2022 Association of Clinicians for the Underserved Conference - Resilience and Transformation in Care Logo

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2022 ACU Conference Posters

The following poster sessions are confirmed for the 2022 ACU Annual Conference, “Resilience & Transformation in Care,” taking place in Washington, D.C., and online on July 31-August 2. Additional posters will be added as they are confirmed. Click on any title below to view details and presenters, and register now to join us online at ACU’s 2022 Annual Conference.

Click the title for poster abstract and presenter information

A Novel Population Health Approach to Improving Autism Screening at a Community Health Center

Screening for autism improves early diagnosis and long-term outcomes. Hispanic and Black children disproportionately experience diagnosis delays. In our community health center serving an urban, low-income, majority Hispanic and Black population, we aimed to increase autism screening rates through a novel approach using population health data, a community health worker (CHW), and telemedicine. During the 6-month effort, we generated reports of 18-30 mo patients who lacked a documented M-CHAT, ordered by risk of high healthcare costs. The CHW contacted families, provided brief education on autism screening, and scheduled telemedicine visits with a pediatrician. During the visit, the pediatrician completed the M-CHAT, provided developmental counseling, and referred to services as indicated. In total 469 families of children lacking an M-CHAT were called, 225 were scheduled for a visit, 182 completed screenings, and 21 screened positively. The proportion of children with a documented M-CHAT increased from 48% to 78%. This work revealed improvement opportunities in clinic workflows and data collection. We demonstrate that a novel effort to increase autism screening using a population health approach is possible in an urban community health center environment.

Presenter: Lacey Whitmire, MD, MPH, Medical Director, Fair Haven Community Health Care

Poster Summary Video

Grocery Voucher Pilot: Reimagining Diabetes Self-Management Among Low-Income Patients

Food insecurity is a major barrier to diabetes self-management among low-income individuals. The distribution of grocery vouchers has been shown to improve diet and food insecurity in various settings. We developed a grocery voucher program to address food insecurity, increase clinical engagement, and enhance diabetes self-management among patients with poorly controlled type II diabetes at a community health center in New Haven, Connecticut. Over three months, each participant had diabetes nurse educator visits, obtained individualized nutrition education, and received gift cards to a local grocery store. The program was evaluated using a mixed-methods approach. We enrolled 38 patients in the grocery voucher program over eight months. There were significant improvements in final HbA1c values among study participants. Participants could not only better afford healthier food but also felt more confident in controlling their blood glucose levels. By developing and implementing a program that addresses both the medical and social needs of patients with poorly controlled diabetes, we have provided an infrastructure to better engage patients in their care and address health inequities in the community setting.

Presenter: Janani Arangan, BS, Medical Student (Year 3), Frank H. Netter MD School of Medicine at Quinnipiac University

Poster Summary Video

Bridges to Access 2022: The Impact of an Interdisciplinary, Educational Conference About Climate-Related Health Effects and Climate Disparities on Pre-Health and Health Professional Student Knowledge, Self-Efficacy, and Beliefs

Bridges to Access (B2A) is an annual, free, student-led, interdisciplinary conference that aims to educate health students on important health issues, with a particular focus on issues affecting underserved communities. In 2022, B2A centered on the health effects of climate change and associated inequities. The effectiveness of this educational model was evaluated with a descriptive and statistical analysis of 177 pre- and post-conference survey responses from pre-health and health professional students. A paired t-test (α=0.05) showed that students had an increased understanding of and perceived ability to teach others about climate-related health effects, climate injustice, health system level impacts, and causative factors of climate change, and the analysis demonstrated a statistically significant increase in their concern for the effects of climate change on health (p-values <0.0001). These results provide evidence to support the benefit and validity this model has for educating health students on climate change-related health topics. While further studies are required, B2A can serve as an adaptable model other academic institutions can use as they seek to incorporate health and climate education into their curricula.

Presenters:
  • Brandon William Moritz, BS, Medical Student, University of Oklahoma College of Medicine
  • Alice Moon, BS, Medical Student, University of Oklahoma College of Medicine
  • Willa Xie, BA, Medical Student, University of Oklahoma College of Medicine
  • Joy Suh, BA, Medical Student, University of Oklahoma College of Medicine

Poster Summary Video

Primary Care Staff Education on Health Equity and Social Determinants of Health

Achieving health equity in healthcare is a significant concern in the United States, based on the discussions in clinical and social platforms that recognize the need to address social determinants of health in the healthcare delivery system. In 2021, the National Academies of Sciences, Engineering, and Medicine identified a nursing strategy to chart a path to achieve health equity for the population it serves. Based on this report, nursing practice, education, and policies must support nursing staff in all clinical settings to manage social determinants of health and direct interventions to screen and identify social factors affecting health equity. Major nursing programs are adopting a formal health equity curriculum to educate nurses, and practicing nurses need education on managing social determinants of health and health equity. Health care institutions are adopting health equity policy. Implementation will take time. There is a correlation between educating the nurses, addressing social determinants of health to achieve health equity, and clinical outcome measures. This presentation summarizes staff training for the primary care setting based on a needs assessment directed by the organization’s leadership and in response to the need to provide the knowledge foundation of basic concepts of health equity and social determinants of health.

Presenter: Dr. Dawn Fetzko, APRN, ANP, Clinic Owner, Colorado Primary Care Clinic

Poster Summary Video

Medical Scribe-Led, Drive-Through, COVID Test-Only Lanes

The COVID19 Pandemic accelerated the development of alternative ways of providing care in addition to patients going inside brick-and-mortar locations. We present the development and implementation of a medical scribe-led outdoor, drive-through COVID test-only lane. These lanes are conveniently located adjacent to our health centers, open 2-4 hours per day and have the capacity to serve patients within 5 mins of arrival and without requiring them to leave their cars. During the omicron surge, our lanes were serving 80-100 patients per day. We will present lane setup, workflow, staffing ratios, tasks before, during, and after the test, and demographics of patients served. To fulfill funding requirements, we removed identification, financial barriers, and scheduling barriers. Patients can come and get tested without proof of ID, insurance, or appointment. Initial data analysis suggest that our lanes served a significant number of uninsured patients from historically marginalized groups.

Presenter: JanLee Santos, MD, MHA, Director of Research and Professional Development, Piedmont Health Services

Poster Summary Video

Implementation and Process Evaluation of Mobile School-Based Immunization Partnerships

Due to the COVID-19 pandemic there has been an increased burden on local health departments and decreased immunization access for Manassas Park City Schools (MPCS) students. Barriers include low-income and uninsured population of Manassas Park, VA, increased school immunization requirements, and lack of immunization data sharing between schools and Virginia Immunization Information System. Conclusions: Mobile school-based immunization partnerships of education leaders, school health sectors, and public health systems efficiently improve required school immunizations rates, increase data sharing, lower care costs, and improve provider satisfaction. Dissemination of this model allows mobile school-based immunization programs to be translated to other communities, thus improving holistic wellbeing of children and their families (CDC, 2021b).

Presenter: Crystal Jones, DNP, FNP Student, DNP Candidate, George Mason University

Innovative Partnerships Addressing Health and Food Insecurity Among Refugees in Crisis

The 2021 Afghanistan crisis caused the displacement of over 700,000 Afghans. Out of the roughly 3500 refugees who arrived in the Tampa Bay area in 2021, several hundred were Afghans. The sudden influx of new arrivals contributed to a backlog of cases and further exacerbated barriers to healthcare, food, housing, and transportation for an already-oppressed population. The Tampa Bay Refugee Clinic, a medical student-run free clinic, is helping solve food insecurity and lapses in healthcare through partnerships with organizations working to provide housing and transportation. The Refugee Clinic worked closely with local agencies to offer free prescriptions, labs, imaging, and psychological services for Afghan arrivals, including enrollment of pediatric patients for the first time. The Clinic worked with a food-based non-profit to launch the “Food as Medicine” program, through which patients are given produce and non-perishables during every appointment. Resettlement agencies increased volunteer recruitment and fundraised to provide housing and transportation. This collective effort to provide comprehensive services that meet the acute physical and psychosocial needs of displaced Afghans demonstrated resilience and humanistic medicine.

Presenters: Richa Bisht, Third Year Medical Student, USF Refugee Clinic Co-Director, Refugee Clinic, USF Morsani College of Medicine

Poster Summary Video

Development of an Equity-Focused Virtual Leadership Program for Behavioral Health Medical Leaders

Given deep and enduring institutionalized racism within the US health care system (Dickman et al., 2017; Paradies et al., 2015; Shavers & Shavers, 2006), and more specifically within behavioral health care (Alang, 2019; Wade, 1993; Williams & Williams-Morris, 2000), it is important that medical leaders assess their own bias and use their power and privilege to confront and dismantle oppressive policies and practices that persist in health care. This poster details the creation of a multi-session virtual equity-focused leadership program designed for physicians working in public behavioral health in California (e.g., county depts. of behavioral health, CBOs, FQHCs, etc.). The poster highlights the needs assessment that led to this collaborative effort one that matched the expertise, credibility, and resources of an academic-based research institution and a state advocacy and training association (and guided by a committee of physician peers). The poster illustrates how two theoretical models, the social ecological model (Bronfenbrenner, 1977) and the Government Alliance on Race and Equity Theory of Change model (GARE, 2016), helped guide aspects of program development. Findings, insights, and lessons learned are shared.

Presenters: Tommy Royston, PhD Candidate, Graduate Assistant, University of San Diego

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Lower-Extremity Skin Care Among Unsheltered Patients: Findings from Miami Street Medicine

Introduction Unsheltered homeless (USH) individuals’ main mode of transportation is by foot and any trauma, injury, or disease affecting the lower extremity can greatly affect their ability to complete activities of daily living, such as finding food and shelter. The Miami Street Medicine (MSM) team conducts weekly mobile clinics and has noticed large numbers of foot complaints among unsheltered patients. Methods: USH patients were interviewed and evaluated during weekly clinics between April 2021 and January 2022. After assessing relevant medical history, their chief concerns were addressed. Patients with foot concerns were evaluated and provided protective footwear, socks, and hygiene supplies. Results: Tinea Pedis (TP) was encountered frequently in approximately 26.8% of patient care instances. Powder-based antifungals were provided for most (75%) of TP cases. Onychomycosis and dystrophic nails were often seen alongside TP infections. Foot (29.3%) and leg (17.1%) ulcers were seen mostly in patients with a history of diabetes. Socks have been the most requested and distributed item of clothing at MSM clinics, with over 400 pairs distributed in 8 months. Low-cost measures such as socks and antifungal powder can provide subjective relief and partially manage symptoms.

Presenters: Taha Rasul, BS, Medical Student, University of Miami Miller School of Medicine

Poster Summary Video

Integrating Medication-Assisted Treatment into an FQHC-based family medicine residency program in DC

Opioid-related deaths in Washington DC have nearly doubled in 2020. The National Family Medicine Residency at Unity Health Care has incorporated Medication-Assisted Treatment (MAT) into the curriculum but recently has made it a priority to increase resident experience through a MAT walk-in clinic to expand access for patients with opioid-use disorder (OUD) in the district. As part of this initiative, all community preceptors are required to obtain their X-waiver to support residents in prescribing buprenorphine during their continuity clinic. We surveyed preceptors on their experience with MAT during residency and patients with OUD. 21 community preceptors completed the survey. 66% did not have any exposure to MAT during residency, but the majority see patients monthly who have a diagnosis of OUD. 9 of 21 preceptors have their X-waiver and are actively treating patients with OUD. A preceptor was more likely to have their X-waiver if they were exposed to MAT during residency. Our findings highlight the importance of integrating MAT education early in health professional training to increase access to OUD treatment in primary care.

Presenters: James Huang, MD, Unity Health Care and the National Family Medicine Residency

Developing a Medical Student Service Learning Program: Mammography Screening Assistance

The Linda Fenner Mobile 3D Mammography Center (LFMMC) has been an essential part of Florida International University’s Herbert Wertheim College of Medicine (HWCOM) community outreach to underserved women. It has provided free mammography screening, health education, and navigation services to uninsured women in Miami-Dade County since its inception in 2014. In 2021, the Clinical Mammography Art Initiative (CMAI), a student group at HWCOM, created a service-learning program that has allowed medical students to volunteer on the LFMMC and directly assist uninsured women across the community in receiving free mammography screenings. Students who volunteer are asked to complete a survey that allows for reflection on their experience on the LFMMC. Students reported learning how: to take a breast health history, a mammography machine works and, to overcome language barriers especially when discussing sensitive health information. Volunteering on the LFMMC affords HWCOM students the ability to apply what they have learned in their preclinical courses, provides an opportunity to understand the process women navigate to receive a mammogram, and encourages creative thinking on ways to assist underserved women in the community.

Presenters: Daniella Nunez, BS, Medical Student, Florida International University, Herbert Wertheim College of Medicine

Poster Summary Video

Implementing Pediatric Adverse Childhood Experiences Screening in an FQHC

Adverse Childhood Experiences (ACEs) are traumatic life events in childhood that hold long-lasting physical and mental health impacts for patients with scores ≥4  of the 10 factors that measure abuse, neglect, and household dysfunction. In a 2012 study, 12% of a comparable low-income Federally Qualified Health Center (FQHC) pediatric population scored ≥4 on their ACE questionnaire. This score is significantly correlated with learning and behavior problems and the potential risk for obesity and cardiovascular diseases. AltaMed serves a similar population, and 64% of our patients are at or below the 200% of the Federal Poverty Level.    The screening tool used at AltaMed’s four pilot sites was the Pediatric ACEs and Related Life-Events Screener (PEARLS). A screener is considered positive if 4 or more experiences apply or if the patient scores between 1-3 and has an ACE-Associated Health Condition (AAHC). Between June 2021 and February 2022, over 1,500 pediatric patients were screened with 7.9% positive scores. By introducing ACE screenings at primary care clinics, early intervention through referrals to social services and resiliency programs can potentially mitigate the long-term health outcomes of pediatric patients.   

Presenters: Mary Valencia, Health Educator, AltaMed Health Services

Poster Summary Video

Expansion of a Family Planning Community Advisory Board

Currently, much legislation in the US focuses on restrictions to comprehensive reproductive care for pregnant people. These limitations hit marginalized communities particularly hard. Black individuals die at twice the rate among pregnant people, and Latinx death rates are 30% higher than white individuals. These inequities are expected to worsen with the expansion of these restrictive laws. This project seeks to reverse these trends by expanding an existing Family Planning Community Advisory Board (CAB) to include 3-5 additional members from historically marginalized groups. Recruitment efforts focused on Black, Indigenous, and Hispanic people in Washington and the greater Seattle area. Recruitment methods were connections through the research team and sitting CAB members, working with the UW Translational Center Community Engagement consultancy, and searching social media for groups of people with interests in comprehensive reproductive care. CAB meetings utilized the Research Justice Framework, which focuses on communities as research leaders and balances power differentials between communities and researchers. Communities create research priorities, and researchers facilitate answering research questions as equal partners in the process. The Hyde Amendment is a legislative provision barring the use of federal funds to pay for abortion, except to save the life of the woman, or if the pregnancy arises from incest or rape.  

Presenters: Brittany Rattiliff, University of Washington

Poster Summary Video