variety of clinical challenges that presented themselves in family medicine. I really enjoyed going from one clinical arena to the next. I found it challenging to be able to go from the ICU to the 10

emergency room to the obstetrics unit to the medicine floor to the endoscopy suite. I found the variety of being able to practice good medicine across all of those different venues enjoyable. I really became interested in rural health after doing some rural initiatives while in medical school. I practiced family medicine in rural Louisiana for almost 10 years.

Do you encourage students to practice in rural areas? That’s why we’re (College of Community Health Sciences) here. I think those opportunities exist. I think we have to continue to nurture, develop and continue to support rural hospitals. I think we’re doing an excellent job of training world class physicians. In rural areas, they’re having a hard time retaining doctors because of the challenges that many of our local communities are going through with health care.

What are some of the strategies you think can improve rural health care? The biggest thing is there’s always a need for well-trained family physicians in rural communities. Each rural family physician brings in about two million dollars in economic revenue to a rural community. As rural communities are changing, I think the models in those communities are going to change very quickly. Some of the communities that always had a hospital may be better served with a large primary care base and a free-standing emergency room or some afterhours urgent care. It’s especially true for those within 30 to 60 miles of a major hospital. It will be a challenge in the next decade to help the state and the region transform itself into a model that is sustainable over time.


What does the College do well, and where would you like to see improvement? How has the transition from patient care to academics and administration been for you? We all have to continue to practice to keep our license active, so I still do some patient care here (at University Medical Center, which CCHS operates) and in the hospital, occasionally. I think it’s been an evolution for me away from patient care into administrative roles. When I first got into academics, I was assistant residency director (in Louisiana) and then become the residency director. Then I became chair of family, internal, and rural medicine (at CCHS) and was (UA Family Medicine) residency director. And of course last year, I was interim dean. I think my administrative roles have just grown over time and you adapt as things change to serve the needs of the organization. I have tried to be a good team player and take on additional roles as opportunities presented themselves. I have learned a tremendous amount along the way.

Tell me about the degree programs the College has started. The College is at an exciting time in its history right now. For most of its history, the College of Community Health Sciences did not grant degrees. Just within the last year has that started. We now have 29 graduate students in the College in our master’s of population health and our master’s in rural community health programs. It has enabled us to more closely align with the mission of The University of Alabama. I am very interested in bringing more degree programs to CCHS - offering undergraduate degrees related to the health sciences, and some expansion of the graduate degrees. I think that is going to be very challenging, but also very rewarding. It will allow us to really continue to give back to the University.

We provide excellent patient care. We are improving accessibility to our patients. We are very patient-centered, but we are challenged with some new quality programs. Starting those from the drawing board is really going to give us an opportunity to achieve excellence in patient care and prepare us for successful revenue strategies in the future. I am excited that we are getting into undergraduate and graduate education. In fact, we have already begun a record of accomplishment of excellence in graduate education. Our two new master’s degree programs have been reviewed by the UA Office for Institutional Effectiveness and both programs qualify for the Spring 2020 Assessment Honor Roll (as top 10% of all degree programs across campus). This is the type of excellence that I would like to see throughout the College.

Tell me about the College’s alumni relations. We really have an opportunity to work with our alumni to develop our alumni relations. We want to keep them informed and energize them to help support the College in the future. Developing a culture of philanthropy within the College is very important. The reimbursement challenges in health care are tremendous and they vacillate greatly. We will need to continue to rely on our alumni to help support our initiatives. The support goes both ways. We have many alumni in Pickens County and we are working with the hospital there. We have alumni all over the state and all over the Southeast. We try to get keep them involved through our communications efforts, like our Annual Report and On Rounds magazines, our Board of Visitors and our Capstone Health Services Foundation Board. We value their input and want them to be a part of our day-to-day operations and our long-term strategic planning.

What is your plan for continuing the push for more research and publications?

What is your message to the College?

We’re trying to create an organizational structure that empowers faculty to be creative and innovative. We are trying to establish a leadership within the College that will support the work of the faculty. We have established a mission, a vision and goals for research. We are also giving frequent feedback to the faculty about our metrics. We are driving them to continue to reach for external funding and achieve excellence. I am very excited about the untapped potential that CCHS has in this area and we have made great progress in the interim period. Our submission rate for external awards is up well over 150% and our award rate is up over 10% from this same time last year. I am very proud of the work that our faculty, staff and administration has done in this area. I look for that to continue.

My message to the entire organization is that we will become excellent in all that we do. We are committed to helping our learners, our faculty and our staff find their true passion and support them in that. I am very much a collaborative leader. The College has developed an excellent relationship with our community hospital partner, DCH, and we want to see that continue to grow and flourish. We have also done that with the other colleges on campus and our UA School of Medicine medical student education partner. Having MD and PhD partnerships in research collaborations will benefit both our clinicians and the PhD researchers. It can really make our (external funding) submission and award rate continue to accelerate going forward. C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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F E AT U R E

PREPARE FOR A CRISIS WITH

Save

Life

T R AININ G

Y

“ You need confidence, which

comes from the knowledge you know what to do, and that knowledge comes from training. ” - Glenn Davis

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our co-worker can’t breathe. What do you do? You come across a person injured and bleeding. How do you respond? In both scenarios, time is critical, and you may be the only one who can help. While most people instinctively want to assist, not knowing what to do can prevent a bystander from acting, said Glenn Davis, director of Emergency Medical Services for the Institute for Rural Health Research, which is part of the College of Community Health Sciences. “You need confidence, which comes from the knowledge you know what to do, and that knowledge comes from training,” Davis said. He and Travis Parker, program specialist for the Institute for Rural Health Research, collaborate with partners across campus to provide that confidence and knowledge to The University of Alabama community through Save a Life Training. SALT is a free, two-hour class, with the first hour covering high-quality CPR, the Heimlich maneuver, airway obstruction and Automated External Defibrillator skills. The second hour covers Stop the Bleed. For those who have taken a CPR course in the past, SALT can be a needed refresher covering the American Heart Association’s updated guidelines, Davis said. “High-quality CPR is more than just pushing on a victim’s chest. It must keep the blood flowing. To do so, we teach, “Push hard. Push fast. Full recoil. Minimize delays.”


Participants practice compressions on CPR mannequins during a SALT class led by Glenn Davis and Travis Parker.

PU SH HAR D. P U S H FA S T. FULL RECOIL. MINIMIZE DELAYS.

Automated External Defibrillators, or AEDs, are found in buildings throughout campus. SALT makes people more aware of their presence, helps them remember to use the devices and gives people the confidence to work through the steps quickly. “The AEDs will let you know if the person needs to be shocked,” Davis said. “If you can turn on the machine and follow directions, you can use an AED. The training is to minimize delays by increasing familiarity with the steps and giving people the confidence to act.” Lindsey Hughey, open records and policy specialist for UA’s Department of Communications, recently completed the training and echoed Davis’s comments on gaining confidence. “The class was a bit harder than I expected, just because you do not

realize how much energy you exert when giving CPR. But I do feel much more prepared to help someone in the event I am ever involved in a crisis situation.” As for the Stop the Bleed portion of the training, the main skill learned is how to apply pressure to a wound or to use a tourniquet. While models are available, Davis encouraged people who identify as squeamish to give the training a try. “They can practice on their own arm. We want people to be comfortable and we don’t pressure.” SALT is usually offered the third Friday of each month in the Northeast Medical Building on the Bryce campus, but Davis and Parker will also bring the training to groups across campus. Registration is required and certificates are issued upon completion. For more information, contact Davis at gadavis@ua.edu and (205) 348-4549.

C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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BRIDGING THE DIVIDE

BRIDGING

THE DIVIDE

REDUCING THE IMPACT OF SOCIAL DETERMINANTS OF HEALTH IN ALABAMA BY: KAYLIN BOWEN PHOTOS: GREG RANDALL

Faculty and staff of the Office of Case Management and Social Services at University Medical Center are striving to put themselves out of work.

They acknowledge it’s a strange way to approach their jobs. But their focus, and the primary focus of the office’s programs and personnel, is to help treat the causes of preventable health crises, not just the symptoms. The unseen causes behind many health issues for Alabama residents, and around the US and even the world, can be classified as the social determinants of health (SDOH). These are the environmental, social and economic climates. Economic stability, access to education, public transportation and access to healthy sources of food are just a few of the factors classified as social determinants of health. In Alabama, where more than 17% of the population lives at or below the federally defined poverty line, it is not hard to see the impact of SDOH. Every action and program the UMC Office of Case Management and Social Services takes is directly working to mitigate and lessen the effects of the negative SDOH that Alabamians in Tuscaloosa and surrounding areas experience. UMC is operated by The University of Alabama College of Community Health Sciences. “This department acts as a bridge between patients and resources,” said Victoria Mallon, the office’s patient services coordinator. “We aren’t solving the problem, but we are making that connection to help patients solve it.” The office consists of three practicing social workers and a patient services coordinator, as well as a rotating group of UA social work student interns. The four core members act as pillars of support for UMC patients. Dr. Bob McKinney, a licensed clinical social worker, leads the office. He is also an assistant professor in the Department of Psychiatry and Behavioral Medicine at CCHS and is jointly appointed to the UA School of Social Work.

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Laura Beth Brown, a licensed master social worker, and Paige Parish, a licensed clinical social worker, are the office’s two licensed social workers and they each head programs that they have created and honed to benefit the community. Mallon ensures the tools are available for the social work experts to succeed while simultaneously providing an access point and assistance to patients seeking daily case management.

The social work field student education program, the TRANSITIONS program, the Foster Care Clinic, Christmas in July fundraiser, community education outreach programs and the ComCare program enable the office, as well as physicians and other health care providers at UMC and in the community, to improve conditions for underserved residents of West Alabama.

PATIENT CARE

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t the UMC Office of Case Management and Social Services, patients do not have to have an appointment to be seen, though it is recommended. Patients explain their need to Victoria Mallon, patient services coordinator, or an intake worker (usually a social work student intern) who then directs them to the appropriate resource. If the patient’s situation cannot be resolved quickly, Mallon or the intake worker schedules a consultation with a social worker or a student intern. In 2018, Mallon implemented a patient intake tracking system that has recorded 1,105 unique patients visits in the 14 months since its creation. The office sees patients struggling daily with the five placebased social determinants of health (economic stability, education, social community context, health and health care, and neighborhood and built environment) defined by Healthy People 2020 and endorsed by the US Centers for Disease Control and Prevention. Mallon, the offices’ social workers, Paige Parish and Laura Beth Brown, and Dr. Bob McKinney, director of the office, agree that inadequate or nonexistent public transportation is one of the most challenging obstacles that many West Alabama residents face. Neither the state of Alabama nor the city of Tuscaloosa has a widespread, accessible public transportation

infrastructure, and with the cost of owning and maintaining a vehicle impossible for many residents, the inability to find timely and affordable public transportation limits many Alabamians’ access to food, health care and resource centers. “We’ve got the Tuscaloosa Trolley, which a lot of our patients use, but we don’t even have a Trolley stop in front of our building (UMC),” McKinney said. “They’ve got to cross the street to get here, so that’s an issue if you’re a patient in a wheelchair or someone who has mobility issues.” Brown said that when teaching social work students, one of the key topics she stresses is the importance of doing all legwork at the clinic while patients are there. It is crucial to get everything done while student interns are meeting with patients in person because it may be difficult for patients to come back, she said. “If the patient is here, see them,” Brown said. “Ten dollars (for transportation), that might not seem like a lot, but $10 to come back and sign a form because we’ve forgotten something on our part is unnecessary.” Transportation is just one of the many issues the social work team at UMC sees in a day, as they continue to develop programs, including those that are community-based, to connect patients with services and to address SDOH.

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Pictured left to right: Paige Parish, Dr. Bob McKinney, Laure Beth Brown and Victoria Mallon comprise the core of the Office of Case Management and Social Services at UMC.

COMCARE PROGRAM

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he ComCare Program at University Medical Center offers services to individuals who are unable to afford health insurance. Patients must be at or below 200% of the current federal poverty level in order to be eligible for ComCare, in addition to other requirements. The Office of Case Management and Social Services is allowed to add three new patients to the ComCare roster every two weeks. ComCare applications must be renewed every six months; renewals don’t count against the new patient limit. Patients are covered for a female annual exam, a yearly physical exam, X-rays, ultrasounds and in-house labs. Services that may be provided by external providers (i.e., a technician to read X-rays and ultrasounds) are not covered. The coverage offered by ComCare is intended to provide community residents with access to health care to prevent the development of more serious conditions that might be avoidable. The value is returned by finding

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early warning signs and educating patients about lifestyle changes that may reduce their risk for disease and keep the overall population healthy.


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STEP S TO APP LY

TO THE COMCARE PROGRAM

1. PATIENT INQUIRY

2. APPLICATION SUBMISSION 3. APPLY FOR MEDICAID 4. FILE PROOF OF MEDICAID DENIAL 5. UMC MAKES FINAL DECISION 6. RECEIVE TREATMENT AT UMC

Approved applicants to the ConCare Program can recieve treatment at UMC with no cost to the patient.

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A BRIDGE TO MENTAL HEALTH CARE

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he Psychiatric Collaborative Care program at University Medical Center helps build a bridge to mental health care for patients. The program links patients, primary care providers, psychiatrists and care managers to increase access to mental health care and to reduce the amount of time between initial visit and treatment. UMC patients have the opportunity to be screened for mental health concerns when they visit their primary care provider. Patients who screen positively for mental health depression or anxiety can be referred to the Psychiatric Collaborative Care program, if they wish. A care manager meets with the patient to conduct a thorough assessment. The care manager then consults with a psychiatrist about the diagnosis and possible pharmacological interventions. This information is shared with the

primary care provider, who manages recommended prescriptions. The care manager facilitates scheduling, contact, and medication recommendations determined by the primary care provider and psychiatrist and provides brief therapeutic services to the patient monthly by phone. By linking patients, primary care physicians, the care manager and psychiatrists, a balanced treatment plan can be developed that reduces the risk of a patient’s treatment being delayed due to paperwork and scheduling issues, said Paige Parish, a licensed clinical social worker with the UMC Office of Case Management and Social Services. For patients who lack transportation or funds for copays for both primary care and mental health care visits, the Psychiatric Collaborative Care program can ensure they receive the care they need.

LINKING RESOURCES TO CREATE A BALANCED TREATMENT PLAN

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TRANSITIONING THE ACTION PROGRAM

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he ACTION Program began in Tuscaloosa in 2017 as a way to reduce the number of non-emergency 911 calls that potentially misdirect emergency services at an unnecessary cost to the patient, the hospital and the city. The program initially ran a two-response front: a medical care team and a mental health care team. Moving forward, the ACTION Program, short for Appropriate Care and Treatment in Our Neighborhood and a partnership of Tuscaloosa Fire and Rescue Services and The University of Alabama College of Community Health Sciences, has expanded and refined its target purpose. It will no longer provide response services but, instead, will focus on prevention and intervention. And it will operate under a new name – University Medical Center Transitions Program. “This year, we are looking forward to further supporting our patients and hospital through robust transition services,” said Paige Parish, a licensed clinical social worker in the UMC Office of Case Management and Social Services. The College operates UMC. The UMC Transitions Program will continue followup services that were provided by the ACTION Program and that bridge the gap between the needs of patients and the demands of their in-home medical and social services care after their discharge from the hospital. The follow-up visits are designed to reduce the likelihood of readmittance to the hospital. The UMC Transitions Program has two facets: Transitions Primary Care and Transitions Hospitalists. Eligible patients of both groups will be offered an in-

home visit that includes a medical assessment and a social needs assessment, in addition to 30 days of follow up with a social worker. “Under the ACTION Program, we have been able to pilot these transition services with a small, multidisciplinary team,” Parish said. “We are looking forward to expanding these services to meet the needs of our patients.” Additionally, in the last year the former ACTION Program and the UMC Office of Case Management and Social Services have continued to bridge the gap left from various social determinants of health through the Social Work Hub. The hub is intended to meet the immediate needs of low-income areas of Tuscaloosa by offering on-the-spot referrals to community social service providers. The former ACTION and now Transitions multidisciplinary team—comprised of social workers, Tuscaloosa Fire and Rescue paramedics, a nurse practitioner and students—has participated in six Social Work Hubs in the past six months. Personnel worked with more than 200 residents providing more than 400 referrals for food services, utility assistance and access to health care. The overall goal of the Social Work Hub is to educate high-risk and high-need communities about local social services and resources available to them. The initiative was recently recognized by the Tuscaloosa City Council for its contributions to the community (see story page 21).

Reid Galyon, a nurse practitioner, and Yolanda Sanders-Williams, a social worker, make house calls as part of the newly minted TRANSITIONS Program. They go to patients’ homes to provide medical and social services. C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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Below: A social work student intern, Morgan Holcombe (center), accompanies Yolanda Sanders-Williams (left) and Reid Galyon (right) on house calls.

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ACTION PROGRAM RECOGNIZED BY CITY

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he City of Tuscaloosa recognized the exceptional community service efforts of four members of the former ACTION Program on May 15, 2019. ACTION team members Paige Parish, Reid Galyon, Yolanda Sanders-Williams and Brianna Parrales worked with other Tuscaloosa civil agencies, like the fire and police departments, at the underserved community of Creekwood Village in Tuscaloosa’s West End. The interdisciplinary task force included various city departments and was assigned to assess housing code violations, fire hazards and address immediate needs. The ACTION Program set up a Social Work Hub to handle case management referral requests and to perform basic medical assessments for any resident of the complex. ACTION Program Coordinator Paige Parish said the majority of referrals were for food resources. Tuscaloosa Mayor Walt Maddox led the May meeting and personally thanked each of

the individuals receiving recognition for their efforts at Creekwood Village. “I appreciate everyone taking what we had and making a difference in the face of what can often seem to be overwhelming odds,” Maddox said. The Social Work Hub goes out monthly to provide social service referrals to Tuscaloosa communities in an effort to connect them with appropriate care. ACTION (Appropriate Care and Treatment in Our Neighborhood), a partnership of Tuscaloosa Fire and Rescue and The University of Alabama College of Community Health Sciences, was created in 2017 to meet less critical medical needs of the community and reduce costly hospital emergency room transports of people with low-level emergency conditions through linkage to appropriate medical, mental health and social services. The program has since become the TRANSITIONS Program (see page 19).

Tuscaloosa Mayor Walt Maddox C O L L E G E O F C O MMU N I T Y H E ALT H SC IIEN EN C ES

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CARING FOR FOSTER CHILDREN

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he University Medical Center Foster Care Clinic works with the Tuscaloosa County Department of Human Resources to care for foster children in the county. Once a child is in the custody of the state, a mandatory physical exam is required in the initial 90 days. The UMC Foster Care Clinic reduces the separation between at-risk children and reliable health care with a pediatrician. Child wellness is important in the early developmental stages and an interruption in care can have lifelong consequences. Dr. Brian Gannon, a physician in the Pediatrics Clinic at UMC, treats incoming foster care children. Victoria Mallon, patient services coordinator for the UMC Office of Case Management and Social Services, leads the filing and paperwork process for their care. She has streamlined the internal system and hopes to one day see a continuous line of communication between the office and the Pediatrics Clinic at UMC and the case manager with the state. The physical exam gives the case manager and physician a chance to identify and, hopefully, address early on some of the negative environmental factors that could cause or lead to future heath issues for foster children. Above: Dr. Brian Gannon cares for children in the Foster Care Clinic at UMC. Left: The pediatrics team at UMC looks for any signs that a child’s environment might be affecting his or her health.

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POVERTY SIMULATION TRAINING

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ocial work student interns from University Medical Center took part in a Community Action Poverty Simulation held at The University of Alabama Ferguson Student Center alongside College of Community Health Sciences faculty, residents, medical and master’s students. The poverty simulation mimicked what it would be like to live for one month in a low-income household. “Social workers take it as their mission to work with people who are at risk, who are marginalized, who live on the fringes of society and frequently those people find themselves in poverty,” said Dr. Bob McKinney, who coordinated the simulation and who teaches social work students, residents and medical students. “Those are the folks with whom we work, and this is a great opportunity for the students to see how it is to live if you are a person in poverty.” McKinney also directs UMC’s Office of Case Management and Social Services. The simulation took place in the ballroom where tables were arranged around the room with volunteers manning the stations that represented work, school, social services, a bank, grocery store, pawn shop and many other common community locations. Participants were divided into family units, given identification and assigned a job or school to attend. Each family was issued a budget and a set of rules to abide by. If a worker missed work, then the family did not receive money that week and had to attempt to feed their family by other means. The simulations try to recreate the costs of living by including check cashing fees and after-school activities. Additionally, families were given a limited number of transportation vouchers to mimic one

of the biggest barriers to low-income families in Alabama, where there is no access to affordable public transportation. “It’s frustrating to be the provider; I can only imagine what it is like in the real world,” said Rabecca Davis, a UMC social work intern who works with the Tuscaloosa Fire and Rescue Services’ Emergency Medical Services Prevention Program. “I couldn’t go to work because I didn’t have enough transportation passes, so that’s an entire week we’re going to be out of money. We take into account that people need referrals, but we don’t see how much is actually being taken out of their checks.” The poverty simulations take place twice a year for the general public, but program specific simulations can be scheduled. The simulations can take place with anywhere between 30 to 80 people. They are facilitated by Bailey Duke, coordinator of volunteer management at the UA Center for Service and Leadership. The program is the Missouri Community Action Network Poverty Simulation. Duke added that the simulations take two to three hours to complete and are designed to replicate the frustrations that community members who live in poverty face on a daily basis. There are additional luck-of-the-draw cards that are given to family units at random that mimic the random windfalls and pitfalls that happen in life. “We work with populations like this all the time,” said Danielle Guido, a social work intern at UMC. “It’s good to experience it, especially transportation problems, because we deal with those all the time, so I think it is realistic in that aspect. It’s very informative.”

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SOCIAL WORK STUDENT FIELD EDUCATION

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ach year, The University of Alabama School of Social Work sends students earning a bachelor’s degree or master’s degree in social work to various organizations to obtain hands-on experience. These students are taught by experts in the field about how to work with and on behalf of underserved members of the community, and how to build bridges to resources and services for clients. The University Medical Center Office of Case Management and Social Services has on average four social work students each academic year who are required to complete 450500 hours of service, depending upon the degree they are earning. These students are given a full workload of cases, as well as theoretical training in social determinants of health (SDOH), mental health awareness, empathetic practice, diversity and other topics. Led by Dr. Bob McKinney, director of the office, and Laura Beth Brown, a licensed master social worker with the office, the UMC Social Work Education Program has undergone a complete renovation in the last two years, giving students more hands-on experience with a variety of cases and a more thorough grasp of the skills that are required to be an effective social worker in a variety of settings and with a broad range of clients. Continuing to revolutionize the UMC Social Work Education Program, Brown began administering social work focused modified Objective Clinical Structure Examinations (OSCE) this fall. OSCEs have a long tradition in medical education but have not been widely used in social work education. Brown and the rest of the UMC

Office of Case Management and Social Services team are trying to change that. The exams use actors to portray situations that social work students must then react to as they would in the field. “With the OSCEs, we can see where the students are in their skills,” Brown said. “We can know who to send out to a case based on their expertise. We know where the strengths and weaknesses are in their training.” Brown anticipates that the first few groups of students who participate in the OSCEs will act as a basis for improving the strategy and honing the process. The scenarios will gauge competencies for social work practices. She would like the examination technique to expand to other field education programs at other schools as well. Educating future social workers about negative social determinants of health and how to respond and best locate resources for people in those circumstances is a vital part of how the office ensures the continuation of good practices to address SDOH. Hailee Benson, a current social work intern at UMC pursuing her master’s degree, has worked closely with the UMC Foster Care Clinic and has honed her desire to work with children and teenagers in her future career. “This experience has just opened my eyes a lot to the fact that people from all walks of life deserve to have dignity and deserve to be heard,” Benson said. “Lots of our systems are hard to navigate even for very competent, smart people, and for a lot of our patients who are illiterate or never graduated high school, I can’t imagine how much harder it is for them to accomplish these things on their own.”

“This experience has just opened my eyes a lot to the fact that people from all walks of life deserve to have dignity and deserve to be heard

” -HAILEE BENSON

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Top: Dr. Bob McKinney (center), director of UMC’s Office of Case Management and Social Services, and Dr. Anne HalliTierney, director of the UMC’s Geriatric Clinic, worked a community table at the simulation. Above: During the poverty simulation, social work interns participated in an exercise to survive one month with the resources of a low-income family. The simulation included luck of the draw cards that accounted for unexpected misfortunes and windfalls that life has. Right: Rabecca Davis, a UMC social work student intern, visits the bank to exchange her check for cash to visit the food bank, and learns of a $5 fee for not holding an account at that branch. C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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Above: Victoria Mallon acts as an elderly patients seeking referrals during the OSCE. Left: Brown observes and rates the students performance in reacting to the situation. Right: Brown received the 2019 E. Roger Sayers Distinguished Service Award for her efforts to improve social work education at UA and social services in the community.

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LAURA BETH BROWN PERSISTENT ABOUT SOLUTIONS

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ocial workers are frequently called upon to be patient, resourceful, positive and generous. Laura Beth Brown exemplifies these qualities. She furthers them by inspiring others to be tireless and devoted to helping improve the lives of those around her. Though she has only been working in social services for three years, she has made a measurable difference in the quality of life for people in The University of Alabama and Tuscaloosa communities. Brown is a licensed master social worker in the Office of Case Management and Social Services at University Medical Center, which is operated by the College of Community Health Sciences. It is for her exemplary work ethic, problem solving ability and dedication to helping people that she was awarded the E. Roger Sayers Distinguished Service Award at the 2019 Capstone Awards ceremony. The award was created in 1996 to recognize UA faculty and administrative personnel who have performed in an exemplary manner to further the mission of the University. “She’s the type of person who never says no,” said Paige Parish, who peer-nominated Brown for the award. “She says let’s find a solution for this.” Brown was hired as an intern to work for University Medical Center while studying at the UA School of Social Work. She made a strong impression within her first two months and was asked to work as a fellow for the inaugural year of the UA Pickens County Partnership program. While working there she served rural communities in West Alabama daily and created the Pickens County Resource Guide in 2017. Once when a client’s home was overrun with bedbugs and the person was unable to retrieve their

belongings prior to an extermination, she and another fellow purchased hazmat suits, went into the apartment and prepped it for debugging. Dr. Bob McKinney, director of the UMC Office of Case Management and Social Services, said that in addition to her work as a social worker, Brown prioritizes educating others. She has completely reshaped the educational component of the field placement for social work students making the program one of the most unique in the country. “She’s incredibly passionate about the clients and her students,” McKinney said. “She’s persistent. She doesn’t want to stop until she finds a solution.” Brown said she wants to use the award as a call to action to raise awareness of what social workers are capable of providing for their communities. She said social workers are one of the most valuable all-purpose tools available to the general public. Social workers are often licensed to provide counseling, resource management and client liaison with doctors, lawyers and pharmacists. Social workers can help translate complicated legal, insurance or tax documents that may not make sense to someone not familiar with the jargon. “There’s a lot that social workers can do for our clients,” Brown said. “We are really good at advocating for our patients and clients, but we have a hard time advocating for ourselves.” When Brown was informed of the lack of options for breastfeeding mothers on UA football home game days, she immediately started working to find a way to help them. In the past, nursing mothers had nowhere to go unless they used a temporary toilet stall on the

“She’s incredibly passionate

about the clients and her students. She’s persistent. She doesn’t want to stop until she finds a solution.

” -DR. BOB MCKINNEY

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UA Quad. Brown worked with organizers of the Family Friendly Tailgate to create the Nursing Mothers Tent as a designated private space for nursing women. Social work departments rely on community partners and resources to provide the care and support their clients need. Often those seeking social services are the people least able to access help by any other

Left: The T-Town Tots tent has many partners to ensure that nursing mothers have a place to feed their babies or pump on UA home football games. Center: Volunteer Courtney Greene points out locations where there are nursing stations located inside UA’s Bryant Denny Stadium. Right: Laura Beth Brown and Trendle Samuel, co-founders of T-Town Tots, instruct their volunteers on the procedures for the upcoming game day.

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means due to poverty, a lack of local resources or other impairments. Social work professionals assist people from infancy to old age. “It’s hard, difficult work, but we address it. We take it day-by-day,” Brown said. “We figure out what’s wrong and how to best help people with the resources that are available to us.”


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GAMEDAY MOTHER’S TENT

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ursing mothers with their babies or those needing a place to pump while tailgating at The University of Alabama now have a convenient location closer to Bryant-Denny Stadium. The T-Town Tots Breastfeeding Support lactation tent moved to the UA Quad near the Amelia Gayle Gorgas Library. This will be the second year the tent has been available to nursing mothers at tailgating during football season. Last year the tent was located at the Family Friendly Tailgate, which was located near the soccer fields a quarter mile from the stadium. The tent offers, at no charge, a private area with seating and fans for new mothers to nurse or pump. The tent is a partnership of the University Medical Center Office of Case Management and Social Services, UA Gameday, the State Perinatal Program and the Tuscaloosa County Department of Public Health. UMC is operated by the UA College of

Community Health Sciences. The tent was initiated by Laura Beth Brown, a licensed master social worker who practices at UMC and is a member of the State Perinatal Program. She received funding from the CCHS Initiatives Fund to buy the tent and supplies necessary to get the service started. UA Gameday provides the generator, electricity, and Quad location. “The ultimate goal here is to normalize breastfeeding and provide a safe place for women to breastfeed or pump,” Brown said. “Even if only one mom comes, it’s worth it. It’s hard to breastfeed, and not having a place to do it doesn’t help.” Brown said the partners expect to experience a higher number of mothers coming through the tent this year and are looking for volunteers to staff the tent. The nursing mothers’ tent will be on the Quad every UA football home game.

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Above and left: Victoria Mallon collects hygiene products, such as shampoo, conditioner and deodorant, to place into stockings for children.

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CHRISTMAS IN JULY

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he Christmas in July Fundraiser organized by the University Medical Center Office of Case Management and Social Services assists the College of Community Health Sciences December Holiday Toy Drive. The internal fundraisers have so far brought in more than $1,000 this year to provide holiday gifts for underserved children. Headed by Victoria Mallon and Laura Beth Brown, both with the Office of Case Management and Social Services, the fundraisers are intended to provide as many children as possible a toy from their list, a book, a jacket and a hygiene stocking. “We talked to the families last year and asked what the kids asked for Christmas,” Mallon said. “It was an overwhelming amount that said they wanted their own

towel or shampoo and conditioner.” The negative aspects social determinants of health can often affect children more than adults, Mallon said. Access to nutritious food, clean water and breathable air are essential for child development. Experts say a lack in any of these areas can lead to lifelong health and wellness issues. The Christmas in July and Holiday Toy Drive work in conjunction to provide children of West Alabama resources they might need. Children are selected based on nominations from CCHS faculty and staff and must be current UMC patients under the age of 18. The fundraisers will benefit 20-25 children this year. The Office of Case Management and Social Services will take additional donations to fulfill a child’s wish list as well. CCHS operates UMC.

PROVIDING RESOURCES FOR CHILDREN

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REACHING OUT TO EDUCATE THE COMMUNITY

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n addition to providing a connection to resources to assist residents of the community with pressing issues, social work staff at University Medical Center are also a source of education to empower community members to seek and utilize tools that ease the effects of negative social determinants of health in their lives. Dr. Bob McKinney, director of the UMC Office of Case Management and Social Services, works with the Diabetes Self-Management Course at UMC, providing counseling tools to help newly diagnosed diabetic patients find the support they need to manage their diabetes. The diagnosis can often feel overwhelming and a solid foundation of support can make the difference between living with or suffering through the lifelong condition, he said. McKinney and Paige Parish, a licensed clinical social worker with the office, participate in

The University of Alabama Osher Lifelong Learning Institute. The OLLI program offers educational courses and activities for older citizens in Tuscaloosa County. Both provide lectures and other presentations on emerging health topics and new medical practices and discoveries. In addition, McKinney and Parish help educate UMC and community physicians on special topics about caring for patients through the College of Community Health Sciences Grand Rounds continuing medical education program. CCHS operates UMC. “I’m glad for the opportunity here,” Parish said. “We have so many learners and it’s just a constant education setting. We’re constantly educating and learning and being a part of both presenting that information and receiving that information.”

“We have so many learners

and it’s just a constant education setting. We’re constantly educating and learning and being a part of both presenting that information and receiving that information

-PAIGE PARISH

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BUILDING THE BRIDGE

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hrough their work and programs, the University Medical Center Office of Case Management and Social Services and its faculty and staff are making strides every day to mitigate the negative effects of social determinants of health that are the reality for many Alabamians. The continuous need ensures that the office will not run out of business any time soon. “Medical interventions address approximately 10% of the causes of premature death,” said Dr. Bob McKinney, director of the office. “The issues that social workers work with address roughly 70%. Social work is a powerful health care profession.” McKinney and his colleagues, social workers Paige

Parish and Laura Beth Brown, and Victoria Mallon, patient services coordinator, are not discouraged. They remain positive about the effect they have in the community and with their patients. Their dedication is contagious, and they pass on their convictions to the next generation of social workers. “There have been certain cases where I’ve watched my patients succeed or get things that they needed and surpass barriers that I don’t think they ever thought they would,” said Hailee Benson, a social work student intern with the office. “Watching them do that, those are my biggest achievements. It’s just cool to be a part of all the different people’s stories just a little bit.”

Above: Dr. Bob McKinney has built the Office of Case Management and Social Services team during his three years as director. Right: The team works to educate and empower patients at University Medical Center.

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F E AT U R E

DIABETES EDUCATION FROM AN EXPERT

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BY: KAYLIN BOWEN PHOTOS: GREG RANDALL

iving with diabetes is not as simple as taking a once daily medication and moving on. It is a constant struggle that needs diet, exercise and a strict insulin and blood sugar testing regimen. It takes constant vigilance to maintain a regular, healthy amount of glucose in the blood and cells. This is why life often gets in the way of managing diabetes, said Dr. Robert Osburne, a board-certified endocrinologist at University Medical Center and faculty member at the College of Community Health Sciences, which operates UMC. Early detection during an annual screening can be the difference between a lifetime of medications and needles, or simple diet and exercise changes. Prevention of the disease is the ideal route, but often people do not know they have diabetes or prediabetes. Education must be used to encourage prevention and detection. “Diabetes, more than most diseases, requires selfmanagement,” Osburne said. “The diabetic has to be educated in how to take care of themselves. They need to understand the disease process and to know, for example, why some foods impact their sugar more than 34

other foods and why, when they get sick, they have to pay more attention to their sugar than usual.” UMC offers self-management education courses that include workbooks, support groups and guided grocery store visits. Endocrinologists like Osburne are experts in glands and hormones, and the most common disease they treat is diabetes. However, most diabetic patients will never see an endocrinologist; often only the most serious cases are referred to an endocrinologist. There are an estimated 38 million Americans living with diabetes; however there are only around 5,000 practicing endocrinologists. That’s why, Osburne said, primary care physicians must remain up-to-date on the latest treatment recommendations for patients with diabetes. “It enables more time for the specialist to manage the more complex issues,” Osburne said. “Type 1 diabetics, for example, need a referral to an endocrinologist more frequently than Type 2 diabetics because they do not produce, insulin at all and often have metabolic complications.” Osburne began his medical career in the U.S. Navy.


FA L L 2 0 1 9 Diabetic patients made up roughly half of his patients while in the Navy, primarily in retired members who received care through the military medical system. After leaving the Navy, Osburne continued to see about half his practice dedicated to diabetes treatment in Birmingham, Alabama, and Atlanta, Georgia. To all of his patients, he reiterates the value of prevention and accurate reporting of sugar levels as ways of avoiding complications. The complications of diabetes are often what make it deadly. When the disease progresses to damaging nerves, eyesight and kidneys, it can potentially lead to death. Diabetic patients are now the most common recipients of non-trauma necessitated amputations. Once nerve damage, or neuropathy, from diabetes has occurred there is no reversing the damage. Patients can only try to avoid damaging the tissue of the foot by checking their feet daily, wearing proper shoes and not smoking. Osburne said that one of the greatest achievements in diabetic medical care since he began practicing in the 1970s has been the development of home blood glucose monitors, which enable much safer and more accurate insulin dosing for diabetics who require it. Another great advance has been the evolution of technology to read A1C levels and growing use of that technology said Osburne. A1C provides an average measure of blood glucose levels for the previous two to three months and is a more accurate measure of a patient’s control over his or her disease than an instant read. The future of diabetes care lies in continuing to develop the algorithms, pumps and home glucose meters that can be trusted for treatment. This technology can be the key to finding balance for diabetics, especially Type 1 patients. “The holy grail now is closing the loop,” said Osburne. A closed loop insulin delivery system will one day be able to perfectly mimic the pancreas’s regulation of insulin. “It’s what they’ve been working on for decades now.”

Far Left: Dr. Robert Osburne is a boardcertified endocrinologist with 35 years of experience who joined CCHS as an assistant professor in the Department of Family, Internal, and Rural Medicine and who practices at UMC. Below: Regular foot exams by a physician and daily by the patient are vital for avoiding serious complications, such as amputation from neuropathy, or numbness in the feet. Osburne uses a small pin that puts 10 grams of pressure on the foot that can be felt easily if there is no nerve damage.

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A higher body mass index (BMI) and larger waist circumference have been closely linked with the development of Type 2 diabetes. Maintaining a healthy weight can prevent further development of serious complications.

What’s the difference between Type 1 and Type 2 diabetes? Diabetes is a worldwide problem. The World Health Organization listed diabetes as the seventh leading cause of death in the world in 2016, and that standing is expected to rise as the number of diabetic patients increases. The two types of diabetes are often confused or misunderstood. Awareness and education are necessary to prevent serious complications from the disease. Primary care doctors are often the first line of defense against the development of Type 2 diabetes. 36

Both types occur when the body can’t store and use glucose in the cells, causing a buildup in the bloodstream.

Type • Pancreas can’t make insulin • Not Preventable • Less Common • Often seen in children • Must use supplemental insulin • More likely to need to see an endocrinologist.

Type • Body can’t use the insulin produced by the pancreas • Most common type • Often can be prevented with lifestyle changes • Can be slowed down or placed in remission • Can often be managed without supplemental insulin


THE RISING BURDEN OF

INSULIN BY: KATHERINE FISH PHOTOS: GREG RANDALL

It used to be $20 for a vial of it. Now it’s $156.

-Angela Hammond

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eanndra Thompson reached shakily toward one of the grocery store shelves. She could feel her body shutting down. As Thompson frantically opened a package of donuts, she realized it was already too late, her blood sugar was too low. Unable to move, she seized and crashed to the floor. This was not the first time Thompson had woken up in the hospital due to her diabetes, and she feared it would not be the last. Thompson is one of many diabetics greatly impacted by the rapidly rising cost of insulin, a medication vital to their health. Thompson, like many others, has Type 1 diabetes, meaning that insulin is not important for just her health, but for her survival. Unlike Type 2 diabetes, which is characterized by the inability of one’s body to effectively utilize the insulin being produced, those affected by Type 1 diabetes do not produce insulin on their own. Insulin is a hormone necessary for one’s body to function, as it allows glucose to enter the body’s cells instead of building up in the bloodstream. Without a constant supply of glucose to every cell, the body would shut down. Over the past six years, the price of insulin has risen drastically, with some companies having increased the medication price by more than 500%. “You can buy regular insulins, like Humulin R, at Walmart without a prescription, but it used to be $20 for a vial of it. Now it’s $156,” said Angela Hammond, a diabetes educator and nurse practitioner at University Medical Center, which is operated by The University of Alabama College of Community Health Sciences. A recent American Diabetes Association study suggests that a complex supply chain from the drug factory to the pharmacy might promote higher prices. These growing medication prices, some of which amount to hundreds of dollars, have become a dangerous financial burden for diabetics like Thompson. The high costs have caused many patients to risk their health in attempts to stretch out their insulin, even skipping it for a day, because they could not afford it. “For a while I was put on the pump, but my doctor hadn’t prescribed me enough insulin for what I needed each month. I was running out of insulin halfway through the month, but my insurance wouldn’t pay for any more, so I had to start rationing out my insulin,” said Thompson. “A couple times, it has gotten to the point where I’ve had to go and buy it myself out-of-pocket.

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F E AT U R E F E AT U R E

A blood glucose meter measures the levels of sugar in the bloodstream. Artificial insulin makes up for what the body lacks.

One tube of my insulin costs about $150 and for me, paying that has sometimes meant not being able to buy all of the groceries I need.” Even with good health insurance, it has not been guaranteed that the appropriate amount of medication will always be covered. Monthly restrictions placed on prescription refills by insurance companies have caused patients to suffer when their insulin has not lasted them as long as intended. “If my daughter’s insulin got warm, if for some reason the refrigerator broke and it wasn’t kept cool, the insulin would be ruined, it wouldn’t work. If that happens, or if she lost it or something, then she would have to ration, literally meaning she wouldn’t be able to eat as much, she couldn’t eat any carbohydrates,” said Kelly Darragh, a parent of a Type 1 diabetic. For people with diabetes, being able to maintain healthy insulin levels is vital to their long-term health. In addition to the struggles they have always faced, diabetics are 38

now also faced with the constant fear of their medication becoming a financial obstacle in their lives. “It’s scary knowing that in the future I’ll always have to, or at least I should, find a job that has good insurance because without it my medication adds up to a whole lot of money,” said Hannah Jones, a 22-year-old Type 1 diabetic. “For my insulin alone, before insurance, it’s hundreds of dollars for a box that will last me a month. Each supply of the test strips costs about $60, and that’s just for a little bottle. If I am checking my blood sugar all day every day, as I’m supposed to, I’ll go through that little bottle in one week.”


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H e lpi n g w i t h hyp e rte n s i o n BY: LESLIE ZGANJAR PHOTOS: GREG RANDALL

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aculty at The University of Alabama College of Community Health Sciences received a demonstration project grant from the American College of Preventive Medicine (ACPM) to develop an innovative medical practice model for addressing high blood pressure in African American males, a population group with disproportionately large numbers of hypertension diagnoses. The grant, The Impact of Electronic Health Records on Hypertension Screening, Diagnosis and Management in African American Males, was one of only six awarded nationwide by the ACPM. Dr. Louanne Friend, assistant professor of community medicine and population health, and Dr. Tamer Elsayed, director of The University of Alabama Family Medicine Residency, are project directors. The grant was awarded to the Capstone Health Services Foundation (CHSF) and is the first grant ever awarded to the foundation, said Dr. Richard Friend, dean of CCHS and a family medicine physician. The non-profit CHSF provides the organizational framework for the operation of the College’s education programs and for the provision of patient care provided by University Medical Center. “This is very significant because the CHSF may qualify for additional external funding opportunities related to its patient base and organizational structure,” Friend said. “We have worked hard to integrate CHSF with broader University initiatives.” The ACPM has partnered with the Division for Heart Disease and Stroke Prevention at the US Centers for Disease Control and Prevention on the grant program. Awardees will work to develop and implement protocols to detect, control and prevent hypertension, or high

blood pressure, among black males ages 35 to 64, using data from existing electronic health records. The goal is to improve the standard of care for hypertensive patient identification, referral and treatment. The work by the CCHS group will be conducted at University Medical Center, a multi-specialty community medical practice operated by the College and the largest in West Alabama with locations in Tuscaloosa, Northport and Demopolis. UMC has used electronic health records for more than a decade. Grant awardees have the potential to receive funding for a total of three years, depending on availability of federal funding and successful completion of initial work. The College was awarded $20,000 in April 2019 for the first year of the research project, which will last through July 2020. There is the opportunity for the project to be awarded a total of $50,000. Addressing and reducing the burden of hypertension, a known risk factor for heart disease and stroke, is a public health priority, according to the ACPM. Nearly 1 of 3 adults in the US, about 75 million people, have high blood pressure and only about half of those have their hypertension under control. More than 40% of adults in Alabama have high blood pressure, according to the Alabama Department of Public Health. A population group that experiences higher rates of high blood pressure are African American men. In Alabama, 47.6% of African Americans are diagnosed with hypertension, compared to the US rate of 41.1%, according to America’s Health Rankings 2018 Annual Report. C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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From left: Dr. Louanne Friend, Blake Newman from the Center for Advanced Public Safety, Suzanne Henson and Dr. Gregg Bell conduct a planning meeting for the HYPE app.

Team approach to care The ACPM grant program seeks to increase physician awareness of African American men with hypertension, or at risk for the condition, and to implement protocols to identify, screen, treat and refer these patients to evidence-based Self-Measured Blood Pressure (SMBP) programs that can provide clinical support and lifestyle changes. The ACPM strongly encourages use of a teambased care approach for management of hypertension that includes the patient, primary care provider and other health care professionals – an accepted and preferred strategy for reducing and controlling high blood pressure. The grant program calls on program participants to test and evaluate innovative approaches to: SCREEN AND TEST PATIENTS FROM THE TARGETED POPULATION AND REFER THESE PATIENTS TO SMBP PROGRAMS. ENCOURAGE PATIENTS TO ENROLL IN SMBP PROGRAMS AND SUPPORT THE REFERRAL AND RETENTION PROCESS. ADDRESS A SOCIAL DETERMINANT OF HEALTH THAT PRESENTS A BARRIER TO SCREENING, CARE MANAGEMENT AND ENROLLMENT IN SMBP PROGRAMS. COLLECT AND REPORT DATA ON PROCESS AND OUTCOME MEASURES RELEVANT TO THE EXPERIENCES OF THE TARGETED POPULATION IN ACHIEVING THE GOALS OF THE GRANT PROGRAM AND ASSESS THE IMPACT OF INTERVENTIONS TAKEN.

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The ACPM is providing technical assistance, resources and expertise to help grant awardees achieve the goals of the program and will work with grant awardees to support their efforts and to disseminate lessons learned. ACPM representatives from Washington, DC, conducted a site visit at the College on July 8. Andrea Price, ACPM’s project director for partner programs, and Dr. Stacey Schott with the Dartmouth Institute for Health Policy and Clinical Practice, suggested the CCHS team work first on designing and testing a patient-focused and patient-driven evidencebased lifestyle intervention to reduce hypertension in the target population. They encouraged the team to include the patient perspective in the design of their work, to “help generate context around what will or will not work for them,” and to consider including a patient on the care team. An intervention can then be selected based on feasibility and potential impact and piloted with a small group, the representatives said. “The potential for great success is evident, given the creativity, dedication and innovation already utilized to create their own self-monitoring digital app, named HYPE (see story page 41),” according to the ACPM’s site visit report.

A model for other chronic conditions Louanne Friend said work has already begun to identify potential participants for the project. She said UMC patients will have the opportunity to enroll in an on-site or online education and training program to develop lifestyle habits for self-monitoring and blood pressure control. The on-site education classes will be held at UMC and patients will receive assistance and support from UMC nurses, social workers, physicians, pharmacists and its dietitian to help meet their blood pressure goals. Patients will also be provided with blood pressure testing equipment and access to a free mobile health tracking app with diet and exercise tips.


FA L L 2 0 1 9 “While the ACPM project focuses on a particular patient population, UMC physicians can use the practice model and techniques to help patients with other chronic health conditions,” said Richard Friend. “Hypertension will be the first chronic disease process, but we can look for others and, in this way, provide even better care for our patients,” he said. In addition to CCHS, other awardees of the ACPM demonstration project are: Access Health Louisiana in Kenner; Cook County Health in Chicago; Grady Health System in Atlanta; Henry Ford Health System in Detroit; and Lincoln Community Health Center in Durham, North Carolina. The APCM is a professional organization that provides leadership in research, professional education, development of public policy and that works to enhance standards of preventive medicine on behalf of its physician members.

hypertension: there’s an app for that

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r. Louanne Friend, assistant professor of community medicine and population health at The University of Alabama College of Community Health Sciences, is working to help patients reduce their hypertension, or high blood pressure, with the help of an app. Friend and her team at CCHS, including Suzanne Henson, assistant professor of family, internal, and rural medicine and a registered dietitian, and Dr. Gregg Bell, assistant professor of community medicine and population health, were awarded $75,000 in funding last year from the Alabama Department of Public Health through the US Centers for Disease Control and Prevention. The award is funding work to detect and treat hypertension in University Medical Center patients, and to provide lifestyle training for patients with hypertension and high blood cholesterol. Friend and her team have received an additional $75,000 for 2019-2020.

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The partnership with ADPH began in 2017 with a $20,000 community grant, which supported the development of a hypertension template that was embedded into the electronic medical record at University Medical Center’s Northport location. The template alerts physicians when patients might be undiagnosed with hypertension and provides physicians access to a decisionmaking tree for referral to lifestyle education and pharmacotherapy. The template is also now in use in all UMC family medicine clinics at UMC’s main location in Tuscaloosa and at UMC-Demopolis. CCHS operates University Medical Center. Once the hypertension template was in use at UMC-Northport, Friend’s work as part of this project included development of a mobile health app, called HYPE, in collaboration with the UA Center for Advanced Public Safety. HYPE, a free mobile app available in both iOS and Android platforms, provides evidenced-based lifestyle education and allows users to download and print their health information, including blood pressure, heart rate, weight, physical activity and medications being taken, to bring with them to doctor visits. Friend and her team hope to improve the standard of care for hypertensive patient identification and treatment, particularly for patients who cannot attend in-person education classes due to transportation barriers, a main social determinant of health. The app will also be highlighted with a demonstration project funded this year by the American College of Preventive Medicine and also being led by Friend, providing the opportunity for the technology to be utilized across the nation. Friend said work is continuing to fine-tune the app. Year 2 plans call for reminder and motivator communications pushes, and for a feature that would allow users to share their information collected by the HYPE app with their electronic medical record at UMC.

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SNAPSHoTS 1

The College of Community Health Sciences, in partnership with The University of Alabama Office for Research and Economic Development, Alabama Life Research Institute, Institute for Rural Health Research and University Medical Center, unveiled the new Mobile Outreach Unit in April at the 2019 Rural Health Conference held at the UA Bryant Conference Center. The vehicle has been instrumental in continuing efforts of the UA Flu Shot Campaign on the UA campus, and the All of Us Program in Tuscaloosa County, a nationwide precision medicine research project of which the Institute for Rural Health Research is a partner.

Mobile Outreach Unit

2

Community Health

Partnerships with communities to improve health was the focus of the 20th annual Rural Health Conference hosted this year by The University of Alabama College of Community Health Sciences and its Institute for Rural Health Research. The conference, “Partnering with Resilient Communities,� was held April 10-11 and included presentations about creating community networks and health care coalitions, and the impact of rural hospital closures on emergency medical services response times. C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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SNAPSHOTS

3 Ten students who want to become physicians and practice in rural Alabama communities were recognized April 27 at a convocation for the Rural Medical Scholars Program, which is operated by the College of Community Health Sciences and the University of Alabama School of Medicine. Rex Farris was one of the scholars who presented his research at a poster presentation held the day of the convocation.

RMS Convocation

4

FMR Graduation 44

Twenty-one physicians were honored June 30 at the 44th annual graduation ceremony of The University of Alabama Family Medicine Residency and Fellowships. Residency Director Dr. Tamer Elsayed presented outstanding recognition awards to residents. The 15 graduating residents and six fellows have gone on to begin their own practices in Alabama and other states, or to fellowship programs.


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5 Thirty-six medical students were honored at the College of Community Health Sciences Senior Banquet on May 16 at the Tuscaloosa River Market. The students, now physicians, have begun their residency training in programs across 14 states.

Senior Banquet

6 The University of Alabama named Dr. Richard Friend dean of the College in July 2019. A reception was held to introduce him in his new role to the campus community and the College’s partners across the state. Friend had served as interim dean since August 2018.

Dean’s Reception C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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SNAPSHOTS

7 The College of Community Health Sciences has again partnered with WVUA-23 in Tuscaloosa to produce the award-winning news program Health Matters. The segments feature University Medical Center physicians and CCHS faculty experts discussing topics ranging from balancing your diet to increasing access to care for expectant rural mothers.

Health Matters

8

Practice Makes Perfect 46

Dr. Louanne Friend, assistant professor of community medicine and population health, was one of the faculty on hand to teach new residents and medical students at the College of Community Health Sciences the proper technique for inserting an IV during a practice training session.


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FA C U LT YNEW TO THE COLLEGE of COMMUNITY HEALTH SCIENCES DR. BRITTNEY ANDERSON

Anderson joined the College of Community Health Sciences as assistant professor of family, internal, and rural medicine. She will also care for patients at University Medical Center, which the College operates, and teach and supervise the College’s family medicine residents, medical students and clinical learners. Anderson earned a bachelor’s degree in Psychology from Duke University in Durham, North Carolina, and completed her master’s degree in Human Environmental Sciences as a Rural Medical Scholar at The University of Alabama. She received her medical degree from the UA School of Medicine, completing her third and fourth years of clinical education at the College, which also serves as a regional campus for the School of Medicine. She completed her residency training at the UA Family Medicine Residency, which is operated by the College. Anderson has a special interest in rural medicine.

F A M I LY M E D I C I N E DR. SHAWN CECIL

Cecil joined the College of Community Health Sciences as assistant professor of pediatrics. He will also care for patients at University Medical Center, which the College operates. Cecil received a bachelor’s degree from The University of Alabama and his medical degree from the University of Alabama School of Medicine. He completed his third and fourth years of medical school at CCHS, which serves as a regional campus of the School of Medicine. Cecil completed his residency at the University of Arkansas for Medical Sciences and served as chief resident at Children’s Hospital in Little Rock, Arkansas.

P E D I AT R I C S

DR. IL GYU CHO

Cho joined the College of Community Health Sciences as a clinical assistant professor of psychiatry and behavioral medicine. He will primarily care for patients at University Medical Center’s Betty Shirley Clinic and will also spend time teaching the College’s family medicine residents and medical students. Cho earned bachelor’s degrees in biomedical sciences and biological sciences from Colorado State University in Fort Collins. He received his medical degree from the University of Colorado School of Medicine in Aurora. Cho completed general psychiatry residency training as well as child and adolescent psychiatry fellowship training at the University of North Carolina at Chapel Hill. He is board certified in psychiatry by the American Board of Psychiatry and Neurology and his clinical interests are in child and adolescent psychiatry and psychotic disorders.

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N E W F A C U LT Y

DR. DALE DICKINSON

Dickinson joined the College of Community Health Sciences as director of the Office of Medical Student Affairs and associate professor of community medicine and population health. In the director role, Dickinson will provide strategic leadership and oversight for programs that support the education of medical students at the College. CCHS is a regional campus of the University of Alabama School of Medicine. Specifically, Dickinson will lead the College’s Office of Medical Student Affairs in the areas of academic and career success, professional development, student health and wellness, student leadership, and student organizations and interest groups. Prior to joining the College, Dickinson spent nearly two decades at the University of Alabama at Birmingham as faculty and in senior administration, including in the provost’s office as director of UAB’s Quality Enhancement Plan. Dickinson received a bachelor’s degree in biology from McMaster University in Hamilton, Ontario, and a PhD in molecular biology and genetics from the University of Guelph in Guelph, Ontario. He completed post-doctoral work at the University of Southern California. As an associate professor of public health at UAB, he published numerous scientific manuscripts, designed and taught courses and was twice honored with the President’s Award for Excellence in Teaching.

M E D I C A L S T U D E N T A F FA I R S DR. LILLIAN FINDLAY

Findlay joined the College of Community Health Sciences as associate professor and psychiatric mental health nurse practitioner in the Department of Psychiatry and Behavioral Medicine. Findlay has more than 20 years of advanced practice experience in psychiatric-mental health nursing in both inpatient and outpatient settings. She also has experience as a registered nurse in a medical intensive care unit. Findlay has extensive experience in research as a study coordinator and with psychiatric research teams in university settings. Her most recent research includes examining health behaviors, health behavior decision making and the importance of support services and other mechanisms to improve treatment adherence among adults with serious mental illnesses. In addition, she developed a transitional care model for a state mental health hospital aimed at improving health outcomes and reducing health disparities and frequency of inpatient readmissions. Findlay earned a bachelor’s degree from The University of Alabama, a master’s degree in nursing from the University of Alabama at Birmingham and a PhD in nursing from the University of Kentucky.

B E H AV I O R A L M E D I C I N E

DR. LISLE HITES

Hites joined the College of Community Health Sciences as associate professor in the Department of Community Medicine and Population Health. He is also affiliated with the Institute for Rural Health Research, which is operated by the College. Hites received a bachelor’s degree in philosophy from the University of Missouri at Kansas City and a bachelor’s degree in psychology from the University of Southern Mississippi (USM), followed by a master’s degree in adult education, also from USM. He received a master’s degree in industrial/organizational psychology from Tulane University in New Orleans, and a PhD in occupational health psychology from the Tulane University School of Public Health and Tropical Medicine. Hites’s research interests include burnout in health care workers, chronic disease disparities in rural and underserved communities, and the associated health outcomes and financial impact.

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DR. HARITHA GUTTIKONDA

Guttikonda joined the College of Community Health Sciences as an assistant professor. She will serve as a hospitalist at DCH Regional Medical Center in Tuscaloosa as part of the College’s University Hospitalist Group. Guttikonda earned her medical degree from Guntur Medical College in India and completed her residency at the Montgomery Family Medicine Residency in Montgomery, Alabama. She spent 10 years working as a primary care physician in Birmingham, Alabama, before joining the College. She has special interests in women’s health, pediatrics, acute care and hospital medicine.

H O S P I TA L M E D I C I N E DR. JACQUELYNN LUKER

Luker joined the College of Community Health Sciences as assistant professor of family, internal, and rural medicine. She will also care for patients at University Medical Center. Luker completed her undergraduate degree in biological sciences at The University of Alabama. As a Rural Medical Scholar at UA, she went on to complete her master’s degree in Rural Community Health. She earned her medical degree from the UA School of Medicine and completed her residency training at the UA Family Medicine Residency, which the College operates. She also completed a geriatrics fellowship at the College. Luker has special interests in rural medicine, geriatrics, endof-life care and hospice care.

F A M I LY M E D I C I N E

DR. CHEREE MELTON

Melton joined the College of Community Health Sciences as assistant professor of family, internal, and rural medicine. She will also care for patients at University Medical Center, which the College operates, and teach and supervise the College’s family medicine residents, medical students and clinical learners. Melton earned a bachelor’s degree in biology from the University of Mobile, in Mobile, Alabama. She received her medical degree from the Edward Via College of Osteopathic Medicine in Spartanburg, South Carolina. She completed her residency training at The University of Alabama Family Medicine Residency, which is operated by the College, as well as a fellowship in obstetrics at the College. She has special interests in adolescent female health, obstetrics and long-acting reversible contraception.

F A M I LY M E D I C I N E DR. GILMER RODRIGUEZ

Rodriguez joined the College of Community Health Sciences as assistant professor. He will serve as a hospitalist at DCH Regional Medical Center in Tuscaloosa as part of the College’s University Hospitalist Group. Rodriguez earned his medical degree from the National University of Trujillo in Peru and his internal medicine training from the National University of Trujillo and the University of Rochester in Rochester, New York. He has postgraduate degrees in general preventive medicine and public health from the Medical College of Wisconsin, and in medical management from Tulane University in New Orleans. Rodriguez previously served as associate chief of staff of Central Alabama Healthcare System, providing leadership and management to the system’s acute care hospitals and multi-specialty clinics and was the designated educational officer responsible for 60 affiliated academic institutions and 21 Veterans Affairs program directors.

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N E W F A C U LT Y

DR. HEATHER SKANES-DEVOLD

Skanes-Devold joined the College of Community Health Sciences as assistant professor of obstetrics and gynecology. She will also care for patients at University Medical Center. Skanes-Devold earned her medical degree from Wright State University Boonshoft School of Medicine in Dayton, Ohio. She completed her residency training at Morehouse School of Medicine in Atlanta, where she served as the chief administrative resident. She has specific interests in health care disparities in maternal-child health and in medical education.

OBSTETRICS AND GYNECOLOGY DR. ASHLEY WAMBOLT STEINER

Steiner joined the College of Community Health Sciences as assistant professor of family, internal, and rural medicine. She will primarily care for patients at UMCDemopolis, which is operated by the College. Wambolt earned her medical degree from Saba University School of Medicine in the Caribbean Netherlands and completed her residency training at The University of Alabama Family Medicine Residency, which is operated by the College. She also completed an obstetrics fellowship at the College. She has specific interests in women’s health and long-acting reversible contraception. Steiner is a native of Cape Breton Island in Nova Scotia and a graduate of Cape Breton University, where she was an Academic All-Canadian volleyball player. Prior to graduation, she spent seven years in the Canadian Armed Forces, where she reached the rank of Lieutenant Navy, served as executive officer for a regional section of the Canadian Cadet Movement, and trained bi-athletes for national competitions with particular attention to the development of distinguished marksmanship.

DR. TIFFANY THOMAS

F A M I LY M E D I C I N E

Thomas joined the College of Community Health Sciences as assistant professor of family, internal, and rural medicine. She will also care for patients at University Medical Center, which the College operates. Thomas earned a bachelor’s degree in microbiology from Clemson University in Clemson, South Carolina. She received her medical degree from the Medical University of South Carolina in Charleston and completed her residency training at The University of Alabama Family Medicine Residency, which is operated by the College. She has special interests in rural and global health and has visited four countries while participating in mission trips. Thomas hopes one day to lead an annual mission trip to Kenya, while also finding ways to serve small rural communities in Alabama.

F A M I LY M E D I C I N E

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SEVEN FELLOWSHIPS The College of Community Health Sciences offers post-residency fellowships in Emergency Medicine, Behavioral Health, Hospital Medicine, Geriatric Medicine, Obstetrics, Sports Medicine and Pediatrics. Each fellowship is a year-long program designed to provide additional, specialized training to family medicine physicians.

PEDIATRICS PEDIATRICS

DR. RUSS GUIN

Guin is a sports medicine fellow with the College of Community Health Sciences. The Sports Medicine Fellowship offers education, training and certification to family medicine physicians, who are often called to serve as team physicians for high school sports program in their communities. Sports medicine fellows also care for patients at University Medical Center, which the College operates. Guin received a bachelor’s degree in health sciences from The University of Alabama. He received his medical degree from the UA School of Medicine and completed his residency training at the UA Family Medicine Residency, which is operated by the College.

SPORTS MEDICINE DR. ELIZABETH JUNKIN Junkin is an obstetrics fellow with the College of Community Health Sciences. The Obstetrics Fellowship, for family medicine physicians, one of the first of its kind in the US, aims to address the need for obstetric care in rural areas. Obstetrics fellows master high-risk, operative obstetrics and office ob/gyn procedures, including ultrasound, colposcopy, cryotherapy and endometrial biopsies. They also care for patients at University Medical Center, which the College operates. Junkin received a bachelor’s degree in chemical engineering from The University of Alabama. She earned her medical degree from the UA School of Medicine and completed her residency training at the UA Family Medicine Residency, which the College operates.

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N E W F A C U LT Y

DR. SOOJUNG LEE

Lee is a geriatrics fellow with the College of Community Health Sciences. The Geriatrics Fellowship offers a variety of experiences, including collaborating with interdisciplinary teams and working at nursing home facilities, geriatric psychiatry facilities, hospice and assisted living facilities. The fellowship also provides opportunities to work in rural settings, and fellows care for patients at University Medical Center, which is operated by the College. Lee earned a bachelor’s degree in chemistry from Tulane University in New Orleans and her medical degree from the Louisiana State University School of Medicine in New Orleans. She completed her residency training at The University of Alabama Family Medicine Residency, which is operated by the College.

G E R I AT R I C S

DR. SHAWNA OGDEN

Ogden is a behavioral health fellow with the College of Community Health Sciences. The Behavioral Health Fellowship trains family medicine physicians, particularly those planning to practice in rural communities, to better care for patients with mental health and psychiatric concerns. Ogden received a bachelor’s degree in Kinesiology from Louisiana State University in Baton Rouge and a master’s degree in biomedical science from Barry University in Miami Shores, Florida. She received her medical degree from St. George’s University in Grenada, West Indies, and completed her family medicine residency training at LSU Health Sciences Center in Shreveport. As a resident, Ogden was awarded the Family Medicine Resident Award for Advocacy for persistent efforts to represent family medicine at a state level.

B E H AV I O R A L H E A LT H DR. LIDIANNY POLANCO

Polanco is a hospitalist fellow with the College of Community Health Sciences. The Hospitalist Fellowship is housed at DCH Regional Medical Center in Tuscaloosa, a tertiary-care facility with more than 580 beds that offers a variety of specialty units and advanced care services, including cancer, cardiology, robotic and minimally-invasive surgery, critical care pulmonology, gastroenterology, nephrology and the region’s most advanced trauma center. Polanco, originally from the Dominican Republic, was raised in the Bronx in New York City and earned her bachelor’s degree at Touro College in Harlem, New York. She completed her medical education at the Touro College of Osteopathic Medicine and her residency training at Our Lady of Lourdes Memorial Hospital in Binghamton, New York. She has a special interest in inpatient medicine.

H O S P I TA L M E D I C I N E DR. GAYLE WONG

Wong is a hospitalist fellow with the College of Community Health Sciences. The Hospitalist Fellowship is housed at DCH Regional Medical Center in Tuscaloosa, a tertiary-care facility with more than 580 beds that offers a variety of specialty units and advanced care services, including cancer, cardiology, robotic and minimally-invasive surgery, critical care pulmonology, gastroenterology, nephrology and the region’s most advanced trauma center. Wong received a Bachelor of Sciences degree as a Toxicology Specialist, with honors, from The University of Toronto in Ontario, Canada. She earned her medical degree from Windsor University School of Medicine in the Caribbean and completed her residency at Emory University Family Medicine Residency in Atlanta.

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FA C U LT YNEW ROLES IN THE COLLEGE

of COMMUNITY HEALTH SCIENCES

DR. MARTHA CROWTHER

Crowther was named associate dean for Research and Health Policy. She had been serving in the position in an interim role. Crowther is professor of community medicine and population health, and family, internal, and rural medicine. She is also an investigator with the College’s Institute for Rural Health Research. Crowther received her PhD in clinical psychology from Duke University in Durham, North Carolina. She received a master’s degree in public health with a focus on chronic disease epidemiology from Yale University, and earned a bachelor’s degree in psychology from The University of California-Berkley. Crowther has built a solid research portfolio on aging and racial diversity in urban and rural populations. Her research has focused primarily on the elimination of mental and physical health disparities in older adults, as well as the assessment of caregivingrelated stressors and outcomes at local, state and national levels. Her work has considered the reduction of health disparities through community-engaged research. She has been awarded research funding from federal, state, foundations and industry, and has published journal articles and book chapters on topics that include mental health, sexuality, aging and psychology.

A S S O C I AT E D E A N F O R R E S E A R C H DR. TAMER ELSAYED

Elsayed was named director of The University of Alabama Family Medicine Residency, which is operated by the College. In the role, he is responsible for the overall operation of the residency, including resident recruitment and selection, residency teaching and scholarly activities, supervision of residents, resident education in the context of patient care, and ensuring compliance with accreditation requirements. Elsayed served as interim residency director for the past year and before that held the role of assistant director of the residency. The UA Family Medicine Residency is one of the oldest and largest family medicine residencies in the US, training 48 residents per year and having graduated nearly 500 family medicine physicians to date. Elsayed earned a bachelor’s degree in medicine and a master’s degree in internal medicine from the Medical School, Cairo University, Egypt, where he graduated with honors. He also received an Award of Excellence from the Kuwait Ministry of Health. He completed his residency training at the UA Family Medicine Residency. Elsayed joined the College as assistant professor of family medicine in 2014. In addition to participating in the clinical education of medical students and residents, he cares for patients in the Family Medicine Clinic at University Medical Center, which is operated by the College. Elsayed is also co-director of the College’s Emergency Medicine Fellowship.

RESIDENCY DIRECTOR C O L L E G E O F C O MMU N I T Y H E ALT H SC IEN C ES

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DR. JOHN C. HIGGINBOTHAM

Higginbotham, professor and chair of the Department of Community Medicine and Population Health and director of the College’s Institute for Rural Health Research, was named senior associate vice president for Research and Economic Development for The University of Alabama. In the role, Higginbotham works to develop and enhance research initiatives across campus and serves as the chief operating officer for the UA Office for Research and Economic Development. In his UA role, Higginbotham focuses on overseeing and growing ORED’s internal grant program and the annual process for identifying federal priorities for the University. He is continuing his leadership roles with CCHS. Higginbotham received a bachelor’s degree from UA, a master’s degree in public health from the University of Alabama at Birmingham, and his doctorate in preventive medicine and community health from the University of Texas Medical Branch at Galveston. He has an extensive portfolio of funded research, and his most recent presentations and publications focus on racial and ethnic disparities related to cancer and other health issues. He has chaired standing grant review committees for the National Institutes of Health, received the Charles Barkley Excellence in Mentoring Award, and received the Alabama Public Health Association’s Ira L Myers Award for having a significant impact on public health. In his leadership roles with the College, Higginbotham teaches, conducts research and oversees the CCHS research infrastructure. He works in partnership with all areas of the College to promote research and scholarly activities among faculty, fellows, family medicine resident physicians, medical students and others.

U A S E N I O R A S S O C I AT E V I C E P R E S I D E N T FOR RESEARCH AND ECONOMIC DEVELOPMENT DR. DRAKE LAVENDER

Lavender, assistant professor of family, internal, and rural medicine, was named director of Rural Programs. He was in the first class of the College’s Rural Medical Scholars, a program created in 1996 to address the shortage of primary care physicians in Alabama’s rural communities. Lavender was raised in a small, rural Alabama community and earned a bachelor’s degree in microbiology from The University of Alabama. He completed the Rural Medical Scholars Program before going on to the UA School of Medicine, where he earned his medical degree in 2001. The Rural Medical Scholars Program includes a year of study, after students receive their undergraduate degree, which leads to a master’s degree in rural community health and early admission to the School of Medicine. Lavender completed his residency training at the UA Family Medicine Residency, which is operated by the College, serving as a chief resident. He went into private practice in Gordo, Alabama, before joining the College in 2014. Lavender has been actively involved with the College’s longitudinal curriculum for medical students, and also teaches endoscopy to resident physicians. In addition, he cares for patients in Pickens County in need of endoscopy services. He is active both regionally and nationally in the advocacy of family medicine and rural medicine training.

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DR. JOHN MCDONALD

McDonald, associate professor of OB/GYN, was named interim chair of the Department of Obstetrics and Gynecology. In his new role, McDonald will continue teaching the College’s medical students and resident physicians and caring for patients at University Medical Center, which the College operates. He will also continue as director of the College’s Obstetrics and Gynecology Clerkship, a position he has held since 2008. After graduating from The University of Alabama with bachelor’s and master’s degrees in accounting, McDonald earned his medical degree from the University of Alabama School of Medicine. He completed residency training at the University of South Alabama in Mobile, where he served as chief resident. He is board certified by the American Board of Obstetrics and Gynecology. McDonald has received a number of teaching awards throughout his career and has served on numerous CCHS and UA committees. He has served as chair of the OB/GYN Department at DCH Regional Medical Center in Tuscaloosa. He is a certified public accountant (inactive) and a member of the Alabama Society of CPAs.

INTERIM CHAIR OF OB/GYN

DR. GRIER STEWART

Stewart, associate professor of family, internal, and rural medicine, was named assistant dean for Medical Student Education. He has been an integral part of the design, development and implementation of the College’s longitudinal curriculum for medical student education. CCHS also functions as a regional campus of the University of Alabama School of Medicine and in that role provides the clinical years of medical education (third and fourth years) to a portion of School of Medicine students. Stewart joined the volunteer faculty for CCHS shortly after going into private practice in Tuscaloosa. He attended on the College’s Internal Medicine Service and served as a preceptor for the fourth-year elective for medical students. He joined CCHS full time in 2008 and became Internal Medicine Clerkship director in 2014. Stewart works with medical students learning at University Medical Center, which the College operates, and DCH Regional Medical Center in Tuscaloosa. He serves on the School of Medicine Admissions Committee and is involved with the College’s Primary Care Track that is currently admitting its second class of medical students. The track, the only four-year MD program in the School of Medicine system, is for students interested in primary care careers and provides a strong foundation in clinical medicine focused on primary care. Stewart’s interests also include geriatrics and nursing home care and he serves as a medical director for a Tuscaloosa nursing home.

A S S I S TA N T D E A N , M E D I C A L S T U D E N T E D U C AT I O N

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ACCOLADES Sports Medicine Fellows Present at National Conferences Drs. Aloiya Earl and Mike Bradburn, who recently completed the Sports Medicine Fellowship at the College of Community Health Sciences, presented at two national conferences – the American Medical Society of Sports Medicine and the American College of Sports Medicine. Earl presented “A unique case of recurrent stress fractures in a pediatric multi-sport athlete,” and Bradburn presented “Isolated popliteus rupture in a 7th grade running back.” The Sports Medicine Fellowship is a yearlong program for family medicine physicians that offers education and training in sports medicine care. During the year, fellows work with local high school athletes and University of Alabama athletic team physicians, coaches, trainers and athletes.

Residency Graduates Author EKG Textbook Drs. Richard Giovane and Stephanie Kinsley, recent graduates of The University of Alabama Family Medicine Residency, authored the textbook EKGs in a Nutshell: A Practical Companion. The residency is operated by the College of Community Health Sciences. Dr. Robert Sheppard, an associate professor of family, internal, and rural medicine for the College and director of its Hospitalist Medicine Services, is also an author. The textbook on EKG interpretation is written for the generalist and includes a broad array of clinical examples and detailed clinical applications. It provides readers with real-life EKG analysis taken from patients the authors have personally cared for, enabling them to provide clinical details most helpful to the interpreting and referring physicians.

Recent Graduate Presents at International Conference Dr. Jessica Powell, a recent graduate of The University of Alabama Family Medicine Residency, presented a poster titled “The Impact of Family Medicine-Obstetric Care on Infant Mortality Rates in Rural Alabama” at the Society of Teachers of Family Medicine Annual Spring Conference in Toronto, Canada. The residency is operated by the College of Community Health Sciences. The results of Powell’s study show that access to local prenatal care and delivery services in Pickens County, Alabama, was associated with a more than 60% drop in the infant mortality rate for the rural county. The study also found that when the hospital in Pickens County closed its labor and delivery unit and patients had to find prenatal care and delivery services in neighboring cities and counties, infant mortality rates returned almost to baseline. Powell presented her poster with CCHS faculty Dr. Catherine Skinner, a family medicine obstetrician, and Dr. Drake Lavender, a family medicine physician. 56


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Weida Selected to Permanent Seat on National Committee Dr. Tom Weida, chief medical officer for University Medical Center, was selected by the American Academy of Family Physicians for its permanent seat on the Relative Value Scale Update Committee (RUC). The committee, established in 1991 by the American Medical Association, is a volunteer group of physicians who make recommendations about how to value a physician’s work when computing health care prices in the country’s Medicare program. Weida, also a professor of family medicine for the College of Community Health Sciences, which operates UMC, is currently an alternate for the permanent RUC seat and will begin his service as a permanent seat member in January 2020. He also serves as a member of the RUC’s Practice Expense Subcommittee.

Payne-Foster Publishes Research in National Journals Dr. Pamela Payne-Foster, professor of community medicine and population health for the College of Community Health Sciences, co-authored: “Interdisciplinary, community, and peer leadership approach to addressing housing among persons living with HIV in the rural South,” published in the January 2019 issue of Housing Policy Debate; “Physician trust and home remedy use among lowincome black and whites with hypertension: Findings from the TRUST study,” accepted for publication in the Journal of Racial and Health Disparities; and “Reducing the African American disease burden in the Deep South: Addressing the role of faith and spirituality,” accepted for publication in AIDS and Behavior.

Halli-Tierney and Carroll Publish Research in National Journal Drs. Anne Halli-Tierney and Dana Carroll authored “Polypharmacy: Evaluating Risks and Deprescribing” published in the July 2019 issue of American Family Physician. Halli-Tierney is assistant professor of family, internal, and rural medicine for the College of Community Health Sciences and a practicing geriatrician at University Medical Center, which the College operates. Carroll is clinical assistant professor of pharmacy for the College.

Dr. Anne Halli-Tierney

Dr. Dana Carroll

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ACCOLADES

McKinney Co-Authors Editorial for National Journal Dr. Robert McKinney, assistant professor of social work for the College of Community Health Sciences, co-authored “Editorial: Abortion and The Routledge Handbook of Social Work Ethics and Values,” published in the spring 2019 issue of Journal of Social Work Values and Ethics.

Weida Authors Chapter on Measles Dr. Jane Weida, interim chair of the Department of Family, Internal, and Rural Medicine at the College of Community Health Sciences, authored the chapter “Measles (Rubeola),” published in the 2019 edition of Conn’s Current Therapy, a family medicine textbook. Weida, a family medicine physician and associate professor of family medicine, also cares for patients at University Medical Center, which the College operates.

Hammond Receives Travel Health Certification Angela Hammond, CRNP, has received a Certificate of Knowledge Examination from the International Society of Travel Medicine. Achieving certification demonstrates expertise in the profession and solid knowledge of travel medicine. Hammond, a nurse practitioner at University Medical Center, which the College operates, leads the provision of travel health services for UMC’s Faculty-Staff Clinic.

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College Faculty Recognized with Argus Awards Tuscaloosa campus winners of the 2019 Argus Awards Students from the University of Alabama School of Medicine named a faculty member and a resident on the Tuscaloosa Regional Campus winners of 2019 Argus Awards. The College of Community Health Sciences, which operates The University of Alabama Family Medicine Residency and University Medical Center, also serves as the School of Medicine’s Tuscaloosa Regional Campus and provides clinical education for a portion of third- and fourth-year medical students. Dr. Joseph Wallace, chair of the College’s Department of Surgery, received the Excellence in Education by a Community-Based Physician award. Dr. Zach Smith, a third-year resident of the UA Family Medicine Residency, received the Best Resident Educator award. The Argus Awards give medical students the chance to honor their mentors, professors, courses and course directors for outstanding service to medical education and training. The awards were presented during a ceremony on September 20 at the UAB Alumni House in Birmingham, Alabama.

Excellence in Education by a Community-Based Physician Dr. Joseph Wallace, Department of Surgery

Best Resident Educator Dr. Zach Smith, The University of Alabama Family Medicine Residency Dr. Zach Smith

Dr. Joseph Wallace

Paxton Co-Authors Articles for Research Journals Dr. Raheem Paxton, associate professor of community medicine and population health for the College of Community Health Sciences, has co-authored: “Patient recommendations for reducing long-lasting economic burden after breast cancer,” accepted for publication in Cancer; “Health behaviors and lifestyle interventions in African American breast cancer survivors – A review,” accepted for publication in Frontiers in Oncology; “Correlates of dysfunctional career thoughts in breast cancer survivors from the Bahamas,” accepted for publication in the Journal of Psychosocial Oncology; “Survivorship issues in older breast cancer survivors,” accepted for publication in Breast Cancer Research and Treatment; “Health disparities among the United States Mainland, Puerto Rico, Guam, and the United States Virgin Islands,” in The Journal of Health Disparities Research and Practice; and “Managing spirituality within distress throughout the cancer continuum,” accepted for publication in the American Journal of Nursing.

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ACCOLADES

Adams and Cole Receive Outstanding Recognition Award Alison Adams and Leif Cole, employees of the College of Community Health Sciences, were awarded the 2019 Outstanding Staff Award by The University of Alabama Office, Clerical and Technical Staff Assembly. The award recognizes two outstanding employees from among the office, clerical and technical staff of the University whose exceptional ability, performance and attitude have advanced the mission of UA. Adams is the administrative specialist for the UA Family Medicine Residency, which is operated by CCHS. Cole is a medical records coding clerk at University Medical Center’s Northport location. The College operates UMC.

Alison Adams

Leif Cole

Chief Residents 2019–2020 Academic Year

Dr. Larab Ahmad

Dr. Meghan Bonds

Dr. Anthony Johnson

*Not pictured: Dr. Ben Lee

Four residents of The University of Alabama Family Medicine Residency were named chief residents for the 2019-2020 academic year. Drs. Larab Ahmad, Meghan Bonds, Ben Lee (not pictured) and Anthony Johnson officially started in the chief resident role July 1. The three-year residency is operated by the College of Community Health Sciences.

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P.O. Box 870326 Tuscaloosa, AL 35487-O326 CHANGE SERVICE REQUESTED

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Profile for College of Community Health Sciences

On Rounds Fall 2019  

On Rounds Fall 2019  

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