Community Health Fellowship Program Past Student Research Studies

Community Team
Dallas County Health & Human Services: John Carlo, MD & Wendy Chung, MD, MSPH

Fellow: Tessa Novick
Research Mentor: Flora Dallo, PhD
(2010)

The purpose of this study was to examine the association between characteristics of clients attending the Dallas County Health and Human Services (DCHHS) immunization clinics between 07/2009 and 10/2009 and their month of immunization with the meningococcal conjugate vaccine. The specific client characteristics we analyzed included demographic information (age, sex, race, ethnicity, and home zip code) and socioeconomic status information (Texas Vaccines For Children eligibility). Results will be used to identify areas in need of additional immunization clinics and other services. Furthermore, this study will lead to a better understanding of patients, and will assist DCHHS in meeting the health care needs of the Dallas community.

Community Team
Community Hospice: Tamara McGregor, MD

Fellow: Amy Gowan
Research Mentor: Jay Morrow, DVM, MPH
(2010)

The purpose of this study was to assess patient or caregiver knowledge, attitudes and beliefs prior to admission to Community Hospice of Texas. The five (5) specific aims of this study were to (1) determine what patients or caregivers know and think about hospice care before it was initially brought up to them, (2) determine when, with who, and how initial conversations about hospice occur with patients or caregivers, (3) determine patient or caregiver's previous experience with hospice care or the terminally ill, (4) explore possible cultural differences in patient or caregiver's knowledge, attitudes and beliefs about hospice care and (5) determine where opportunities exist to improve patient or caregiver knowledge  and doctor-patient communications regarding end of life care. Results of the study will be used provide insight into areas where communication and education about hospice care can be improved.

Community Team
UT Southwestern Department of Dermatology: Amit Pandya, MD & Arturo Dominguez, MD

Fellow: Fabiola Reyes
Research Mentor: Patti Pagels, MPAS, PA-C
(2010)

The objective of this study was to determine the effectiveness of a Promotora training curriculum addressing the effective management of Atopic Dermatitis (AD) by Spanish-speaking caregivers of children with AD. The specific aims of this pilot study include:  (1) determine how knowledge about AD in Promotoras changed after the training session; (2) determine how behavioral theory constructs changed in Promotoras after the training session; (3) asses Promotora skill acquisition by conducting a standardized role-play; (4) gather suggestions on how the curriculum could be improved to be more culturally appropriate and (5) gather suggestions on how the training curriculum can provide materials that will be useful for Promotoras when they visit their clients. The results of the study will be used as a guide to improve the training curriculum for other Promotora training sessions.

Community Team
Parkland Health & Hospital System Division of Community Medicine: Janet Scott-Harris, PhD, MA, MBM, RN

Fellow: Neil Murthy
Research Mentor: Tiffany Powell, MD, MPH
(2010)

The purpose of this project was to assess the perceptions on the quality of care and assess the level of satisfaction among health care workers implementing SMAs at Parkland Health and Hospital System’s (PHHS) Community Oriented Primary Care Clinics (COPC).  Views on program efficacy and program structure were collected from SMA team members. In addition, views on quality of care provided to the patients and views on health care satisfaction were assessed from each member of the SMA team. Data was collected using an online survey tool. Results will be used to identify areas of program improvement and ultimately design a more effective SMA format.

Community Team
UT Southwestern Prevention & Intervention Unit: Anne Freeman, MSPH

Fellow: Elisabeth Merrill
Research Mentor: Manjula Julka, MD
(2010)

The purpose of this study was to conduct a community assessment and program evaluation of the Healthy Relationships intervention for HIV positive people. The four (4) specific aims of the study are to determine how the Healthy Relationships intervention and its implementation be improved to maximized by (1) participant confidence in making healthy decisions about HIV status disclosure (2) participant reported self-efficacy around making appropriate disclosure decisions, (3) participant reported self-efficacy around making appropriate sexual behavior decisions and (4) participant reported condom use. Results of this study will be used to improve the existing Healthy Relationships program, increasing relevancy for the target population and refining the curriculum.

Community Team
Irving Childhood Obesity Coalition: Doug Fox, YMCA

Fellow: Kymberly Gonzalez
Research Mentor: Mark DeHaven, PhD
(2009)

FIT (Families in Training) For Health is an on-going family-based childhood obesity program held at a community center led and taught by over 25 medical and allied-health students and faculty. In this study, a medical student evaluated changes in physical activity (PA) and nutrition knowledge, behavior, attitudes, and body mass index (BMI) pre- and post-program among program participants.  Families showed an improvement in nutrition and physical activity attitudes and behaviors.

Community Team
GRACE Outreach Community Clinic : Griselle Estrada, Cheryl Mart, R.N.

Fellow: Bhavini Patel
Research Mentor: Jay Morrow, DVM, MS, MPH
(2009)

Partnering with the GRACE Community Clinic, a medical student evaluated the educational needs of an obese, adult Hispanic population qualifying for free health services at a metropolitan community health center. Health literacy, prevalence of depression, level of physical activity, nutritional habits, patient interest in health education topics related to overweight and obesity and the most effective format for a brief educational intervention were assessed. Results were used to develop an obesity educational intervention program for clinic patients at 200% below poverty level.

Community Team
Wesley Rankin Community Center: Kathy Stutesman, Maria Pintor, Rosemary Hinajosa

Fellow: Allison Peddle
Research Mentors: Patti Pagels, MPAS, PA-C & Tiffany Billmeier, MPH
(2009)

The purpose of this study was to assess the health needs of Latino seniors attending the Wesley Rankin Community Center.  Additional aims focused on determining the prevalence of chronic disease and depression, measuring quality of life and determining health literacy level. These findings were used to determine the curriculum needs for future health education programs at the center.

Community Team
GRACE Outreach Community Clinic : Griselle Estrada, Cheryl Mart, R.N.,

Fellow: Robert Martin
Research Mentor: Mark DeHaven, Ph. D.
(2008)

This project was conducted in collaboration with GRACE Outreach Community Clinic, in order to  examine perception, knowledge, and behaviors related to obesity in Hispanics living in Grapevine, TX, as well as the health care providers that volunteer at the clinic. Acquisition of project data used an ethnographic approach, including interviews and observations. Interviews with patients assessed perceptions, Explanatory Models (EMs) of obesity and overweight and behaviors relating to the management of patient body weight. Additional data assessed how the medical professionals with these patient at the time of the patient’s visit. 

Community Team
Paso del Norte Foundation : Jon Law

Fellow: Marlene Garcia
Research Mentor: Florence J. Dallo, Ph. D., MPH
(2008)

Partnering with Paso del Norte Foundation, a medical student assessed the prevalence of depression in relation to the knowledge and behaviors toward mental health care among Mexican American women in a colonia outside of El Paso, Texas. The study also identified sociodemographic and physical health conditions associated with the prevalence of depression.  A face-to-face questionnaire was administered to a random sample of households in the Montana Vista community.  In addition, patient charts from the Montana Vista Community Partnership Clinic were analyzed to evaluate the number of patients that utilize the clinic for depression.

Community Team
The New Connections Program: Emily West, MSW

Fellow: Kirtan Nautiyal
Research Mentor: Margaret Caughy, Sc. D.
(2008)

A medical student worked with the New Connections Family Intervention program to determine the attitudes, beliefs, behaviors, and knowledge regarding childhood obesity among participating mothers in A short survey was administered to address current parental behavior, attitudes, and beliefs regarding nutrition and exercise involving themselves as well as their children, current parental knowledge of proper nutrition and exercise, and parental attitudes towards learning additional information about proper nutrition and exercise.

Community Team
North Dallas Shared Ministries: Susan Briner, M.D.,

Fellow: Andrea Quintana
Research Mentor: Mark DeHaven, Ph. D.
(2007)

Collaborating with North Dallas Shared Ministries (NDSM), a medical student assessed the patient care-seeking behaviors, perceptions, and health awareness at the NDSM Clinic. The results of the study  improved health care services, understanding, and communication between the NDSM staff and patients.

Community Team
West Dallas Clinic: Anne Hardeman
North Dallas Clinic: Kristin Kaser

Fellow: Suratha Elango
Research Mentor: Nora Gimpel, M.D.,
(2007)

A medical student partnered with the City of Dallas’ West Dallas Clinic and North Dallas Clinic to identify the characteristics of childhood obesity education program participants versus non-program participants. The study results improve the effectiveness of the West Dallas and North Dallas Clinics in childhood obesity education. 

Community Team
Dallas County Health and Human Services: Karine Lancaster

Fellow: Elizabeth Newsom
Research Mentor: Florence J. Dallo, Ph. D., MPH
(2007)

Working with Dallas County Health and Human Services, a medical student assessed the attitudes, perceived barriers, and preferences in regard to immunizations in the Dallas Hispanic community. The results of the study facilitate promoting the immunization program throughout the Dallas Hispanic community.

Community Team
Parkland Community Oriented Primary Care (COPC) Clinics: Brad Walsh, MPH, Renuka Khurana, M.D., MPH,

Fellow: Kalpana Manthiram
Research Mentor: Mark DeHaven, Ph. D., Nora Gimpel, M.D.
(2006)

Working with Parkland’s Community Oriented Primary Care Clinics, a medical student evaluated the clinical effectiveness of Shared Medical Appointments (SMA).  Studies indicated high levels of patient and provider satisfaction with SMAs, although few studies have examined the clinical outcomes of SMAs.  The results of the study showed that many of the clinical outcomes improved following SMA attendance. 

Community Team
Agape Clinic: Charles Kemp, F.N.P.

Fellow: Liz Ramirez
Research Mentors: Mark DeHaven, Ph. D., Nora Gimpel, M.D.
(2006)

Through work with the Agape Clinic, a medical student administered surveys to patients to assess their level of diabetes self-management knowledge.  The results of the study indicated a low level of knowledge regarding diabetes self-management.  In addition, the results of the study were instrumental in developing recommendations for a culturally competent diabetes education program.

Community Team
Mission East Dallas: Danica Simmons, R.N., Jenny Williams, R.N.

Fellow: Nehdia Mumuni

Research Mentors: Mark DeHaven, Ph. D., Nora Gimpel, M.D.
(2006)

A medical student worked with Mission East Dallas, a clinic that provides healthcare to low-income and uninsured patient populations, to describe patients’ understanding of their hypertension and providers’ awareness of their patients’ education needs, in order to develop an effective hypertension patient education and self-management program.  The results of the study implicated that patients’ would like to know more about hypertension and self-management.  In addition, results showed that a development of an effective hypertension patient education program in this clinic would be well received by their patients.

Community Team
Collin County Adult Clinic: Julia Grenier, R.N. Mitzi Yavoski, R.N., Terry Abla, Jerry Weis, Albert Grenier 

Fellow: Sarah Kuykendall
Research Mentor: Mark DeHaven, Ph. D., Nora Gimpel, M.D.
(2006)

Through work with the Collin County Adult Clinic, a medical student examined the prioritization of needs for a free health clinic in a county without a public healthcare system.  The results of the study were instrumental in making connections with the outside medical community, provider education, patient education and increasing quality of patient care. 

A collaborative project was conducted to investigate the strengths and resources of the Agape Clinic in Central Dallas and the Collin County Adult Clinic (CCAC) both serving a low-income Hispanic patient population. Agape uses a Promotora (lay health promoter) program and CCAC relies on a system of educating patients using the services of a volunteer certified diabetes educator. An assessment was conducted describing the structure, strengths, and effectiveness of these alternative approaches to managing the needs of patients with diabetes.

These data will be used to guide the development of a collaborative approach applying the strengths of the Promotora model with the diabetes educator model. The desired outcome was the development of a program for establishing linkages between the two clinics, in a way that will enhance understanding of the most efficient and effective means for improving patient outcomes.

Community Team
The Dallas Concilio: Silvia Gallegos, Monica Lugo
GRACE: Cheryl Mart, R.N., B.S.N., Pat Frosch
Mission East Dallas: Danica Simmons, R.N.

Fellow: Juan Olivares
Research Mentor: Nora Gimpel, M.D.
(2005)

The Dallas Concilio addresses the goal of reducing the incidence and complications of diabetes in Hispanics by providing diabetes awareness presentations, presenting a chronic disease management program titled "Viviendo con la Diabetes" (Living with Diabetes), and offering support groups. A comprehensive study was developed for assessing the effectiveness of the Dallas Concilio's program. Three components were examined: 1) structure and content of the "Vivendo con la Diabetes" program, 2) two separate case studies in clinic(s) where the program has been offered, and 3) a summary qualitative assessment of the program's effectiveness based on the results of the case study(s) performed in one of the Dallas Metroplex free clinics.

Community Team
Parkland Health & Hospital System Community Oriented Primary Clinics (COPC)
Angelique Ramirez, M.D. and Jaquelne Stephens, Ph.D.

Fellow: Cindy Chavez
Research Mentor: Mark DeHaven, Ph.D.
(2005)

The Parkland COPC seeks to improve primary and preventive care delivery among pediatric patients seeking care in their eight community-based clinics. A study was developed to gather data from pediatric caregivers using the "Promoting Healthy Development Survey," developed by the National Initiative for Children's Healthcare Quality. This project provided information for redesigning pediatric preventive care delivery in the Parkland COPC system, from the health promotion perspective.

Community Team
Agape Clinic, Dallas: Charles Kemp

Fellow: Miguel Terrazas
Research Mentor: Mark DeHaven, Ph.D.
(2004)

At the Agape Clinic in Dallas, a medical student conducted interviews to assess the barriers that both patients and providers face in receiving care, specifically diabetes care, in a free clinic with a unique indigent Latino population. The results of the study were instrumental in the implementation of a Promotores de Salud Program in increasing health education for the patients.

Community Team
Church Health Center, Memphis: Teresa Cutts, Ph.D.

Fellow: Kimbell Kornu
Research Mentor: Mark DeHaven, Ph.D.
(2004)

Working with a multi-dimensional, non-profit, faith-based clinic in Memphis, TN, Church Health Center, a medical student conducted a qualitative study to identify Church Health Center's community health assets, determine the perceived level of integration among the assets, and develop the best means for combining them in an effort to build stronger partnerships for a healthier community. Several conclusions and recommendations were developed based on the study results that will aid the leaders in clearly formulating a common vision across ministries and the community.

Community Team
Parkland Health & Hospital System Community Oriented Primary Clinics (COPC): Linda Galindo, Ph.D.

Fellow: Stephanie Van Rooy
Research Mentors: Mark DeHaven, Ph.D.; Nora Gimpel, M.D.
(2004)

Working with the DeHaro Salvidar Community Oriented Primary Care Health Center, a medical student evaluated the effectiveness of the diabetes educational program, specifically the stress-management class. The study identified the major stressors faced by the Latino diabetic population and the ways in which the program could be improved to better target the Latino population it serves.

Community Team
UT Southwestern Medical Center

Fellow: Erica Ruger
Research Mentor: Ronald Victor, M.D.
(2003)

Working with the UTSW Community Prevention and Intervention Unit: Division of Hypertension, a medical student studied the health and behavioral effects of a barbershop-based intervention on hypertensive African-American men. The intervention significantly impacted awareness, treatment, and control of hypertension in this high-risk population. The student presented her project orally at the 42nd Annual UTSW Medical Student Research Forum.

Community Team
The Islamic Association of North Texas Clinic

Fellow: Osamah Saeedi
Research Mentor: Amer Shakil, M.D.
(2003)

At the Islamic Association of North Texas Clinic, a medical student developed and translated surveys to assess baseline knowledge of diabetes and hypertension in a predominantly South Asian community. The results helped clarify what information should be emphasized in patient education programs for diabetes and hypertension.

Community Team
Parkland Health & Hospital System

Fellow: Edward Schiller
Research Mentor: David Faris, M.D.
(2003)

Through the Parkland Health and Hospital System, the student conducted telephone surveys to measure the short-term and long-term effectiveness of Parkland's QuitSmart smoking cessation program. Other factors affecting the patients' success rates were also analyzed to determine their relative importance to the program.

Community Team
UT Southwestern Medical Center
Secretary of Health, Oportunidades Program, Chihuahua, Mexico

Fellow: Tariq Ibrahim
Research Mentors: Mark DeHaven, Ph.D.,  James Walton, D.O.
(2003)

At community-based health care clinics in NC, TX, TN, and Mexico, the student administered questionnaires to examine the use of preventive medicine services and the effect of biological, psychological, sociological, and spiritual factors on care delivery. This descriptive study helped evaluate the association between preventive care delivery and care providers' beliefs.