Wisconsin Population Health Service Fellowship

Fellows, alumni, and staff gather

2012-02-09T14:43:00.000-06:00

Fellows, alumni, and staff gathered at Program Director Marion's home for an informal reunion. We had a wonderful time visiting and hearing how former Fellows are currently changing the world!

Multiple Fellow cohorts were represented at the gathering!

Public Health Preparedness

2012-01-20T11:15:00.002-06:00

Radio coverage areas in Wisconsin: important for public health preparedness

<<Alert: train derailment/toxic chemicals on board/major spill<<
Although this alert wasn't real, emergency responders in Wisconsin gathered at the State Emergency Operations Center to simulate their response to the hypothetical event. Representatives from the Department of Health Services, hospital systems, National Guard, police, and firefighters participated in the exercise--along with the Population Health Fellows. Though our role was mostly observational, Fellows and staff asked the experts about the community's role in preparedness (what is being done to ready the community?) as well as the potential for policy changes to arise from tabletop exercises.

A scene from the State Emergency Operations Center

Fellows participating in the train derailment response simulation

After the preparedness exercise, we focused the afternoon around public health ethics. Dan Stier, the Program Director for the Network for Public Health Law, spoke to the group about some of the legal issues public health faces. Did you know the 1st, 4th, 5th, and 14th Amendments are particularly relevant to public health law?

The meeting ended with Professor Claire Wendland from UW-Madison hosting a skill-building session on the history of ethics and Institutional Review Boards. We discussed tricky scenarios like the balance between individual freedom and risk to a community in the context of infectious disease.

Community Health Improvement Plan

2012-01-05T12:24:00.000-06:00


photo credit: Black River Falls Memorial Hospital, http://www.brmh.net/map.aspx

An ongoing project I have been working on is assisting the Black River Falls Memorial Hospital located in Black River Falls, WI complete their community health improvement plan. One of the changes brought on by healthcare reform has been the requirement of hospitals to complete a community health improvement plan to maintain their non-profit status. Many hospitals across the nation have been relying on public health professionals to help with the process as it has traditionally been a public health function.

Black River Falls is located in Jackson County and is unique in that not only does have a community hospital and a local health department but it is also home to the Ho-Chunk Nation. During the fall of 2011 I helped the core group facilitate a community health forum to identify health priorities and brainstorm ways to address them. It was great to see representatives from the local health department, the Ho-Chunk nation, law enforcement, schools, human services, various community groups and local residents come together. Many of the attendees shared the same concerns but were unable to identify allies in the community. The forum provided a space to network and discuss the health of the community.

The core group is continuing to meet and is transitioning from identify priorities to developing action plans. I'll be sure share updates along the way.

-Akbar

Straw Purchasing

2012-01-04T16:50:00.001-06:00

photo credit: Express Milwaukee, http://www.expressmilwaukee.com/article-2205-guns-in-the-wrong-hands.html

Currently, I am working on a project with the Milwaukee Health Department’s Office of Violence Prevention (OVP) on “straw purchasing.” “Straw Purchasing” is the act of one person buying a gun for another person, who is not allowed to own one. “Straw Purchasing” is a problem in Milwaukee and something that OVP is trying to address. In order to address this issue, we have conducted focus groups, interviews, and will be writing a report in the near future with recommendations on how one could effectively create a campaign to discourage straw purchasing, with information specific to Milwaukee.

-Rashonda

Malawi journey

2012-01-03T17:41:00.001-06:00

This chicken was given to Loren and me by village residents we visited. Field scientist Gerald was much better at holding the chicken than I.

In October 2011, I had the incredible opportunity to travel to Malawi with my preceptor, Loren Galvao, to learn about and assist with a project called “Tiphunzitsane: Pathways Linking Poverty, Food Insecurity, and HIV in Rural Malawi.” The 5-year, NIH-funded project (Lance Weinhardt of the ZSPH is the Principle Investigator; Loren the Co-PI) examines links between structural interventions like improved farming practices and village savings groups and health. This project is fascinating because it really dives deeply into the root contributors to health. We know that things like vaccines and healthcare access contribute to health, but through this project we’re learning more about how factors like economic security, women’s empowerment, and food security play a significant role. Though the project resides in Malawi, some of the findings will likely be applicable worldwide—Wisconsin included.

My three weeks in Malawi were packed with excitement. I re-united with Thoko, the project manager, and Esther, the data manager, who work for CARE-Malawi. I had met the two outstanding women a year ago, when they came to Milwaukee for a training. I quickly embedded myself within the CARE-Malawi field scientist team—Chrispine, Thula, Florence, Chrissie, and Gerald—a dynamic group passionately committed to improving the health of Malawians. Loren and I visited with the team to discuss findings and progress on the qualitative and quantitative research. We also met with representatives from CARE, the Ministry of Health, and the Ministry of Finance to get a broader picture of current projects and health priorities in the country.

Loren, joyously welcomed by women in the village

We split our time between Kasungu, the base for field operations, and the capitol city, Lilongwe, where the head CARE office is located. We went on a few field visits, where we met participants in the study. The women held a village savings and loans meeting during our visit, which is an intervention we are studying. Without access to formal banking in the very rural areas, village residents struggle to save money or procure loans. Village savings and loans groups essentially make it possible for villagers to save and grow their money. Read more about VS&L groups here . It was extremely helpful to visualize how the savings group functions: members each contribute a sum of money to the group; when someone wants to borrow money, she may do so, but must re-pay the amount back with interest in a designated period of time. The group members shared examples of what they do with the loans—buy bikes for transportation, expand businesses, pay for school uniforms and fees.

The field team and me after a day-long data analysis and interpretation workshop

During the weekends, I experienced Malawi culture by attending a wedding (and learning how to do the “money dance,” where money is tossed at the bride and groom in a celebratory dance), visiting beautiful Lake Malawi, and learning how to de-feather a freshly slaughtered chicken.

I’m putting together a mini-documentary describing the project and perspectives of project leaders and staff—stay tuned for the link!

En route to a field visit via motorbike

Many, many thanks to Loren and Lance for making this trip possible--and also to the entire field team in Malawi. I miss everyone!

-Katarina

Food security and nutrition

2011-12-14T14:35:00.002-06:00

Fellows visited SHARE Wisconsin, a food-buying club committed to making affordable food available to both areas undeserved by traditional grocery stores (areas known as "food deserts") as well as anyone interested in saving money. We began our day with a volunteer project, which mirrors the operational model of SHARE--highly volunteer-run. We packed 436 boxes of organic produce for SHARE clients (and had a great time doing it)!


Tyler, Anneke, Emma, Paula, and Jim work the assembly line

SHARE organic produce box

Rashonda, Kelli, and Anneke act as quality control inspectors

Kat and Kristen provide the assembly line muscle by stacking full boxes onto pallets

After a hearty lunch provided by SHARE, we heard about the SHARE Mobile Markets Project from the project's academic partners: Dr. Paul Hunter from UW-Madison and the Milwaukee Health Department, Courtenay Kessler and David Frazer from the Center for Urban Population Health, and Fellow Kelli Stader. Along with the project's evaluation and logistics, we learned a lot about processes and partnerships. For a more vibrant look at the project, watch this video.

The final session was a skill-building workshop hosted by David Frazer on facilitation. We had a great discussion on the differences between networks, collaborations, and relationships in the context of groups.

Acceptance Journeys

2011-12-05T12:34:00.001-06:00

On National Coming Out Day, October 11, I had the pleasure of attending the launch of an anti-homophobia campaign in Milwaukee. The campaign is called Acceptance Journeys, and it features photographs and stories of members of the lesbian, gay, bisexual and transgender (LGBT) community and their friends and family. Each story highlights how the friend or family member came to accept the LGBT person.
These photos and stories are printed on cards that are being distributed to United Way agencies and churches throughout Milwaukee to help start conversations about the importance of creating a supportive environment for people who identify as LGBT. Several people who are featured in Acceptance Journeys, including Milwaukee mayor Tom Barrett, shared their story in front of an audience of community members and leaders at the launch, held at Milwaukee City Hall.

Mayor Barrett with Kofi from Diverse and Resilient looking on

The project is the result of a CDC Epi Aid investigation of increased HIV among young African American gay and bisexual men in Milwaukee that concluded that homophobia is a major contributor to the increased infection rates. A Community Readiness Assessment helped identify one-on-one conversations and a low intensity media campaign as the best approach to address homophobia, and focus groups conducted by UW Communications professor Shawnika Hull helped identify key themes to highlight in the stories. The second phase of the project, a low intensity media campaign, has subsequently been launched, with billboards and advertisements featuring the Acceptance Journey photos at transit stations throughout Milwaukee. I can’t think of a better way to spend National Coming Out Day!

Shawnika Hull, Mari, and Anneke by some of the photos

Kudos to Gary Hollander and Kofi Short of Diverse and Resilient Inc, a community based organization in Milwaukee that is coordinating the project and campaign.

Site Profile: Walnut Way Conservation Corporation

2011-11-29T11:14:00.000-06:00

The next time you are in Milwaukee, consider making a visit to the Walnut Way Conservation Corporation (WWCC). Here, former Fellow Jessie Tobin serves as Preceptor for current Fellow Tyler Weber as the two work with their colleagues and partners at the Lindsay Heights Neighborhood Health Alliance, of which WWCC is a partner. The Health Alliance includes community-based organizations, businesses, public agencies, and academic institutions; its aim is to reduce health disparities and create a deep and sustained culture of health and community sufficiency within the Lindsay Heights Neighborhood.

Even in early winter, lettuce is growing and the view of the neighborhood through Milwaukee's only peach orchard provides a hint of the fruits summer will bring.

Real change is happening here. Engagement and optimism is evident in the staff, the surrounding and the WWCC mission: "to sustain economically diverse and abundant communities through civic engagement, environmental stewardship, and creating venues for prosperity."

You are invited to visit WWCC and the Lindsay Heights Neighborhood. There are free WWCC public tours from 5:30 to 6:30 pm on:
December 6, 2011
January 3, 2012
February 7, 2012

Please contact Tyler Weber (tyler@walnutway.org) if you would like to schedule a WWCC tour for individuals or groups outside of those dates. Feel free to visit the WWCC website for more information: (http://www.walnutway.org/). Enjoy your visit!

Community Research Council

2011-11-21T15:59:00.000-06:00

Hello Blog Readers,

My name is Tyler, and my endeavor as a Wisconsin Population Health Service Fellow just started in July 2011. The time I have in the fellowship is split between the City of Milwaukee Health Department (MHD) and the Lindsay Heights Neighborhood Health Alliance (LHNHA). My task in this post is to share with you a little bit about one of the projects I am currently working. Although I would love to share everything that is happening, I’m going to stay focused on how a majority of my time at the LHNHA is dedicated to the growth of the new Community Research Council (CRC).

The LHNHA’s mission is to, “reduce health disparities and create a deep and sustained culture of health and community sufficiency in our families and in our neighborhoods.” When the mission speaks of “our families and our neighborhoods,” it refers to the Lindsay Heights neighborhood that lives between Locust Street to Walnut Street and I-43 to 20th Street in North Milwaukee. Over the years there have been a number of research initiatives that have been put in place for the purpose of driving this mission forward, and now there is a decision making group within the neighborhood that will help ensure that these initiatives are developed and conducted in a manner that is both useful and meaningful, for the Lindsay Heights community residents.

The CRC is intended to be a decision making body within the Lindsay Heights community that can guide, inform, and direct ongoing and future research initiatives. Funding from the University of Wisconsin-Milwaukee's Cultures and Communities Program has allowed the CRC to get moving. Just having its first meeting in October 2011, the CRC launched with four members from the academic-research community and six residents within the Lindsay Heights Neighborhood. Some CRC members have research experience and some don’t. However, everyone does have a valuable life experience and are experts in their own right.

The first goal was achieved; bring a variety of people together from a variety of backgrounds, with a majority being from Lindsay Heights, to start discussions that engage in research. Now the next step is find a collective voice within CRC to create the synergy required of impactful research processes and outcomes for the Lindsay Heights neighborhood.

There are a number of directions that the CRC can take in order to inform and engage researchers and research initiatives. This could be in the form of required policies that researchers must follow or guidelines for implementation. It is important to note that the CRC is currently in the sharing stage of model included in this post. Consequently, no decisions have been made, but the wheels are turning and the CRC is in motion.

Fellow reviews book, "Deadly Choices: How the Anti- Vaccine Movement Threatens Us All"

2011-11-16T14:05:00.002-06:00

Anti-Vaccine Movement Threatens Us All

Paul Offit’s new book, Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, is reviewed by Kristen Audet, a Population Health Service Fellow with a two year placement at Rural Wisconsin Health Cooperative

Paul Offit opens Deadly Choices with the assertion that Americans are engaged in a war. Indeed, Offit writes, “There’s a war going on out there–a quiet, deadly war.” But Offit’s work somewhat disproves this statement: the war is not quiet. Granted, one can choose to ignore the war, but for those with children, those who work in health care, and those who work in education, the war cannot be avoided and it should not be ignored. Daily, those individuals encounter The Issue: childhood vaccinations. Throughout his book, Offit demonstrates to his readers his subtitle: how the anti-vaccine movement threatens us all.

Offit scientifically disproves the “science” behind the anti-vaccine movement. For Offit to do this is not difficult because for the most part, the scientific case had already been well made. Offit presents arguments put forth by the anti-vaccine movement and then demonstrates how all too often they are clearly disproven not only by scientific study, but through the legal process: the claims have not held up in court. Through his considerations of the various fronts of this “war,” Offit leaves his readers with some major lessons:

1. Don’t believe everything you read. This is something most of us learned from our parents early on, but it is especially pertinent in the vaccination debate. There is a lot of bad science out there, misleading intelligent people everyday. Anyone can put anything on the Internet nowadays. Just because an organization has a webpage does not mean it is credible. When doing research about vaccinations, it is important to consider the source and its credentials.

2. Don’t believe everything you hear or see. Television and media outlets are not the best source for vaccination information. Media can be a good starting point for information, but you should always talk to your doctor if you are unsure about what is best for you or your children. Further, while there can be mild side effects from vaccines, just because someone
you know experiences that does not mean that it will happen to you or your child, or that
those side effects are harmful.

3. Trust: Offit’s final chapter is titled “Trust.” The concept of “trust” truly highlights both sides of his war, and illuminates the need for us as a community to trust in each other. He writes, If we are to get past the constant barrage of misinformation based on mistrust, we have to set aside our cynicism about those who test, license, recommend, produce, and promote vaccines. Only then will we survive this detour-a detour that has caused far too many children to suffer needlessly.

Reading Offit’s work is both sad and encouraging. Reading his work, I was saddened by the masses of parents swayed by bad science, and saddened by the masses of children, as Offit puts it, in the middle of this war. Offit ends his book that he opened with an assertion, with a plea: “Following the tragedy of September 11, 2001, there was a moment when we all stood still and looked at each other. No longer individuals, we were part of a whole. Personal interests were irrelevant. We were united in our grief. One. Then the moment was gone, dissolved in a cloud of lawsuits, fingerpointing, partisanship, and blame. But although fleeting,
it had been there. And if we can recapture the feeling that we are all in this together, all part of a large immunological cooperative, the growing tragedy of children dying from preventable infections can be avoided. We can do this. It’s in us: the better angels of our nature.” It would do all of us well to step back and embrace our communal duty of protecting our nation’s youth.

Spanish social determinants of health researcher visits UW-Madison, Fellows

2011-11-15T11:48:00.001-06:00

Rafa Cofino

In October, Rafa Cofiño, a Spanish primary care physician and public health practitioner from Asturias, Spain, came to the University of Wisconsin Madison to learn about what was going on at the UW Population Health Institute and to teach us a few things about social media along the way. In addition to trying his first fried cheese curds, Rafa got to meet Population Health Service Fellows, public health partners around Wisconsin, and UW staff and faculty, including those at the County Health Rankings and Roadmaps project (Rafa and colleagues have implemented a similar project in Asturias: http://www.obsaludasturias.com/obsa/). For those interested in graphic illustration of the multiple determinants of health, you might want to check out Rafa’s site: http://merops360.com.ar/Examples/VirtualTours/El_Centro_de_la_Salud/El_Centro_de_la_Salud.html

-Marion Ceraso

Policy and Public Health

2011-11-14T22:55:00.001-06:00

Fellows and staff at the Wisconsin State Capitol

Fellows spent a day learning about the link between public health and policy. The meeting, organized by Emma Hynes and Katherine Vaughn-Jehring, included a mini-workshop on analyzing health-related legislation, a tour of the State Capitol building, a meet and greet with Wisconsin State Senator Fred Risser, and a meeting with Department of Health Services Executive Assistant Kevin Moore.

Women's Health in Wisconsin

2011-11-14T21:39:00.000-06:00

A visual representation of the Wisconsin Healthiest Women Initiative's concept and goals

I have a wonderful dual placement for my fellowship. I split my time between the Maternal and Child Health Unit at the Department of Health Services and the WI Alliance for Women's Health. Though I just started my fellowship in July, I have been astounded by how much I've already learned and the many opportunities for project ownership that I've had thus far. There are two projects that I am particularly proud and excited to be working on. One project that I just finished for the WI Alliance for Women's Health is an analysis of how the 2011-2013 budget will impact women and girls. It was a fascinating to investigate how political priorities impact individual lives and to learn about how short-term fiscal savings can have detrimental impacts on public health and the long-term economy. The report will be released in the next month or so.

Another project that I'm still working on is the Wisconsin Healthiest Women Initiative [WHWI]. The WHWI is working to improve the health of Wisconsin women by bringing together many of the organizations and individuals who work on women's health to coordinate a state-wide strategic plan for making these improvements. I've been taking on more and more responsibilities for the initiative as it evolves. I am currently planning an upcoming full-day strategic planning conference for about 90 individuals to continue to narrow down goals and recommendations for the focus areas we've picked. The initiative is a project that I really believe in and I'm excited to be playing such a valued role in it.

I learn new things every day! I am so grateful for the guidance that my preceptors give me and for the opportunities that keep coming my way. I'm excited to find out what's next!

-Emma Hynes

Fellows review community-academic grants

2011-11-11T17:33:00.001-06:00

photo credit: http://www.med.wisc.edu/wisconsin-partnership-program/main/499

Fellows Kelli Stader and Kat Grande were given the opportunity to serve as reviewers for the Wisconsin Partnership Program’s (WPP) Community-Academic Partnership Fund 2011 grant proposals. The WPP represents a far-reaching commitment by University of Wisconsin School of Medicine and Public Health to improve the health and well-being of Wisconsin residents through investments in research, education, prevention practices and interventions, and policy development.
The Community-Academic Partnership grants support efforts by Wisconsin community-based organizations and government agencies working in tandem with an academic partner to improve the health of Wisconsin residents and advance the goals of the State Health Plan, Healthiest Wisconsin 2020. Kelli and Kat each reviewed two Development and two Implementation grant proposals. They will join fellow expert reviewers on December 1st for an in-person discussion of the proposal reviews and scoring. Serving as a grant reviewer is an excellent way to learn about the grant process, to become familiar with a funding agency, or to network with colleagues working in public health!

-Kelli Stader

Improving Immunization Rates

2011-11-11T17:28:00.005-06:00

photo credit: http://www.rwhc.com/Home.aspx

At Rural Wisconsin Health Cooperative, we just had our second regional Southern Wisconsin Immunization Consortium meeting. We have a lot of ideas and energy for reaching out to stakeholders and improving immunization rates of 0-2 year old children in Wisconsin! At the Division of Public Health in Public Health Preparedness, we are preparing templates and processes for analyzing data from each of the state’s 103 local public health agencies on their Public Health Preparedness Capabilities Assessment. We are hoping to present our project at the Wisconsin Public Health Association conference this year and the American Public Health Association conference next year.

-Kristen Audet

Fellows present at American Public Health Association Conference

2011-11-08T16:05:00.001-06:00

A handful of Fellows and staff attended and presented at the annual American Public Health Association (APHA) conference in Washington, D.C. The conference theme, "Healthy Communities Promote Health Minds and Bodies," fit well with the community-based focus of the Fellowship.

Fellows Kat and Paula at the annual APHA confernce

Fellow Anneke Mohr hosted a roundtable discussion on the topic of HIV in rural communities. Director Marion Ceraso and Preceptor Geof Swain supported Fellows Kat Grande and Paula Tran Inzeo in their presentation, "Crossing the Classroom-Practice Chasm: A Model Fellowship Program in Wisconsin," which featured video clips of Fellow alums Kate Konkel, Raisa Koltun, and first-year Tyler Weber [The presentation abstract is posted here]. Fellowship coordinator Lesley Wolf headed to the conference early for a public health institute workshop. Paula ended the conference with her presentation, "Creating a Sustainable Model for Health Departments to Use Health Impact Assessment for Effective Planning and Policy Development" [abstract can be read here].

Lesley, Kat, and Paula enjoy an evening in D.C.'s Chinatown

Video clips from presentation

Raisa

Tyler

Kate

Fellowship Experience Video

2011-10-24T18:48:00.000-05:00

Kate Konkle, Fellow from 2008-2010, talks about her Fellowship experience.

Rural Health and Tribal Health

2011-10-21T11:11:00.076-05:00

Fellows roadtripped north to Lac du Flambeau, Wisconsin, for the annual Tribal Health and Rural Health meeting. Kristin Hill, Director of the Great Lakes Inter-Tribal Epidemiology Center, provided an Indian Health Services overview, which detailed the Trust Responsibility to provide health care, an agreement between the federal government and tribes to provide healthcare for all American Indians. Despite this agreement, gloomy health statistics prevail in Indian Country. To better grasp how issues of historical trauma are embedded in the daily lives of Native people, we spent time talking with Center staff and discussing the films The Canary Effect and Lighting the 7th Fire.

Fellows and GLITE-C staff discuss the film "The Canary Effect"

The sad topics were punctuated with hopeful stories and experienced, however. Epidemiologist Isaiah Brokenleg and Wisconsin Native American Tobacco Network Director Teresa Barber showed the group their traditional tobacco garden, which is used for prayer and offerings to the earth. The pair also hosted a digital storytelling workshop, which has been a therapeutic and inspiring method for sharing stories about painful topics.

Administrative Assistant Stacy Stone provided delicious homemade Indian tacos for the group. The group also took time to reflect on the meeting's themes by canoeing in beautiful Northwoods nature. We even saw two bald eagles!

Fellows and staff enjoy homemade Indian tacos

Mari, Katherine, and Paula canoe in the Northwoods

The following day, the Fellowship crew headed to Eagle River for a meeting with staff at the Vilas County Health Department. Here, we heard about the challenges and successes of working in a rural health setting.

Resource: CBPR Proposals

2011-09-20T15:03:00.001-05:00

From the University of Washington, here's a link to succinct and useful advice for writing community-based participatory research proposals.

Racism, Power, and Privilege

2011-09-14T13:55:00.033-05:00

The Fellows discussed the deeply important issues of racism, power, and privilege's impact on public health. The day started with a session from representatives from The Office for Equity and Diversity. Discussions that followed centered on:

Tyler and Paula, the meeting organizers, stop by Memorial Union's Terrace after an intense day of discussion.

Fellows Rashonda, Tyler, and Akbar enjoy UW-made ice cream.

Paula presents her CAL (Core Activity of Learning) for her project

Resource: Evaluation

2011-09-06T14:57:00.001-05:00

Thanks to Fellow Tyler Weber for reminding us that the CDC has a great comprehensive list of program evaluation resources here: http://www.cdc.gov/eval/resources/index.htm

Happy evaluating!

Meet the new Preceptors

2011-08-25T13:29:00.000-05:00

With a new class of Fellows comes a new group of Preceptors. These amazing mentors work with Fellows one-on-one for two years--check out their profiles here!

Tim Size, BSE, MBA [Preceptor]

2011-08-25T13:00:00.000-05:00

What is your role in the WI Population Health Fellowship program?

This is my first time as a preceptor for the WI Population Health Fellowship program. I am very excited about the opportunity to work with Kristen Audet during her placement at the Rural Wisconsin Health Cooperative (RWHC). Together with rural public health directors, public schools, clinics and RWHC hospitals, we will be developing a consortium to improve low childhood immunization rates.

What inspired you to become involved with the Fellowship program?

Several things came together: Marion Ceraso knew of my interest and offered Kristen and I the opportunity for the placement. I have enjoyed and personally benefited from prior experiences as a preceptor. The timing was ideal; the immunization project had just got to the point where it was ideal to have a Fellow available to help get it off the ground.

The Fellowship program is part of the University of Wisconsin’s Population Health Institute and I have had the pleasure of serving as a member of the Institute’s external advisory board since its beginning in 1994. In that capacity, I have long advocated for the Program to be broad in its vision for placements–to also include sites with a focus on rural health and with organizations that serve their communities but are not public health departments. Last but not least, I had the opportunity of participating in the Kellogg National Leadership Program in the late 1980s so I know first hand the value of fellowship programs.

What are a few highlights of your background in public health?

I started in Wisconsin in the mid 1970’s as an Assistant “Superintendent” at the University of Wisconsin Hospital & Clinics. That led almost immediately to engagement with the broader public health community, and my first experience with collaboration. I was asked to serve (as I was new to Madison and “unaligned”) as the chair of the newly formed Dane County Chemical Dependencies Consortium. Then as now, the Consortium worked to better serve a complex array of health and human service needs in an area chronically under funded. Since then my career has always been based in hospitals but linked to community. In the late 1970’s, I left the UW to become the first director of RWHC and for over thirty years have worked as an advocate for rural health and a developer of shared services amongst rural hospitals.

What are your main areas of interest within public health?

I sometimes joke about being a rural “mercenary as I live in Madison and work from home and at our offices in Sauk City. I work for a board of rural hospital CEOs on issues related to the availability, access, quality and cost of rural health. As you might guess, over time, this constitutes a broad array of issues and opportunities.

If I have had a focus, it has been in trying to “connect the dots” from a systems perspective. That has led me to lots of opportunities to weigh in on behalf of a rural perspective with many state and national boards and commissions. Most notably I had the opportunity to serve two separate terms on the federal National Advisory Committee on Rural Health & Human Services as well as the Institute of Medicine’s Committee on the Future of Rural Health.

What is one project you are working on right now that you are really excited about?

In cooperation with Dean Health Plan (DHP) and Unity Health Insurance, Rural Wisconsin Health Cooperative (RWHC) staff identified a particular low childhood immunization rate for Dean and Unity enrollees in rural southern Wisconsin. A task force of RWHC members and the health plans vetted both the measures and numbers and found them to be credible.

The health plan data showed that the combined Childhood Immunization Status rate for children age two in urban Dane County was 81% and the average in the rural counties* studied was 63%. The average rural on-time immunization rate using county health department data showed similar results. These rates were measured using specifications outlined by the Healthcare Effectiveness Data and Information Set (HEDIS). Rates in all counties were well below the 90th percentile–the frequently cited national Healthy People 2010 target.

The above data is unfortunately consistent with The Health of Wisconsin Report Card 2010 was released on March 23rd. Wisconsin’s grade for overall health is good compared to the other states in the nation—a “B-.” But Wisconsin receives a barely passing grade of D for its efforts to promote health for rural children and young adults.

RWHC asked primary care physicians, clinics, schools and public health departments for their assistance in identifying ideas to close the identified gap in childhood immunizations. The suggestion came back to from county public health directors to form a multi-county consortium to work together across the multiple sectors to achieve higher immunization rates, particular for children. The interim working title for this collaboration is the Southern Wisconsin Immunization Consortium (SWIC). Thirteen local immunization consortia exist in Wisconsin but only one of these consortia impacts a rural county in southern Wisconsin (Columbia). Advice will be sought from the Consortium in Columbia County as well as others nearby while the SWIC is in its formative stage.

Do you read a public health journal/blog/website regularly?

I am addicted to Google as it allows you to quickly look at an issue using multiple sources. I also am a fan of a two daily emails: Kaiser Health News and an instate subscription service, Wisconsin Health News, that also has a web presence at <http://wisconsinhealthnews.com/>. [Under full disclosure, I am on an informal advisory council for WHN.]

Do you have a public health role model/hero?

Dr. David Kindig, the founder of the UW Population Health Institute has long been a role model and hero. While an “emeritus” member of the UW faculty, he is still actively engaged as a national thought leader and moving the field of population health forward with help from a major grant from the Robert Wood Johnson Foundation. David thinks deeply and is not afraid to challenge conventional wisdom from the left or the right. Over several decades, he has been generous as a mentor, not a task for the faint of heart, both professionally and as a friend.

What is one public health-related activity in your community that you are proud about?

I am very proud that in Wisconsin, holes are beginning to be punched in both “medical” and “traditional” public health silos–that the two sectors are beginning to work more with each other.

What is one public health achievement you think will happen in the next 25 years? What is one you would like to see in the next 25 years?

I am at my roots an optimistic, so I would give the same answer to both questions. I believe we will continue to make significant progress in aligning our individual and collective investments with what we know most affects our individual and collective health.

Nicole Angresano, MPH [Preceptor]

2011-08-19T15:58:00.000-05:00

Nicole is the Vice President of Community Impact for United Way of Greater Milwaukee. She oversees more than 160 United Way-funded health and human service programs, as well as leading United Way’s community-wide teen pregnancy prevention efforts aimed at reducing Milwaukee’s rate of births to teens by 46% by 2015–an issue that has been a focus for her since completing a graduate school thesis on the topic. Nicole received the 2010 Special Achievement of a Public Health Partnership from WPHA for her role in addressing Milwaukee’s teen pregnancy crisis.

Nicole has a Master’s in Public Health from the University of North Carolina-Chapel Hill, concentrating on adolescent health and her personal public health heroes are Dr. Geof Swain and his team at the Milwaukee Health Department.

Born in New Jersey, Nicole spent her earlier years in rural Virginia. Today, she is a resident of Brown Deer where she lives with her husband, Josh, and their four-year-old son, Lucas. Both Yankees fans since birth, Nicole and Josh are embracing life in Milwaukee and raising their son to love the Brewers.

Mari Gasiorowicz, M.A [Preceptor]

2011-08-19T15:51:00.003-05:00

I’m an Epidemiologist in the Wisconsin Division of Public Health, AIDS/HIV Program. I joined DPH in 1994, initially as coordinator of the statewide HIV prevention community planning process, then as HIV prevention evaluation coordinator, and have focused on epidemiology in the last few years.

My greatest work interest is in triangulating multiple data sources and presenting the data in meaningful ways that lead to action. One of the AIDS/HIV Program’s biggest areas of emphasis in the last few years has been on addressing HIV in young African American MSM in Milwaukee County. HIV incidence and prevalence are both very high in this population. The DPH AIDS/HIV Program and City of Milwaukee Health Department invited Centers for Disease Control and Prevention (CDC) to conduct an investigation in 2009. Since then, we have been working with community partners to mount a response to this situation. It is exciting to see both the level of community engagement and the amount of funding that the planning process has leveraged.

We have conducted other investigations regarding clusters of Hepatitis C and HIV in various parts of the state. I appreciate the opportunity to work with hard-working local health department staff and others who have so many different health priorities on their plates. Here our challenges are to define the cluster and then to design prevention messages that reach the population without stigmatizing those affected, especially in rural communities.

Another interest of mine is analyzing and presenting data in ways that highlight critical health disparities, including for lesbian, gay, bisexual, and transgender (LGBT) populations. We saw in the Healthiest Wisconsin 2020 planning process the impact that the data had on elevating the goal of reducing health disparities for racial/ethnic minorities, people of lower socio-economic status, and LGBT youth and adults.

I have lived in East Africa twice. The first time was as a Peace Corps Volunteer teaching secondary school French in the 1980s. From 2006-2008, my family and I lived in Dar Es Salaam, Tanzania. I worked on monitoring and evaluation efforts under the President’s Emergency Plan for AIDS Relief (PEPFAR) for the Centers for Disease Control and Prevention (CDC). My favorite part of that job was helping young, smart, eager Government of Tanzania M&E specialists to develop their M&E capacity. The main reason for taking this position was to afford my kids (now teenagers) the opportunity to live in a developing country. It’s my hope that when they turn on the shower now that they think, “Wow, we have water today!”

This is my first year as a Population Health Institute Preceptor. I enjoy the process of guiding people in challenging and fulfilling opportunities to contribute to our important work in public health. My advice? If you’re in grad school in public health and are interested in data analysis, get some SAS and GIS classes under your belt. Our work is increasingly demanding these skills.

Sara Finger [Preceptor]

2011-08-19T15:07:00.002-05:00

Since June of 2004, Sara has been leading the effort to develop a new organizational coalition to unite, coordinate and amplify the voices of women's health supporters in Wisconsin. The Wisconsin Alliance for Women's Health is dedicated to advancing comprehensive women’s health in Wisconsin by engaging, educating, empowering and mobilizing individuals and organizations. Prior to assuming this role, Sara was the Northeast Director of Membership and Professional Relations for the Wisconsin Medical Society. She received her undergraduate degree in Political Science from the University of Wisconsin Eau Claire. She was a 2009 Mid-America Public Health Leadership Institute Fellow and currently serves as a Steering Commttee member of the Wisconsin Covering Kids & Families and board member of the Wellness Center for Door County. In 2010, Sara received a Champion of Women's Health Award from the Wisconsin Women's Health Foundation. In 2011, she was recognized by the Wisconsin Coalition Against Sexual Assault with a Voices of Courage Award.

Millie Jones, MPH [Preceptor]

2011-08-19T15:04:00.002-05:00

Millie Jones is employed by the Department of Health Services where she currently serves as the Family Health Clinical Consultant in the Family Health Section, Bureau of Community Health Promotion. Millie has experience in management and program positions in the Division of Public Health for over 20 years. Millie is currently committed to the life span approach for women and is interested in improving the health promotion messages targeted to women 15-44 years of age. Millie is a graduate of Wake Forest University, Wake Forest Medical School Physician Assistant Program and the University of North Carolina-Chapel Hill School of Public Health.

Lesley Wolf [Program Coordinator]

2011-08-19T14:58:00.004-05:00

What is your role in the WI Population Health Fellowship program?

Program Coordinator

What are a few highlights of your background in public health?

Prior to joining the University of Wisconsin Population Health Institute, I served as the Sales Manager for Homegrown Wisconsin Cooperative. I supported Wisconsin organic vegetable growers as a liaison to chefs in Chicago, Milwaukee and Madison and worked with communities to develop localized food systems.

What are your main areas of interest within public health?

Food systems, intersection of public health, nutrition and agricultural policy, urban and rural planning.

Heroes/person you have met?

As far as heroes, from the moment I met Ken Dunn, the founder and director of City Farm in Chicago, I knew what I wanted to be when I grew up. I took a tour of City Farm when I was first working for Home Grown and I was blown away, an urban farm in the middle of the city of Chicago! City Farm sits on a vacant lot flanked by Cabrini-Green on one side and the Gold Coast neighborhood on the other. City Farm not only grows amazing produce but they also serve as a training/learning facility for replicating the urban farm model. They set the bar high for urban planning, including a comprehensive, city wide recycling program that includes food scraps for compost and kitchen oil for bio fuels.

Do you have any advice for those interested in the Fellowship?

Apply! This is such a unique opportunity to find and define your public health role.

Which public health journal/blog/websites do you read regularly?

http://sustainableagriculture.net/

http://urbancycles.resourcecenterchicago.org/

What is one public health achievement you think will happen in the next 25 years? What is one you would like to see in the next 25 years?

We will achieve a healthier, more just and environmentally sustainable food and farming system.

Welcome 2011-2013 Wisconsin Population Health Service Fellows!

2011-08-02T16:12:00.000-05:00

On July 1, six new Wisconsin Population Health Service Fellows – Kristen Audet, Akbar Husain, Emma Hynes, Rashonda Jones, Anneke Mohr and Tyler Weber arrived in Wisconsin, rolled up their sleeves, and got to work. As part of their orientation to the program, new Fellows joined continuing Fellows Katarina Grande, Kelli Stader, Paula Tran Inzeo and Katherine Vaughn-Jehring in a day of service, landscaping a recently completed home for Habitat for Humanity.

New Fellows will be providing research, program and policy support to organizations working to improve health in communities across Wisconsin. This year’s placement organizations are in Eau Claire, Lac du Flambeau, Madison, Milwaukee and Sauk City.

Over the coming months, Kat - our Fellowship blogger - and the rest of the Fellows will keep us updated on the important public health work they are engaged in with partners across the state.

For now, here’s a small sample:

Kristen Audet (placed in the Wisconsin Public Health Preparedness Program at the Division of Public Health and the Rural Wisconsin Health Cooperative) is conducting research to address disparities in childhood immunization rates between rural and urban communities; Katarina (Kat) Grande (placed in the Milwaukee Health Department and the Center for Urban Population Health) is working with the Milwaukee Consortium for Hmong Health’s community health worker program to encourage breast and cervical cancer screening for Hmong women; Akbar Husain (placed in the Western Regional Office of the Division of Public Health in Eau Claire) is providing capacity building for community health improvement in communities in the western region; Emma Hynes (placed in the Maternal and Child Health Program at the Division of Public Health and the Wisconsin Alliance for Women’s Health) is engaging community partners to improve health and reduce health disparities through the Wisconsin Healthiest Women Initiative; Rashonda Jones (placed at the Milwaukee Health Department and the United Way of Greater Milwaukee) will provide project leadership to United Way of Greater Milwaukee’s Healthy Births Initiative; Anneke Mohr (placed at the AIDS/HIV Program in the Division of Public Health and at the Great Lakes Inter-tribal Epidemiology Center in Lac du Flambeau) is developing a protocol to improve access to medication in cases of non-occupational exposure to HIV/AIDS; Kelli Stader (placed with the Southern Regional Office of the Division of Public Health) is coordinating a division-wide self-assessment process in the Division of Public Health to prepare for national public health accreditation; Paula Tran Inzeo (placed in the Division of Public Health and the Wisconsin Center for Health Equity) is working on a grant to build the capacity of local health departments to include health perspectives in decision-making processes (Health Impact Assessment) and is generally focused on projects related to health inequities, social determinants of health and public health policy; Katherine Vaughn-Jehring (placed with the Division of Public Health and the Allied Wellness Center) is working with a statewide team to implement Wisconsin’s state health plan, Healthiest Wisconsin 2020; Tyler Weber (placed with the Milwaukee Health Department and the Lindsay Heights Neighborhood Health Alliance) is working on increasing access to health resources for families in North Milwaukee neighborhoods through community collaborations.

Action: Preceptor up for CLASSY Award

2011-08-01T16:00:00.001-05:00

Preceptor Sara Finger is a finalist for a CLASSY Award for Young Nonprofit Leader of the Year. Winners receive national recognition and $150,000 for their cause. You can vote for Sara by visiting this site: http://classyawards.stayclassy.org/classy-awards/voting

Quick! Voting closes August 26th.

Emma Hynes

2011-08-01T11:16:00.000-05:00

When did you begin your Fellowship?

July 1st, 2011

Where is your Fellowship?
I split my time between the Department of Health Services - Maternal & Child Health Unit and the Wisconsin Alliance for Women's Health.

What were you up to prior to your Fellowship?
Prior to my fellowship, I finished a Masters in Public Health and Masters in Public Affairs at the University of Wisconsin-Madison and then I took a year off and taught yoga while living abroad in Costa Rica and Nicaragua. I ate mangoes and spent lots of time practicing and teaching yoga. It was fantastic!

What inspired you to take the Fellowship route rather than a different type of job/school/etc.?
I wanted the opportunity to learn about a lot of different parts of the public health system. My current position allows me to discover the strengths and weaknesses of both the state and non-profit efforts happening in public health in the state. I couldn't have asked for a more interesting position or a bigger challenge.

What are your main areas of interest within public health?
I'm interested in the social determinants of health especially as it relates to women, health disparities and chronic disease.

What is one thing (or many!) you are working on right now in your fellowship? Please describe.
I am currently working on the leadership committee for the Wisconsin Healthiest Women Initiative. It is just getting off the ground but it is a fascinating project that aims to bring together organizations and community stakeholders in the state to determine how we can collectively improve the health of women in order to improve birth outcomes and reduce health disparities. In addition to the Healthiest Women Initiative I spend a lot of my time right now working on an analysis of the 2011-2013 budget and its effect on women and girls.

Do you read a public health journal/blog/website regularly? If so, what?

Though I find it helpful to read many different sites regularly, I read the Kaiser Family Foundation updates daily. It gives me a good dose of what's happening at the national level and I learn about a lot of the most recent health reports and policy updates.

Do you have a public health role model/hero? If so, describe.
I have countless public health role models and heroes. And I'm lucky enough to work with many of them. To go even broader though, I once read that Paul Farmer said that the way to end AIDS in Haiti was to give women jobs. When I read that quote (or something close to that) many years ago, something clicked in my brain that hadn't been there before. In a much clearer way than I ever had, I suddenly started to see the connection between socio-economic conditions and health status. So in some way, Paul Farmer is a role-model for me. But so are all of the incredible people that come to work in obscurity every day in order to make small but important improvements in the lives of others. The work relentlessly on our behalf and I'm constantly grateful.

What is one you would like to see in the next 25 years?

There are two public health achievements I would like to see happen in the next 25 years. I think it will be our generation's responsibility to change the current paradigm around both mental health and end-of-life care. I would like to see mental health spoken about, screened for, covered by providers and insurers and for people to not suffer from discrimination due to mental health. Similarly, I would like to see end-of-life care and death to be spoken about earlier and more openly. I would like it to be considered a natural part of life rather than a symptom to be cured or an unacceptable failure in the health care system. It's an issue we'll some day have to face as a culture due to our escalating health care costs.

Anneke Mohr

2011-08-01T11:09:00.000-05:00

When did you begin your Fellowship?

July 2011

Where is your Fellowship?

My primary placement is with the AIDS/HIV Program at the Department of Health Services, and my secondary placement is with the Great Lakes Inter-Tribal Epidemiology Center in Lac du Flambeau.

What were you up to prior to your Fellowship?

I spent the past three years completing my Master of Social Work and Master of Public Health at Washington University in St Louis. Prior to that I was an HIV case manager in Washington, DC and an HIV educator with the Peace Corps in Swaziland.

What inspired you to take the Fellowship route rather than a different type of job/school/etc.?

I’m originally from Wisconsin, so this was an excellent opportunity to come back. I’m interested in learning more about state government and tribal health and wanted to hone some of the skills I learned in my MPH program. Through the fellowship I am able to get involved in a variety of projects, see policy in action, and learn from the best in the field.

What are your main areas of interest within public health?

I’m most interested in HIV, tobacco control policy, physical activity, health equity, and social determinants of health. My final project for my MPH looked at smoking cessation for people living with HIV.

What is one thing (or many!) you are working on right now in your fellowship?

I’m currently working on a needs assessment and protocol development regarding medication access to prevent HIV transmission in cases of non-occupational exposure to HIV. I’m also working on grant writing and will soon be involved in evaluating a structural intervention to address homophobia in Milwaukee. After learning SAS, I will work on analyzing lesbian, gay, and bisexual (LGB) data from the BRFSS and YRBS. My work with Great Lakes Inter-Tribal Epidemiology Center will likely touch on accreditation of tribal clinics, County Health Rankings, and commercial tobacco policy work.

What is one public health achievement you think will happen in the next 25 years? What is one you would like to see in the next 25 years?
In the next 25 years, I (and the CDC) think that all states could have comprehensive smokefree policies so that no one is involuntarily exposed to secondhand smoke. I also like to speculate that the elimination of policies that discriminate against the LGBT community could have significant health implications, reducing the spread of HIV among gay and bisexual men and reducing some of the health disparities we’re currently seeing overall in the LGBT community.

Kristen Audet

2011-07-28T22:32:00.001-05:00

When did you begin your Fellowship?

August, 2011

Where is your Fellowship?

Dual placement at the Division of Public Health-Preparedness and the Rural Wisconsin Health Cooperative.

What were you up to prior to your Fellowship?

I was finishing up my JD /MPH at the University of Iowa by doing a practicum in tobacco control at the local public health department. I also spent evenings and weekends this summer working at a local bicycle shop, which was great.

What are your main areas of interest within public health?

Prevention, environmental health, and policy.

Who is one of the coolest public health people you've met?

All of my co-fellows! I spent the majority of orientation just being amazed at the experiences they’d had, the intellectual curiosity they harbored, and the friendliness they exuded!

What is one public health-related activity in your community that you are proud about?

Though I am new to Madison, I am really impressed at the city’s encouragement of walking, bicycling, and public transportation. It really eliminates the need for a car.

What is one public health achievement you think will happen in the next 25 years? What is one you would like to see in the next 25 years?

What do I think will happen? I am hopeful that we are going to see a decrease in tobacco use as the current generation ages. Working with youth during my practicum I got to see how engaged and excited the current generation of high school students is about promoting health among themselves and their peers.

Rashonda Jones

2011-07-28T22:27:00.002-05:00

When did you begin your fellowship?

July, 2011

Where is your fellowship?

My time is split between the Milwaukee Health Department and the United Way of Greater Milwaukee.

What were you up to prior to the fellowship?

I was finishing my MPH at the University of Wisconsin-Madison and raising my awesome twenty-two month old son, Elijah.

What inspired you to take the fellowship route rather than a different type of job/school/etc.?

There are so many opportunities to learn and grow, as a public health professional, with the fellowship. With the fellowship, I am given the opportunity to work on projects in my interest areas, and to have mentors to guide me in the process. This is not an experience available in regular public health positions.

What are your main areas of interest in public health?

I am most interested in improving birth outcomes in Milwaukee, as well as STD/HIV prevention, and teen pregnancy prevention.

What is one public health achievement that you would like to see in the next twenty-five years?

I would like to see the infant mortality rate for African-American infants in Milwaukee drop drastically.

Akbar Husain

2011-07-28T22:22:00.003-05:00

When did you begin your Fellowship?

July 1, 2011

Where is your Fellowship?

The Division of Public Health Western Regional Office in Eau Claire, WI

What were you up to prior to your Fellowship?

Before becoming a fellow I was completing my MPH in Health Behavior and Health Education at the University of Michigan (GO BLUE!). While in Ann Arbor I was working on cross-site evaluations of two project; the first focusing on access to fresh foods and the built environment and the second on childhood asthma in Missouri. In addition, I worked with various organizations in the Twin Cities developing programs and policies around the issues of tobacco policy and cancer screening.

What inspired you to take the Fellowship route rather than a different type of job/school/etc.?

I knew I didn’t want to pursue anymore school because I wanted to gain more practical experience in the public health field. The idea of becoming a fellow appealed to me more than a regular job because I felt that it would allow me to engage in public health work more broadly. The flexibility within the fellowship program is something I would not be able to experience as a regular employee.

What are your main areas of interest within public health?

Health disparities, evaluation, built environment.

What is one thing (or many!) you are working on right now in your fellowship?

Working at the regional office has really allowed me to become exposed to a variety of public health issues because it requires close collaboration with local health departments. My main projects will focus on providing technical assistance to local health departments as they work through the process of becoming accredited. In addition I will be working with health departments on their Community Health Improvement Process & Plans (CHIPP).

What is one public health-related activity in your community that you are proud about?

I am new to Eau Claire, but I have been very impressed by the city’s and surrounding area’s push to make the alternative forms of transportation such as walking and biking accessible and normative. There are a lot of options for outdoor recreation.

What is one public health achievement you think will happen in the next 25 years? What is one you would like to see in the next 25 years?

I would really like to see the public health world continue to value the wealth of knowledge that community members have when it comes to developing solutions to our most pressing health issues. Academics and public health officials have valuable skills and access to resources, but community members are the experts when it comes to identifying what will and will not work in their communities.

Tyler Weber

2011-07-28T22:18:00.002-05:00

When did you begin your Fellowship?

July 2011

Where is your Fellowship?

I spend half my time at the Milwaukee Health Department on 4 month rotations through a variety of different programs including, but not limited to, communicable disease, emergency preparedness, violence prevention, and community health. The other half of my time is spent at Walnut Way working with the Lindsay Heights Neighborhood Health Alliance on a number of different community health initiatives.

What were you up to prior to your Fellowship?

Before moving to Milwaukee I was out in Minneapolis, Minnesota finishing up my Master of Public Health in Maternal and Child Health with a Global Health Concentration at the University of Minnesota and working with the Refugee Health Program at the Minnesota Department of Health.

What inspired you to take the Fellowship route rather than a different type of job/school/etc.?

I carry a strong interest in service learning and community programming. The fellowship placements in state, local, and community public health programs, accompanied by an extensive support network of diverse health professionals, made for a very attractive opportunity.

What are your main areas of interest within public health?

My main interest at the moment is in improving birth outcomes in low resource settings, at home and abroad. More specifically, I want to work to accomplish this by working through public-private partnerships, community collaborative efforts, and conducting and utilizing program evaluations.

Do you have any advice for those interested in the Fellowship?

Take the initiative and apply! This fellowship will challenge your current knowledge and force you to step outside yourself.

Do you read a public health journal/blog/website regularly? If so, what?

I very much enjoy checking into the Global Health Hub every week. There are an overwhelming number of health issues on the planet but there are even more opportunities overcome them. The Global Health Hub does a nice job of giving information about both the problems and solutions.

I also love the Zunia knowledge exchange website, but you’ll just have to check it out yourself…www.zunia.org.

Who is one of the coolest public health people you’ve met?

I must give a shout out to my friends Dr. Osman Ahmed and Asli Ashkir back in Minneapolis, MN. They are hard working, dedicated, and delightful individuals that are tirelessly improving the health of the Somali community both in Minnesota and Somalia.

What is one public health-related activity in your community that you are proud about?

Well I’m new to Milwaukee, but I can say that I’m already impressed with the number initiatives and individuals that are working to better the health of Milwaukee. From the City Health Department to the neighborhoods, there are a lot of involved and incredible people.

What is one public health achievement you think will happen in the next 25 years? What is one you would like to see in the next 25 years?

I would like to see more research and programs that highlight and emphasize the importance of collective action and the environmental structures that support it. Even public health we sometimes miss the fact that we are an outcome of whom and what are around us. I see a stronger push in the future towards the wide recognition of topics such as collective efficacy, structural peace, and community resilience.

Fellows present at national conference

2011-07-23T16:01:00.016-05:00

Fellows Paul (left) and Kat (right) are joined by colleagues from the University of Minnesota at the NACCHO conference in Hartford, Connecticut

Fellows Kat and Paula, along with Preceptor Geof attended the National Association of City and County Health Officials conference in Hartford, Connecticut. Paula and Geof connected with the health equity community, while Kat presented a poster on tuberculosis.

Kat's poster: "City of Milwaukee Health Department response to a multi-family tuberculosis cluster: Novel methodologies in a case-contact investigation"

Fellow paves way for Wisconsin in federal health grants

2011-07-18T10:02:00.000-05:00

Thanks to efforts by Fellow Sara Soka and her team, Wisconsin communities are now able to apply for CDC Community Transformation grants. Read about the team's efforts in the story, "State reverses course, supports city's bid for federal health grants." For a video summarizing Sara's quest, visit this link. Congratulations, Sara!

Survey of the Health of Wisconsin Community Advisory Board

2011-06-30T16:56:00.000-05:00

Ella Dunbar (Social Development Commission), Samuel Holland (SHOW CAB spokesperson), Loren Galvao (Center for Urban Population Health), Kat Grande (Fellow), David Frazer (CUPH)

As a state, Wisconsin is relatively health; it ranked 16th in the United Health Foundation's 2010 American Health Rankings. Milwaukee County, however, presents a starkly different picture in terms of health determinants, ranking as one of the state's least healthy counties: 72st out of the state's 72 counties. To be effective in enhancing the health of Wisconsin's population, Survey of the Health of Wisconsin (SHOW) findings must reach and influence the lay public. Elimination of health disparities for African Americans requires that representatives from the affected communities be actively involved in all phases of the research, particularly in planning dissemination strategies. SHOW Community Advisory Board (CAB) members accepted this challenge by participating in an advisory board to SHOW. Fellow Kat Grande was part of the team that supported the efforts of the CAB.

For more details on the SHOW CAB project, visit this website: SHOW CAB project

To view a video of the SHOW CAB's presentation to community leaders and researchers about their perspective on health issues affecting their community, visit this website: SHOW CAB presentation

To view photos from the SHOW CAB presentation, visit this website: Photos from SHOW CAB presentation

Fellow Class of 2011 graduates!

2011-06-10T11:07:00.002-05:00

Congratulations to the Population Health Fellow Class of 2011! Fellows Marisa Stanley, Sara Soka, and Raisa Koltun will be greatly missed. But...keep your eye out for these three women--they'll continue improving the health of Wisconsin and beyond for years to come.


Fellows, preceptors, and staff attend the 2011 Fellow graduation ceremony

Preceptor Casey Schumann, Fellow Marisa Stanley, Preceptor Kristin Hill, Preceptor Jim Vergeront

Jim Vergeront, Director Marion Ceraso, Preceptor Amy Meinen, Fellow Sara Soka, Tom Oliver

Director Marion Ceraso, Preceptor Geof Swain, Fellow Raisa Koltun, Preceptor Sherri Ohly

Fellow Marisa Stanley gives a graduation speech, sporting a handmade graduation stole from a friend at the Great Lakes Inter-Tribal Epidemiology Center


Fellow Sara Soka delivers her graduation speech, highlighting lessons she has taken from the Fellowship experience

Fellow Raisa Koltun gives her graduation speech, describing how the Fellowship helped her discover her passion for public health policy work

Tribal Health

2011-05-24T19:24:00.000-05:00

Each year, the Fellowship crew embarks on a multi-day meeting to learn about an area of public health more deeply. This year's quest took the group to Wisconsin's North Woods to learn about tribal health. We piled into vans and headed north to the Great Lakes Inter-Tribal Council Epidemiology Center. Fellow Marisa Stanley spent Summer 2010 working with the Epi Center and, with the Center staff, graciously gave the Fellows a look into the world of tribal health.

After a restful night spent in cabins at the Trout Lake Research Center, we arrived at the Epi Center and received a crash course in Indian Health from Center Director Kristin Hill. We learned about the unique situation of tribal sovereign status, the Federal Government's Trust Responsibility to provide health care to native people, the impact of historical trauma on health, and that there are currently 564 federally recognized tribes nationwide.

Next, we heard from the Center's Program Director, Isaiah Brokenleg, who provided a straightforward "Working with Native Americans 101." Isaiah's personal stories and experiences working as a Native American public health professional were incredibly powerful and informative.

An amazingly authentic lunch followed the morning's presentations. Center administrator Stacy Stone presented the salivating group with fresh walleye speared by her husband and son, freshly hunted venison, wild rice, berries, frybread, and salad. Basically the most delicious meal ever.

The day's excitement escalated with the afternoon's "Johnnie Cakes Experience," which involved native drumming, dance and singing while learning about the meaning of certain sounds, voices, and messages. A supremely talented singing and drumming duo, Sonny Smart and Keith, got the group moving and grooving.

Next up: a tour of the reservation that included a stop at a cemetery (where we saw mini longhouses next to graves, in which the body's spirit lives), pow wow grounds, and many lakes.

The educational portion of the day concluded with the viewing of two emotionally exhausting, but critically important documentaries: "Lighting of the Seventh Fire" (about the spearfishing controversy in Northern Wisconsin) and "The Canary Effect" (about the effect of U.S. policies on tribes). The group reflected and vowed to share these films and knowledge with others.

The next day, the group heard about the uneasy history of boarding schools at a restored Lac du Flambeau boarding school. The historian shared tales of separated families, lost culture, and extremely poor health outcomes as a result of the school policies.

Next, we toured the beautiful new Pete Christensen Health Center, which provides health care to the region's tribal members. Then we toured the Lac du Flambeau Museum, which tied together all the topics we'd learned about. Lastly, we stopped at the casino for a brunch lunch and goodbye session with our incredible hosts.

What a unique experience--how lucky are we to have been given this intimate look into a culture and its tumultuous yet resilient history in the context of health? Very.

Social Marketing, New Media & Public Health

2011-04-21T11:38:00.003-05:00

Fellows gathered for a day of learning about social marketing--think anti-tobacco Truth campaign, anti-drug Above the Influence public service announcements, and, if you're in Milwaukee, the Strong Babies [get immunized, are breast-fed, shouldn't be around smokers] plastered on billboards and buses.

At KW2 Creative Communications Company, we learned how to develop a social marketing campaign: set goals, determine the target audience, understand the audience, develop a message, deliver the message, and evaluate the results. To practice, we tried to develop a campaign to address bullying. It was tough! We got pretty stuck on determining our target audience: bullies? parents? bullied kids? teachers? And so forth...

Sara, Kelli, and Paula developing a faux-anti-bullying social marketing campaign at KW2 in Madison

For the afternoon session, we headed to UW's brand shiny new Institutes for Discovery and then UW's brand shiny new Union South. As we passed the rock climbing wall and wine bar to our meeting room, the UW alumni among us were in awe.

Wisconsin Institute for Discovery

Marisa enjoying the Star Trek-like exhibits at the Institute for Discovery


Wisconsin Institute for Discovery

Mesozoic garden and Fibonacci fountain at the Wisconsin Institute for Discovery

Raisa at the Wisconsin Institute for Discovery

Katherine, Paula, and Sara presented "Social Marketing and Framing for Public Health" to the group, which inspired a good deal of discussion. We ended the session by critiquing (and enjoying) some current public health PSAs like this one from the New York City Health Department.

Water and Public Health

2011-03-24T11:41:00.001-05:00

Fellows and faculty prepare for a tour of the Milwaukee Metropolitan Sewerage District facility

On World Water Day 2011, Fellows and faculty celebrated appropriately by spending the monthly meeting focusing on the connections between water and public health. The day began with a discussion with the Communications Manager at the Milwaukee wastewater treatment plant.

We learned:

How wastewater is cleaned
How wastewater byproducts are transformed into Milorganite, a fertilizer
How combined sewer overflows happen
Details on Milwaukee's Deep Tunnel, which can store over 400 million gallons of water during times of heavy rain
About the challenges of treating stormwater


Joyce Harms, MMSD's Communications and Community Relations Manager, describes the current water storage volumes of the plant's systems

This machine drains water from material that will become Milorganite

Exploring the Milorganite heating chambers


Aeration tanks

Clarifiers

After learning about wastewater treatment, the group headed over to the Great Lakes WATER Institute to meet with Dr. Sandra McLellan. She presented her research on bacterial indicators of fecal pollution. That is, she figures out how to tell if places like beaches have traces of human waste--a major transmitter of disease.

Research vessel at the Great Lakes WATER Institute

Geof Swain and Jim Vergeront at the rainy Great Lakes WATER Institute

Discuss: Numbers that Matter

2011-02-24T16:23:00.002-06:00

Health information and data can be very powerful in influencing programming, policy and even everyday behavior. Medical and public health research go to great lengths to produce data to inform. We use it all the time to base our work and move innovation, but what about the lay community? What about Milwaukee residents for example?

As you most likely know, infant mortality is and has been a very real and pressing issue for Milwaukee, particularly in comparison to the rest of the state and the country. UWSMPH and the Wisconsin Partnership Program have initiated a three city initiative, gathering the human capital of our communities and putting resources into the planning of strategic plans to systematically address the issue and funding to implement the plans. The Milwaukee Journal Sentinel has also taken on the issue this year and will be providing in-depth coverage of the various risk and protective factors.

The challenge I pose here for discussion is to identify a statistic, comparison or some way to relate this issue or some angle of the issue to the Milwaukee residents- who may not be directly affected. If we want to make significant change in our community around infant mortality or any public health issue, we will need to start shifting the conversations towards addressing the social determinants of health and systems or environmental issues that either support or place barriers on the behavior change we seek in public health. Is there some way to bring the issue or the social determinants of health into our everyday life?

Let me share an example from authors of the book Made to Stick: Why Some Ideas Survive and Others Die, Dan and Chip Health. I think their example provides a nice narrative model for how to bring the enormity of data to an understandable and impactful level….

“It's possible to create intuition without losing shock value. In the film Super Size Me, documentarian Morgan Spurlock mentions a media campaign that encourages kids to eat five fruits and vegetables per day. Its ad budget is $2 million. Meanwhile, McDonald's annual ad budget for the United States is around $750 million. That's a ratio of 375 to 1. That may help explain why your daughter is more likely to beg for a Happy Meal than a fruit salad.

Spurlock could have gone one step further. His ratio is good -- better than millions and billions -- but we still haven't pulled it inside the frame of daily life. So suppose your 5-year-old daughter watches three hours of cartoons every Saturday morning and sees two McDonald's commercials per hour. Every Saturday, then, Ronald McDonald engages her six times.

How long will it be before your daughter sees a fruits-and-veggies commercial? She'd wait about 14 months to see the first one, and she'd have a driver's license before she saw 10 of them (the same number of McDonald's ads she'd see in two Saturdays).

A good statistic is one that aids a decision or shapes an opinion. For a stat to do either of those, it must be dragged within the everyday. That's your job -- to do the dragging. In our world of billions and trillions, that can be a lot of manual labor. But it's worth it: A number people can grasp is a number that can make a difference.”

Now you have the idea, can we work together to come up with one or more examples of a good statistic that can shape opinion and make a difference in Milwaukee?

Share your ideas and thoughts here. If you want to share your views but don’t want to post here, please email wipopulationhealthfellows@gmail.com.

Read more for background or details about the issues facing Milwaukee as they relate to Infant Mortality.

-David Frazer, MPH
Center for Urban Popuation Health

New content

2011-02-20T22:25:00.000-06:00

Fellow updates

Meeting highlights

Announcements, articles, and fun

Resource: Framing public health messages

2011-02-20T22:08:00.000-06:00

http://www.frameworksinstitute.org/

A handful of Fellows recently attended a workshop, hosted by Sara Soka and colleagues, on framing public health messages. The Frameworks Institute embraces peoples' deeply held values to communicate public health research and messages in a relevant way. If you're interested, check out their e-workshops here.

Public Health Policy and Politics

2011-02-20T22:00:00.000-06:00

State Capitol photo by Raisa Koltun

As Fellows met Tuesday, February 15, in an Assembly Hearing room in the state capitol building, cheers could be heard from the demonstrators convened in the rotunda to protest Governor Walker's budget repair bill, particularly the proposal to eliminate collective bargaining for state workers. Serendipitously, the "policy and politics" Fellow meeting theme was right on target.

After a brief introduction to advocacy in public health and a “Wisconsin Government 101” lesson by Fellow Raisa Koltun, the group welcomed Sandy Pasch, the second-term legislator from Assembly District 22. As a psychiatric nurse with training in bioethics, Representative Pasch spoke on a number of public health topics, including the importance of access to health care, challenges in communicating public health messages, and convincing legislators to make health a priority.

Representative Pasch identified challenges and opportunities for public health in the current political environment. Since public health yields savings over a longer timeline, investing in public health can be a tough sell—especially in economically volatile times. When she successfully steers public health policy through the legislature, she half-jokingly tells her dissenting colleagues, "Forty years from now, you're going to thank me for this!"

Fellows and staff asked Pasch how public health can have more of a voice in steering policy. When legislators disregard evidence-based information on which to base policy, Pasch advised public health practitioners to take the information back to the electorate, set up individual appointments with legislators, and encourage constituents to share personal stories related to the topic. “If we are serious about reigning in healthcare costs, we are going to have to do a lot more public health,” Pasch says.

Raisa Koltun

2011-02-10T14:31:00.001-06:00

Raisa is currently completing a fellowship in SMPH Department of Population Health where she has gained experience and expertise in adderessing social determinants of health through education and policy change. As of October 2011 she will be serving as the Associate Director for the Wisconsin Center for Health Equity. Raisa brings experience in evaluation, data analysis, program planning and implementation, grant writing and coalition building. She has held trainings, created and implemented strategies around health equity and social determinants of health. She has worked in partnership with several organizations in Milwaukee and statewide with various community, governmental and health care organizations. She currently serves as the chair of the Policy Development committee of WPHA and sits on the Steering Committee of the Milwaukee Latino Health Coalition.

Alison Gustafson, PhD, MPH, RD

2011-02-08T14:01:00.000-06:00

Alison was part of the first class of Fellows. She has recently accepted an Assistant Professor position at the University of Kentucky. She will be working in the Department of Nutrition.

Public Health’s Role in the Justice System

2011-02-02T18:50:00.001-06:00

photo credit: http://www.wi-doc.com/milwaukee_secure_detention_fac.htm

Fellows gathered for a tour of the Milwaukee Secure Detention Facility where they learned about public health challenges in the corrections system, especially those related to inmates re-entering society.


photo credit: http://www.ca-ppi.org/

The group then visited the Community Advocates Public Policy Institute to discuss the organization's Community Justice Project with Marilyn Walczak. The goal of this project is to address many of the public health challenges within the criminal justice system. The project aims to increase the presence of community-based programs as an alternative to incarceration and re-incarceration.

Health Equity and Social Justice

2011-02-02T18:45:00.000-06:00

Hightlights

Geof Swain provided an overview of the topics of health equity and social justice and introduced some of the Fellows to the Wisconsin Center for Health Equity. [Paula and Raisa work with the Center].
Virginia Zerpa-Uriona, Outreach Specialist at the Center for Urban Population Health, gave a moving presentation on "Social justice and research: Anti-HIV stigma campaign in the Latino Community in Milwaukee"
Claudia Kabler-Babbit and Maggi Cage of the Milwaukee LGBT Community Center presented LGBT public health intiatives underway at the LGBT Community Center
Mark O'Neil, the Director of Youth Services at Diverse and Resilient spoke to the group about capacity building

Global Health and Focus Groups

2011-02-02T18:35:00.000-06:00

Highlights

Fellows engaged in a panel discussion on global health with John Ferrick, Director of the College of Agriculture and Life Sciences International Programs, Jake Moskol, Coordinator of the University of Wisconsin-Madison Global Health Initiative, and Linda Vakunta, MS student in Rehabilitation Psychology from Cameroon.
Betty Kramer, Professor in the School of Social Work at UW-Madison, gave a presentation on "The Art and Science of Interviewing Groups: Focus Group Fundamentals."

Health and the Built Environment: Community Spaces, Parks, and Urban Gardens

2011-02-02T18:16:00.000-06:00

Growing Power

Fellow Paula Tran Inzeo enjoying greens at Growing Power

Fellows learn about urban gardens at Growing Power

Speaking with Venice Williams, Alice's Garden Program Director

Program Coordinator Lesley Wolf sprinkles worm dropping fertilizer onto lettuce at Growing Power

Fellow Sara Soka observes the aquaculture setup at Growing Power

Learning about the mulching process at Growing Power

Alice's Garden

Management and Leadership

2011-02-02T18:15:00.000-06:00

Highlights

We spoke with Paul Soglin, JD, about public management. He shared his experiences with Harambe, a clinic and education center that provided access and trust to a previously marginalized community in Madison.
Fellows took a leadership type inventory and discussed findings with Linda Heisler, Division of Health Services Training Director.
Mary Young and Lieske Giese of the Division of Health Services Regional Offices spoke about the differences between leaders and managers.

Health Disparities and Social Justice Conference: A Focus on Women’s Health

2011-02-01T15:07:00.000-06:00

Inspired by a recent Fellow meeting on the topic, Fellow Katarina Grande attended a social justice-themed conference hosted by DePaul University. Here’s her review of the event:

Session highlights:

Collaborating to reduce health disparities among African American women: A Community-Based Participatory Research workshop

I attended this session because I work with an African American community advisory board that utilizes components of community-based participatory research (CBPR). This talk showcased a few Washington, D.C.-based CBPR projects, one of which focused on infant mortality, a huge topic in Milwaukee. The speakers emphasized the need to treat these research relationships like personal relationships that should be nurtured over time. They advised that financial challenges should be discussed openly with the community partners…a wise lesson.

Promoting sexual health: going beyond the usual suspects

I was super late to this session because I was participating in a conference call about a tuberculosis cluster. When I arrived, groups were practicing identifying root causes of public health issues and potential structural interventions. I coaxed my group into using an example relevant to my work: health issues within the Hmong community, specifically access to mental health services in Milwaukee. We listed root causes of this issue: lack of transportation, language barriers, lack of Hmong mental health providers, gender roles, stigma, etc., and thought about structural-level, that is, big picture policy or community-level changes. The facilitator encouraged us to think beyond education campaigns and the dissemination of information—it was certainly a challenge.

Creating conditions of empowerment, behavior change and wellbeing among women of low socioeconomic status

Behavior change is one of the most difficult areas of public health I’ve witnessed. Even when changing behavior can greatly positively impact one’s health, it is still a major challenge. This session was quite useful—we learned about the components of motivational interviewing. A professor from the UW-Madison School of Nursing, Diane Lauver, spoke about the self-determination theory (this has a lot to do with motivation) as it relates to community-based participatory research. The premise of this type of motivational interviewing: for behavior change to occur, you cannot tell people what to do. You must ask people what they think about a problem or situation, assess their readiness to deal with the issue, allow them to develop realistic goals, and help them identify resources to form an action plan. We practiced motivational interviewing in small groups using case studies. It was a great exercise—we all found it difficult to not tell the “client” what we thought she should do!

Female condoms: Ringing in the New Year with Empowerment and Education

Female condoms are an interesting topic to me because they are frequently billed as a key to women’s empowerment in global health contexts where women have little control over their sexual health. But…I’ve always been a bit skeptical about the feasibility of this solution. After this dynamic presentation, however, I am officially an advocate (and cheerleader) for female condoms. Check out the excellent campaign website.

Health Impact Assessment: Wisconsin Capacity Building Initiative

2011-02-01T12:13:00.000-06:00

When Fellow Paula Tran Inzeo looks at buildings, highways, agriculture, and housing, she sees public health. Her work with Health Impact Assessments gives public health a seat at the table when it comes to planning and understanding impacts of policies and projects.

She writes, "The health impacts of the built environment are a growing concern for Wisconsin’s communities. While Wisconsin’s public health agencies have some existing capacity, a clear and coordinated strategy for keeping public health at the forefront of urban growth and land-use policies is lacking. The Bureau of Environmental and Occupational Health (BEOH) within the Division of Public Health (DPH) is integrated into a number of collaborative projects involving land redevelopment initiatives and has established excellent working relationships with state agencies, internal and external to public health. Therefore, BEOH applied for funding from the Association of State and Territorial Health Officials to continue development and implementation of strategies to engage with local partners, build capacity, and address the health consequences of built environment projects and policies at the state and local level through Health Impact Assessment (HIA).

HIA is a combination of procedures, methods and tools that systematically judges the potential, and sometimes unintended, effects of a policy, plan, program or project on the health of a population and the distribution of those effects within the population. HIA identifies appropriate actions to manage those effects. HIA includes five major steps: screening, scooping, assessment, reporting, and monitoring.

Screening	Determines the need and value of a HIA
Scoping	Determines which health impacts to evaluate, methods for analysis, and a workplan
Assessment	Provides: 1) a profile of existing health conditions, 2) evaluation of potential health impacts, 3) strategies to manage identified adverse health impacts
Reporting	Includes: 1) development of the HIA report and 2) communication of findings & recommendations
Monitoring	Tracks: 1) impacts on decision-making processes and the decision and 2) impacts of the decision on health determinants

BEOH learned a great deal from our efforts to build capacity statewide to integrate health into the decision-making processes where such conversations had not previously been had. Below is a summary of the key lessons learned which could be considered recommendations for best practices for HIA capacity building at the state level.

1) Successful development of a Health Impact Assessment Program at the state level must build off of existing programs or projects as funding for HIA projects is fleeting and often inadequate to support independent staff positions. Program staff must be grounded in other areas.

2) Capacity building efforts are enhanced when promotion of the HIA framework can be erected in unison with existing initiatives and with the support of functional, interdisciplinary groups.

3) Establishing connections and information exchange with other states or organizations building HIA programs or implementing the HIA framework, such as other ASTHO grantees, serves as an excellent resource for linking with new partners, circumventing barriers, and leveraging efforts.

4) With trainings as the centerpiece of capacity building efforts, develop an engaging curriculum that can be catered to the issues and concerns of participants’ communities. Trainings must be introduced and advertised well via multiple marketing outlets, including surveys, listservs, conferences seminars, and poster sessions. However, the value of personal contact can not be underestimated.

5) Trainings must be practical and relevant for participants, and sensitive to the potential limitations of rural health departments or understaffed organizations or agencies. Scaffolding the HIA framework and highlighting resources within the community that can alleviate time or staffing restraints increases the perceived feasibility of employing HIA.

6) Multidisciplinary training experiences are preferable to targeting only LHDs. Participants should represent diversity in professional fields of expertise but also in level of management.

7) Participation in HIA capacity building efforts and conducting HIAs requires managerial or supervisory staff to buy-in to the initiative. Since current staff resources for HIA must draw upon existing programs, upper-level consent for use of time and resources for HIA is imperative.

8) It is critical to capitalize on training momentum by establishing and maintaining regular communication with emerging HIA practitioners."

Allied Wellness Cooperative Receives Grant

2011-02-01T09:52:00.000-06:00

Thanks to Fellow Katherine Vaughn-Jehring, the Allied Wellness Center of Madison, Wisc., has received a Wisconsin Partnership Program grant. According to the awards web page, "This grant engages community members and the five core organizations of the Allied Wellness Center to investigate the best route to organizing a social cooperative that will address the social determinants of health."

Fellow Raisa Koltun's Community-Academic Partnership Grant Funded

2011-01-24T14:58:00.000-06:00

Second-year fellow Raisa Koltun has helped her community placement site, CORE/El Centro, receive a Wisconsin Partnership Program grant. The project, "Public Will Building to Reduce Obesity in the Latino Community of Milwaukee" focuses on the socioeconomic and environmental determinants of health, specifically obesity.

Read her executive summary:

Proyecto Salud is a grassroots collaborative project of two agencies, CORE/El Centro and Aurora Walker’s Point Community Clinic, located on the south side of Milwaukee. Proyecto Salud works with a largely Spanish-speaking, Latino immigrant population. Obesity is a nationwide epidemic, but has a much higher prevalence in the Latino community. This accounts for large disparities in health outcomes, including heart disease and diabetes. In this community, there are many programs and interventions available to fight the epidemic, however a vast majority of them focus on altering individual behaviors related to diet and exercise. Although this is a critical aspect of the solution, it does not take into consideration the many levels of influence on health behaviors – especially socioeconomic and environmental factors.

The goal of the proposed projecct is to increase awareness and build public will of Latino community members to address socioeconomicc and environmental determinants of obesity. This work will build on previous research conducted within this community regarding food and the community nutrition environment, by strengthening the evidence-base through the inclusion of community members’ experiences.

The main activities of this project are:

1 Create new partnerships be etween academic colleagues, Proyecto Salud and community members.

2 Hold guided group discussions, grounded in the public will building framework, with community members around the impact of socioeconomic and environmental determinants of obesity.

3 Bring together a Community Action Board who will analyze the data from the group discussions.

4 From the analyzed data, CAB will create a community-driven, evidence-based action plan.

We are requesting $50,000 to carry out this 15-month project beginning in June 2011, which will result in the following outcomes:

1 Strong community-academic partnership and increased CAB cohesion

2 Increased understanding of f community experiences regarding social and environmental determinants of obesity.

3 Increased CAB cohesion.

4. Compiled action plan The World Health Organization states: “The increased incorporation of community engagement and social participation in policy processes helps to ensure fair decision-making on health equity issues.” This speaks to the need for community-led advocacy efforts and is the basis for this project. Furthermore, most efforts in the community to fight obesity center around individual behavior change. A large body of evidence points to the fact that socioeconomic and environmental factors also play a significant role in health outcomes. This project develops the base of support for community-led advocacy efforts around socioeconoomic and environmental factors that contribute to obesity rates in the Latino community of Milwaukee. This project, in the long-term, aims to reduce health disparities by building strong community partnerships. This project supports the following WPP guiding principles: prevention, collaboration, responsiveness and sustainability. Furthermore, we will contribute to the State Health Plan, Healthiest Wisconsin 2020, by advancing the following three focus areas: Adequate, appropriate, and safe food and nutrition; Chronic disease prevention and management; and Collaborative partnerships for community health improvement.

New Partner Management Option Implemented for Controlling Sexually Transmitted Disease in Wisconsin

2011-01-05T15:46:00.000-06:00

Wisconsin has introduced expedited partner therapy (EPT) legislation for more than a decade. EPT - which allows sex partners of patients diagnosed with sexually transmitted diseases (STDs) to receive medication or a prescription without a prior medical evaluation- is considered by the Centers for Disease Control and Prevention to be a useful option to prevent persistent or re-current chlamydia or gonorrhea infection when other partner management strategies are impractical or unsuccessful. In Wisconsin there are more bacterial STDs reported than all other reportable communicable diseases combined. Over 30,000 cases were reported in Wisconsin in 2008, according to the STD Control Program at the Wisconsin Division of Public Health, and the rate of STDs has increased 33% in Wisconsin from 1999 to 2008.

As the Department of Health Services prepared to deliver research and guidance related to the re-introduction of EPT legislation, Marisa Stanley, a first-year Fellow working in the Bureau of Communicable Disease and Emergency Response, was called upon to help. With her preceptor, former Fellow Casey Schumann, AIDS/HIV Program Director and Fellowship mentor, Jim Vergeront, and the staff of the STD Control Program, Marisa researched legislation from other states, helped draft legislative language and organized testimony for the legislative hearings related to the public health initiative. She worked with the STD Control Program to develop educational documents for health care providers, patients and pharmacists. With successful passage of the legislation in 2010, Marisa is now working to ensure appropriate implementation and evaluation of the program.

Recipe: Vegan Chocolate Chip Pumpkin Cookies

2010-12-22T11:44:00.000-06:00

As featured at our December Fellow meeting:

Vegan Chocolate Chip Pumpkin Cookies
2 cups sugar
1 cup margarine
1 (15.5 oz) can solid pumpkin puree
2 teaspoons vanilla extract
4 cups flour
2 teaspoons baking soda
2 teaspoons ground cinnamon
12 oz. vegan semisweet chocolate chips (regular chocolate chips work too if you're not a vegan)

1. preheat oven to 375
2. cream the sugar, margarine, pumpkin and vanilla together. Mix until light and well combined.
3. mix the flour, baking soda and ground cinnamon. Stir the flour mixture into the creamed mixture. Mix until combined. Stir in the cholocate chips.
4. Drop by teaspoons onto an ungreased baking sheet. Bake for 12 to 15 minutes or until set. Let cookies cool on a rack.
**Makes 8-10 dozen**

Article: How to Fail at Grant Writing

2010-12-22T11:41:00.000-06:00

For a funny (yet insightful) look at the don'ts of grant writing, check out this article from The Chronicle of Higher Education.

Opportunity: UW Global Health Initiative RFP

2010-12-22T11:31:00.000-06:00

Interested in global health? Check out UW's Global Health Initiative Request for Proposals. Proposals are due on June 1, 2011.

Loren Galvao, MD, MPH [Preceptor]

2010-11-08T15:01:00.001-06:00

What is your role in the WI Population Health Fellowship program?
Loren Galvao, MD, MPH, joined the preceptor ranks in August 2010. “I believe it is a very exciting role because I get to see people grow in their career plans. For me, it is very gratifying to be working with a Fellow and develop with them new initiatives, new research, and publications.”

What inspired you to become involved with the Fellowship program?
“I am involved in the Population Health Sciences Dept; I have had an appointment as an honorary Fellow since 2005 so I have been working with other investigators there. I am also one of the Associate Directors for the SHOW [Survey of the Health of Wisconsin] project— a statewide population health project since 2005. I was contacted by the Fellow also who is very interested in global health. I work globally and locally—this Fellow is also interested in working globally and locally so I think we have a lot in common; it was a good match.”

What are a few highlights of your background in public health?
“I’m a physician, my medical degree is from Brazil and I also did training in OB/GYN early in my career. After that, my work has been very focused in public health and global health. For the past 20 years I have been working mostly in the area of reproductive health, HIV prevention, family planning, maternal and child health. So my research has evolved into a wide range of areas.

Early in my career I thought I would be a gynecologist. But then I moved to the U.S. and became interested in public health. My plan was to go back to Brazil and practice OB/GYN…but after I completed my degree in public health at the University of Michigan, my views changed a bit. However, even when I was in Brazil working in obstetrics and gynecology wards in large hospitals, I saw girls 12 and 13 delivering babies or having abortions—some of them would die at a young age due to abortions and complications. I wanted to work more to prevent these sorts of things from happening. So, I already had view of public health. Also, in my training in Brazil as a medical student, I had the opportunity to do a lot in community health and public health. Our university was very strongly focused on social medicine. So I had an opportunity as a medical student to already see these kinds of broad approaches—public health, social medicine. We also looked at the broader determinants of health because it is a country that has major disparities—economic and healthcare access. I grew up in that environment where I felt I needed to address these broader issues that are associated with health. When I came to the U.S. to do a Master’s degree in public health, I felt that my clinical background was helpful, but I really wanted to focus more on the public health. Most of my career has been public health but the clinical background helps, especially in global health. It was something that grew—through Master’s in public health, working in international organizations and now being in academia, I feel I can connect these worlds—of international non-governmental organizations (NGOs) and academia.

I have worked with the Population Council in Brazil researching family planning and HIV; conducting national assessments, qualitative studies and a randomized trial comparing female and male condoms in Brazil and several other studies on the female condom. Before that, I worked with Save the Children where I was mostly involved in global health programs; my work focused a lot on maternal and child health. At that time I worked with several countries in Latin America, Asia and Africa providing support to programs that implemented child survival, maternal health and family planning. The main areas where I worked were southern Africa, Bangladesh, and Bolivia. To date I have worked in 19 countries.

Since 1996, my research interests have really focused more on HIV prevention. When I came to the U.S. in 2001, I still was doing consulting for international organizations. I spent two years doing consulting for WHO, Family Health International, and the Population Health Council, mostly in the areas of HIV prevention, providing support and advice for studies.

In 2003 I joined the UW-Milwaukee Center for Cultural Diversity and Global Health and started developing research in Africa. After that, I also joined the Center for Urban Population Health as the Associate Director for Community Partnerships. So my work is really balanced between the global and the local. I divide my time and it’s a real challenge sometimes to do both global and local public health research—but it is possible and very rewarding.”

What are you working on right now?
“My major project internationally is an NIH-funded project where I’m a co-Principal Investigator in a 5-year study entitled “Pathways.” In this study, we are examining the pathways between HIV, poverty, and food security. This is in collaboration with the Medical College of Wisconsin and CARE-Malawi. CARE is a large humanitarian organization working in about 72 countries globally. This project is a large evaluation of a development intervention; the major components are microfinance, sustainable agriculture, and health. We are evaluating the long-term effects of these interventions on health outcomes including HIV, nutrition, reproductive health, gender, empowerment, and community and individual behaviors. It’s a multi-level evaluation. It’s important because there are few studies doing such a controlled, quasi-experimental design. You have a lot of evaluations for international NGOs that are limited in study design or scientific rigor. As we are reviewing the literature, we have found few evaluations using a quasi-experimental design. So it’s a very exciting study—this is the one I’m really focusing on globally.

In Wisconsin I’m very involved in SHOW—a major population-based cross-sectional household study that will be done over many years. One important thing about this study is that it forms an infrastructure for ancillary studies so there are opportunities for other researchers to join and design, for instance, community-specific surveys (“mini-SHOWs”) or “before and after” community-based intervention studies. I’m very interested, either in U.S. or globally, in studies that have effects and impacts on the community. Studies such as SHOW and Pathways provide an opportunity for others to join—other researchers, Fellows, and graduate students, to come and really sustain these kinds of studies. I am very pleased to have a Fellow working with us. She is involved in a community advisory board to the SHOW—it’s a small pilot study where we are looking at how we can use SHOW findings to interest communities to use this data to develop community action. So, the Fellow is involved in global and local projects. Hopefully there will be more Fellows in the future who are interested in this connection with the local and global. The U.S. is part of the global…but sometimes there is a separation. I believe there has been more interest in global health in the past decade in the U.S.; many universities are starting to expand their programs in global health so hopefully the universities in Wisconsin will expand their work in global health. I believe Fellows, graduate students, and other researchers are the key for that. The young people who are coming who are excited about it—they are key for this, to really keep this going…We’re trying to build a global health research team in Milwaukee—very exciting!”

Do you have any advice for those interested in the Fellowship?
“It’s important to have some experience in the community. It’s very important to have that connection where you deal directly with people—otherwise it becomes very theoretical. If you’re interested in global health, go to another country and spend at least a few months working with an international organization. Or if your focus is local—do something in the U.S. working directly with people. Even if a Fellow is going to focus on biostatistics or epidemiology or areas such as those, the Fellow would then have the experience with people in the communities and face the problems that affect the people in those communities. I believe this is essential.”

Do you have a public health role model/hero?
“There are so many that are wonderful people! One person I admire a lot is Dr. Helene Gayle—she is the president of CARE-USA. Her career is really fantastic—she’s worked with the CDC, Gates Foundation, and now CARE. She’s doing a wonderful job there and has been a leader both in the organization but also globally—she has been supportive of our project in Malawi. She is a person who really has a strong passion for global health and has been doing wonderful work.

Dr. Paul Farmer also on the academic side is a wonderful role model with all his work in Haiti and globally and looking really broadly at HIV and other health issues.”

What is one public health-related activity in your community that you are proud about?
“I believe there are many large studies that are published in academic journals and they are kept as…almost a secret by academics—they don’t really get to the communities. The way academia is set up is that the researchers have to publish their findings in peer-reviewed journals and books, but many times it doesn’t get to the real people—the lay people in the community. So, in working with SHOW for all these years, I felt that I would really like to see the findings get to the communities.

Milwaukee is one of the cities with major disparities in the U.S.—poverty levels are very high compared with other cities—fourth in terms of poverty. I believe SHOW is an extraordinary study that has a lot to give. I wouldn’t like to wait until we publish all the findings—it doesn’t get to those communities in need. So, the idea of the SHOW Community Advisory Board (CAB) came about in discussions with the community organizations here including the Social Development Commission (SDC), which is an organization that is also interested in addressing poverty and health issues. So I think it was a good marriage of academia and a local social service organization to look at research in a different way—really trying to translate those findings of a large and very important population health study to the communities.

And the idea is very simple: to bring people together who are clients of the SDC who are interested in improving health in their communities to discuss these findings as they are available. The preliminary findings from SHOW are becoming available now, so the idea is that they look at these findings through their own eyes—we have about 12 members—in sessions throughout the year where we discuss health and the ethics of research—this is very important given the history of African Americans with ethical issues and research; many people in the community are afraid of research, many don’t trust research, they are tired of being “researched.” The idea is to bring people together who are affected by major health disparities and look at the data and then from there, interpret the findings through their own eyes—not through the eyes of researchers only—and see how they could use the findings either to affect policies or to use the data for simple interventions they could do in the community, like community action.

Also they (the CAB) are serving as an advisory group on how we can disseminate the data to the community in a way that is understandable and it makes sense—that really reaches the community. For example, most researchers believe that publishing is enough. So we ask how can we make the data “talk,” and be meaningful for those communities and really affect change? There are many levels of affecting change—obviously it is very important to publish in the peer-reviewed literature and books but there are other ways to reach the community. It could be through media, art, songs, local journals, or local newspapers. I also believe it is important to let the data “talk” and can bring the real histories of people through narratives. Sometimes if you just present numbers it is not attractive to communities. We are already hearing from our SHOWCAB that they would like to see more visual dissemination of data. We are in the process of getting their advice at this point. We’ll have more recommendations next year but I believe it will be very interesting to see the inputs of the African American community. Hopefully there will be other researchers interested in this and it can multiply to other communities in Wisconsin. Since SHOW is statewide, there could be other communities who are interested in getting data and replicating this model for community action and really contributing to effect change.”

What is one public health achievement you think will happen in the next 25 years? What is one you would like to see in the next 25 years?
“Well, since I work in the area of HIV/AIDS, I would like to see a vaccine for HIV…and hopefully in 25 years we will have one. Before that, given that I have been working in primary prevention research with female and male condom—I would like to see a microbicide that is user-friendly for women, safe and low cost. Before we have a vaccine, this could be a great technology. I’m very interested in user-friendly, safe, effective and low-cost technologies for reproductive health that could improve women’s lives.”

Any closing thoughts?
“The Fellowship is a very important program. I would really like to see more Fellows interested in the connection between the local and the global—that the local is part of the global. So hopefully we’ll have more Fellows in the future in Wisconsin who are interested in this kind of work. I believe this program has enormous potential in public health and global health by bringing the passion of young investigators and people who will be doing this kind of research to the field!”

Matthew Landis

2010-11-03T12:49:00.000-05:00

When did you complete your Fellowship?

I completed my Fellowship in 2007

Where did you complete your Fellowship?

WI DHS Bureau of Health Information and Policy

What are you doing now, and where?

I graduated law school in 2010 with a Health Care Law and Compliance focus

How did the Fellowship contribute to your current situation?

The Fellowship solidified my desire to persue a legal education and bridge the gap between law policy and practice.

Do you have any advice for current Fellows or those interested in the Fellowship?

Take time to explore, but also have some goals developed that you want to work toward. It took me about 6 months to meet people, become a face people would associate with the position, and land on a project that I thought would enable me to meet the goals I set for myself (like give a presentation as a program representative, publish a paper, or manage an aspect of program development, implementation, or evaluation).

What types of projects are you currently involved in?

Currently I am a Health Care Compliance Consultant for a University of Minnesota affiliated Federally Qualified Health Center.

What are your main areas of interest within public health?

Objective approaches to measure key aspects of quality and compliance in health care settings, eliminating racial and ethnic disparities in health outcomes, developing multidisciplinary collaborations to address emerging policy issues, health reform.

Marisa Stanley

2010-11-03T12:38:00.001-05:00

When did you begin your Fellowship?

July 1, 2009

Where is your Fellowship?

Department of Health Services in the Division of Public Health and Great Lakes Inter-Tribal Epidemiology Center

What were you up to prior to your Fellowship?

Before graduate school, I was a research associate for a biotech company in Minneapolis, MN. During graduate school, I worked for the Minnesota Department of Health in the Immunization Program and was an intern with the Ryan White Program at Hennepin County.

What inspired you to take the Fellowship route rather than a different type of job/school/etc.?

I was/still am very interested in public health policy and wanted to explore and gain experience in that area. I especially like this fellowship because it is self guided. I can choose my own projects and explore many aspects of public health rather then being constrained by a specific description.

What are your main areas of interest within public health?

Policy, infectious diseases, and Tribal health

Do you have any advice for those interested in the Fellowship?

My advice is to apply. When else in your career are you going to have designated mentors to help you succeed and learn, the ability to pursue your own interests, and find where you want to be in public health?

Kate Konkle

2010-11-03T12:34:00.000-05:00

Fellowship

I completed the fellowship at the Division of Public Health Western Regional Office in Eau Claire.

I am now working for the UW Population Health Institute. I am a Program Manager for the Healthy Wisconsin Leadership Institute (HWLI), and I also work with the Community Engagement Team for the Mobilizing Action Toward Community Health (MATCH), also referred to as the County Health Rankings project.

I feel really lucky to be able to work and collaborate with so many wonderful people at PHI, and work on projects that are both fun and meaningful.

As a program manager with HWLI, I spend a lot of time on the Community Teams Program, developing curriculum around coalition building, collaborative leadership and community health improvement processes. I also provide technical assistance to the teams participating in the program. I love still getting to go out into communities and see the amazing work being done, and the passion and commitment for making communities healthier.

I am excited to work with the MATCH project since it offers an opportunity to work with communities around the country. I hope that I can both share some successes that we’ve had in Wisconsin with folks in other states, and learn from them and bring their success stories and lessons learned back to Wisconsin.

The fellowship was an invaluable experience, and absolutely is a huge part of why I am now working with HWLI and MATCH. When I graduated from my MPH program, I really wasn’t sure in what area of public health I wanted to focus. The fellowship gave me an opportunity to explore a few areas that were of interest, and introduced me to others. I had never considered public health systems work as an area of the field that might interest me, but through the fellowship I discovered that this is really where my passion is. Working to improve how the public health system functions is an important and sometimes overlooked part of making sure we can be successful. I find this work to be challenging but really rewarding.

The fellowship also offered a unique opportunity to have a leadership role on projects. Had I been an entry level employee in a public health agency, these opportunities would have been less likely. This also allowed me to build a network with public health leaders across the state, which was probably one of the greatest benefits of the fellowship.

If I have any advice for the current fellows, it would be to be a good self-advocate - make sure you are getting, and taking advantage of opportunities that are meaningful and valuable to you. And network, network network. Often who you know can be just as important as what you know, and when it comes time to find a job post fellowship, having lots of advocates in your corner will be a huge asset!

Other topics:

Hmmmm….do I have any public health heroes. When I was exploring public health as a career option, I read Mountains Beyond Mountains by Tracy Kidder, and Paul Farmer became one of my public health heroes. But since starting to work in the field, I feel like I’ve met so many people working every day in Wisconsin who have become mentors and also heroes. People are care very much about their community and seem to have a tireless energy for making it a healthier place; people who do so much with very few resources. I think heroes are people that inspire us to work harder and be better, and some the people I’ve had the opportunity to work with are definitely heroes as well as colleagues and mentors.

Amanda Schultz

2010-11-03T12:15:00.000-05:00

I completed my fellowship with UW Population Health Sciences July 07- June 09.

During my fellowship, I worked with the City of Milwaukee Health Department on various planning and evaluation projects and CORE/El Centro´s Proyecto Salud, organizing communities around Latino health on Milwaukee´s South side.I am currently an international volunteer with Asociacion Mujeres Defensoras de la Vida in Choluteca, Honduras. Here I work with women to improve the wellbeing of individuals, families, and communities through female leadership, political engagement, and strengthening of local economies. I feel that much of my experience in the fellowship has prepared me for the work that I am doing here by providing me with a strong base in community organizing, group facilitation, and planning. One of the primary projects I am currently involved in is a county wide effort to unite NGO and government programs and improve efficiency in preventing childhood malnourishment. I am also working with the Hesperian Foundation to create a culturally competent digital health commons in Spanish, where health workers will be able to access and create health literacy materials specific to the needs of their communities. Similarly, I rely primarily on electronic sources of news to stay informed. My electronic subscription to the American Public Health Journal has been a great way to stay up to date and plugged in…when I have time to read!

If I were to wish for a major public health achievement in the next 25 years, it would be a significant reduction in the income disparities between classes and a reduction in poverty on both a national and international scale. To me, poverty is one of the largest root causes of the public health concerns we face both as a nation and a world. In the next 25 years I think we will see a breaking down of race barriers (especially as whites will become the minority) and an increasing focus on collective efforts to address social determinants of health. Let´s get to work!