Research

Flint, MI
This research project focuses on identifying leverage points for positive transformation in the Flint, Michigan food system. As a result of the city’s economic decline, aid from all levels of government and organizations are working to decrease the rise in food insecurity and malnutrition. This project collaborates with multiple stakeholders to determine how these interventions from all levels can work together. A series of workshops, interviews, and historical research will identify the factors that inhibit positive change in the Flint food system. Researchers will then develop models together with Flint residents to analyze the food system and formulate plans to transform the system towards better human health and sustainability outcomes. This research will help develop a model food system to support collective action that promotes healthy and affordable food access for the Flint community.
Dr. Steven Gray, Department of Community Sustainability, Michigan State University; Dr. Laura Schmitt Olabisi, Department of Community Sustainability, Michigan State University
Michigan State University
Genesee County, especially Flint
The purpose of this study is to get the perspectives of Flint and Genesee County women and professionals who serve them on: (1) women’s greatest needs in the area, (2) especially perinatal women and mothers, (3) the greatest unmet mental health needs in the area. This will be a qualitative study with interviews of about ~150 women. Community members (especially Janice Muhammud, Bernadel Jefferson, and Kent Key) were involved in writing the interview questions, are involved in recruiting, and will help with qualitative coding and analysis. Mrs. Muhammud helps to interview participants. The plan is to bring participants together at the end, bring the themes back to everyone, and then work together to create initiatives to address the identified needs. That way, we create a network and women and organizations working together for women in the area.

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Jennifer Johnson; Janice Muhammud; Bernadel Jefferson; Kent Key
Michigan State University
Genesee County
The Speak to Your Health! Community Survey project examines health patterns, health behaviors and attitudes, and social and environmental determinants of health for Genesee County, MI residents. The survey has been conducted biennially since 2003 and the results have been extensively utilized by local agencies and organizations. For example, the Genesee County Health Department uses STYH results to develop and assess progress related to their 5-­year strategic plan. The project has brought direct benefits to Genesee County residents, including the creation and guidance of health service delivery programs and perhaps most notably through the establishment of the Genesee Health Plan, which provided basic health coverage to uninsured adults a decade before the Affordable Care Act was implemented. The project is unique in several ways including community ownership, the connection to capacity building for research by community institutions and organizations, and a focus on how social justice issues are linked to health behaviors and service utilization.

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Daniel J. Kruger, PhD
Genesee County Health Department
http://www.gchd.us/speak/
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Strengthening Flint Families is a community-based behavioral health intervention designed to reduce behavioral health disparities and improve family resilience in the Flint Community by providing multiple levels of peer support and family services. Strengthening Flint Families is comprised of three behavioral health interventions: at the Individual level: Peer Recovery Coaches (PRCs); at the Family level: Strengthening Families Program; and at the Community-level: a Multi-Media Campaign. As a major project of the Flint Center for Health Equity Solutions (FCHES), the three behavioral health interventions are excellent fit for the needs of economically distressed, minority-majority cities such as Flint. This research project is a hybrid type III implementation trial that focuses on how to best implement these effective behavioral health interventions to reach under-served populations and maximize sustainability while evaluating the effectiveness of the programs themselves.

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Debra Furr-Holden, PhD; Kristen Senters Young, MS; Sarah Stoddard, PhD, RN
Michigan State University College of Human Medicine Division of Public Health
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The mission of the Church Challenge is to support healthy living environments and improve the health of the Flint Community, with a focus on effective blood pressure management. Actions to achieve the mission of the Church Challenge include: increase food availability, highlight local resources that support healthy living, provide skills training for church health team members, and disseminate strategies for policy change to area pastors. The Church Challenge has a multi-level approach: community, church, individual. Community: Partner with pastors from local churches to advocate for policy changes that promote health living in the community. Church: Support local churches to promote healthy living through diet, physical activity, chronic disease management, and stress management. Individual: Create opportunities to improve health and well-being.

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Dr. Vicki Johnson-Lawrence
Michigan State University College of Human Medicine Division of Public Health
Flint, MIDetroit, MI
This project is a partnership lead by the Michigan State University’s CREATE for STEM Institute in partnership with the University of Michigan’s School of Public Health’s Center for Public Health and Community Genomics, MSU BEACON Center, the Concord Consortium, Flint Community Schools, Detroit Public Schools Community District, Community-based Organization Partners of Flint, Sloan Museum, Flint Public Library, Charles Wright Museum of African American History, Michigan Science Center, Detroit Public Library, and Friends of Parkside. The project is funded by the National Institutes of Health Science Education Partnership Awards (SEPA). We are developing a new framework for the learning of genomics, gene-environment relationships and evolution by middle school students and are designing and testing the curriculum in Flint and Detroit schools. In the first unit, students study the phenomena of Type 2 diabetes in science class as part of a new curriculum called, “Health in Our Hands: What Controls My Health?” Through their studies, students discover how genetic risk factors and environmental factors, such as poor diet or lack of exercise, put them at risk for disease. For their final projects, students conduct an action research project to improve their school or neighborhood to help prevent or reduce diabetes. The curriculum features project-based learning, rich in technology and aligned with the Next Generation Science Standards. Student learning is strengthened by a variety of informal science education activities in each community culminating in a district-wide final presentation back to report their results to their community. These informal science education activities are also aimed at parents and other adults in the community, to share learning and encourage parent-child discussions. CREATE for STEM Institute coordinates all project activities and develops and assesses the curriculum materials.

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Joseph Krajcik
Michigan State University – CREATE for STEM Institute
Genesee County
Increased understanding about the etiology of having poor health status in older people has led to the recognition that social factors play a major role in the initiation of having functional limitations. Less understood however are the effects of neighborhood characteristics on functional limitation among older African-Americans. The purpose of this project is to examine the degree to which the quality of neighborhoods is associated with having functional limitations. We hypothesize that older African-Americans living in neighborhoods with negative characteristics (high crime, unemployment and poverty rates) are more likely to indicate functional limitations than those living in neighborhoods without these characteristics. We will use disability data from the long form (SF 3) of the US Census. Using Arc View 9.0 GIS we will map by zip-code the population with functional limitations. In addition we will merge data from the Speak to Your Health Community Survey to determine the individual and neighborhood characteristics. Using logistic regression, we expect to find a relationship between environmental factors and individuals with functional limitations.

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Rie Suzuki and Arletha Mathis
University of Michigan-Flint Public Health
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Genesee County
Transportation barriers to primary health care providers are one of the major health concerns in Flint, MI. Generally, Geographic Information Systems (GIS) has been used extensively as a method to examine spatial relationships between transportation and access to primary health care providers. Unfortunately, the Mass Transit Authority (MTA) did not have the complete directionality incorporated in their bus routes on the GIS data. Closest facility layer analysis is often used in health and spatial properties; however, lack of information in MTA data, limits accurate estimations. Route layer analysis is the additional estimation technique to correct this limitation to obtain absolute values without errors. The purpose of this study was to compare between the utilization of the closest facility layer analysis alone and the integration of both the closest facility layer and the route layer analysis to estimate the travel distance and time for patients to access primary health care providers. The ArcGIS 10 was used for these analyses. The results indicated that the closest facility layer analysis alone could not detect directionality on some bus routes. These estimation errors occurred when the locations of the primary health care providers were closer than transfer bus stops. In order to correct this error, the route layer analysis was implemented to correct the directionality of the MTA bus routes. The differences between corrected and uncorrected errors were 3.22 km and 4 minutes. Complexity of utilizing the multi-modal network to assess the barriers with access to care was observed

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Rie Suzuki
University of Michigan-Flint Public Health
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Assisted living facility in Flint
Purpose: To examine the association between balance confidence, social engagement, life space, friend contacts and the likelihood of better social functioning by using the ICF model. Methods: Cross-sectional observational study using the mediational path analysis. Participants: Eligibility criteria included; living in the assisted living facility more than 3 months, being able to communicate in English, and not having acute illness such as infection, inflammation, ongoing chest pain, short of breath with walking and light activities. Of 255 residents in the assisted living facility, 117 older adults participated in this study. Results: Balance confidence was indirectly associated with social functioning through life space. Although friend contacts was not directly associate with social functioning, the results also showed that it was indirectly associated with social functioning through life space. Conclusion: the integration of the environmental resources and services was significantly important in self-reported mobility, the frequency of friend contacts and social functioning. This result suggests that further research and interventions are needed to determine the role of the supportive environment in improving social functioning of the populations

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Rie Suzuki
University of Michigan-Flint, Public Health
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Genesee County
Prematurity or birth at less than 37 completed weeks of gestation is a leading cause of neonatal and infant mortality rates among Americans and represents a major public concern for all women including women with disabilities. The World Health Organization defines disability broadly to include impairments, activity limitations, or participation restriction and entails disruptions to normal functioning of movement, vision, hearing, or social relationships and interactions. Women with disabilities are less likely to receive adequate prenatal care. Common barriers to obtaining prenatal care as early as desired can include lack of time, lack of money, no insurance coverage, lower education level, difficulties in making appointments, lack of transportation, and not knowing that one is pregnant. Barriers unique to women with disabilities include inaccessible equipment. Race differences in prenatal care use and birth outcomes have been well documented. African Americans have a lower rate of first trimester prenatal care than Caucasians. The Michigan Department of Community Health released the Infant Mortality Reduction Plan to implement a regional perinatal system, support better health status of women and girls, and promote the reduction of racial and ethnic disparities in infant mortality. However, Flint is still one of the cities indicating a high infant mortality rate. The purpose of this study is to investigate 1) the association of mothers’ disability(chronic conditions) status with the likelihood of adherence to prenatal care and low birth weight, and 2) the mothers’ barriers to prenatal care due to having a disability (and chronic conditions) in residents living in Flint, MI.

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Rie Suzuki
University of Michigan Flint Public Health
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