Epinephrine Auto-Injector Use Among Young Adults Aided By Financial Incentives: PRC Researcher Carolyn Cannuscio

New research from UPenn PRC Community Engagement, Partnerships, & Technical Assistance Core Leads Carolyn Cannuscio, ScD, and David Grande, MD, MPA, shows that financial incentives may encourage epinephrine auto-injector use among young adults.

 

Published in the  Annals of Allergy, Asthma & Immunology. their study found that young adults ages 18- 30 who received both financial incentives and text messages appear to carry their epinephrine auto-injectors far more often than those who received only text messages. Prompt administration of epinephrine is critically important in case of anaphylaxis, a life-threatening allergic reaction that can include trouble breathing or swallowing.

 

“We were impressed by the effects of the incentives,” said lead researcher Carolyn Cannuscio, a social epidemiologist with Penn’s Center for Public Health Initiatives, faculty member at the Center for Health Incentives and Behavioral Economics (CHIBE),  and assistant professor of family medicine and community health at the Hospital of the University of Pennsylvania. “Adolescents and young adults have the highest rate of adverse events from food allergies,” with a high fatality rate, she said. When children move from elementary to middle school, school support for those with food allergies tends to drop off, according to Cannuscio, who said it’s a difficult transition to navigate.”We have learned that in very active situations, sporting events or socializing, going out to nightclubs,” said Cannuscio, “those are times when people really need to have their auto-injectors present.”

 

Read more about Cannuscio and Grande’s study here.

 

Racial Disparities in Access to Primary Care: PRC Researchers David Grande and Daniel Polsky

In the August issue of Health Affairs, UPenn PRC Researchers David Grande, MD, MPA, and Daniel Polsky, Ph.D, investigate racial disparities in spatial accessibility of primary care among different neighborhoods in the city of Philadelphia.  Noting that “areas of the city with high percentages of African Americans or Hispanics were likely to also be areas with poor primary care spatial accessibility” and that ” people who live in those areas might be forced to travel farther or wait longer, which creates additional barriers to primary care,” Grande and Polsky show similarities between their research and research on food deserts – neighborhoods which have limited access to healthy food.  This study furthers research on neighborhood health risk and how the built environment impacts the health status of different urban populations.

 

 

 

How Neighborhood Impacts Health and Well-Being for Low-Resource, Single-Parent Families: PRC Researcher Doug Wiebe

In the April 2016 issue of Health and Social Care in the community,  UPenn PRC Training and Evaluation Core Lead Doug Wiebe, Ph.D, and colleagues investigate factors in the physical and psycho-social well-being of low-resource, housing-unstable, single parent families living in violent neighborhoods in Philadelphia

The researchers looked at families who were participants in a housing-plus program in Philadelphia and the relationship between the characteristics of the neighborhoods in which the families lived and their perceptions of well-being and safety. Noting that health dynamics in this population are “not well-described,” the researchers sought to contribute a better understanding of how the stresses of where one lives impacts how well one can live.

Among the key findings:

  • Parents of low-income, single-parent families who participate in a housing support program in an urban setting with high community violence met or exceeded the US national average for self-reported physical health but fell below the national average across all mental health domains, including symptoms for moderate to severe depression.
  • These parents described high levels of stress resulting from competing priorities, financial instability, and concern for their children’s well-being and safety.
  • External markers of violence (crime rates) in their proximate neighborhood affected how parents and children conducted their daily activities and moved within their neighborhoods.

 

Gun violence: location a key risk factor, according to Doug Weibe, PRC Core Lead

In the January 2016 issue of Epidemiology, Doug Wiebe, PhD, UPenn PRC Training Core Lead, and other health researchers from the University of Pennsylvania analyze detailed activity paths of urban youth to investigate the interplay between their lived experiences, time spent in different environments, and risk of violent assault.

 

Since gunshot violence is now the leading cause of death among 10- to 24-year-old African American males and the second-leading cause of death among all males in that age group in the United States, identifying the factors in exposure to violence by guns and other weapons is critical. A key finding is that location matters.

 

Building on research that suggests youth violence is the end result of a web of factors that include alcohol use, access to firearms, and disadvantaged urban environments, Wiebe and his co-authors developed a new approach for studying the dynamics of activities in an urban environment. They found that the context of young people’s activities and characteristics of the places they spent time put them at risk to be assaulted or protected them from being assaulted, and certain activities appeared to trigger the onset of assault.

 

 

Read the article here.

Examining The Use Of Fear In Urban Violence Prevention Programs

 

In the July 23, 2015 edition of Injury Prevention, UPenn PRC’s Doug Wiebe, PhD., joins researchers Jonathan Purtle, Rose Cheney, and Rochelle Dicker in examining the impact of fear appeal persuasive messaging on violence prevention programs in urban communities.

As an alternative to fear appeal, the authors recommend violence prevention programs that embrace trauma-informed practice and a social-ecological approach. Trauma-informed practice acknowledges prior exposures to violence and provides services that recognize the social, emotional, biological, and cognitive impacts of those experiences.

Read the article here.

Purtle JCheney RWiebe DJ, et al

Issues for Expanding Role of Community Health Workers

Community Health Workers in Post-Reform U.S. Health Care

Shreya Kangovi, M.D., M.S., founding executive of the Penn Center for Community Health Workers, and David Grande, M.D., M.P.A., Co-Director for the PRC’s Community Engagement, Partnerships & Technical Assistance Core, wrote in last week’s published issue of New England Journal of Medicine. First, they wrote about the need for more community health workers. Kangovi and Grande highlight the need for community health workers to assist patients in navigating health systems.

Secondly, Kangovi and Grande address several implementation issues that come with the potential increase of CHWs, including the need to establish a working network between CHWs and healthcare providers rather than CHWs working for standalone companies or programs. In addition, it will be important for CHWs’ tendency to shift focus from “disease education” to providing assistance with specific insurance implementation issues. David Grande says that “addressing historical implementation barriers will allow programs to maximize this opportunity.”

Read the article published on June 15, 2015, here.