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The conference focused on lifelong learning in health care and the collaboration between primary care and population health research. Rodriguez presented on the Latino Community Health Survey, a study led by the Survey of the Health of Wisconsin that she has been coordinating for the last year.

The SHOW team is currently wrapping up data collection for the Latino Community Health Survey in Milwaukee. The survey was a pilot study to implement the traditional SHOW core survey using community-engaged research methods.

Other changes included offering the survey in Spanish and focusing on data dissemination back to community members once the study concludes. This survey reached 100 Latinx adults living in the Milwaukee area. Data will be available in the SHOW database for interested researchers later this year.

Rodriguez has worked on this study as part of her Master of Public Health fieldwork and capstone project through UW-Madison’s School of Medicine and Public Health. In her work as a research program assistant, she collaborated with community leaders, SHOW researchers, and study participants. From planning meetings, to recruiting participants at community events, to conducting in-home interviews for data collection, Rodriguez has gotten to experience it all.

She shared that “working with SHOW on this project has complimented what I’ve learned in my classes and allowed me to directly apply new knowledge right away.” SHOW is one of many sites that MPH students can work with to complete either or both of their fieldwork and capstone projects.

Each year, the ISEE conference attracts the world’s top environmental scientists, public health professionals, and industry representatives to discuss new developments in the field. The 2019 theme “On Airs, Waters, Places” explored topics such as global warming, cobalt mining, and examples of intervention strategies employed in countries around the world.

The SHOW team presented two posters with some of the program’s recent findings. One poster highlighted new methods to collect air composition and noise exposure data for the CREATE pilot study. The Cumulative Risks, Early Development and Emerging Academic Trajectories (CREATE) study focuses on how children develop based on their surroundings.

A second poster focused on differences in the gut bacteria among urban and rural populations. Based on the analysis, whether or not a person uses primarily private well water is the best indication of variability in the microbiome between these two populations.

Malecki was also invited to speak on how different sources of fine particulate matter (or PM2.5) contribute to respiratory health in Milwaukee.

Team members were excited to share these findings on an international scale. The researchers received valuable feedback and forged new relationships for future work using SHOW data to explore environmental health risks.

SHOW will use one of Community Care’s clinic rooms to conduct a portion of its survey for participants in the area while connecting interested participants to Community Care’s resources and information.

Community Care is a nonprofit organization that coordinates and delivers a full range of support services for older adults. It helps individuals with long-term care needs live as independently as possible. Its Medicare/Medicaid long-term care programs serve both older adults and adults with disabilities.

Community Care has Wisconsin’s only Program of All-inclusive Care for the Elderly (PACE), which offers a benefit package that combines medical care, long-term care and prescription drugs. The program serves individuals 55 and older who are eligible for nursing home care. Individuals who join PACE are assigned a care team that develops a cost-effective, one-stop-shop care plan.

The PACE team consists of:

• Primary care physician
• Nurse practitioner
• Registered nurse
• Social worker
• Rehabilitation therapists
• Recreational therapist
• Dietician
• Day center manager
• Home care coordinator
• Transportation coordinator
• Personal care workers

 

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The award was presented at United Migrant Opportunity Services’ awards luncheon on July 20.

As the community engagement specialist for the Survey of the Health of Wisconsin (SHOW), Jackson has led SHOW’s recruitment in underserved communities. She has immersed herself in the community she loves, partnering with other organizations like the United Migrant Opportunity Services, and working to build a stronger and healthier City of Milwaukee.

Jackson has a master’s degree in public health care and experience working with seniors, individuals with special needs and promoting healthy eating in communities.

“In order to receive the proper support needed to build healthier communities for African Americans and Latinos, we must make sure all voices are heard. I am working to bring education, access, awareness and representation to all communities,” Jackson said.

All of Us is a National Institutes of Health (NIH) research program occurring over the next five years that will collect health data from 1 million or more individuals and contribute to the future of precision medicine.

United Migrant Opportunity Services is a nonprofit advocacy organization that provides programs and services to improve employment, housing, education and health opportunities among underserved populations.

Health research often underrepresents these populations, which further perpetuates the lack of resources available to them. The Survey of the Health of Wisconsin aims to engage with underserved communities in Milwaukee and improve health data collection in these areas.

Health disparities between lesbian, gay, bisexual, and transgender people and non-LGBT people are well documented and have been studied for decades.

The Centers for Disease Control and Prevention’s Healthy People 2020 initiative and the Healthiest Wisconsin 2020: State Health Plan both include goals to improve the health of LGBT populations. One of the first steps towards improving LGBT health is including questions about sexual orientation and gender identity in health surveys so the health needs of these populations can be understood and addressed. Often LGBT health research is limited to studies with small sample sizes, which makes it difficult to demonstrate the magnitude of LGBT health disparities.

Only in the past couple of decades have national population-health surveys, such as the CDC’s Behavioral Risk Factor Surveillance System and the National Health Interview Survey, included questions on sexual orientation and gender identity. Additionally, few statewide surveys include these questions. SHOW is a unique population-based health survey, and even more unique in that it is one of the few statewide surveys in the Midwest to include questions on sexual orientation and gender identity.

In 2014, SHOW began collecting information on sexual orientation and gender identity based on the recommended questions published by the Williams Institute. Linn Jennings, MS, an assistant researcher at SHOW and graduate of the Population Health master’s program, is first author of this work summarizing LGBT health outcomes and healthcare access and utilization in Wisconsin published in Preventive Medicine Reports this month.

Key takeaways on LGBT health and health care utilization in Wisconsin

The results of this study indicate that large disparities in health outcomes, access to healthcare services, and quality of healthcare exist for LGBT individuals in Wisconsin.

Compared to non-LGBT individuals, LGBT individuals were over two times more likely to report fair/poor health, LGB individuals were over two times more likely to have a depression diagnosis and to delay obtaining healthcare services, and transgender individuals were almost three times more likely to receive poor quality of healthcare and experience unfair treatment when receiving health care.

As we near 2020, it is clear that LGBT health disparities persist, and in order to address these disparities, healthcare policy changes are needed to achieve health equity for LGBT populations.

SHOW has funds available for UW investigators to generate laboratory-based preliminary data using SHOW biospecimens (up to four proposals of $5,000-$10,000 each).

The SHOW biobank maintains a state-of-art biorepository linked to extensive population-based data for health-related research. It offers several types of biospecimens (plasma, serum, urine, whole blood DNA) from more than 5,000 adults and stool samples from 700 adults of diverse racial, age, socioeconomic and geographic background.

To be eligible for SHOW funds, the following criteria should be met:

1. UW-Madison investigator
2. hypothesis-driven research proposal
3. plans to submit R01 grant application (or other type of extramurally-funded grant) within approximately 18 months of receiving assay results
4. use of SHOW biospecimens to generate preliminary data
5. plans to use SHOW biospecimens/infrastructure in the proposed grant application

Interested investigators should submit a proposal, no longer than two pages, containing the following information:

• name
• contact information
• department
• budget
• narrative – including a brief background, description of aims, preliminary data needed for the R01 (or other) proposal, methods used for biosample analysis, and plans including timeline for the R01 submission

Proposals should be submitted to researchers@show.wisc.edu

Each proposal will be reviewed by the SHOW Scientific Committee (chaired by Drs. Kristen Malecki and Paul Peppard). Funding decisions will be based on the criteria above, and other factors including proposals’ compatibility with SHOW’s overall goals/objectives.

Please share this information with investigators in your department. There is no formal deadline although a limited amount of funds is available. Proposals will be reviewed on an ongoing but first-come first-serve basis starting Jan. 10, 2019 until all funds are distributed. Biospecimen fees may be waived or reduced for proposals receiving SHOW funds.

To understand causes and consequences of ongoing health disparities, it is important to have a truly representative sample of individuals from all communities to provide evidence-based solutions to local and state policymakers and health care providers. Yet, minorities are still largely under-represented in current biomedical and population research.

One of the barriers for conducting research in Hispanic communities is a general mistrust of authorities. Over the years, the Survey of the Health of Wisconsin (SHOW) has been building partnerships with community leaders throughout the state to gain trust and to design health research surveys that address issues and problems that are important to the particular community. One such partnership we started building in early 2018, and fostered by previous UW collaborations, is with leaders in the Latino population on the South Side of Milwaukee. SHOW is collaborating with the United Community Center to identify specific health-related topics that will not only support innovative biomedical research, but also provide data to support community-based health promotion efforts. Based on input from community focus groups and guidance from community leaders, SHOW and United Community Center have selected priority topics that include: access to proper healthcare and family history of diabetes and other diseases.

SHOW is a population-based research study aiming to have a representative statewide sample of Wisconsin residents and has traditionally recruited members of randomly selected households to participate in the survey. However, for this pilot study, community leaders recommended finding an alternative to randomly knocking on doors due to fear and mistrust that exist in the Latino community. Instead, we will offer open recruitment at United Community Center and various community events where interested individuals will be able to sign up for the survey at sponsored events and various community events. We plan to enroll up to 100 adults who meet the eligibility criteria. United Community Center has provided guidance along the way and plans to continue to provide community input, meeting space, and professional support as this study progresses. To build trust with the community and to increase the successful execution of this pilot, SHOW will have bilingual and bicultural field interviewers, and will provide interpreters at bio-sample collection appointments. Another important step in the preparation for this pilot was translation of SHOW survey questionnaires, recruitment and outreach materials to Spanish.

This pilot study is SHOW’s latest initiative to strengthen community based research and collaboration. In addition to the close partnership with United Community Center, this study also draws upon the UW Masters in Public Health program. Through a project assistantship and MPH fieldwork, current MPH student, Allison Rodriguez has provided project coordination, translation of SHOW documents and support both in the field and administratively. SHOW also relies on our Community Outreach Specialist, Tara Jackson, to represent SHOW at community events, to provide feedback based on work in the field, and to form key partnerships in the Milwaukee area. Moving forward SHOW hopes to continue developing partnerships and collaboration both in the Milwaukee area and across UW-Madison departments.

Additional benefit of this pilot study for us and a broader UW research community is a hands-on experience with developing strategies to better adapt health surveys to meet local community needs and interests that will potentially include bilingual field team members in the statewide core survey in future years. We are at the final stages of preparation phase of this study and we expect that the fieldwork will begin in early 2019.