Opioid Abuse & Viral Infections: UW SMPH Support of Rural Prevention Programs

As an Associate Professor of Medicine and Population Health Sciences, Ryan Westergaard, MD, PhD, MPH, is an infectious disease physician and epidemiologist who specializes in the treatment of HIV and viral hepatitis. He has a particular focus and passion to improve treatment of HIV in vulnerable, underserved populations.

Notably, drug abuse from injecting heroin and other opioids is commonly complicated by HIV or viral hepatitis infection. This risk is especially high in rural communities lacking adequate public health infrastructure, medical homes, and/or effective prevention programs. In Wisconsin, treatment admissions for heroin and other opioids tripled between 2005 and 2014 and Hepatitis C virus (HCV) infections increased at the same time.

Since 2011, Westergaard and his interdisciplinary team have created a research program to evaluate the role of non-clinical settings in coordinating delivery of essential prevention services. The team particularly concentrates on six contiguous rural counties of Wisconsin with peak opioid injection and HIV/HCV infection rates. With an NIH R01 award in 2016, the team began implementing and evaluating a novel community response model to support prevention services for high risk clients. Westergaard comments,

Ryan WestergaardOur project, the Client Centered Prevention Home model, reflects a partnership with the Aids Resource Center of Wisconsin. Much of our work is done through their field sites in northern Wisconsin and we observed that a considerable number of Native American participants were enrolling. We knew we wanted to explore a collaboration with one or more of the tribal communities.

Because our work is so community focused, we have received a lot of support over time via the UW Community Academic Partnerships core and the Collaborative Center for Health Equity (CCHE). So we knew who to turn to for advice.

Westergaard and Assistant Scientist, Wajiha Akhtar, PhD, contacted CCHE Administrative Director, Sarah Esmond, to introduce the research and explore how best to raise visibility about the project with tribal leaders. She promptly connected with Gail Nahwahquaw, Wisconsin Department of Health Services Office of the Secretary and Tribal Affairs Director. Nahwahquaw confirmed time for the project team to present at the next Wisconsin Tribal Health Directors meeting. Esmond then notified Melissa Metoxen, a community and academic support coordinator with the UW Native American Center for Health Professions (NACHP). As a member of the Oneida Nation, Metoxen was able to provide insight about how to prepare the team for their presentation to the Directors. Metoxen notes,

Melissa MetoxenWestergaard worked with NACHP to seek knowledge around working and pursuing partnerships with tribal communities. We appreciated his awareness in knowing that our communities are unique, especially given we are sovereign nations. Working with our communities often means working with tribal leadership, tribal governance bodies, and more. We were happy to assist in this effort and look forward to Westergaard creating sustainable relationships with some of our communities.

Esmond adds,

Sarah EsmondWestergaard’s work with NACHP and CCHE is an exciting case study of the efficiencies and partnerships that can result when investigators are willing to prepare for working in community settings in advance. This approach is always important when creating trusting community-academic partnerships, but is particularly significant when projects involve sensitive topics, stigmatizing behaviors, and/or engage communities from which individuals have been underrepresented in or treated poorly as part of research.

Another important step will be to establish collaboratively with our tribal partners how to share the research data with communities. For Westergaard’s project, tribal clinic staff and health directors will have a strong interest in understanding the data and strategizing how to use it to advance positive community health outcomes.

Westergaard’s work would not be possible without ICTR support. The project received an ICTR Type 2 Pilot Award in 2013, and expert guidance from the Community Academic Partnerships core and the Collaborative Center for Health Equity, which both promote work that strives for health equity through community partnership. His projects also use the services of the ICTR Scientific Review Committee, as part of review by the UW Institutional Review Boards.

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Pilot Awards Program Funds 22 Projects for 2018

ICTR granted 22 awards totaling $1.6 million for the 2018 Pilot Awards Program competition. Five of those awards were co-funded with campus partners; one each by the UW Waisman Center and the Department of Radiology, and three by the UW Carbone Cancer Center. Likewise, ICTR participated as a co-funder for two awards in the UW Alzheimer’s Disease Research Center Pilot Awards Program. Such braided funding has been a hallmark of our pilot awards program for a number of years and allows ICTR to fund additional meritorious pilot awards that otherwise would not be possible.

Complete list of awards.

Five award types are included in this month’s announcement. They include Translational Basic & Clinical Pilot Awards (10), Novel Methods Pilot Awards (4), Clinical & Community Outcomes Research Pilot Awards (4), Dissemination & Implementation Research Awards (3), and a Stakeholder and Patient Engaged Research Award (1). Other ICTR pilot awards announced earlier in the year include the new Evidence to Implementation (E2I) awards and the Collaborative Health Equity Research (CHER) awards. Read more on our funding opportunities page.

Christine Sorkness, ICTR Senior Associate Executive Director, notes:

We are thrilled with this cohort of pilot awardees on multiple levels: We have an outstanding group of principal investigators representing schools from across campus including the School of Business, the School of Human Ecology, and the College of Agriculture and Life Sciences, as well as from the UW schools and college making up the ICTR partnership.

In addition, many of the proposals shine a health equity lens on health issues across Wisconsin. As well as interventions targeting Milwaukee community members from low-income and/or minority households, there are projects testing interventions to improve rural health. Finally, the health issues addressed by this year’s awards are of importance across the lifespan including issues specific to pediatric and geriatric populations.

Overall, pilot projects focus on research likely to lead to a direct impact on human health and that span the entire clinical and translational research spectrum. Examples include understanding sudden infant death syndrome, analysis of clinical workflows, increasing ambulation by geriatric patients, and improving breast cancer follow-up.

ICTR provides a variety of resources to investigators that support their research and enhance their ability to obtain research funding including ICTR Pilot Awards.

Maureen Smith, ICTR Director for Community-Academic Partnerships, comments:

Maureen Smith, MD, PhD, MPHMany of the applicants for Community Engagement and Research (T2 to T4) awards developed exceptional proposals with meaningful stakeholder engagement components by leveraging ICTR-CAP resources.

Some investigators took advantage of consultations with  ICTR-CAP Programs/Affiliate Programs, others completed the Certificate in Clinical & Community Outcomes Research, and still others incorporated feedback from the External Community Review Committee from previous application rounds.  Well done, 2018 pilot awardees!

Groundbreaking Interventions Selected for New ‘Evidence to Implementation’ Awards

After a competitive application process, two evidence-based interventions have been selected to receive the new ICTR-Community-Academic Partnerships (CAP) Evidence to Implementation (E2I) Awards that provide implementation support for high-demand, evidence-based interventions.

In addition to direct support, E2I awardees receive comprehensive in-kind resources from the ICTR-CAP D&I Launchpad program to help their healthcare advances make the successful, sustained leap from research to practice.

Maureen Smith, Director of ICTR-CAP, notes:Maureen Smith, MD, PhD, MPH

Both projects, a Tai Chi program for seniors to improve their balance and stability and a peer-to-peer coaching institute for improving surgical education and performance, represent evidence-based interventions developed with support from ICTR-CAP research funding.

Working with their UW and community partners, these awardees will be able to leverage ICTR-CAP D&I Launchpad services to more effectively and efficiently disseminate their projects. Congratulations!

  • Tai Chi Prime for Community-based Falls Prevention
    Betty Chewning, PhD, UW School of Pharmacy
    Previous ICTR-CAP Support: 2015 D&I Research Award, Improving Balance for Older Adults: Disseminating Tai Chi Fundamentals Through Community Organizations
  • Wisconsin Surgical Coaching Program™ (WSCP)
    Caprice Greenberg, MD, UW Department of Surgery, WI Surgical Outcomes Research Program
    Previous ICTR-CAP Support: 2012 CCOR Pilot Award, A Video Analytic Approach to Deconstructing Surgical Skill

Click here for a detailed description of these two awards.

Jane Mahoney, Associate Director of ICTR-CAP for Implementation Science, notes:

The D&I Launchpad Team couldn’t be more excited to work in partnership with these two important, innovative and evidence-based programs. Both programs have incredible potential, and we look forward to putting the Launchpad team’s expertise to work to help them thrive.

Mahoney recently expanded her role within CAP to better assist with the ICTR goal of impacting health by bringing more high quality, evidence-based innovations, such as those developed by the E2I awardees, successfully into practice.

For more information about the E2I Award program and the 2019 RFA, contact Melody Bockenfeld.

Read more about the E2I RFA


WINRS Staff Member Honored With Excellence in Research Award

Gay Thomas, director of Stakeholder Engagement for the Wisconsin Network for Research Support (WINRS) was honored in April with a Chancellor’s Academic Staff Excellence Award. WINRS is part of the federation of the programs allied with the ICTR Community Academic Partnerships group that provides assistance with stakeholder engagement to clinical and translational researchers. WINRS is headquartered in the UW School of Nursing, a UW ICTR partner school

Thomas is one of the creators of CARDS® (Community Advisors on Research Design and Strategies). CARDS is a signature program of WINRS that is comprised of focus groups of Madison community members from diverse racial, socioeconomic, and educational backgrounds who are trained to give feedback to investigators on recruitment plans and materials, consent forms, survey or interview questions, smartphone apps, websites and more. CARDS has consistently outstanding reviews from investigators and research teams for constructive and effective critical review.

Read more about Thomas and her work as part of the university press release describing all nine 2018 winners of Chancellor’s Academic Staff Excellence Awards.




First Collaborative Health Equity Research Pilot Awards Announced

Two black women discussing diabetes education in a book filled room.

The new Collaborative Health Equity Research (CHER) Pilot Award has announced its first awardees. Olayinka Shiyanbola (School of Pharmacy) and Andrea Gilmore-Bykovskyi (School of Nursing) each received $50,000 to support community-engaged research projects focused on health disparities.

The health issues addressed by these research projects, type 2 diabetes and Alzheimer’s disease, are both ones for which considerable disparities exist in disease burden and prevalence. Applicants are required to cite published evidence that the health disparity or inequity is recognized by state or federal agencies as significant and warranting intervention.

Full description of the research awards.

Like several other pilot awards, the CHER pilots will allow investigators to collect preliminary data for future grant applications. In addition, these awards have an explicit commitment to the career development of early stage investigators and require applicants to identify a senior mentor and form an interdisciplinary team.

The award program was jointly developed by the ICTR Community-Academic Partnerships core (ICTR-CAP) and the UW Collaborative Center for Health Equity (CCHE) as part of their shared mission to support community-engaged research.

Maureen Smith, Director of ICTR-CAP core, comments:

Maureen Smith, MD, PhD, MPHICTR-CAP proudly supported the launch of the new CHER award. All the T2 to T4 funding mechanisms encourage health disparities research, support mentorship of early career investigators, and provide incentives for community and academic collaborations. The new CHER award is unique in requiring all three of these components for a successful proposal. Congratulations CHER awardees!

Christine Sorkness, ICTR Senior Associate Executive Director, adds,

Christine Sorkness, PharmDThis award program builds on the existing AHEAD pilot awards program that ICTR  administers for the campus Advancing Health Equity and Diversity initiative. CCHE plays a major role in supporting post-doctoral or junior faculty scholars through that program and the new CHER awards are a natural progression. We are very pleased to have the opportunity to facilitate these two excellent research projects from Olayinka and Andrea in collaboration with our colleagues from CAP.

Read more about the initial release of the CHER RFA last August.

Spotlight: Engaging Patients and Their Families in Family-Centered Care

Health Services Research | Elizabeth Cox

Elizabeth Cox, MD, PhD
Elizabeth Cox

Goal: To engage the voices of children and families to deliver safer, higher quality pediatric care.

ICTR Support: In addition to receiving ICTR Pilot Awards in 2008 and 2013 to support her research, Dr. Cox’s work was strengthened through a variety of collaborations with program partners within the ICTR Community Academic Partnerships core, assistance from biostatisticians, the Office of Clinical Trials, and scientific editing. Cox also received competitive ICTR-CAP supplemental funding to create state-of-the-art resources to support researchers wishing to conduct patient and other stakeholder engaged research.

Outcomes: Cox’s 2008 Pilot Award, Patient-Centered Care for Children with Chronic Disease, led to an AHRQ R18 which generated evidence to support adoption of the family-centered rounds approach to care in hospital settings. UW Health has incorporated this approach within the pediatrics service. The resultant Family-Centered Rounds (FCR) Toolkit has been widely disseminated and accessed by users in 44 states, Washington DC, and 11 countries.

Her 2013 ICTR Patient Centered Outcomes Research (PCOR) Pilot Award, Engaging Stakeholders to Deliver Family-Centered Diabetes Self-Management Resources, and a PCORI-funded study have engaged children with type 1 diabetes and their parents to tailor diabetes self-management resources to the unique needs of each child and family. In addition, the Children’s Hospital of Wisconsin explored the development of group-based chronic disease management visits that would utilize Cox’s scheduling models, needs assessment tools, and content.

With support from the 2013 PCOR award and other ICTR resources, Cox has co-authored three toolkits to support patient and other stakeholder engagement including the Toolkit on Patient Partner Engagement in Research (TOPPER), Hard-to-Reach Patient Stakeholders (HARPS): An Engagement Guide, and Sustaining Engagement of Blended Stakeholder Boards Across the Research Trajectory. Collectively, these toolkits have been accessed by over 200 individuals world-wide.

Cox has become a leader in patient-centered outcomes research, and has been instrumental in developing local and national resources to support investigators wishing to conduct high-quality patient and other stakeholder engaged research.

Cox ED, et al. A Family-Centered Rounds Checklist, Family Engagement, and Patient Safety: A Randomized Trial. Pediatrics. 2017. Apr 25. 139(5): e20161688. doi: 10.1542/peds.2016-1688.

More: Does a Personalized Approach Help Young People Manage Type 1 Diabetes?

2024 Stakeholder and Patient Engaged Research (SPER) RFA

Uploaded 9/13/2023
The goal of this Stakeholder and Patient Engaged Research (SPER) RFA is to support excellent, community-partnered health research that will strengthen a competitive application for external funding for research requiring strong stakeholder engagement as a foundation for a successful application. This includes but is not limited to PCOR. New or previously unsuccessful applicants to PCOR funders are encouraged to apply.

File: WPP_SPER_RFA_2024_final.docx

2024 Clinical & Community Outcomes Research (CCOR) RFA

Uploaded 9/13/2023
The ICTR Clinical & Community Outcomes Research (CCOR) Pilot Award supports excellent, community-partnered health research that solves problems translating knowledge into improvements in clinical practice, community programs and health policy. This Pilot Award may also support the development of interventions that require individual, organizational, or system behavior change.

File: WPP_CCOR_RFA_2024_final.docx