The Power of Science and Practice Integration

One of the most substantial challenges facing the field of injury and violence prevention is bridging the gap between scientific knowledge and its real-world application to achieve population-level impact. Much synergy is gained when academic and practice communities collaborate; however, a number of barriers prevent better integration of science and practice. The Journal of Public Health Management & Practice examines 3 examples of academic-practitioner collaborations, including our own InjuryFreeNC Academy.

Each example falls along the spectrum of engagement with nonacademic partners as co-investigators and knowledge producers. They also highlight the benefits of academic-community partnerships and the engaged scholarship model under which Centers for Disease Control and Prevention–funded Injury Control Research Centers operate to address the research-to-practice and practice-to-research gap.

Find the article here.

Report Released on Sustained Effects of North Carolina’s Medicaid “lock-in” Program on Prescription Drugs

Highlights:

  • NC Medicaid “lock-in” program appeared to reduce numbers of controlled substances (e.g., painkillers) dispensed
  • Reductions were evident both while patients were enrolled in the program and in year following program release
  • Dosages of opioids (in terms of morphine milligram equivalents) increased while patients were enrolled in the program and following release
  • Use of cash payment increased during lock-in and after release

(Chapel Hill, N.C. November 14, 2017) – A new study examined the immediate and sustained effects of North Carolina’s Medicaid “lock-in” program on the amounts of prescriptions drugs dispensed to those enrolled in the program.

Rebecca Naumann, MSPH, graduate research assistant with the Injury Prevention Research Center and a doctoral student in the Department of Epidemiology in the UNC Gillings School of Global Public Health, is first author of the study. Other co-authors included Dr. Stephen Marshall, Dr. Jennifer Lund, Dr. Nisha Gottfredson, Dr. Christopher Ringwalt, and Dr. Asheley Skinner.

The full article on their findings, titled “Evaluating short- and long-term impacts of a Medicaid ‘lock-in’ program on opioid and benzodiazepine prescriptions dispensed to beneficiaries,” was published online November 14, 2017 in the journal Drug and Alcohol Dependence.

Insurance-based “lock-in” programs have become an increasingly popular strategy to address the potential overutilization of controlled substance prescriptions, such as opioids (painkillers) and benzodiazepines (anti-anxiety drugs). “Lock-in” programs typically require patients to use a single prescriber and/or pharmacy to obtain certain controlled substance prescriptions (e.g., opioids, benzodiazepines) for a specified period of time. Naumann and her colleagues examined the specific impacts of North Carolina’s Medicaid “lock-in” program on the amounts of these prescriptions obtained.

Researchers followed a cohort of adults enrolled in the “lock-in” program in the first two years of its operation (October 2010-September 2012). They analyzed patients’ Medicaid claims linked to their Prescription Drug Monitoring Program (PDMP) records to gain a more complete understanding of all opioids and benzodiazepines dispensed to “lock-in” program patients. This unique linkage allowed Naumann and her colleagues to not only examine the number of opioids and benzodiazepines acquired by patients through Medicaid, but also those acquired using other sources of payment, such as cash.

Among the findings, it appeared that the program did reduce the average number of controlled substances dispensed during and after the patient’s “lock-in.” At the same time, the researchers found that the dosage of opioids (in terms of morphine milligram equivalents) increased during and after their “lock-in” period. Some participants in the program increased their purchase of controlled substances outside of Medicaid, paying cash for these prescriptions during their “lock-in” period and after release.

“While it’s important to see that the program reduced the average number of controlled substances dispensed during lock-in and following program release, it’s also important to note that patients acquired more controlled substances using cash payment,” said Naumann. “The increase in cash payment could be related to a number of factors, but overall signals an important need for improved care coordination in this population.”

These findings highlight the need for providers to regularly check the state’s PDMP database in order to obtain a complete picture of all controlled substances dispensed to patients. Naumann also noted that designing or modifying these programs to increase patient’s accessibility to substance use disorder treatment and treatment for other comorbid conditions, such as mental health disorders, may improve patient outcomes.

“Our understanding of the impacts of these programs has generally been limited to understanding changes in healthcare utilization and costs from an insurer perspective,” said Naumann. “This research sought to provide a more complete understanding of program effects on the magnitude of prescriptions dispensed from a patient perspective. In working to address the opioid crisis, it is critical that we gain a full understanding of the effects of opioid-related policies and programs so that we can design and implement interventions that have the greatest public health impact.”

Raluca Iosif IPV Research Awardee presentation Oct. 12

When: October 12, 2017 2:00 – 3:30 PM
Where: IntraHealth International
6340 Quadrangle Drive, Suite 200
Chapel Hill, NC 27517

Light refreshments will be served. The event is free and open to the public.

Please join us October 12 for a presentation by Josie Caves, winner of the Raluca Iosif Intimate Partner Violence Research Award. The research is designed to further our global understanding of intimate-partner violence and the factors associated with it in relation to homicide.

Caves, a PhD student at the University of North Carolina Gillings School of Global Public Health, will discuss her research on the impact of firearm regulations on intimate-partner violence. IntraHealth gender expert Constance Newman and UNC professor Beth Moracco will also discuss the larger research agenda around intimate-partner violence.

IntraHealth launched this award in spring 2016 to honor Raluca Iosif, an IntraHealth colleague whose life was cut short by violence in October 2015, and to ensure that Raluca’s deep commitment to global health—and to ending injustice and violence against women—lives on.

Light refreshments will be served. The event is free and open to the public.

New Safety UTC Envisions Safe Systems Approach for U.S. Roadways

The Collaborative Sciences Center for Road Safety (CSCRS), the new University Transportation Center (UTC) at The University of North Carolina, Chapel Hill (UNC) is taking a fresh approach to road safety. This national safety UTC is focused on implementing a collaborative, multidisciplinary, safe systems approach to reducing transportation-related injuries and fatalities and to helping traffic safety become recognized as a public health priority in the United States. Learn more about it!

HSRC Child Passenger Safety Expert Bill Hall Receives Governors Highway Safety Association Award

LOUISVILLE, Ky. (Sept. 19, 2017) – Today, the Governors Highway Safety Association presented one of its most prestigious honors, the 2017 Kathryn J.R. Swanson Public Service Award, to long-time University of North Carolina Highway Safety Research Center child passenger safety advocate, Bill Hall. Hall received the award at the Highway Safety Awards luncheon today at the 2017 GHSA Annual Meeting in Louisville, Ky.

Bill Hall was selected as one of two recipients of the 2017 Kathryn J.R. Swanson Public Service Award for his dedicated service to child passenger safety. His contributions span a 40-year career at HSRC as an expert in child restraints, safety belts, airbags, and occupant restraint issues.

“Child passenger safety is one of our biggest safety success stories, due in large part due to the work of Bill Hall,” said Jonathon Adkins, GHSA Executive Director. “His passion for keeping kids safe in vehicles has undoubtedly saved many lives in North Carolina and across the country. We are proud to be able to recognize his service.”

“Over the course of his 40-year career, Bill’s efforts have protected a generation of children who grew up riding safely in the car,” said David Harkey, director of HSRC. “Bill’s contributions to road safety are present every day when children travel safely restrained in cars.”

When Hall began his career in the late 1970s, seatbelts had only been required in vehicles for a decade, and child car seats were just starting to become commercially available. Hall’s early work, funded by the North Carolina Governors Highway Safety Program, focused on educating parents about the benefits of car seats in an effort to encourage their use. Hall and a team of HSRC staff traveled across the state of North Carolina talking to physicians, nurses, and parent groups about the importance of protecting children in cars. This grassroots work led to support for North Carolina’s first-ever child passenger safety law passed in 1981. And, by extension, resulted in child passenger laws being enacted in all states across the nation.

Hall served as a founding member of the National Child Passenger Safety Board and helped develop the National Highway Traffic Safety Administration’s “Standardized Child Passenger Safety Technical Training” certification curriculum for child passenger safety advocates and educators. Today, more than 142,000 individuals nationwide have successfully completed the program.

Hall’s commitment to making sure every single child is safe has always been a personal one. He is responsible for establishing a North Carolina toll-free number that anyone in the state can use to ask questions about car seats and seatbelts. Over the decades, Hall has personally answered thousands of questions through this phone line. In the early days of child passenger safety, Hall spent many afternoons upside-down in car trunks installing tether anchors for child seats, and, to this day, he can still be found in the community helping parents and other caregivers install seats and educating the community on best practices.

In addition to improvements for child safety, Hall has also been involved in some of the most influential passenger safety programs in the country. Hall’s work on the “Click It Or Ticket” campaign, started in North Carolina, became a nationwide success and has contributed significantly to the high seatbelt use rates seen throughout the country.

Along with Hall’s recognition, the HSRC-led Watch for Me NC program, funded by the North Carolina Department of Transportation, will be recognized with the 2017 Peter K. O’Rourke Special Achievement Award. To learn more about GHSA and the awards program, visit http://www.ghsa.org/about/safety-awards.

About the UNC Highway Safety Research Center
The University of North Carolina Highway Safety Research Center is working hard to help shape the field of transportation safety. HSRC is committed to excellence in sound research, and safety is the preeminent goal – every day and in every project staff undertakes. Birthplace of innovative national programs like Click It or Ticket, graduated driver licensing and Walk to School Day, the center’s mission is to improve the safety, sustainability and efficiency of all surface transportation modes through a balanced, interdisciplinary program of research, evaluation and information dissemination. Learn more at www.hsrc.unc.edu.

HSRC media contact:
Colleen Oliver, 919-962-7769, oliver@hsrc.unc.edu

NFL grant funds international research on the role of active rehabilitation strategies in concussion management

Led by scientists at UNC-Chapel Hill and the Medical College of Wisconsin, research will involve international collaborations and diverse participants — high school, college and professional athletes — across a variety of sports. 

(Chapel Hill, N.C. – Wednesday, June 14, 2017) – The NFL will fund a $2.6 million international study on the role of active rehabilitation strategies in concussion management, led by the University of North Carolina at Chapel Hill and the Medical College of Wisconsin.

The project was identified as a priority at the NFL’s International Professional Sports Concussion Research Think Tank, where medical representatives of many of the world’s leading sports leagues convened to share best medical practices and protocols and collaborate on ways to advance science through research.

The study, one of the first of its kind, will examine the efficacy of two clinically supervised management strategies, including both the international concussion return-to-play protocol and early therapeutic interventions on concussions.

Professional athletes from the Canadian Football League and New Zealand Rugby, as well as amateur athletes from American and Canadian colleges and universities and Wisconsin high schools, will be included in the study. The research will cover a variety of sports, including football, rugby, soccer, lacrosse, basketball and ice hockey. The three-year study will enroll more than 200 concussed athletes, both male and female.

“Player health and safety is a high priority for the CFL,” said Kevin McDonald, the league’s vice-president, Football Operations and Player Safety. “This research on concussion management is innovative and important, and our participation is consistent with our commitment to advance player health and safety initiatives.”

New Zealand Rugby’s Medical Director Ian Murphy is also very supportive of the research.

“Concussion is a significant issue in our game, and we believe that through multi-sport collaboration on research projects like this, we can take steps to ensure that our respective games are as safe as possible for all those who play them,” Murphy said.

“Currently there’s little information available about the most effective strategies to manage and treat concussion,” said Johna Register-Mihalik, the co-principal investigator at UNC, assistant professor of exercise and sport science in the College of Arts & Sciences and faculty member of the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center and the Injury Prevention Research Center. “We want to see how early, clinically guided activity could benefit recovery from concussion.”

“A major goal of the study is not only to find out what works best in terms of rehabilitative strategies for concussion, but to also determine the real-world application of these approaches and return-to-play strategies,” added Michael McCrea, the co-principal investigator at the Medical College of Wisconsin. McCrea is director of the Brain Injury Research Program and a professor of neurosurgery and neurology.

“What help do clinicians need to implement these types of management strategies, and do the athletes find them beneficial? Concussions affect each individual differently,” he said. “Most of all, we want to maximize the translational impact of this study for athletes and clinicians.”

United States colleges and universities included in the study are Catawba College, Elon University, Lynchburg College and North Carolina Central University. Canadian universities include the University of Alberta and York University.

Other members of the UNC-Chapel Hill investigative team include co-principal investigator Kevin Guskiewicz (dean of the College of Arts & Sciences, Kenan Distinguished Professor of Exercise and Sport Science and co-director of the Gfeller Center), Stephen Marshall (Injury Prevention Research Center and epidemiology), Jason Mihalik (exercise and sport science and Matthew Gfeller Sport-Related TBI Research Center), Shabbar Ranapurwala (Injury Prevention Research Center and epidemiology), Karen McCulloch (division of physical therapy) and Paula Gildner (project manager, Injury Prevention Research Center). UNC undergraduate and graduate students are also involved in the research.

U.S high schools included in the study are Arrowhead High School, Mukwonago High School, Waukesha South High School, Waukesha West High School, Waukesha North High School and Kettle Moraine High School, all in Wisconsin.

In addition to McCrea, members of the MCW investigative team include Jennifer Hill (program manager, Brain Injury Research Program), Lin Nelsen (assistant professor of neurosurgery, Brain Injury Research Program) and Anna Klotz (research assistant, Brain Injury Research Program.)

See original announcement here

–Carolina —

About the University of North Carolina at Chapel Hill
The University of North Carolina at Chapel Hill, the nation’s first public university, is a global higher education leader known for innovative teaching, research and public service. A member of the prestigious Association of American Universities, Carolina regularly ranks as the best value for academic quality in U.S. public higher education. Now in its third century, the University offers 77 bachelor’s, 113 master’s, 68 doctorate and seven professional degree programs through 14 schools and the College of Arts and Sciences. Every day, faculty – including two Nobel laureates – staff and students shape their teaching, research and public service to meet North Carolina’s most pressing needs in every region and all 100 counties. Carolina’s more than 308,000 alumni live in all 50 states and 150 countries. More than 167,000 live in North Carolina.

College of Arts & Sciences contact: Kim Spurr, (919) 962–4093, spurrk@email.unc.edu
Office of University Communications contact: Media Relations, (919) 962–8596, mediarelations@unc.edu

UNC Injury Prevention Research Center to screen Newtown, a film by Kim A. Snyder.

newtown-poster-1Tuesday, January 17th

5:00 – 7:00 PM

Blue Cross Blue Shield Auditorium,  

Michael Hooker Research Center

Light snacks will be provided for the screening. Parking for the event will be available in the McCauley Parking Deck.

What Remains after all is lost? Twenty months after the horrific mass shooting in Newtown, CT that took the lives of twenty elementary school children and six educators on December 14, 2012, the small New England town is a complex psychological web of tragic aftermath in the wake of yet another act of mass killing at the hands of a disturbed young gunman. Kim A. Snyder’s searing Newtown documents a traumatized community fractured by grief and driven toward a sense of purpose.

Filmed over the course of three years, the film weaves together powerful and honest testimonials from parents, teachers, school staff, first responders and clergy members grappling with the tragedy. Taken together, their stories document a traumatized community whose resilience and sense of purpose is as powerful as its grief. The film bears witness not only to a community seeking healing in the midst of national media attention, but to all that is left to cope with after the cameras leave.

As a film that focuses on community resilience and trauma, Newtown offers an opportunity to broaden dialogue. Speakers who represent a cross section of community will lead conversations following the film screening.

 

 

2016 IPOP – Applications Now Being Accepted!

Join us for a free two-part webinar series this fall to learn about the changing landscape of opioid overdose, the rise of this public health epidemic, the current burden and the different governmental, nonprofit, business, and advocacy groups involved in this complex issue. Examine solutions and strategies for preventing and reducing opioid overdose. Register Now!

Build on your knowledge from webinars 1 & 2 and apply to join the IPOP Faculty Team for a “Going Further” Webinar and 3 day Spring skills-building workshop. Come as a team or an individual and learn how to use tools to assess and document information about opioid overdose with stakeholders in your community. Develop your work over 3 months to come back for the 3-day skills-building workshop in Chapel Hill, NC. Now accepting applications, learn more!

Raluca Iosif Intimate Partner Violence Research Award

Photo at top: © Yolanda Merced-Graves used under CC BY-NC-SA 2.0

© Yolanda Merced-Graves used under CC BY-NC-SA 2.0

Please join us for an event dedicated to launching the Raluca Iosif Intimate Partner Violence Research Award. Light refreshments will be served and music will be performed by Kamara Thomas.

October 11, 2016 4:00 – 6:00 PM
North Carolina Botanical Gardens, Reeves Auditorium
Please RSVP 

Speakers:

  • Rebecca Kohler, Senior Vice President of Corporate Strategy & Development, IntraHealth International
  • Constance Newman, Senior Team Leader, Gender Equality and Health, IntraHealth International
  • Sabrina Garcia, Chapel Hill Police Department, Domestic Violence/Sexual Assault Specialist
  • Peggy Bentley, Associate Dean for Global Health, UNC Gillings School of Global Public Health
  • Steve Marshall, Director, UNC Injury Prevention Research Center and Professor of Epidemiology, UNC Gillings School of Global Public Health
  • Beth Moracco, Director of the Master of Public Health Program for the Department of Health Behavior and Research Associate Professor, Department of Health Behavior, UNC Gillings School of Global Public Health

IntraHealth International is pleased to announce, in partnership with the University of North Carolina (UNC) Gillings School of Global Public Health and the  Injury Prevention Research Center, this award. It serves as a tribute to Raluca Iosif, an IntraHealth colleague whose life was cut short by violence. The award will fund research focused on better understanding and preventing intimate partner violence and will be open to graduate students enrolled at the Gillings school.

More About the Award

IntraHealth International is pleased to announce, in partnership with the University of North Carolina (UNC) Gillings School of Global Public Health and the UNC Injury Prevention Research Center (IPRC) the launch of a new research award to advance understanding of the global problem of intimate partner violence, especially the little understood and under-researched human rights and public health-related aspects of the phenomenon. The award is made possible by the Raluca Iosif Memorial Fund established by IntraHealth.

Rigorous evidence on intimate partner violence forms the basis of effective advocacy and prevention, to achieve Sustainable Development Goal 5.2, “Eliminate all forms of violence against all women and girls in the public and private spheres.” Currently, different definitions and classifications used for conceptualizing fatal intimate partner violence complicate the collection of information from various sources, resulting in documentation that is not comparable or actionable across communities, regions, and countries. Initially, recipients of the award will contribute to the academic research body of knowledge on the nature and extent of fatal intimate partner violence, including the definition, measurement and data sources; patterns in different settings and environments; who is at greatest risk; or how risk can be assessed, reduced and prevented, and governments’ obligations for protecting at-risk women.

Eligible candidates will be UNC Gillings doctoral or master’s students engaged in dissertation or thesis research focused on intimate partner violence. The annual selection process for this award will be overseen by an advisory committee from UNC. Student awardees will be mentored by IntraHealth and UNC technical leadership.

Upon completion of research, each student will present a public lecture to professional schools in the North Carolina Research Triangle Area, and will write a publication that contributes to the research base.  The immediate outcomes of the Raluca Iosif Intimate Partner Violence Research Award research will be a stronger evidence base, standardized measurement and improved guidelines to strengthen the capacity of police, forensic, and health care personnel to assess, prevent, and respond effectively.

The longer-term impact of the award will be institutional commitment and priority given to intimate partner violence against women in global public health policy and practice, starting early in the professional education of  global health practitioners.

The award is made possible by the Raluca Iosif Memorial Fund which was established by IntraHealth International in October 2015 to honor the legacy of IntraHealth’s former colleague, Raluca Iosif, who was killed in an act of fatal intimate partner violence in Durham, North Carolina, on October 6, 2015.

A dedicated member of IntraHealth’s program development unit, Raluca led initiatives that expanded IntraHealth’s work and global impact. Her sharp wit, bright spirit, and devotion to making health care available to more people in need were inspirational to IntraHealth staff and partners around the world.

This fund also was established to ensure that her deep commitment to global health, and to ending injustice, inequity, and violence against women, lives on. Contributions to the Raluca Iosif Memorial Fund can be made here.

Upcoming Gender-Based Violence Speaker Series Events

Please join us for our first Gender-Based Violence Research Group Speaker Series Events of Fall 2016!

Ammunition for Change: Explaining the Surprising Adoption of Domestic Violence and Gun Control Policies Across the United States from 2009-2015

Sierra Smucker, MSc, PhD Candidate, Duke University

Thursday October 6, 12:00 – 1:00 pm, 3100 MHRC

The availability of firearms continues to threaten the lives of American citizens on a daily basis. However, a persistent political narrative suggests that calls for policy change are futile; that any legislation at the national level will be killed by the powerful gun lobby; and because of our permissive gun laws, the United States will continue to have more gun violence than any other developed country in the world. While this narrative is supported by the failure of federal policies that regulate firearms, a significant number of state legislatures have passed gun reforms that protect women in abusive relationships. Since 2013, 18 states, including historically pro-gun states like Louisiana, Tennessee, and Washington, have passed new laws to protect victims of domestic violence from firearms. In a time of deep political polarization, particularly around the issue of firearms, why are some state legislators passing these policies while rejecting other types of gun control policies? Is the change we are seeing in DV and firearms policy evidence of a transformative change in American politics or is it an outlier? Using an in-depth case study approach, this study begins to unravel the puzzle of DV and firearms policy by investigating the passage of domestic violence and firearm policy at the state level.


Sport-based HIV prevention: Innovation and research on gender-based violence

Jeff DeCelles, Technical Advisor of Curriculum & Research at Grassroot Soccer and DrPH student at UNC Department of Health Policy & Management

Tuesday October 25th, 1:00 – 2:00 pm, 101 Rosenau Hall

The Gender-based violence research group and Health Behavior Global Health Roundtable are organizing a guest speaker, Jeff DeCelles, from Grassroot Soccer (GRS). GRS is an international non-profit that develops and implements sport-based health programming for adolescent youth across sub-Saharan Africa. Jeff will be speaking about the organization’s innovative gender-based violence programming and research.