2008 Funded Projects

Global Information Systems (GIS) Analysis of the Milwaukee and Menomonee Rivers; pathogen concentrations and correlations

  1. Robert S. Burlage, Ph.D., Associate Professor, Clinical Laboratory Sciences, College of Health Sciences
  2. Changshan Wu, Ph.D., Assistant Professor, Department of Geography, College of Health Sciences
  3. Milwaukee Health Department
  4. Milwaukee River Basin Partnership

Abstract

This project is a continuation of the present Center Scientist Development Program-funded project, A GIS approach to waterborne infectious disease: Cryptosporidium. In this project we are currently measuring pathogen concentrations in the two major area rivers and correlating the results with urban characteristics. This has been successful, although surprisingly it has suggested that the Menomonee River is significantly more contaminated than the Milwaukee River. It was expected that the rivers, both flowing from a northern watershed area with large agricultural inputs, would be equally contaminated. We have correlated microbial contamination with land uses, raising the question of whether this observation will persist over a larger geographic area.

In this continuation we will extend our zone of monitoring to a much larger, extraurban area. We will use the same techniques as previously used. Our results should indicate where the peak of contamination is located, allowing a correlation with local environmental conditions. This also permits a much clearer comparison of urban vs. rural settings, presenting a starker contrast in land use, population density, and other pertinent factors.

Fetal and Infant Mortality Review (FIMR) Project of Racine

  1. Teresa S. Johnson, Ph.D., R.N., Associate Professor, College of Nursing
  2. Sheryl T. Kelber, M.S., Biostatistician & Information Specialist, College of Nursing, Center for Nursing Research & Evaluation
  3. Emily Nowak, Student Worker, College of Nursing
  4. Margaret Malnory, M.S.N., R.N., Executive Director of Specialty Services, Wheaton Franciscan Healthcare–All Saints
  5. Duane Stich, M.D., Neonatologist, Wheaton Franciscan Healthcare-All Saints
  6. Thelma Jones, M.S.N., R.N., Community Services Supervisor, City of Racine Health Department

Abstract

Infant mortality in the city of Racine continues to be a serious problem and is higher than any other city in the state. The infant mortality rate for 2002-2006 was as follows: non-Hispanic black = 23/1000; non-Hispanic white = 6.9/1000 and Hispanic = 8.9/1000, and B/W ratio is 3.3. The purpose of the project is to investigate the causes of fetal and infant mortality in the city of Racine through partnerships and access of information from the city of Racine Health Department and Wheaton Franciscan Healthcare–All Saints.

This year of funding will allow Dr. Johnson, principal investigator for FIMR to continue participating and overseeing data collection, entry, and analysis from birth certificates, death certificates, and hospital and outpatient records of fetal and infant deaths during this year of transition. The FIMR process will be transitioned under the auspices of the City of Racine Health Department, since FIMR is tied to new GPR funding for infant mortality. 2007 data collection will be completed by May 2008, and the streamlined process developed this year will allow 2008 data to be collected in a more timely manner. Interview will continue. A regular meeting schedule for the Steering and Case Review Committee will be established.

Family Caregiver Self-Management of the Unmet Needs of Persons with Dementia

  1. Sarah W. Morgan, Ph.D., R.N., Clinical Assistant Professor, College of Nursing
  2. Stephanie Sue Stein, Director, Milwaukee County Department on Aging

Abstract

This project is an expansion of a currently funded study evaluating the feasibility and efficacy of the Caregiver Self-Management of Unmet Needs (C-SUM) intervention to include the Milwaukee County Family Care Program. The C-SUM, designed in consultation with Dr. Christine Kovach as an adaptation of her Serial Trial Intervention, is a three step, staged intervention that incorporates the caregiver as well as a registered nurse. The intervention is intended to teach family caregivers to self-manage the needs of their family members living with dementia in hopes of avoiding unmet needs resulting in reductions in family member’s discomfort, agitation, and stress and caregiver burden and stress. By making the caregiver the primary assessor it makes this a more realistic model for more wide-spread use in the community setting. In Phase 1 ten caregiver/family member dyads will be enrolled to test the feasibility of the C-SUM intervention as determined by successful completion of all aspects of the intervention. Data gathered in Phase 1 will be used for Phase II of the currently funded study for pilot testing of the intervention which will be used to apply for further extramural funding for a fully powered randomized controlled trial of the C-SUM.

Utilizing Tailored Step-Count Feedback to Enhance Physical Activity in the Elderly

  1. Scott J. Strath, Ph.D., Assistant Professor, Human Movement Sciences, College of Health Sciences
  2. Keith Genusso & Daniel Romanowich, UWM Graduate Students
  3. Healthy Aging Clinics in the VA
  4. Milwaukee County Department on Aging

Abstract

The proportion of the United States population aged 65 years or older is projected to double in the next 30 years (U.S. Census Bureau, 1996). This dramatic rise in the number of older adults will place an increased demand on public health and medical services. Chronic conditions, such as coronary heart disease, diabetes, hypertension, arthritis, and depression affect the elderly segment of society disproportionately (Berg, 1990; Hoffman, 1996), much of which is preventable. These conditions, either in isolation, or in conjunction with one another contribute to disability, a reduced quality of life, and increased health care costs. It is estimated that 88 percent of adults over age 65 have at least one chronic health condition, and that 21 percent of adults over age 65 have a chronic disability (CDC, 2003). Therefore, public health programs need to respond to the growing prevalence of older adults, and proactively address the increased burden of chronic diseases, disabilities, and growing health care costs. Recent randomized controlled trials (RCTs) have demonstrated that intensive dietary and exercise interventions can prevent or at least delay the onset of chronic diseases, such as within people at high risk for developing type 2 diabetes (Knowler, 2002; Tuomilehto, 2001). However, these interventions are generally so complex and expensive that they are not feasible in a community or primary care settings. Studies of less intensive counseling interventions have failed to demonstrate effectiveness (Whitlock, 2002). Therefore, to realize the dramatic benefits observed in physical activity (PA) efficacy studies, we must develop effective and feasible low-cost interventions that can produce sustained improvements in PA. We propose to develop and test a program to motivate patients at risk for chronic disease to increase their walking using objectively measured step-count feedback and motivationally matched messaging. Our goal is to provide community partners and primary care providers with an effective and practical intervention to help sedentary patients at risk for chronic disease become more active, in an attempt to increase the health and well-being of older adults.

Development of a Senior Housing Health Environment and Health Behavior Index

  1. Kathryn R. Zalewski, Ph.D., M.P.A., P.T., Assistant Professor, College of Health Sciences; Program Director, Doctor of Physical Therapy Program
  2. Lori Neighbors, Ph.D., Assistant Professor, College of Health Sciences
  3. Lisa Stueland, R.N., Vice President, The Laureate Group

Abstract

Wisconsin seniors are among the nation’s worst for prevalence of obesity. We rank high for reporting no leisure-time physical activity and poor nutritional habits. Previous research has suggested that environmental factors exert a major influence on health-related behaviors at the individual level, such as physical activity and eating behaviors. Retirement communities provide structured living environments that could be optimized to increase activity levels and promote healthy eating habits, thereby attacking obesity in Wisconsin seniors. A comprehensive assessment index would enable retirement communities to objectively assess the health promoting potential of the built environment, and identify strengths and weaknesses of existing and future health-related programs and practices. Results from a facility assessment process would facilitate the development of customized, site-specific action plans for improving senior health behaviors. The purpose of this proposal is to develop and test a Senior Health Environment and Health Behavior Index (SHEHBI) applied to community based senior/retirement housing. The initial focus in the development of this index will concentrate on developing the sub-categories of leisure-time physical activity and nutrition. Future grant applications will seek to add additional modules for holistic assessment of health behaviors as recommended by the Centers for Disease Control.

Our Address

Center for Urban Population Health 1020 North 12th Street, Suite 4180, Milwaukee, WI 53233 414-219-5100 (Phone) 414-219-6563 (Fax)

Our Partners

  • University of Wisconsin School of Medicine and Public Health
  • University of Wisconsin–Milwaukee
  • Aurora Health Care