The National Cancer Institute has awarded three Brown School researchers a $356,000 grant to identify confirmed and suspected cancer cases among more than 3,000 HIV-positive youth (ages 10-21), and explore preliminary outcomes of an intervention on access to cancer diagnosis, care and treatment of HIV-infected children in sub-Saharan Africa.
The researchers are Fred Ssewamala, William E. Gordon Distinguished Professor; Kim Johnson, associate professor; and Ozge Sensoy Bahar, assistant research professor.
Worldwide, there are 2.1 million HIV-infected children younger than 15, with over 90 percent living in sub-Saharan Africa. In Uganda, where this study will take place, no prevalence data are available for pediatric cancer among youths with HIV.
The study is titled Suubi4Cancer (Suubi means hope in Luganda, the local language). It will enhance the Suubi Economic Empowerment intervention by incorporating cancer education addressing cultural misconceptions about cancer tumors. Researchers will test the theory that youth and their families’ cognitive and behavioral change is influenced by economic stability. They will also examine if enhanced cancer knowledge through intra-familial support and communication will help maintain positive behavioral health functioning and reinforce engagement in care and treatment.
The study findings will contribute to the initiation of a regional registry for youths with HIV for cancer research. It also will increase understanding of the short-term impact of combination interventions addressing access to cancer diagnosis, care, and treatment adherence among youth living with HIV in sub-Saharan Africa.
Ross Hammond, the Betty Bofinger Brown Associate Professor, and Peter Hovmand, director of the Social System Design Lab and professor of practice, both of the Brown School at Washington University in St. Louis, took part in the international Lancet Commission on Obesity.
The commission released its major new report Jan. 27. The main takeaway?
Obesity, climate change and hunger and inextricably linked and must be fought as one challenge.
“The obesity pandemic, the undernutrition pandemic and global climate change are deeply inter-related — they are driven by common underlying complex systems, and may be amenable to common ‘double’ and ‘triple-duty’ solutions, which complex systems science can help us to implement,” Hammond said.
“A secondary message is that bottom-up, community-driven change and demand for policy shifts is extremely important,” he said. “This message is very well aligned with both Peter’s work and my own, and especially with the NIH-funded COMPACT (Childhood Obesity Modeling for Prevention and Community Transformation) study that we both have contributed to over the past five years.”
The commission report includes several main findings, including:
- The global interplay of obesity, undernutrition and climate change represents what’s being called “The Global Syndemic,” and is the greatest threat to human and planetary health, affecting most people in every country and region.
- Powerful opposition by commercial vested interests, lack of political leadership and insufficient societal demand for change are preventing action on The Global Syndemic, with rising rates of obesity and greenhouse gas emissions, and stagnating rates of undernutrition.
- New social movement for change and radical rethink of the relationship between policymakers, business, governance and civil society is urgently needed.
- The commission calls for a global treaty to limit the political influence of Big Food (a proposed Framework Convention on Food Systems — modeled on global conventions on tobacco and climate change); redirection of $5 trillion in government subsidies away from harmful products and towards sustainable alternatives; and advocacy from civil society to break decades of policy inertia.
Malnutrition in all its forms, including undernutrition and obesity, is by far the biggest cause of ill-health and premature death globally, the report suggests. Both undernutrition and obesity are expected to be made significantly worse by climate change.
A key recommendation from the commission is the call to establish a new global treaty on food systems to limit the political influence of Big Food — the world’s food manufacturing giants and the industries that support them — that the report suggests has used multiple strategies to obstruct obesity prevention.
Doctoral student Alex Morshed served as a commission fellow and contributed to review and preparation of the content.
The Brown School has partnered with Preferred Family Healthcare in St. Louis to launch the Community Academic Partnership on Addiction (CAPA), a teaching, learning and research clinic aimed at combating the opioid epidemic and treating other substance use disorders.
“Our aim is to develop a system of shared resources for attacking this issue, in St. Louis and in the surrounding area,” said David Patterson Silver Wolf, associate professor at the Brown School and chief research officer at CAPA Clinic.
“We are creating an innovative, first of its kind community organization and social work school partnership that is similar to the models used by university hospitals and medical schools,” said Patterson Silver Wolf, an expert on substance use disorder treatment services.
In order to address the deficits in specialized substance use disorder trainings for social workers and public health students, the CAPA Clinic will offer practicum/internship opportunities for Brown School master and doctoral students as well as provide professional development trainings for the existing workforce.
“We will also be leveraging the latest sciences of substance use disorder treatment and incorporating into standard care performance-based measurement software developed by Takoda,” he said. Takoda is Patterson Silver Wolf’s recently founded startup aimed at improving therapist success and patient outcomes.
“We are trying to envision a future where community health programs and academics act as a single cooperative,” Patterson Silver Wolf said. “Well-developed and strong exchanges will serve as the link between teaching, learning and research. Brown School social work and public health students will be embedded in community health services working alongside and learning with the current workforce. It’s a win-win for all involved, especially for patients being served in the CAPA Clinic.”
The clinic is located at 4066 Dunnica Ave. in St. Louis. It serves individuals diagnosed with a substance use disorder and other associated behavioral disorders.
U.S. communities with higher smoking rates or lower excise taxes were less likely to adopt retail policies restricting tobacco sales, according to new research from the Brown School at Washington University in St. Louis.
Researchers interviewed personnel from 80 county tobacco control programs from 24 states about progress on retail policies that restrict retail practices such as price discounting and promotion of tobacco products. Results were compared with smoking rates and taxes for those communities.
The results of the study, “Local Retail Tobacco Environment Regulation: Early Adoption in the United States,” were published in the January issue of the journal Tobacco Regulatory Science.
Researchers, led by Todd Combs, assistant director of research at the Center for Public Health Systems Science at the Brown School, found that communities with high smoking rates that would benefit more from retail restrictions and higher taxes on tobacco were less likely to have such policies in place.
“Localities with more resources, such as program capacity, political will or policy options, were more likely to adopt policies,” Combs said. “As local retail policy work becomes more commonplace, only time will tell if this ‘rich-get-richer’ trend continues, or if the contexts in which retail policies are adopted diversify.”
When a person is struggling to meet basic needs such as food, housing, childcare or transportation, their health suffers. What’s not yet known is the best way for health care organizations to address these basic needs, and whether those approaches will lead to health improvement.
The Brown School and Washington University School of Medicine in St. Louis have received a $2.9 million grant from the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health. The collaborative, interdisciplinary study will examine the impact of addressing unmet basic needs among Medicaid beneficiaries with diabetes.
The schools are partnering with Louisiana Healthcare Connections, a Medicaid health plan that provides coverage to more than 465,000 in the state of Louisiana.
The study will provide participants with a “basic needs navigator” to help them access community resources to address a wide range of unmet needs. Investigators will follow participants for one year to assess change in basic needs and management of their diabetes.
“The gaps in health outcomes by income are really big and haven’t improved much with current approaches,” said Matthew Kreuter, the Kahn Family Professor of Public Health at the Brown School and principal investigator of the study.
“We need effective, sustainable solutions that will improve people’s lives and their health. This study takes an important step toward meeting that goal,” said Amy McQueen, associate professor of medicine at the School of Medicine and co-principal investigator on the grant.
Scientists and researchers face an ongoing quandary: How can they demonstrate the health and societal benefits of their work to the world at large in an impactful way? Clinical and translational researchers run studies with human participants. They then take those findings and develop techniques and tools to address critical needs in society. More and more, scientists are deeply invested in moving research from discovery to implementation.
The Institute of Clinical and Translational Sciences (ICTS) and the Center for Public Health Systems Science (CPHSS) at the Brown School, in partnership with the Bernard Becker Medical Library at the School of Medicine, have launched a new website featuring the Translational Science Benefits Model (TSBM), a framework for assessing the health and societal benefits of clinical and translational science.
In an increasingly competitive budgetary environment, the framework seeks to help researchers, administrators, and policymakers measure the impact of their work in four distinct domains with 30 tangible benefits:
- Clinical – new biomedical technologies and therapeutic procedures
- Community – health education resources and improved access to care
- Economic – increased cost effectiveness and new commercial entities
- Policy – new legislation and policies
The website includes explanations of the framework, resources and guidance on how to use the indicators, and case studies that show the path from research to real-world impact. TSBM has been used successfully in case studies to prevent pregnancy and HIV, treat Wolfram Syndrome, and improve diagnoses of Kidney Cancer and Creutzfeldt–Jakob Disease.
“We hope the TSBM can serve as a bridge between scientists and the community,” said Brown School Professor Doug Luke, who serves as director of tracking and evaluation at ICTS and director of CPHSS. “We want to remind scientists of the societal value of the work they do and encourage community partners to stay engaged with clinical and public health research.”