Integrating mental health care in primary care

Behavioral health issues such as depression and anxiety are debilitating conditions and, unfortunately, common. But the integration of behavioral health and primary care services is proving successful in improving patient outcomes.

The College of Community Health Sciences is exploring such an integrated model of care for University Medical Center, which it operates. In September, the College will host a group from the University of Washington AIMS Center, short for Advancing Integrated Mental Health Solutions, that will present about its Collaborative Care model to providers and resident physicians who care for patients at UMC.

“This is a way to improve access to mental health care,” says Dr. Tom Weida, UMC’s chief medical officer. “This is a great opportunity for folks who have mental health needs to get the care they need.”

Collaborative Care treats common mental health conditions such as depression and anxiety that require systematic follow-up due to their persistent nature. Primary care providers and embedded behavioral health professionals provide medications or psychosocial treatments and are supported by psychiatric consultation.

According to the AIMS Center, offering mental health care in primary care is convenient for patients, builds on existing provider-patient relationships and can help improve care for patients who have both medical and mental issues.

Weida said the use of such a model at UMC could have a social worker or psychologist working with a patient and linking the patient with a psychiatrist if needed. He said the social worker and psychologist would keep in regular contact with the patient to monitor outcomes.

West Nile Virus

By Jared Ellis, MD
Assistant Professor of Family Medicine,
Associate Residency Director,
University of Alabama Family Medicine Residency Program

Late summer brings excitement about football, and hopes that the weather will soon cool off. However, it brings a risk that some have heard of, but few are familiar with: West Nile Virus (WNV) infection. This infection is rather common, and most cases occur in August and September (see chart below), but the diagnosis is infrequently made. For many, it only gives mild symptoms, but for a few, it can lead to devastating consequences or death. It is important to be familiar with the signs and symptoms of this infection, but even more so on how to prevent it.

WNV is not new, having been first identified in 1937 in the African county of Uganda. It was first diagnosed in 1999 in the US in New York. It has rapidly spread across the country. It is transmitted from mosquitoes that have bitten infected birds and then bite humans. Fortunately, 60-80 % of persons who contract the virus have no symptoms. 20-40 % of infected persons have only mild to moderate nonspecific symptoms, which may include fever, headache, muscle aches, swollen lymph nodes, and loss of appetite. 25-50% of these have a rash on the trunk and arms. See picture:

Studies estimate that in the US, one of every 140 to 250 persons has been infected at some point, few of whom were diagnosed. However, about 1 % of persons who get this infection develop serious neurologic (brain) effects, known as West Nile Neuroinvasive Disease (WNND). Symptoms of WNND include tremor, confusion, severe headache, weakness in one or more limbs, and coma. Of these, between 3-15% die. This is more common in younger children and older persons, and those with significant chronic diseases.

If you are concerned that you may have any form of WNV, see your doctor, and mention your concerns. Blood and other tests can be performed, but take a number of days to return. If symptoms are not severe, it may not be necessary to be tested as there is no specific treatment that cures WNV or WNND.

Awareness and prevention are the keys to avoiding this infection. Avoid mosquito bites! Avoid being outside at dusk or dawn. Wear long sleeves and long pants when outdoors if possible. Use mosquito repellants, whether applied to the body, or placed near you or those that they you can attach to yourself. Drain any standing water in your area to limit mosquito breeding. Communities with higher rates of WNV may choose to spray appropriate insecticides in key areas. All of these things may prove helpful.

College leading UA’s United Way fundraising campaign

The College of Community Health Sciences is leading this year’s United Way of West Alabama fundraising campaign for The University of Alabama.

UA has set a goal of raising $375,000, just a little more than last year’s goal, which was exceeded.

“This University is very special,” Sarah Patterson, former head coach for UA women’s gymnastics, told University employee volunteers assisting with the fundraising effort during a meeting at CCHS earlier this month. “If it weren’t for you, this campaign wouldn’t be successful.”

Patterson is heading the overall United Way of West Alabama fundraising campaign, which has set a goal of raising $3.8 million.

United Way of West Alabama covers nine counties and has 26 partner agencies, including Good Samaritan Clinic, Big Brothers Big Sisters, the Phoenix House and Temporary Emergency Services.

Patterson said another of her goals is to make people more aware of the services provided by United Way’s partner agencies. “There are things about United Way agencies that if you let people know about, you can make a difference in their lives.”

New faculty join College

Dr. Martha Crowther joined the College of Community Health Sciences as a professor in the Department of Community Medicine and Population Health and the Institute for Rural Health Research.

Prior to joining the College, Crowther held faculty positions in the Department of Psychology in The University of Alabama’s College of Arts and Sciences, where she also directed the Clinical Psychology Program. She holds appointments as a Faculty Scholar at the UA Center for Mental Health and Aging and as a Scientist at the Center for Healthy Aging in the Department of Medicine/Division of Gerontology and Geriatric Medicine at the University of Alabama at Birmingham.

Crowther earned a bachelor’s degree at the University of California at Berkley, a Master’s in Public Health degree from Yale University and a PhD from Duke University. She completed a clinical internship and was a postdoctoral fellow at the US Veteran’s Administration Palo Alto Health Care System.

Her research interests include aging and racial diversity in urban and rural populations with a focus on eliminating mental and physical health disparities in older adults. Her work at the College will focus on the teaching of and research in Population Health.

Crowther has presented and published extensively, and is the recipient of numerous honors, including the National Role Model Award from the National Institute on Minority Health and Health Disparities.


Dr. Abbey Gregg joined the College of Community Health Sciences as an assistant professor in the Department of Community Medicine and Population Health and the Institute for Rural Health Research.

Previously, she was a program coordinator for Navigating the Road to Health for Nebraska Families Collaborative in Omaha, and manager of public health services for Three Rivers Public Health Department in Fremont, Nebraska.

Gregg earned a Bachelor’s Degree in Nutrition Science from the University of Nebraska in Lincoln, a Master’s in Public Health degree in Community Health Education from the University of Nebraska, and a PhD in Health Services Research, Administration, and Policy from the University of Nebraska Medical Center in Omaha.

She has published in peer-reviewed journals and has received grant funding for research focusing on improvement initiative and activities in local health departments.

Dr. Mercedes Morales-Aleman selected for national Future Research Leaders Conference

Dr. Mercedes Morales-Aleman, assistant professor in the Department of Community Medicine and Population Health and the Institute for Rural Health Research at the College of Community Health Sciences, was one of 30 faculty nationwide selected for the National Institutes of Health’s Future Research Leaders Conference.

It is an honor to be selected,” said Morales-Aleman. “Few early career scientists have the opportunity to showcase their research and receive feedback from NIH leadership and investigators.”

The conference is an opportunity for talented biomedical and behavioral scientists early in their careers for career-development. During the conference, selected scientists will showcase their research and gain insights from NIH leadership and investigators about developing independent scientific careers.

Dr. James Leeper Celebrates 40 Years with CCHS

The College of Community Health Sciences congratulates Dr. James Leeper for 40 years of service. Leeper joined the College in 1977 and is a professor in the Department of Community Medicine and Population Health. He additionally serves as Rural Programs Director of Education and Evaluation. Beyond his extensive research support of the College, Leeper has impacted the academic careers of countless students through both teaching in the classroom and guidance along the path to medical school. A recipient of The University of Alabama Outstanding Commitment to Teaching Award, Leeper exemplifies the core values and standards of both the University and the College. We offer him our sincere thanks for his dedication to the fulfillment of our mission through his leadership in medical education and scholarly achievements.

Medical students at College recognized for patient-centered care

Six University of Alabama School of Medicine students completing their clinical years of education at the College of Community Health Sciences have been recognized as 2017 Gold Humanism Honor Society inductees.

The students are: Rachel Daniell and Amie Lemley of the Class of 2017; and Mary Craig, Luke Iannuzzi, John Pickering and Christopher Ray of the Class of 2018.

CCHS serves as the Tuscaloosa Regional Campus of the School of Medicine.

The Gold Humanism Honor Society was established to recognize medical students, residents and faculty who practice patient-centered care by modeling such qualities as integrity, excellence, compassion, altruism, respect and empathy. Each year, the Gold Humanism Honor Society extends membership to medical students in their clinical years who are committed to these qualities. Between 10 percent and 15 percent of each class can be selected cumulatively during the third and fourth years of medical school.

The Gold Humanism Honor Society is a signature program of the Arnold P. Gold Foundation, which works to create “compassionate, collaborative and scientifically excellent health care and to support clinicians throughout their careers so that that the humanistic passion that motivates them at the beginning of their education can be sustained throughout their practice.”

Protecting UA employees, students from the flu

The annual University of Alabama flu shot campaign, an effort by UA to protect students, faculty and staff from the flu, kicks off in September and continues through early November with free flu shots provided at locations across campus, including the Quad, university buildings and student residence halls.

The goal of the flu shot campaign, which is led by UA’s College of Community Health Sciences and now in its sixth year, is to make getting a flu shot as easy and convenient as possible. The shots are free and no insurance is required, although students and employees will need to provide their Campus Wide Identification.

Last year, more than 8,000 vaccinations were given.

The shots will be administered by nurses from University Medical Center, which CCHS operates, and the University’s Student Health Center and Capstone College of Nursing. WellBAMA and UA’s Division of Financial Affairs are also partners in the flu shot campaign.

Spouses of employees can receive the free flu vaccines at the campus flu shot stations or at the Faculty-Staff Clinic in University Medical Center, and insurance is not required. Children of employees with UA health insurance can receive flu vaccinations at University Medical Center, and children of employees with non-UA health insurance can receive flu shots at the Faculty-Staff Clinic if their insurance has previously approved nurse practitioner coverage.

In addition to the campus flu shot stations, flu shots will also be provided at University Medical Center and its Faculty-Staff Clinic.

The US Centers for Disease Control and Prevention recommends everyone aged six months and older get a flu shot annually. According to the CDC, a flu vaccine is needed every year because flu viruses are constantly changing and it is not unusual for new viruses to appear. The flu vaccine is formulated each year to keep up with the flu viruses as they change.

Dr. Richard Streiffer, dean of CCHS and a family medicine physician, said flu, or influenza, is not just a bad cold but can present a serious threat to many people. While the risk for severe illness is highest for children, the elderly and those with chronic medical conditions, even healthy people who get sick can miss up to two weeks of work, and may experience serious complications and even require hospitalization.

“You want to take every opportunity to protect yourself, as we do know that flu shots work to lower the risk of getting influenza,” Streiffer said. “If we can vaccinate enough people in the community and especially at and around the UA campus, and in our families and social circles, we are starting to create a ‘herd immunity,’ which is a more effective way to protect yourself and those around you.”

Risks associated with receiving a flu shot are extremely small, and the viruses in the flu shot are inactivated so they cannot cause the flu, according to the CDC. For more information, visit http://cchs.ua.edu/flu.

Flu shots are scheduled at the following locations, and additional dates and locations are expected to be added:

Date Location Time
September 7, Thursday North Lawn Classroom Building 9 am to 4 pm
September 12, Tuesday Russell Hall 7:30 am to 11 am
September 13, Wednesday Student Health Fair, Ferguson Student Center 9 am to 4 pm
September 13, Wednesday Quad in Motion, Quad 8 am to 4 pm
September 14, Thursday Tutwiler 9 am to 4 pm
September 18, Monday Capstone College of Nursing 10 am to 1 pm
September 19, Tuesday Law School 7:30 am to 11 am
September 21, Thursday Quad, Northeast Corner (across from Smith Hall) 9 am to 4 pm
September 26, Tuesday Procurement 7:30 am to 11 am
September 27, Wednesday Quad, Northeast Corner (across from Smith Hall) 9 am to 4 pm
September 28, Thursday Presidential Two 1 pm to 4 pm
September 28, Thursday Presidential One 9 am to noon
October 4, Wednesday UA Employee Health Fair, Coleman Coliseum 6:30 am to 4 pm
October 10, Tuesday Systems Office 7 am to 10 am
October 12, Thursday Paty Hall 9 am to noon
October 17, Tuesday Reese Phifer Hall 7:30 am to 11 am
October 18, Wednesday Quad, Southwest corner (across from Graves Hall) 9 am to 4 pm
October 24, Tuesday Ferguson Center 7:30 am to 11 am
November 1, Wednesday Ridgecrest South 9 am to 4 pm
November 1, Wednesday UAPD 7:30 am to 10 am
November 7, Tuesday Gorgas Library 7:45 am to 11 am
November 8, Wednesday Mary Burke Hall 9 am to 4 pm
November 9, Thursday Quad, Southeast corner (across from Gallalee Hall) 9 am to 4 pm

Dr. Caroline Boxmeyer is new Assistant Dean for Academic Affairs

Dr. Caroline Boxmeyer is now Assistant Dean for Academic Affairs for the College. Her responsibilities as assistant dean will include providing support and cross communication to the academic programs offered within the College, supporting faculty, and leading an initiative to create an Academic Oversight Committee and Process to centralize oversight of the undergraduate and graduate education offered in the college.

“This [new] work has the potential to have broad, lasting impact on health and well-being, which has always been a central motivating factor for me professionally,” said Boxmeyer, a professor in the Department of Psychiatry and Behavioral Medicine.

Boxmeyer, who is also a practicing clinical psychologist, hopes her contributions will grow CCHS to offer an innovative and supportive learning environment for all learners.

“I consider it a tremendous privilege to be part of this work and to contribute to the training the next generation of health care providers.”

Partnering for better health: UA partnership with Pickens County enters second year

The University of Alabama-Pickens County Partnership enters its second year with an increase in the number of student fellowships and health-related projects as work continues to provide health-care resources to the rural county.

Five recent UA graduates were selected as partnership fellows, up from four last year, and they will serve through June 2018. In addition, one prior fellow will remain for a second year to continue her work and also provide leadership for the new fellows.  The fellows will spend time working in Pickens County in community engagement and project development, and will participate in seminars about health and public policy, social determinants of health and leadership.

Along with the fellows, a total of 13 projects that address Pickens County health issues were funded in the second year, up from seven during the partnership’s initial year. Several of the projects are continuations from year one.

The overall goals of the UA-Pickens County Partnership are to expand health-care resources for Pickens County while simultaneously providing real world education and training for UA students in medicine, nursing, social work, psychology, health education and other disciplines.

During its recent session, the Alabama Legislature provided an additional year of funding for the partnership. The money is being used to provide stipends for the fellows and to fund new and ongoing health-related projects that involve UA faculty and students in collaboration with Pickens County organizations.

Rural counties throughout the country, especially in Alabama, face special challenges in sustaining health care services and addressing social factors that lead to a lower than average health measure. Pickens County is no different in that nearly one-third of its population lives below the poverty line and health outcome rankings show that the county is 41st among the state’s 67 counties.

The UA-Pickens County Partnership came about when the county feared its hospital, the Pickens County Medical Center, would close. The Friends of the Hospital in Pickens County, a citizen’s committee, worked with UA and its College of Community Sciences to help, resulting in this unique academic-community partnership.

The College’s mission is to improve and promote the health of individuals and communities in Alabama and the region, and one way it seeks to do that is by engaging communities as partners, particularly in rural and underserved areas.

Fellows 2017-2018:

August Anderson begins her second year as a fellow. During her first year, she worked with UA and Pickens County partners to establish sustainable programs to improve the overall health and well-being of residents, and she worked with children on comprehensive health and wellness education. Anderson has a bachelor’s degree in human development and family studies with a concentration in child development and addiction treatment.

Emma Bjornson graduated summa cum laude from UA in May 2017 with a bachelor’s degree in human environmental sciences/public health. As a fellow, she will help implement health programming and education to improve health outcomes in the county. She aspires to pursue a Master’s in Social Work with a focus on medically underserved populations and health disparities in rural and urban populations.

Crystal Bice is a registered dietitian and graduated from UA in May 2017 with a master’s degree in clinical nutrition. She earned a bachelor’s degree from UA in May 2016 in human nutrition. As a fellow, she will work to gain a better understanding of nutrition and health care in the county. She plans to become a physician’s assistant.

Steven Simmons graduated from UA in May 2017 with a bachelor’s degree in psychology. As a fellow, he will work to implement programs that improve access to mental health care for Pickens County residents. He is passionate about tele-mental health services and civic engagement with adolescents. He aspires to pursue a doctoral degree in clinical psychology.

Emily Stebbins graduated magna cum laude in May 2017 from UA with a bachelor’s degree in psychology. As a fellow, she will work to assess mental health awareness in the county and help educate residents about mental health, particularly as it relates to children, adolescents and county school systems.

Caroline Whittington graduated in May 2017 from UA with a bachelor’s degree in psychology and a minor in human development and family studies. As an undergraduate, she received the “Significant Contribution to Research in Psychology” award. As a fellow, she hopes to strengthen mental health resources within Pickens County, primarily for the elderly.

Projects (New) 2017-2018:

Women Wellness Workshops for Breast Cancer Awareness

Implement church-based, nurse-led educational sessions about breast cancer awareness and early detection among rural, African-American women, and train community health workers and undergraduate pre-nursing/nursing students to lead sessions.

UA partners: Dr. Mary Ann Kelley, Capstone College of Nursing

Pickens County partner: Pickens County Medical Center


 

Developing Awareness of Services Offered by Pickens County Medical Center

Work to better promote services offered by Pickens County Medical Center to address important health care needs in the county.

UA partner: Dr. Jef Naidoo, Culverhouse College of Commerce

Pickens County partner: Jim Marshall, CEO, Pickens County Medical Center


Automated External Defibrillators (AEDs) for Pickens County

Place AEDs in areas where large numbers of people gather on a daily basis.

UA partners: Glenn Davis, College of Community Health Sciences

Pickens County partners: Vicki McCrory, Manager, Pickens County Ambulance; Pickens County Board of Education; Pickens County and City Governments; Pickens County senior centers


EXPO Exploring Professional Opportunities in the Health Care Field

Continue this program for Pickens County 10th and 11th graders to explore health care careers.

UA partner: College of Community Health Sciences

Pickens County Partners: Jamie Chapman, superintendent, Pickens County Board of Education; Patti Presley Fuller, Pickens County Extension Office


Managing Frequent Attenders in Medical Care to Improve Patient Well-being and Reduce Provider Burden: Part 1 – Assessing the Scope of the Problem

Understand the degree and nature of unnecessary medical care in ambulatory medical practices and hospital settings in Pickens County.

UA partner: Dr. James Hamilton, College of Arts and Sciences/Department of Psychology

Pickens County partner: Jim Marshall, CEO, Pickens County Medical Center


Understanding Pain Management Needs among Community Dwelling Older Adults with Chronic Illness

Assess the need for pain management among older adults with chronic illness in Pickens County, and explore strategies to promote access to and use of palliative care in community settings.

UA partners: Dr. Hyunjin Noh, School of Social Work; Dr. Anne Halli-Tierney, College of Community Health Sciences

Pickens County partners: Ashley McGee, administrator, Aliceville Manor Nursing Home; Myra ShuffleBarger, director, Carrollton Senior Activity Center; Dr. Julia Boothe, Pickens County Family Medicine


UASSW-Pickens County Schools Partnership to Provide Behavioral Health Services to Students in the Context of a Positive School Climate

Increase access to behavioral health services for students.

UA partner: Dr. Laura Hopson, School of Social Work

Pickens County partner: Jamie Chapman, superintendent, Pickens County Schools

Projects (Ongoing) 2017-2018:

Improving Access to Cardiac Rehabilitation Services in Pickens County

Continue the partnership between UA and Pickens County Medical Center’s Cardiopulmonary Department to develop a sustainable, evidence-based cardiac rehabilitation program for county residents.

UA partners: Dr. Johnathan Wingo, College of Education/Department of Kinesiology; Dr. Avani Shah, School of Social Work

Pickens County partner: Sharon Wester, Pickens County Medical Center Cardiopulmonary Services


Disseminating the Power PATH Mental Health Preventive Intervention to the Pickens County Community Action Committee and Pickens County Schools

Provide the curriculum and training for school personnel at Pickens County Early Learning Center to implement the Power PATH mental health program with pre-school students and their parents.

UA partner: Dr. Caroline Boxmeyer, College of Community Health Sciences

Pickens County partners: Cynthia Simpson, Pickens County Community Action Committee and Community Development Corporation Inc.; Pickens County Head Start Program


Alabama Literacy Project: Supporting Early Literacy Development and Instruction

Continue support for early literacy and language development in Pickens County, including professional development for teachers, family literacy programs and vision and hearing screenings for young children.

UA partners: Drs. Carol Donovan and Nicole Swoszowski, College of Education

Pickens County partner: Fred Woods, Pickens County Head Start


Literacy Outreach as One Component of Health and Wellness

Expand literacy outreach to include community health.

UA partners: Drs. Nicole Swoszowski and Carol Donovan, College of Education

Pickens County partner: Jamie Chapman, Pickens County Schools


Improving Pickens County Residents’ Knowledge of Risk Factors for Cardiovascular Disease and Type 2 Diabetes through Increased Access to Screenings: The Pickens Health Improvement Program

Implement health promotion “clinics” in Pickens County to help change how residents think about risk factors, prevention and health behaviors, and to improve their knowledge of health risk factors.

UA partners: Drs. Michele Montgomery and Paige Johnson, Capstone College of Nursing

Pickens County partner: Patti Pressley Fuller, Pickens County Extension Office


TelePlay: Connecting Physicians, Families, and Autism Professionals to Increase Early Autism Identification in Pickens County

Connecting a primary care provider and parents in Pickens County with The University of Alabama Autism Clinic team to identify children at risk for autism by piloting Teleplay, an interactive secure online communication system.

UA Partners: Lea Yerby, PhD, College of Community Health Sciences; Angela Barber, PhD, College of Arts and Sciences

Pickens County Partners: Julia Boothe, MD, Pickens County Primary Care