SLU Center for Cancer Prevention, Research and Outreach (CCPRO)

Ibrahim Khalifa AbukendaPractice Experience Dates: April, 2015 – July,

2015SLU Center for Cancer Prevention, Research

and Outreach (CCPRO)• The CCPRO was set up to address cancer disparities in the

St. Louis region specifically focusing on Head & Neck Cancers, Prostate Cancer & Breast Cancer.

• The Center seeks to address disparities through development of clinical and community networks, outreach activities and education, and research activities.

• CCPRO is collaboration between the Saint Louis University Cancer Center (SLUCC) and College for Public Health & Social Justice.

• The outreach program is multifaceted and includes opportunities for one on one interaction with community members as well as conducting community events. At these events CCPRO provides information on cancer and screening for Head & Neck Cancer and Prostate Cancer.

My Role in CCPRO• Research for prostate cancer screening protocol updates

• Health educator at prostate cancer screening health fair

• Evaluation data collection, entry, analysis, and reporting

My Project• Work collaboratively with CCPRO to empower

underserved population in North St. Louis City and County by providing tools and resources that identify and address cancer disparities with primary focus on prostate cancer.

• Process evaluation of CCPRO screening program objectives and activities.

Public Health Context• Prostate cancer is the most commonly

diagnosed cancer and the 2nd leading cause of death in men.

• On average, more men in St. Louis have prostate cancer than in other areas of Missouri and the nation.

• In 2012 the United States Preventative Services Task Force (USPSTF) recommended that mass screening for prostate cancer in all men be stopped because the harms of screening like the dangers from a biopsy and overtreatment are more than the benefits.

• Other groups like the American Society of Clinical Oncology and the American Urological Association believe that screening is needed in some cases, especially for men at high risk for prostate cancer.

• This controversy create a confusion status among elderly men toward making a decision taking the screening teat or refusing it.

• We at CCPRO working to provide our targeted audience (men under risk) with tools and resources, throughout outreach education program, to help men making informed decision about wither taking or refusing prostate cancer screening.

My Activities• Community outreach activities: I was worked as a health

educator by providing education for our targeted audience about Prostate Cancer. The education will include information about the updated screening protocols and to clarify the controversy about the process of screening and its consequences in order to insure that patients will take an informal decision about their prostate screening.

• Assist with data collection and management: collect data from community members participating in the outreach activities as well as aid in the analysis, interpretation and reporting of evaluation findings.

Practice Experience Progress and Challenges

• Conducting health education for underserved population in North St. Louis through a multiple community based health fair events.

• Involving about 100 men in the process of CCPRO prostate cancer screening program evaluation.

• Pretest survey data entry for more than 100 participants

• Conducting literature review about basic principals of community basis screening for head and neck cancer

Competencies AchievedMPH 7: Utilize appropriate communication strategies to

educate, disseminate, and advocate for health services and preventive interventions

– I reviewed multiple documents regarding public mass education and utilize CCPRO guideline to help me communicating and educating our target audience.

BSHE 2: Examine risk factors and determinants of specific health threats at multiple ecological levels.– I was also contributed to the process of head& neck cancer

screening which was a part of CCPRO programs. I helped during these events to identify people under risk (e.g., smokers, radiation exposure, family history, etc.) and explain to them the importance of the screening and encourage them to participate.

BSHE 7: Conduct evaluations (process, impact, and outcome) of public health related interventions using multiple methods.

– I was directly involved in process evaluation of CCPRO prostate cancer screening program. I was responsible for delivering education message (The intervention) to our participants after they completed pretest survey. Also I was responsible for sorting, entering, and saving pretest data into our server.

EPI 5: Critically analyze the epidemiologic literature.

– I researched and reported many articles about incidence, prevalence, morality and morbidity rates, and risk factors of different cancers within CCPRO area of interest.

BELIZE 2020Jessica Buck

May 2015 – August 2015

BELIZE 2020• Organization created through a partnership

among St. Louis University, St. Martin de Porres Parish and the Jesuit Central and Southern Province

• Belize 2020 works to improve the economic, education and health conditions of families in Belize City

• The Health Initiative seeks to understand problems related to physical or mental health that are barriers to educational achievement for the students at St. Martin’s de Porres School

MY PROJECT• Work with Belize 2020 partners to gain a

better understanding of the barriers of success at St. Martin’s de Porres School

• Disseminate information to stakeholders so that the wider Belize 2020 community is aware of problems at St. Martins

• Assist in the recommendation of future programming at St. Martins that addresses the problems identified through research

MY ROLE AS HEALTH INITIATIVE INTERN• Develop a coding system for the students• Conduct nutrition assessments on all students enrolled

at St. Martin de Porres School• Conduct PTSD assessments on all students in

grades Standard 3- Standard 6• Score the PTSD assessments based on provided

scoring sheet to determine diagnostic information• Compile and analyze all the data from the

PTSD assessments• Report findings to the U.S. Belize 2020 team via

written reports and presentations

PUBLIC HEALTH CONTEXT• Nutrition can greatly affect how students perform

in the classroom. Due to the poverty in Belize City, it is believed that St. Martin’s students are not getting adequate, nutritious meals

• A traumatic event can seriously interrupt learning.Students suffering from PTSD are more likely to have problems concentrating and display more disruptive behavior in the classroom.

• Traumatized students have been shown to have lower grades, more negative reports from their teachers and more reported absences compared to their peers.

• Belize City is home to numerous gangs and violent crime (shooting, stabbing, armed robbery, etc.) has been a serious problem over the last decade

• Our data shows that 20% of students may be currently experiencing PTSD and 26% may be experiencing partial PTSD

• 59% of students at St. Martin de Porres reported having experienced Gang Violence going on around them

ACTIVITIES1. Nutrition Assessment

• All students enrolled at St. Martin de Porres

• Used Anthro Plus and WHO standards of malnourishment

2. Post Traumatic Stress Disorder (PTSD) Assessment• Students in Standard 3-Standard

6• UCLA PTSD Assessment tool used

PROGRESS AND CHALLENGES1. In a very limited time span, we were able to

complete 544 nutrition assessments and 281 PTSD assessments

2. Final data showed a need for further research and future programming

3. Working cross-culturally has its challenges, but working cross-culturally with children has a unique set of challenges. I found that it is crucial to learn and understand certain parts of everyday life (slang, social norms, etc.) in order to properly communicate and gain trust among young target populations.

COMPETENCIES ACHIEVED1. MCH 3: Use data to identify issues related to

the health status of an MCH population• I analyzed quantitative and qualitative data that

assessed the physical and mental health of the students and was able to make recommendations for next steps based on the data.

2. MPH 4: Participate in multidisciplinary partnerships and coalitions as both a leader and a participant• I worked with Belize 2020, which was built on multi-

disciplinary partnerships. Through interacting with these partners, I learned about how collaboration, specifically international collaboration, works and the challenges involved.

3. GLOH 7: Utilize appropriate cultural competency and communication skills via a mentored global health practice experience in a developing country• Through the distribution of PTSD assessments, I

learned about how to learn and utilize cultural appropriate communication skills.

St. Louis County Department of Public Health Communicable Disease Control Services

Megan CopseyMay, 2015 – August, 2015

Communicable Disease ControlServices

• Services cover immunizations, outbreak control, sexually transmitted disease services, HIV testing and counseling, travelers information, safe food handling

• North Hanley Campus built in 2012 which serves as main administrative headquarters and as a clinic

• Provides primary health and prevention services to the county

My RoleWork with STD Program

• Work with monthly data• Work with electronic health records

Work with CDCS Epidemiologists• Surveillance activities• Use access/websurv/excel

Projects• Monthly STD Reports• Heat Surveillance• Rabbit Fever Exercise• STLProtectYours.org Marketing• Grand Rounds• EHR Report• Ebola Preparedness Activities Form• Accreditation forms• STD Testing Flow Sheets• HIV Planning Council Meetings

Public Health Context1. Assessment:

• Looking at data and creating reports

• Identifying trends in prevalence of disease within the county and effectively communicating those findings

2. Assurance:• Heat surveillance

• Ensuring that those exposed are receiving care and future prevention interventions

• Departmental and regional meetings

• Ensuring communication between jurisdictions, as diseases know no border

3. Policy Development:• Ebola Preparedness Activities Grant

• Applying for funds to ensure county preparedness for an infectious disease outbreak by planning simulation activities and exercises for a variety of community stakeholders

• STD Testing Flow Sheets

• Ensuring clinic procedures and appropriate billing for STD labs

Activities• Attend meetings• Make reports using Excel and Access

• Watch webinars that cover a wide variety of public health and local health department topics

• Assist with projects such as accreditation, marketing proposals, STD testing flow sheets, organizing the Emergency Preparedness “Cage”, etc.

Practice Experience Progress and Challenges

• EHR Report required entering in provider paper copies: This was not the most efficient process, but was important in order to disseminate data about labs sent to Quest – It ended up serving as a QI project as well because errors in data reporting were observed

• Three monthly STD reports were created and disseminated on the DPH website – learning the best way to describe the data took time and feedback so that the wording was clear and concise

Competencies AchievedEpi 4: The health department uses Websurv to compile

data from multiple data collection sources in the county, which is then used to create different reports within the department of health. I used this data to create tables, graphs, and a narrative for monthly STD rates.

MPH 2: I observed an Eastern District Epi meeting.Epidemiologists from surrounding counties gave a brief report of the infectious diseases that were reported since their last meeting. Shigella was a problem for multiple counties. The group discussed determinants of health relating to the outbreak – the biological and environmental factors that make it so easy for Shigella to spread.

EOH 4: I participated in a Rabbit Fever Exercise, which was a disease outbreak simulation. In the exercise, the disease was tularemia and a high school was used for antibiotic dispensing. The throughput was measured based on traditional forms and electronic forms. It was a good way to mitigate risk by having different stakeholders involved and ensuring that current emergency preparedness protocols are effective.

PredisanJanine Foggia

Practice Experience Dates: June, 2015 – July, 2015

Predisan• Vision: As a Christian organization our vision

is to see people experience wholeness: physical, spiritual, social, economic and environmental health according to God’s redemptive plan.

• A nonprofit organization serving individuals throughout the Catacamas and Culmi regions of Honduras through three primary ministries:• Healthcare

• Spiritual Outreach• Community Development

Project• Assist La Clínica Materno Infantil (CMI) with

assessing needs related to the promotion of institutional births in the region

• Address the absence of health promotion and health education materials regarding the CMI and healthy pregnancies

Role on Project• Research items related to institutional births• Develop a survey and data collection tool to measure items related to:

• knowledge, attitudes, and perceptions surrounding pregnancy and birth• personal pregnancy and birth experiences

• Create informational items to promote the CMI and maternal home throughout the service region

• Improve health literacy through the development of various health education handouts aimed at increasing health knowledge surrounding various topics

Public Health Context• Reducing maternal and infant mortality has been, and continues to be, on the

public health agenda as Millennium Development Goals 4 (reduce child mortality)& 5 (improve maternal health) draw attention to these public health issues.

• The maternal mortality rate in Honduras is 100 maternal deaths per 100,000 live births and the infant mortality rate is 23 infant deaths per 1,000 live births.

• Predisan, in working with the Honduran Ministry of Health, has been charged with reaching the following goals aimed at reducing maternal morbidity and mortality:• 80% of pregnant women will receive their first prenatal care visit within the

first 12 weeks of their pregnancy

• 95% of pregnant women will receive at least 5 prenatal care visits

• 85% of pregnant women will experience an institutional birth

• 80% of women will receive their postpartum visit within the first 7 days after giving birth

• Understanding barriers and facilitators surrounding institutional births and healthy pregnancies will help target future efforts aimed at achieving these goals.

Activities• Create a survey for the CMI• Develop promotional items for the CMI

• Produce health education materials for both the CMI and CESAMO Clinic

Practice Experience Progress and Challenges

• Working to promote institutional births encompasses all levels of the social ecological model. This can prove difficult when working in a resource limited setting. The developed survey will help assess which levels of the model are high priority and identify where the work of the CMI should be targeted.

• Being a public health professional amongst medical workers proved to be challenging at times, but it allowed me to be an advocate for the field.

• In designing the survey it was brought to attention that while much information is pertinent there are often limitations, such as resources and personnel, in gathering the data. Therefore, it is important to understand the difference between data that would be nice to know versus need to know data. In collaborating with my supervisor the most pertinent data was identified and survey was scaled back from its original draft.

Competencies Achieved1. GLOH 1: Assess major forces that influence the health of

vulnerable populations from a global perspective.

• Designed and developed a survey tool to assist in analyzing indicators and barriers related to institutional births from the women’s perspective

• Developed a survey tool to assess from the health promotors’ perspective barriers and facilitators to institutionalizing births

• Interviewed women in remote communities and the maternal home regarding their decisions and influencing factors surrounding institutional births

2. MCH 3: Use data to identify issues related to the health status of an MCH population.

• Analyzed results of the health promotors’ survey and responses from the women’s interview

• Developed a data tracking tool to assist in analyzing results of the women’s survey

3. MPH 7: Utilize appropriate communication strategies to educate, disseminate, and advocate for health services and preventive interventions

• Developed promotional items aimed at increasing awareness of the CMI and maternal home

• Created educational items to increase health knowledge

• Constructed a mural to educate about the importance of institutional births

Culmi Predisan Staff

Health Clinic

Maternal Home Giving A Health Presentation

WASHINGTON UNIVERSITY, INSTITUTE FOR PUBLIC HEALTH DEPARTMENT OF SURGERY

Yismaw D HailegiorgisJuly 01, 2015 to August 10, 2015

Washington University Institute for Public Health

Mission

The mission for public health at Washington University includes five objectives:• To generate distinctive transdisciplinary research discoveries and service

interventions that address significant community and population health problems• To train a cadre of leaders who have an evidence-based approach to public

health interventions, health services and health policy• To educate the next generation of academic leaders in community &

population health• To eliminate health disparities and improve measurable health outcomes

through sustained community and organizational partnerships• To significantly influence the development of sound public health policy

Role in Organization/Project• Participate in making sure that the survey questionnaires are culturally competent• Participate in research writing, presentation and abstract submission for publication• Data analysis using statistical software; SAS, SPSS• Data management and keep confidentiality of participants information• Writing research paper based on the results from the analysis• Keep the standard and quality of research papers on progress for publication• Facilitate and attend team meetings• Communicate results of study to the research coordinator and team leader/ PI

ProjectProstate Cancer research: identifying the role of nutrition, genetics, environmental and epigenetic factors

The research has focused on identifying preventive strategies to reduce cancer disparities.

The objectives of her research program are:

• to identify the modifiable and non-modifiable risk factors for cancer as well as the at-risk groups for these factors;

• to use community-based approaches to design, implement & disseminate research information;

• to promote education and awareness of research and research participation in minority communities.

Public Health Context• Statistics indicated that 60 % of prostate

cancer cases are diagnosed in men older than 65 year, and 97 % occur in men 50 and older.

• The disease is common in North America and northwestern Europe, but less common in Africa, Asia and South America.

• Globally, nearly 1 million new cases being diagnosed among men each year, of which, about one-third cases are fatal, and that accounts for 10% of all new cancer cases in men.

• In 2013, CDC and American census bureau estimated 34,430 African Americans will be newly diagnosed with the disease that was 37% of all cancer cases diagnosed in this group.

Activities• Population based survey questionnaire

development• Literature review• Data clean up and analysis: data collected

from the study population selected from Saint Louis area

• Writing research paper based on the results from the analysis

• Communicate progress of the project with team members

• Attending team meetings• Communicate results of the study to the

research coordinator and team leader/ primary investigator

Practice Experience Progress and Challenges

• Formal communication in research environment

• Working with community partners and clinicians

• Self-initiatives to keep the networking and communication for the research projects

• Cohort studies are difficult to keep participants for long period of time

• Data access and ethical issues

Competencies Achieved

• Developed skills to communicate with stakeholders and partners

• Statistical software experience through real world practice and working with experts in the field

• Professionalism, attendance, respect and team work

• Facilitation of stakeholders meeting on different health topics

St. Louis College of PharmacyCarlin Harp

Practice Experience Dates: June 2015 - August 2015

Office of Emergency Management &

Environmental Health & Safety

The College of Pharmacy works very closely with all other entities on the Washington University Medical Campus in the Central West End

My ProjectI took a leadership role in development of the electronic Student Health Report and the CDOC Policy and the STLCOP Community Emergency Response Team

Projects

• Spearheaded the development of a Communicable Disease Outbreak Control Policy

• Assisted in making an electronic version of a Student Health Report

Public Health Context• Helping organize and create the

inaugural STLCOP Community Emergency Response Team helped better prepare the entire Medical Campus with a new asset in Emergency Preparedness.

• Working on all the policies and with the CERT Members developed new networks among the different departments at the College of Pharmacy.

• Sat in on meetings with individuals from all different departments and offices at the College of Pharmacy to create a more cohesive response in a large-scale event.

Activities• CERT development

• Point of Dispensing training

• Policy research and development

Practice Experience Progress and Challenges

• STLCOP is much closer to having an electronic database of student immunization records

• A new policy for controlling the spread of disease was developed.

• Breaking down the long, accepted culture of poor practice was a challenge.

Competencies Achieved• MPH 4: Participate in multidisciplinary partnerships and

coalitions as both a leader and participant: I participated in developing a CERT team at the College of Pharmacy that can be used by any organization on the WUMC.

• EPI 4: Use data to describe the health of populations: When I arrived at STLCOP to begin my internship, I realized that the college had no data available for analyzing immunization records of the students. In developing a revised Student Health Report, the data is now stored electronically and can be analyzed for future classes.

• BSDP 1: Analyze qualitative and quantitative data to accurately identify biological and other health hazards and measure risks, using epidemiological, statistical, and risk assessment methods and tools: I was tasked with completing the compilation of the data of the Hazard Vulnerability Assessment of the College of Pharmacy and comparing the data with other organizations on the WUMC.

Washington University – St. Louis, School of MedicineXinliang Huang

Practice Experience Dates: April, 2015 – August, 2015

Division of Public Health Sciences, Department of Surgery, WUMS

• The Washington University Department of Surgery is one of the nation's leading academic surgery departments.

• They provide excellent patient care, and are devoted to advancing basic science and clinical research.

• Their surgeons for patients are at Barnes-Jewish Hospital and St. Louis Children’s Hospital.

• Their training for general, thoracic, plastic and reconstructive, and urologic surgery plays a leading role across the states.

My Project• Understand the background of Venous

Thromboembolism (VTE) and Breast Surgery

• Discuss with preceptor about the misclassification of disease (VTE) based on the previous dataset

• Write Code by using R programming (R studio) to build 2 by 2 table and calculate the odds ratio (OR)

• Address the epidemiological and biostatistical meaning from the results

My ProjectEpidemiological and Biostatistical Intern

• Figure out the method to perform bias analysis based on the bias parameters and the dataset about exposure and disease (VTE)

• Write code to build 2 by 2 table between exposure and disease (VTE), to perform each part of bias analysis

• Organize the results and summarize the findings

• Discuss the application of this method into other dataset for the future

Public Health Context• Venous thromboembolism (VTE), including

deep venous thrombosis (DVT) or pulmonary embolism (PE), is a serious but largely preventable condition that has been associated with certain disease states or interventions, including malignancy, medications, or surgery.

• Effect measures obtained from observational research as susceptible to errors arising from chance, confounding and bias, including measurement error.

• The invalidity of the analysis for datasets will bring various issues into following procedures, such as, treatment performing, decision making, intervention designing and etc.

• Bias analysis becomes very important for various analysis of observational data sets instead of ignoring residual systematic error in epidemiologic research.

My Activities• Read literature to understand information related to

the project, and methodology to analyze the data• Analyze the dataset by coding with R language• Weekly meeting to debug the code and do the

troubleshooting for each part of analysis.• Organize the results and discuss how this method

applies on other dataset in the future

Practice Experience Progress and Challenges

• Various literatures were reviewed.

• Several bias analysis were conducted and finished.

• Learning R language from zero to professional is a great challenge to me. With the help of preceptor, I overcome various problems and have a great understanding of bias analysis and how R is utilized into this analysis and what role R plays in this project.

Competencies Achieved MPH3: Describe the approaches to disease prevention and control using tools from the five core areas of public health

• I reviewed literature on the methods related to the project.

MPH5: Appropriately utilize qualitative and quantitative data in order to effectively address public health problems• I looked over the dataset and understood the

meaning of each variable is pretty important as well, and it took me a while to figure out how to put these variables into our project.

BST 2: Compute descriptive and multivariate statistical tests and measures of association using statistical software, e.g., SPSS, Excel, SAS & R.• I learned and used R to analyze dataset.

BST 3: Interpret results of statistical analysis.• I attended regular research meeting to discuss

the interpretation of statistical results with my preceptor.

Seniors Count Initiative of Greater St. LouisElaina Murray

Practice Experience Dates: April 17th, 2015 – August 15th, 2015

Seniors Count Initiative The Seniors Count Initiative is a new community effort to help improve the

health, nutrition, and quality of life of people who are 60 years of age or older in the St. Louis metropolitan region.

Data Analyst Intern• Participate in analysis of survey

data computing descriptive and multivariate statistical tests and measures of association.

• Review available literature and validated survey questions.

• Contribute to needs assessment by designing and conducting a web- based cross-sectional survey of providers.

• Review and participate in the quality assurance of data and documents.

My Project• Work as part of a team of professionals who work in

public health, research and aging services and be supervised by the Seniors Count Program manager.

• Gain valuable public health work experience on important initiatives while adding value to the region by developing, administering, analyzing, and interpreting results of a cross-sectional study of local senior service providers in St. Louis City St. Louis County, and St. Charles County (i.e. metropolitan St. Louis region).

Public Health Context• The older population of the U.S. has increased from

25.7 million in 1980 to 40 million today, and is expected to increase to 72 million by the year 2030.According to the 2012 ACS, the number of older citizens in the St. Louis region is also growing.

• One of the greatest concerns is the growing economic insecurity felt by seniors living on a fixed income. The effects of a life of long-term poverty on this age group appear to accelerate the challenges of aging.

• Lack of affordable access to transportation, health care and housing are great concerns for many independent- living seniors in the St. Louis region.My Activities

• Worked as part of a team of professionals who work in public health, research and aging services

• Developed and administered web- based cross-sectional survey to senior service providers.

• Analyzed survey data, create descriptive figures, and assist in writing a final project manuscript.

Practice Experience Progress and Challenges

1. A survey of senior service provider was created and disseminated to providers.

2. Survey data was analyzed, and descriptive figures were created.

3. Assisted in the writing a final project manuscript.

Competencies Achieved1. BSHE 7: Conduct evaluations (process, impact, and outcome) of public health related interventions using multiple methods.

• I conducted a formative evaluation, which entailed us piloting the needs assessment survey to a select number of testers and integrating recommendations for survey improvement and ease into our final version.

• I conducted a process evaluation to monitor how many respondents we were getting. Additionally, we collected and analyzed data on how many respondents had fully completed the survey, from which counties, and what types of organizations they were from to inform further recruitment.

2.EPI 4: Use data to describe the health of populations

• An initial literature review was completed in order to enable me to understand and communicate the changing “shift in demographics” related to seniors at both the national and local levels; as needed for disseminating the survey and survey purpose to senior service providers.

3.HMP 4: Management: Effectively work with people and develop teams to achieve goals.

• I was required to give periodic ‘status updates’ to my preceptor and the project partners, in addition to collaborating on study design, reporting, and manuscript writing.

Division of Public Health SciencesWashington University School of Medicine in St. Louis

Yiqin PeiPractice Experience Dates: April, 2015 – August, 2015

Washington University School of Medicine in St. Louis

• It is located in St. Louis, Mo, is the medical school of Washington University in St. Louis on the eastern border of Forest Park in St. Louis

• It is currently ranked 6th for research and has been ranked as high as 2nd in 2003 and 2004.

• It has been listed among the top ten medical schools since rankings were first published in 1987

My Project• My project is based on a previous

research aims to examine the impact of breast reconstruction on VTE incidence in patients undergoing breast operations.

• Define parameter for bias analysis on this project and assess how these bias parameter will affect the impact

My RoleData Analyst Intern

• Review literature to understand overall bias analysis model.

• Review literature to define bias parameter for misclassifed exposure

• Master the bias analysis for misclassified exposure.

• To use R to code these methods and test these methods.

• General tables and reports• Write up methods and results part

Public Health Context• VTE is a disease that includes both

deep vein thrombosis (DVT) and pulmonary embolism (PE)

• VTE is a common, lethal disorder that affects hospitalized and non hospitalized patients, recurs frequently

• Cancer and its treatments are well- recognized risk factors for venous thromboembolism (VTE)

• Missclasification on exposure causes the relative risk or ods ratio of disease associated with the exposure in the population be biased toward the null value

Activities• Compute descriptive tests using R on the

NSQIP DATABASE• Review literature about Venous

Thromboembolism and breast cancer reconstruction

• Attend weekly meetings, lead discussion.

• Interpret result, report graph• Write up results and methods

Practice Experience Progress and Challenges

1. Bias parameter for misclassfied exposure was idenfified.

2. Methods and results part of an methodology paper was written

3. When doing the internship, one of the challenges is I have not learn R before the internship and it is somhow challenging to learn R from very begining by myself

4. It is somehow hard to define bias paramter because it is selected based on selection strategy

Competencies Achieved1. BST 2: Compute descriptive and

multivariate statistical tests and measures of association using statistical software, e.g., SPSS, Excel, SAS & R.

Compute descriptive tests using R on the NSQIP DATABASE

2. MPH 2: Recognize the ecological nature of determinants of health. Review literature about VenousThromboembolism and breast cancer reconstruction.

3. BST3： Interpret results of statistical analyses.

Interpret result, summary result and report graph

Assessment Methods and Results: The Impact of On-Campus Living on Student Outcomes

Betelihem B. ToboPractice Experience Dates: August, 2014 – June, 2015

Description of Organization Saint Louis University’s Division of Student Development partners with other University departments and students to assist them in

their personal growth and development using formal and informal learning or educational experiences. One of the departments with which it partners is the Department of Housing and Residence Life whose mission is to provide a safe and inclusive educational living environment that fosters student learning and holistic development via programming.

Role in OrganizationI served as the assessment coordinator and assistant to the leadership team for all assessment planning and implementation of assessment strategies, including generating assessment questions, designing analytic strategies, collecting data , data, managing analyzing data, interpreting results, and generating reports.

ProjectOverall goals:

• Design and implement various assessment methods to evaluate the goals and objectives set by the Department of Housing and Residence Life (HRL)

• Design and implement various assessment methods to evaluate student learning outcomes and needs set by the Residential Curriculum that was produced by HRL

• Design and implement various assessment methods to evaluate student learning and development set by both the Division of Student Development and HRL

• Cross-collaborate between professional staff, student staff, and other University departments, when appropriate and needed

Public Health Context• Early adoption of healthy lifestyles can help ensure a healthy

and productive adult population; yet, only about 25-30% of college students exhibit healthy behaviors.

• It has been reported that college students who follow public health recommendations for healthy lifestyle behaviors tend to have higher grade point averages, after adjusting for socio- demographic and negative health behaviors (Wald et al., 2014).

• It has been shown that healthy behavior is associated with higher academic performance; with students who adhere to public health recommendations for healthy lifestyles having higher academic performance.

• With this association, identification and follow-up on problem behaviors are paramount.

• Data collected in the context of HRL were used to screen students who did not engage in healthy behaviors.

• Improving health promotion behaviors may have a large impact on the future well-being of college students.

• Educators, public health professionals, and policy makers may consider allocating resources to promote healthy lifestyles among college students. This might help improve productivity in the country as a whole and reduce health disparities.

Activities• Collaborate with professional staff and

students to collect data on student learning and outcomes as well as on departmental objectives, programs, and goals

• Provide general direction and support for department assessment

• Coordinate, collect, and analyze assessment data via benchmarking, national and campus surveys, and other appropriate methods

• Collaborate with campus partners, committees, and other groups to provide training

Practice Experience Progress and Challenges

The biggest roadblocks I faced had nothing to do with data analysis as I thought. Instead the following summarize my challenges:• Data management activities – I discovered the long

and tedious of a process it entails, especially in the context of pre-existing data without detailed enough codebooks recording justification for what was done.

• Organizational politics – in the context of business (even centered around health), performance management is not always evidence-based, making my efforts seem fruitless.

Competencies Achieved• MPH 4: Participate in multidisciplinary partnerships

and coalitions as both a leader and participant

> I learned how to engage various stakeholders to acquire important information about approaching assessment strategies.

• MPH 8: Apply principles of management in program, organizational, and community initiatives

> I learned how to utilize foundational documents set by the organization to guide the development of an assessment plan.

• EPI 1: Develop appropriate study designs and analytical strategies to test epidemiologic hypotheses

> I learned how to develop an analytic plan at the population, sub-population, and organizational levels

• EPI 2: Accurately interpret epidemiologic data

> I learned how to interpret and extrapolate health implications from behavioral lifestyle traits among student populations

• BST 4: Communicate results of statistical analyses

> I generated multiple reports to communicate methods and results

TrailnetStephanie Tokarz

Practice Experience Dates: March 2015 − August 2015

About Trailnet• Trailnet is a not-for-profit in the St.

Louis area that fosters healthy, active and vibrant communities where walking, bicycling, and use of public transit are a way of life.

• While programming, planning, and policy work have been the main vehicles to achieve this mission, Trailnet is now looking toward advocacy to become even more relevant.

My Projects• Organization-wide impact

evaluation• Connecting the Cities• Neighborhood

Greenways STL

My Role• Spearhead the development of an overall

evaluation plan with corresponding tools as a way for the entire organization to report out needed information quickly and efficiently for annual reports, grants, etc.

• Attend various conferences and meetings as a representative of Trailnet, in both an active and supporting role.

• Provide support on the assessment and implementation of various projects under the Director of Strategic Initiatives.

Competencies Achieved

• MPH 4: Participate in multidisciplinary partnerships and coalitions as both a leader and participant• I was fortunate enough to be able to attend multiple

conferences and coalition meetings in the St. Louis area and form relationships with other organizations.

• BSHE 5: Collaborate to implement public health related programs, policies, and environmental changes.• My work with Connecting the Cities allowed me to

complete community assessments and help to develop an implementation plan.

• BSHE 7: Conduct evaluations (process, impact, and outcome) of public health related interventions using multiple methods.• I developed a large scale evaluation plan for the

entire organization, which was, at times, different than the program evaluation we learned in class.

Activities• Develop an

organizational evaluation plan

• Collect data on various projects within the organization

• Attend conferences and coalition meetings on behalf of Trailnet

• Assist Jennifer Allen, Director of Strategic Initiatives, in various tasks such as planning future trips and the staff retreat

Public Health Context• Evaluation plans help organizations

determine how they can best impact the community that they serve.

• Both the Connecting the Cities and Neighborhood Greenways STL projects have conducted community assessments through data acquisition and engagement of community members, which is a vital step in implementing health programs.

• Through the built environment, Trailnet is affecting change from the highest level of the Social Ecological Model.

Progress• Working with people of various

experience and education levels to help implement projects.

• Being able to apply evaluation skills learned in class.

• Participating in the daily workings of a not-for-profit organization and the challenges associated.

Challenges• The crossover from the classroom to

the real world can get very frustrating. At times, the evaluation project felt too big and too messy to be able to complete; but, with the guidance of staff I was able to leave Trailnet with a functional evaluation plan.

Environmental Health, Pandemic Preparedness, and Catastrophic Response Internship at NACCHO

Mary WakefieldJune-August 2015

The OrganizationNACCHO is a national association representing 2,800 local health departments across the US. NACCHO’s vision is health, equity, and security for all people in their communities through public health policies and services. NACCHO’s mission is to be a leader, partner, catalyst, and voice for local health departments in order to ensure the conditions that promote health and equity, combat disease, and improve the quality and length of all lives.

My RoleProviding support to the EH-Pan/Cat team by performing research, creating deliverables, participating in exercises, assisting in evaluations, developing projects, and writing reports, blog content, and other training and exercise materials.

The 2015 Scripted Surge- Pandemic Influenza Vaccine Administration at Pharmacies

ExerciseIn July, 2015 I travelled with NACCHO staff to act as a Staff-Controller during this exercise. Prior to the exercise I developed actor scripts, training materials, forms, documents, and assembled packets for use during the exercise.During the exercise I managed the actor volunteers, provided direction and training, pulsed them into the exercise, distributed materials, and tracked necessary data related to throughput.Following the exercise I collected and organized evaluation data and developed the evaluation summary. I also assisted with the preparation for a second exercise in late August, 2015.

Public Health ContextPandemic preparedness and strengthening the partnerships

between local health departments, national and federal organizations, private partners, non-profit organizations, and the public are critical to public health.

Designing and executing exercises, as well as completing evaluations, after action reports, and summaries assist in developing policies, programs, and best practice recommendations that increase disaster and biological event preparedness.

This internship also helped increase understanding of the ways that different concentrations and aspects of public health interact and rely on each other to build successful policies and programs.

Activities• Develop materials including Just

in Time Training Materials and actor scripts for a preparedness exercise

• Perform key information interviews regarding local health departments use of Ebola hotlines

• Develop and refine exercise evaluation summaries and after action reports

Practice Experience Progress and Challenges

• Understanding how public health and private partners work together

• Learning about the programmatic side of public health

• Balancing competencies and core areas

• Coordinating among partners and priorities

• Developing and creating materials appropriate and sufficient for use in exercises and published reports

Competencies• Assess hazards and risks• Create and tailor messages and information

for the public, policy makers, and for internal review

• Critically analyze literature, programs, and policies

• Design and implement programs that incorporate aspects of all five MPH competencies

• Collaborate to implement public health related programs, policies, and environmental changes.

• Identify and describe human hazards in terms of physical, chemical, or biological properties and the potential healthconsequences of human exposure.

Mary Wakefield, MPHwakefiedm@slu.edu or mcwfield@gmail.com

Division of Public Health Sciences, Department of SurgeryXin Wang, M.P.H. Student

Practice Experience Dates: Apr 2015 – Aug 2015

Division of Public HealthSciences

• The Division of Public Health Sciences broadens the scope of population-based research at the Washington University School of Medicine by providing a platform for investigators from multiple disciplines to collaborate on projects that affect strategies in clinical care and outcomes.

• Research projects range from those focused on eliminating health disparities in Missouri and the region, to conducting health services and comparative effectiveness research, to improving service delivery, to measuring outcomes for cancer survivors and other patient groups after major clinical or disease events.

My Project• Work collaboratively with the physician in

Barnes-Jewish Hospital, St. Louis to address unmeasured confounder in estimating the risk ratio for venous thromboembolism (VTE) in both aggregate data level and individual record level under the instruction of preceptor.

• Disseminate the methods of bias analysis for unmeasured confounder.

My RoleIntern of Division of Public Health Sciences• Review literature on the methods of bias analysis for unmeasured

confounder• Study how to use R languages

• Use R to code bias analysis for unmeasured confounder and test the codes

• Participate in designing and implementing the project• Draft the research paper for publication in an academic journal• Attend regular research meetings

Public Health Context• The crude data suggests that any post operative infections would

increase the risk of getting VTE. For those who have any kind of post operative infections, the odds of getting VTE are 5.51 times larger than the odds for those have not any kind of infections.

• We refer to literature for the association between history of VTE and current VTE, which had an OR of 10. After considering unmeasured confounder – history of VTE, the odds ratio for getting current VTE is 4.21, which means that the risk of any post operative infections is not that much higher than the initial result.

• For multidimensional bias analysis, we assume the range of the association between history of VTE and current VTE is 5 to 15, and combined with probabilistic bias analysis, we get the result of getting VTE as follows:

The OR is from 2.7(2.5%)

to 6.17 (97.5%) with the

median of 4.09(50%).

• Disseminating the methods of bias analysis for unmeasured confounder can help epidemiologist estimate the risk more objectively, taking into account for confounders that are hard to collect, or analyze the data from

My Activities• Conduct simple bias analysis for unmeasured

confounder• Conduct multidimensional bias analysis for

unmeasured confounder• Conduct probabilistic bias analysis for

unmeasured confounder• Conduct record level correction for

unmeasured confounder

Practice Experience Progress and Challenges

• R language is new to me, and it is difficult for me to learn from beginning, and code multidimensional bias analysis, probabilistic bias analysis and record level correction for unmeasured confounder

• The bias analysis method in the book needs to be modified to use OR in cohort study setting instead of RR. After referring to other learning materials and with the help of the preceptor, I found the right way to code OR in our study setting.

• It is also hard for me to draft the whole paper as an first author. With the help of the preceptor, I learned a lot by accomplishing the whole project.

Competencies Achieved1. MPH 2: Recognize the ecological nature of determinants of health that include biological, behavioral, social, environmental, economic, and political factors• Use bias analysis methods to explain how the

distribution of history of VTE influences the risk of getting VTE.

2. MPH 7: Utilize appropriate communication strategies to educate, disseminate, and advocate for health services and preventive interventions• Draft a research paper the introduction the bias

analysis methods in epidemiology setting.

3. EPI 1: Develop appropriate study designs and analytical strategies to test epidemiologic hypotheses.• Refer to the physician and the literature for the

distribution of unmeasured confounder, and analyze it using simple bias analysis, multidimensional bias analysis, probabilistic bias analysis and record level correction for unmeasured confounder

4. BST 2: Compute descriptive and multivariate statistical tests and measures of association using statistical software, e.g., SPSS, Excel, SAS & R.• Use R to code bias analysis for unmeasured confounder

the dataset that is not designed for the same purpose.• Draft a research paper for publication

Center for Cancer Prevention, Research and OutreachLei Yang, M.P.H Student

Practice Experience Dates: May 2015 – August 2015

Center for Cancer Prevention, Research and Outreach

• Formed by Saint Louis University's Cancer Center and College for Public Health & Social Justice with funds from Emerson, The Express Scripts Foundation and Ascension Health

• CCPRO offers students opportunities to work with many community organizations in St. Louis .

• CCPRO, who works with community partners, have helped provide cancer education and screening in community

• Long-standing relationship between Saint Louis University Cancer Center and Emerson to help reduce disparities among communities.

Prostate Cancer ScreeningEvaluation

• Work collaboratively with The Empowerment Network and SLU hospital to help provide prostate cancer education and PSA screening.

• Recruit men who are at high-risk from varies community events.

• Conduct impact assessment to determine the screening protocol’s impact on key outcomes, including knowledge, attitude, beliefs, self-efficacy and screening/other follow-up behaviors.

My RoleProstate Cancer Evaluation Intern

• Attend CCPRO outreach and evaluation meetings, as well as other work group meetings set by center leadership or preceptor.

• Review previous CCPRO work document and related articles.

• Assist with CCPRO prostate cancer evaluation measurement design, data collection, data management , and data analysis.

• Create data analysis plan that address our study design.

Public Health Context• Study showed that prostate cancer is 60% more

prevalent and mortality rates are 2.4 times more likely among African American men than White men.

• Participants that are currently recruited in the evaluation study are high-risk and most of them are black (91.9%).

• Provide free prostate cancer screening and evaluation of the prostate cancer screening process can help those men who are at high-risk aware of the issue though prostate cancer screening is not recommended by CDC.

• Collaborating with different community partners and physicians can help correctly disseminate prostate cancer information and provide suggestions.

• Prostate cancer knowledge scores significantly decreased from pre- and post-test (p=0.008) by an average of 1.28 points.

• Significant decreases were observed in three anxiety questions between pre- and post-tests.

• Also, significant increases were observed in decision self-efficacy between pre- and post-tests. The

Activities• Conduct literature review about community-based

intervention for future publication use.• Actively participate in community events to recruit

participants.• Enter recruitment data and write a statistical analysis

plan.• Build a clean raw data base for future use.• Manage data using SPSS.

Practice Experience Progress and Challenges

1. Participated in 6 community events and successfully recruited 145 men in our study.

2. A clean raw final data set is created and disseminate to other group members.

3. Finished writing all data steps for future intern use.

4. I found out some minor problems that may affect the entire analysis. Gladly, my preceptor took them very seriously and solve them immediately. I am glad that I can identify those minor problems and help the entire team.

Competencies Achieved1. Be able collaborate with community partners and

provide education and evaluation informationI provided participants inform consent by myself, and be able

to protect confidential information.

I explain the process of the evaluation and guide them to the next step so our evaluation process can be in the right order.

2. Assist with identifying existing community-based prostate cancer intervention programs and materials

I researched 15-20 articles to help identify community- based prostate cancer intervention among high-risk black males.

3. Assist with data collection, data management, and data analysis using SPSS.

I participated in 6 evaluation events and successfully recruited 145 men in our study.

I merged demographic data, pre- and post-test data into one dataset.

I created data analysis plan and successfully conducted paired t-test.

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•

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average increase was .61.• Perform evaluation statistical analysis using SPSS. • Interpret results accurately.