My main career focus has been on program implementation. I’m currently the PI for a PCORI-funded comparative effectiveness study involving low-income people with asthma between the ages of 5 and 75y, who are patients at either NeighborCare Health or Health Point. We are testing two interventions: a Community Health Worker who visits the patient’s home, and an enhanced clinic intervention. Most of this work is accomplished at King Country Health Department.
We’re using this project as pilot work to prepare a large (six-year) U01 proposal to NIH to test an integrated community-based pediatric asthma intervention to reduce disparities in health outcomes. If funded, the project would be run primarily through the King and Pierce County Heath Departments.
I’m also the site PI of a large international implementation study funded by the European Commission, called Fresh Air 2020. http://www.theipcrg.org/freshair. UW is one of 14 funded centers around the world. The four target countries are Uganda, Kyrgyzstan, Greece, and Vietnam. In each of these developing countries, we are working to implement a variety of evidence based strategies to improve respiratory health (further detailed on website). I lead delivery of an online training and feedback program known as Spirometry 360, and the overall Implementation Science effort.
Since 2009, our evidence-based, 5-month online Spirometry 360 program has been delivered to over 300 primary care sites around the country, as well as to clinical sites in Australia, Holland Pakistan, Bangladesh, India, and Kenya, in addition to the countries mentioned in the FA 2020 project above.
King and Pierce Counties
Southeast and Central Asia
Suzinne Pak-Gorstein MD, MPH, PhD is Associate Professor in the Department of Pediatrics; Adjunct Associate Professor in the Department of Global Health; Co-Director of the Nutrition Think Tank for the Global Center for Integrated Health of Women, Adolescents and Children (WACh-NTT); and Co-Director of the Resident Education and Advocacy for Global Child Health-Kenya program (REACH-Kenya Pathway).
As a clinician-educator, Suzinne trains pediatric residents and graduate students, and is a course instructor and lecturer for UW undergraduate courses on the topics of global public health and global nutrition/food systems. Her main research and service interest is the provision of culturally sensitive and high-quality care for refugee children in the US with a focus on obesity, undernutrition, and caring for medically complex refugee children. She also has interests in program monitoring and evaluation in low-income country settings and has been involved with nutrition surveillance systems, national surveys, and establishment of health information systems in several countries including Indonesia, Laos, Nepal, and Bangladesh.
Suzinne is the Co-Chair of the Academic Pediatric Association’s Global Health Special Interest Group, liaison to the Coalition of Centres in Global Child Health (CCGCH), and active member of the American Academy of Pediatric’s Section on International Child Health. Suzinne participated in the design and implementation of the UW Pediatric Residency Global Health Pathway Program which is a bilateral exchange program that trains pediatric residents from Seattle and Nairobi to integrate population health concepts and approaches into pediatric service through community health assessments, advocacy, and stakeholder engagement. The Global Health Pathways program (now named REACH-Kenya) was bestowed the 2014 Academic Pediatric Association Teaching Program Award.
Global Center for Integrated Health of Women, Adolescents and Children was created to break down the traditional silos between departments and capitalize on the benefits created when multiple disciplines approach a topic with the same end goal in mind. Maternal health expertise from the Department of Obstetrics/Gynecology, neonatal and child health expertise from the Department of Pediatrics, and vast experience working in infectious disease, health evaluation, education, clinical research, and service delivery within the Department of Global Health all combine to create a methodology that views women, children, and adolescents not as three independent populations but as interconnected.
The HIV Technical Cooperation Group (TCG) was formed as a pragmatic ‘think tank’ where thought leaders and practitioners exchange ideas, share best practices and catalyze innovation to build capacity in Public Health for HIV prevention and care.
Its goal is to make all TCG events highly-interactive working-group sessions that focus on pragmatic approaches to infrastructure issues in HIV public health.
The Northwest Pediatric Environmental Health Specialty Unit seeks to reduce environmental health risks to children by providing training for health professionals, communities and families through consultation, educational activities, and referrals.
The PEHSU is a North American network of experts dedicated to providing expertise and training for health professionals, trainees and the public on environmentally related health effects in children.
PEHSU faculty are academically based at university hospitals and include pediatricians, toxicologists, exposure scientists and others.
Over the past 30 years, children in the United States have become gradually less active, less able to do physical activities, and less healthy. Inactive lifestyles are taking away the capacity of children and adolescents to function and develop normally and to achieve peak health.
UW Medicine’s Sports Health and Safety Institute (SHSI) is an international education, advocacy and research organization devoted to helping people pursue an active lifestyle while providing tools to keep them safe and speed healing after illness or injury.
Founded in 2015, SHSI focuses on three core activities:
- Education. Safe sports, good health decisions, excellent care and informed policy begin with education. The Institute’s educational materials are freely available to parents, athletes, coaches and medical professionals.
- Advocacy. SHSI pursues policies and supports legislation that advance sports safety and health.
- Research. SHSI collaborates with researchers to identify best practices for effective public health education, to change behaviors and make sports safer, and to advance knowledge about sports-related concussion.
Our core works on social, behavioral and public health related research supporting HIV prevention and care.
The specific aims of the Sociobehavioral and Prevention Research Core are to support:
HIV Prevention Research, including technical assistance to CFAR investigators, organizing forums for interdisciplinary research community development, expanding our substantive expertise to include addictions, substance use, and mental health research.
Local Community Outreach, including working with CFAR’s Community Action Board to pursue community-based research priorities and translational opportunities, taking advantage of our institutional ties to Seattle & King County Public Health to stimulate collaborative research projects and evidence-based policy development.
International Community Outreach, including working with the International Core to identify collaborative research and translational opportunities with the new University of Nairobi Center for HIV Prevention and Research (UNCHIVPR) on translational research for HIV prevention. Integrating social, behavioral, and clinical science is increasingly necessary for progress in controlling HIV, and the Sociobehavioral and Prevention Research Core works to assure this synergy by providing support to behavioral, clinical, and social scientists in their research.
Assessment of health and quality of life of vulnerable populations including people with disabilities. Tracking of US national health goals with years of healthy life indicator.
Dr. Beverly Green is a family physician and associate investigator at Group Health and Group Health Research Institute. Her areas of interest include population based screening within organized health care and safety net settings, improving the care of chronic conditions such as hypertension, and leveraging technology to optimize the reach and effectiveness of evidence-based health care. She is also a Clinical Associate Professor in the University of Washington Medical School Department of Family Medicine.
Prof Cox is one of the lead investigators in an International Consortium put together with the aim of identifying the genetic basis of cleft lip/palate. Patients, and particularly families with multiple affected individuals, have been collected from the US, Australia, Netherlands, Colombia and the Philippines.
The project, currently supported by federal funding from Australia, has been conducting exome and whole-genome sequencing. New candidate genes are being assessed in Prof Cox’s laboratory through functional studies involving a combination of in vitro assays and mouse models.
Additional research in the Cox lab is focused on the molecular and developmental mechanisms causing facial clefts, the role of diet in mitigating the severity of presentation, and the role of ‘cleft’ genes in other dental phenotypes commonly seen in patients. We are interested in partnering with other clinicians and basic researchers with interests in clinical outcomes in the management of individuals with clefts or other craniofacial malformations, genetic testing, or basic epithelial biology.
The mission of the DeRouen Center, established in 2017, is to promote collaboration and inclusivity in scientific and clinical research that impacts global oral health. Through dedicated teamwork, our center promotes worldwide oral health. We are strategically targeting our efforts to four geographical areas with sites where we have been successfully working: Southeast Asia (with Thailand as our lead site), Africa (with Kenya as our lead site), South America (with Peru as the lead), and Seattle.
Thailand: For over 25 years, the School of Dentistry, University of Washington (UW), has collaborated with Khon Kaen and Thammasat Universities to conduct The Fogarty International Center Training Program in Clinical, Public Health and Behavioral Oral Health Research for Thailand. Through comprehensive workshops and Summer Institutes in Clinical Dental Research Methods, participants received education and training in biostatistics, clinical epidemiology and study design, behavioral research methods, data analysis, clinical trials, grantsmanship, research ethics, and research proposal development. A selected subset of participants completed a two-year long program requiring one year of coursework at UW (which applied towards a Ph.D. program at their home institution) implementation of a research study, Ph.D. dissertation defense, and article publication. Founded in 2002, the revolutionary program has brought Thailand to the international forefront of oral health research.
Kenya: The Universities of Washington and Nairobi have a more than 25-year partnership in maternal-child HIV research. In 2015, we established a new working group focused on improving oral health in HIV-infected and HIV-exposed non-infected children. This collaborative effort is nested within the NIH funded Kenyan Pediatric Studies (KPS) and the study team consists of specialists in molecular epidemiology, pediatrics, dentistry, integration and implementation sciences, epidemiology and neurocognitive science. We initiated our work in 2015 with parents’ assessment of oral manifestations of HIV among the KPS cohorts. In January 2016, with the support of a UW Global Innovation Award, Dr. Seminario conducted training and calibration of dental community health officers and medical providers in the diagnosis of oral manifestations of HIV in Nairobi. Currently, Dr. Seminario has been awarded the 2017 UW SunStar Preventive Dentistry Award to investigate correlations between oral inflammation with general inflammation among these children. In addition, we have expanded our collaboration to Nigeria and were awarded by the International Association for Dental Research (IADR) Regional Development Program for the development of a regional site in Africa targeting the impact of HIV on the oral health of children and adolescents.
Peru: Since 2014, we have had two supplemental NIH (from Fogarty International Center) grants that allowed the development of two 5-day workshops in clinical dental research methods. Approximately seventy junior dental faculty participated in these trainings including attendees from various geographical areas within Peru as well as from other Latin American countries (Colombia, Argentina, Chile, Venezuela and Brazil). Participants were from various specialties, including: orthodontics, pediatric dentistry, endodontics, implantology, community dentistry, special care needs, esthetics, prosthodontics, and periodontics. Workshop topics included general scientific principles in planning and carrying out clinical research projects; levels of evidence in evidence-based clinical research; study designs, their applications, and the levels of evidence they produce; principles in the design and conduct of randomized clinical trials; statistical concepts and principles in testing hypotheses and evaluating evidence from clinical studies; basic behavioral models and principles in clinical dental research; ethical issues in the conduct of research on human subjects; and grantsmanship. Currently, we are partnering with our colleagues in Landscape Architecture and in Environment Health to assess the impact of environment interventions on oral and gut microbiome in a floating community on the Amazon River, in Iquitos, Peru.
Seattle: We are partnering with the SeaMar Community Clinics to improve the quality of life of refugees coming to Seattle for resettlement. The goal of this collaboration is to increase dental utilization by children from refugee families as Medicaid fully covers any pediatric oral health need including treatment under general anesthesia and these families are Medicaid enrolled soon after they arrive to our country. Through this program, we will be researching the impact of oral health on children’s growth and quality of life.
Dr. McKinney received her doctorate in epidemiology from the University of Washington in 2006. Her research interests are focused on craniofacial, oral, and nutritional health in young children. She is based in the Division of Craniofacial Medicine in the Department of Pediatrics at the UW School of Medicine.
Dr. McKinney currently studies the unique intersection of oral clefts, maternal breast milk expression, infant feeding and global health. She spearheaded the development of the NIFTY cup – an infant feeding cup for infants with breastfeeding difficulties such as infants with oral clefts and preterm infants in low resource settings – with a team of multidisciplinary experts from Seattle Childrens, PATH, the University of Washington and Laerdal Global Health. Her global research collaborations involve partners in Thailand, India and Ghana.
The Institute for Health Metrics and Evaluation (IHME) is an independent global health research center at the University of Washington that provides rigorous and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them.
IHME makes this information freely available so that policymakers have the evidence they need to make informed decisions about how to allocate resources to best improve population health.
Assistant Professor based at the Institute for Health Metrics and Evaluation, focusing on a variety of population health topics, including Neglected Tropical Diseases, Vector-borne, Zoonotoc and potentially pandemic pathogens
The Center for Cardiovascular Biology is dedicated to discovering the molecular basis of cardiovascular disease, harnessing this information to develop new therapies, and training the next generation of cardiovascular physicians and scientists.
The University and its affiliated institutions, the Fred Hutchinson Cancer Research Center, and Seattle Children’s Hospital, are widely regarded as leaders among the premiere biomedical research institutions in the world, with great strengths in the constellation of areas crucial for success in stem cell research and regenerative medicine.
Their strategy is to bring these interdisciplinary strengths together, and to leverage their basic research to develop therapies. ISCRM integrates diverse scientific and clinical disciplines.
We conduct research on interventions to promote nurturing early parent child relationships in families with infants birth to five that are living in adverse circumstances. Families may be experiencing adult mental health and substance use, poverty, immigration and refuge status, and/or child maltreatment and neglect.
AIMS (Advancing Integrated Mental Health Solutions) Center faculty and staff at the University of Washington have worked for over 20 years to develop, test and implement an approach called Collaborative Care to treat the large numbers of people suffering unnecessarily from mental illness. Collaborative Care is an integrated care model that brings high quality mental health care to primary care clinics and other familiar settings. Its strength lies in treating persistent mental health conditions like depression and anxiety that require systematic follow-up for patients to get better.
The de Tornyay Center serves as a catalyst for promoting healthy aging through its support of research and education in the field of gerontology.
The Center is committed to advancing and sharing knowledge about successful aging and ways professionals and systems can promote optimal experiences for older adults. Developing competent and compassionate healthcare providers is critically important.
The Center is a resource for faculty involved in teaching gerontology, for students interested in older adults, and for practicing professionals seeking continuing education and collaborative initiatives. Specifically, the Center promotes the development of researchers from undergraduate nursing students through senior nursing faculty by creating opportunities for researchers to exchange ideas, funding projects, and sharing research findings through seminars and presentations.
Nursing faculty affiliated with the de Tornyay Center for Healthy Aging come from several health sciences fields and conduct research ranging from basic research to clinical inquiry and systems research. Studies are conducted in a variety of settings, including both communities and organizations. Some examples of research topics include:
- Cognitive aging
- Dementia and dementia caregivers
- Palliative care
- Physical activity
- Technology and older adults
The Center is committed to improving the lives of older adults locally and globally. We partner with community organizations to host conferences, informational seminars, events, discussions, and more. Our faculty are members of local and national associations and research centers and often are featured speakers or guest lecturers.
The Occupational Epidemiology and Health Outcomes Program uses workers’ compensation data and its own research to improve medical care, update treatment guidelines, and provide information on treatment outcomes to injured workers, employers, and physicians.
The Pacific Northwest Agricultural Safety and Health Center conducts research and promotes best health and safety practices for Northwest producers and workers in farming, fishing and forestry.
Affiliated with the UW School of Public Health, PNASH integrates expertise from multiple disciplines, institutions and community partners. Areas of emphasis include new production technologies and the needs of under-served and vulnerable populations.
Population health research projects in which I am involved follow. All of these are under the auspices of the UW Health Promotion Research Center (http://depts.washington.edu/hprc/), a 30-year, competitively funded member of the CDC Prevention Research Centers Program.
HealthLinks Dissemination in Rural WA, Co-PIs: Peggy Hannon and Jeff Harris
The Northwest Center for Occupational Health and Safety (NWCOHS) is a multi-component training program dedicated to prevention of work-related injury and illness in the four federal Region X states of Alaska, Idaho, Oregon, and Washington by providing academic training for professional workforce needs and professional education and research services to employers, workers, and health and safety professionals.
Since 1977, the NWCOHS has been funded as a National Institute for Occupational Safety and Health (NIOSH) Education and Research Center (ERC), the only one in the region.
The UW School of Nursing Center for Global Health Nursing works to promote nursing research and training to build capacity for appropriate and sustainable improvements in health and healthcare. It aims to do this through innovative nursing science, across differing cultural contexts, both locally and abroad.
The center harnesses the existing expertise, experience, and enthusiasm of the UW School of Nursing faculty and students in partnership with local, national and global nursing organizations and academic institutions.
The University of Washington’s DISCOVER (Disease Investigation through Specialized Clinically Oriented Ventures in Environmental Research) Center studies the mechanistic relationship between cardiovascular disease and traffic related air pollution.
The study is composed of five closely linked projects that explore this relationship through a diverse set of research approaches. Our ultimate mission is to transfer the findings of the center rapidly into the development of improved clinical and public health practice
The UW Psychiatry Division of Population Health is dedicated to improving the health of the public by developing, testing, evaluating, and implementing effective behavioral health interventions across the entire spectrum of health care delivery.
We are committed to finding new and innovative approaches to providing effective behavioral health care to defined populations. Our strength lies in knowledge transfer and practice-based learning with implementation work driving new research questions and research results driving new implementation methodology. Our researchers conduct both qualitative and quantitative research and use large data sets to establish benchmarks for treatment outcomes and to study variation across patients, providers, practice and policy.
The Division of Population Health focuses on four primary challenges facing mental health care:
Although there are numerous effective treatments for psychiatric disorders, these treatments often do not reach the patients who need them. We develop and test innovations that increase the healthcare system’s capacity to deliver effective treatments and increase patient’s access to and engagement in effective treatments. Scientific Aims:
- Shift treatment tasks to lower levels of care and encourage patient
self-management to increase capacity.
- Use technology to substitute virtual care encounters for face-to-face visits to increase access.
- Use virtual care technologies to augment face-to-face visits by facilitating between-visit patient-provider communications and to better determine when face-to-face visits are needed in order to increase both access and capacity.
- “Flip the clinic” and deliver care in non-traditional settings, including the home, to increase access.
For individuals with psychiatric disorders who engage in treatment, it often takes too long to find the right treatment (or combination of treatments) that is most effective. We identify and test methods for predicting which treatment or treatments will be most effective for a particular patient, as well as methods for more quickly detecting when treatment is ineffective. Scientific Aims:
- Develop and test feasible methods for measurement-based care to facilitate identifying treatment non-response.
- Test approaches to promoting shared decision making to encourage the delivery of treatments that address patients’ treatment goals.
- Identify important treatment moderators to help patients and providers choose the right treatment.
- Determine how pharmacogenetics can inform treatment decision making to facilitate precision medicine.
Closing the Mortality Gap
Individuals living with psychiatric disorders endure a greater burden of illness over their lifetimes and experience higher mortality rates. For individuals living with a psychiatric disorder, we develop clinical and public health interventions that promote healthy lifestyles, higher quality of care for physical health disorders and better management of side effects of psychotropic medications. Scientific Aims:
- Develop and test smoking cessation, opioid tapering, and exercise programs for patients with psychiatric disorders.
- Develop and test models of integrating of physical health care into specialty mental health settings.
- Develop and test feasible methods to monitor metabolic side effects of psychotropic medications.
- Develop and test clinical and public health interventions to prevent suicide.
Bridging the Research-Practice Chasm
It takes too long for newly developed evidence-based treatments to be adopted by providers and incorporated into routine care. To bridge the chasm between research and practice, we identify and test implementation strategies that effectively promote the adoption of new evidence-based practices. Scientific Aims:
- Identify variations in the quality of care and deployment of evidence based practices in routine care.
- Identify valid quality metrics and pay-for-performance systems.
- Develop and test clinical decision support systems that encourage evidence based care.
- Test alternative training and facilitation strategies to promote implementation.
- Adapt existing evidence based practices for different populations and clinic settings.