2018 Funded CCRI Projects
Acceptance-based physical activity promotion for low-active middle-school students
Margaret Schneider, PhD, UCI School of Social Ecology
Pamela Penn, MA, Marshall Academy of Arts, Long Beach
Physical activity (PA) is associated with many health benefits 1, and is critical among youth because low adolescent PA predicts low adult PA 2. Unfortunately, 75% of adolescents do not meet current PA guidelines 3. Schools are a promising channel for influencing youth activity, resulting in the widespread implementation of school-based fitness testing. Consequently, we know that 35% of 7th-grade students in the Long Beach Unified School District are outside the “Healthy Fitness Zone” 4, but there exists no effective strategy for targeting these unfit students for behavior change. Acceptance-based behavioral treatments (ABT) teach participants to accept internal experiences (affect, emotions, urges) and to avoid letting these internal experiences dictate their behavioral choices. ABTs have shown efficacy in targeting depression, anxiety, chronic pain, diabetes, smoking, and obesity 5-9, but have not been examined for promoting adolescent PA. Our team has found preliminary support for the efficacy of an ABT intervention combining activity self-monitoring with teaching acceptance-based skills to promote PA among middle-school students. Qualitative data revealed that a major barrier to scaling this study up to a larger sample was the technical limitations on the activity monitors (e.g., limited battery life, manual syncing). New technology has become available that will enable us to overcome these limitations. We would like to repeat the pilot study utilizing these new devices so that we can incorporate them into our planned research proposal to be submitted to the NIH as an RO1.
Survivors of Intimate Partner Violence: A Nursing Case Management Research Project
Candace Burton, PhD, RN, AFN-BC, AGN-BC, FNAP, UCI School of Nursing
Marciela Faust-Rios, Human Options
In California during 2010-2012 nearly 5 million women reported physical, sexual, or stalking abuse by a partner in the previous 12 months. Nationwide, between three and 37% of affected women also report a physical or mental health condition. This suggests significant overlap between women seeking intimate partner violence (IPV)-related services and those with health problems. In Orange County, Human Options—the collaborative partner on this proposal—provided emergency shelter and/or transitional housing to 171 adults and 241 children, accepted 4,224 hotline calls, and provided other services to 1,435 residents during fiscal year 2016-2017. This represents an increase of 23% over the previous year, and reflects an ongoing upward trend. In a county-wide assessment of the needs of domestic violence programs, the Orange County Women’s Health Project (OCWHP) found that many agency clients had unmet health needs and recommended colocation of services in order to address these. The links between experiencing IPV and subsequent mental and physical health problems are well-established, and survivors may experience depression, poor overall health, chronic pain, persistent fear, sleep disturbance, and other issues even after the abuse has ended. Despite being well-equipped to provide crisis intervention services to those affected by IPV, most agencies serving this population lack appropriately trained personnel to assist with health assessment and referrals. In many cases, clients are without health insurance or access to their usual providers owing to having fled an abusive partner. This may mean that they are without any access to health care resources for weeks to months, during which time chronic illness may be unmanaged and other health concerns may manifest. We therefore propose to institute a nurse-run health case management service in the context of Human Options’ client base, and to examine how this service affects the overall client health.
Understanding Contraceptive Needs of Women who Inject Drugs in Orange County: A Qualitative Study
Rachel Perry, MD, UCI Obstetrics & Gynecology
Orli Florsheim, MS3, OC Needle Exchange Program
One of the most pressing public health issues in the United States is the opioid epidemic. Heroin use has increased among the general population, but disproportionately in women aged 18-251, putting women of childbearing age at particular risk for opioid-related health concerns. One such concern is unplanned pregnancy; up to 9 out of 10 pregnancies in opioid-abusing women are unintended 2. Only about half of women with opioid and other substance use disorders use contraception, and those who do tend to use less effective methods such as condoms3,4. In this proposed study, the UCI Department of Obstetrics and Gynecology will further a partnership with the Orange County Needle Exchange Program (OCNEP) to understand barriers to reproductive health care, particularly prevention of unintended pregnancy, among women with substance abuse disorders (WSAD). OCNEP is a volunteer-run 501(c)3 that provides clean needles and safe injection supplies to people who use injection drugs in Orange County and surrounding areas. It is the first and only needle exchange program in Orange County. Currently, UCI Department of Obstetrics and Gynecology and OCNEP are partnered on a grantfunded pilot study to explore the relationships between drug use, intimate partner violence, and unintended pregnancy through surveying OCNEP clients. Through this proposed qualitative study, we will use semi-structured interviews with WSAD to explore in more detail 1) attitudes, personal motivations and barriers to using highly effective contraceptive methods, 2) experiences and comfort level interacting with health care providers regarding reproductive health, 3) attitudes toward pregnancy and future childbearing plans and 4) the impact of substance use on contraception use. This study will allow OCNEP to address women’s preferences for family planning service delivery, and will inform interventions aimed at family planning education and provision.
Children impacted by Cancer in the Latino Community
Michelle Fortier, PhD, UCI Anesthesiology & Perioperative Care, Center for Stress and Health
Lessley Torres, Community Advocate, Grassroots Oncology Taskforce
In 2014 the U.S. Latino population reached 55 million with cancer becoming the leading cause of death among the adult Latino population and 2nd leading cause of death among Latino children. A major problem that warrants research is that low income; Latino/Hispanic children and families are differentially affected by cancer and have an even lower quality of life. In order to adequately address improving quality of life for children and their families during cancer treatment, we must acknowledge that racial and ethnic minorities are at greater risk for reduced quality of life due to factors such as socioeconomic status and cultural values and beliefs which can also affect their access to health care. Accordingly, it is important to understand the psychosocial factors that may underlie these disparities in health outcomes. Therefore, our aim is to launch new research and develop an intervention focused on reducing disparities in quality of life in Latino children and their families during cancer treatment. By incorporating community-researcher collaborations such as community-based participatory research (CBPR), we can meet needs for patient-centered methodological approaches that engage patients in health care improvement. Our plan is to engage a community task force of low income Latino parents whose children are either undergoing or have recently completed treatment for cancer in a series of meetings to identify research needs of the Latino community while building a sustainable partnership and program of research. This partnership would allow the members of the task force to assist in developing an intervention that is culturally tailored to meet the lacking needs of the community such as education, support and access to resources that can knock down barriers that are experienced within the Latino community in the oncology hospital setting.