Saint Charles County Department of Community Health & Environment Andrew Adams June 2014-September 2014 Organization St. Charles County Department of Community.

Saint Charles County Department of Community Health & Environment Andrew Adams June 2014-September 2014 Organization St. Charles County Department of Community Health & Environment employs ~ 60 people, in areas including disaster preparedness, emergency management, communicable disease, and environmental science Serves to keep the residents of the county healthy through offering and improving services including WIC, immunizations, and disaster preparedness Projects County-wide Database; data entry Logistics in exercise planning Role in Organization/Project Served as an intern in the Disaster Preparedness Department of the County Health Department Data entry/database building Worked closely with disaster planners and the epidemiology and communicable disease team Logistics Manager during large scale mass prophylaxis exercise Public Health Context Disaster Preparedness and Emergency Management are key aspects of Public Health and its role in the community; the St. Louis area must be prepared for disasters, both man-made and natural A large scale mass prophylaxis exercise is an important function of Disaster Preparedness; the goal of the exercise was to determine the number of points of dispensing (PODs) needed to serve the population of Saint Charles County (~370,00 people) Activities Create county-wide database of healthcare workers for use in emergency Attend regional meetings for Epidemiology and Disaster Preparedness Help plan Large Scale Exercise, by being on the logistics team Logistics Manager at Exercise Practice Experience Progress and Challenges Engaged in real-world scenarios Gained knowledge of both Epidemiology and Disaster Preparedness Communication and networking Competencies Achieved Communication and Informatics, through database, as well as networking, and attending of meetings Ethics and Professionalism Cultural Competence Program Planning Biosecurity and Disaster Preparedness, through disaster planning and working with disaster preparedness staff from throughout the region

Baylor College of Medicine Christine Aldape Practice Experience Dates:June 2014-September 2014 Baylor College of Medicine Baylor College of Medicine (BCM) is an institute of higher education and research located at the heart of the Houston medical center. BCM partners with Texas Children's Hospital for research focused on improving the health of children. Projects State of Health Update the State of Health Houston/Harris County document through researching existing publications and secondary data sources. This data was compiled to create two-page spreads to be published in 2015. LGBTQ Homeless Initiative Identify national evidence-based programs targeted at preventing LGBTQ homelessness. Houston Youth Voice: Data and Evaluation Workgroup Research data to be included in statistical profile for the general population. My Role Review existing literature. Identify credible sources of data and compile information into publishable spreads for lay people, professionals, and policy makers. Maintain reference database of all information. Attend meetings and present progress of research. Public Health Context Houston is the fourth largest city in the United States with a diverse population. State of Health The State of Health Houston/Harris County is community assessment that allows for public health professionals and policy makers to identify health problems in the area with their corresponding statistics. LGBTQ Homeless Initiative 1 in 910 people in Harris and Fort Bend County is homeless. Nationally, 40% of homeless youth identify as LGBT. LGBTQ homeless youth are at greater risk of violence abuse and exploitation in comparison to their homosexual peers. Houston Youth Voice: Data and Evaluation Workgroup (Violence Prevention, Teen Pregnancy) Homicide is among the three leading causes of death of those ages 10 to 24 in Houston, Texas. Texas ranks 5 th in highest teen births rates among females aged 15-19 and 1 st in repeat teen births. Activities Identify data sources on various health topics included in the State of Health and priority health topics identified by the Houston Youth Voice Collaborative. Reach out to and meet with researchers for data to be included in State of Health 2015 publication. Translate data into two-page spreads. Identify evidence-based programs for LGBTQ population. Attend conferences and meetings. Present findings and progress on State of Health. Practice Experience Progress and Challenges Progress 1.Approximately one-third of the State of Health Houston/Harris County 2015 publication was completed and the remaining is currently in progress. 2.Compiled data on violence prevention and teen pregnancy for statistical profile. 3.Identified and compiled a list of evidence- based programs for the LGBTQ Homeless Initiative. Challenges 1.Attendance from key stakeholders at large collaboratives was often lacking. 2.Balancing scheduling with multiple projects under different organizations. Competencies Achieved Identified and communicated information from various sources into consolidated documents for lay people, professionals, and policy makers. Attended various meetings and conferences where there was information sharing on most recent projects or research done (HIV research, technology used for health, LGBTQ research). Attended and participated in meetings to discuss priority topics from a comprehensive State of Health assessment to include in a summarized executive summary. Identified existing evidence-based programs for the LGBTQ Homeless Initiative steering committee.

Needs Assessment in the Saint Louis Community Cameron Alman May 2013-May 2014 University of Missouri - Saint Louis, College of Nursing The UMSL School of Nursing was established in 1981 as an upper division, post-licensure Bachelor of Science in Nursing degree.A few years later, in 1989, the Master of Science in Nursing (MSN) program was added; the cooperative Doctor of Philosophy (PhD) program began in 1984.Also in 1984 the pre- licensure baccalaureate track of the BSN program began as a merger with Barnes College of Nursing, creating the Barnes College of Nursing at the University of Missouri–St. Louis.In 2005, Barnes-Jewish Hospital retrieved the name "Barnes” making the nursing education entity at the University of Missouri–St. Louis the College of Nursing. The cooperative Doctor of Nursing Practice was added in 2008. Project Needs assessment based on surveys for the UMSL College for Nursing Role in Organization/Project Research Assistant - Visit various different pediatricians’ offices and the health office at UMSL and issue surveys. Intern - As the intern for my preceptor I organized the data and created a database in SPSS for the different types of surveys we had.I then used those databases to determine the top needs for the area as well as merged them and analyzed them after there was one master database. I then performed literature review and review writing for my preceptor. Public Health Context As health is often viewed by professionals in the public health one way, the community has different views of what is necessary. From a needs assessment the needs of the community can be used to determine what the most important health issues are perceived by the community. When we know what the community needs, we can then tailor many of our interventions towards health issues and risk factors for them appropriately. Activities Survey issuing Datamanagement, organization and analysis Literature Review Review Writing Meeting about progress Practice Experience Progress and Challenges Throughout the whole process I learned things that could not be picked up in a classroom, i.e.: Real life research difficulties (difficulties issuing surveys, getting full information on surveys etc.) It also showed me how tedious and time consuming research can be. Competencies Achieved 6.2 Protect confidential data and obtain informed consent 1.1 communicate complex information into formats, both written and oral that are understandable to target audience 1.identify leading public health problems, key risk factors and methods for collecting, analyzing and reporting surveillance data for these health issues 2.able to interpret results make appropriate inferences based on results and recognize public health and clinical implications 3.describe the key facilitator and barriers to the use of epidemiologic data for public health and policy-related decision making

HIV/AIDS Surveillance at the Saint Louis City Health Department Elizabeth Baney Practice Experience Dates: July 2013 – April 2014 Saint Louis City Health Department Governmental agency Manages the greatest case load of HIV/AIDS surveillance in the state Covers St. Louis City, County, and some surrounding areas Evaluation of Reporting Lab Used SPSS to evaluate reporting compliance of a lab Found the lab was reporting over 90% of patient outcomes Role in Organization and Project Data Entry: o One of three workers who would enter data for health department o Update patient records such as address Validation Study: o One of two who completed study o Compared lab’s records with ours in eHARS o Used SPSS to characterize differences Public Health Context Just over 1.1 million people in the United States are HIV positive St. Louis City has one of the highest prevalence rates in the country (554.3 per 100,000) St. Louis County is also very high, but not as much (192.6 per 100,000) The national average is 107.5 per 100,000 Missouri’s prevalence is 131.2 per 100,000 HIV/AIDS is a huge problem for the St. Louis metropolitan area HIV/AIDS surveillance is of utmost importance Helps track those infected for education and interventions to prevent the spread Records must be up-to-date so information can be used for epidemiological research Activities Input viral load and CD4 counts and percents into the CDC’s enhance HIV/AIDS Reporting System (eHARS) Updated patient demographic and location data Used ArcGIS to characterize HIV/AIDS cases Practice Experience Progress and Challenges Results from the validation study have been shared with the reporting lab to encourage future compliance Data entry can get boring, but it is extremely necessary Working in a health department is more political than it seems Competencies Achieved Communicate complex information into formats, both written and oral, that are understandable to target audiences o Results of the validation study to the reporting labs Explain the roles of the public and private sectors in meeting health needs and priorities o Roles of the health department and reporting labs in surveillance Protect confidential data and information, and obtain informed consent for participation in public health interventions, services, and research projects o Learned proper protection of HIV/AIDS data and how to present de-identified data

Department of Obstetrics, Gynecology, and Women’s Health Jessica Berkemeier Practice Experience Dates:March, 2014 – July, 2014 St. Mary’s Health Center St. Mary’s Health Center, located in St. Louis, Missouri has become a leading center for high risk OB careand Vulvar and Vaginal Disorders due to it’s partnership with Saint Louis University School of Medicine. St. Mary’s also has a connection with Cardinal Glennon Children’s Hospital to ensure that expert care continues for all high-risk infants born in its facility. Extremely Low Birth Weight (ELBW) Survival Data collection through a retrospective chart review of infants born under 1000 grams in 2002. Positive Yeast Cultures Data collection through retrospective chart review of patients with positive yeast cultures. My Role Data collection Collection of data from electronic health records (EHR) for patients with positive yeast cultures. Collection of data from pre-EHR records for maternal and infant characteristics of ELBW survival. Data Analyst Analysis of missing data from ELBW database. Public Health Context ELBW infants account for 50% of deaths for all neonatal mortality in the United States. Very few studies have looked at the maternal and fetal characteristics to determine associations for survival. Gestational age and birth weight are known predictors of survival, but associations with other independent risk factors of maternal age, maternal BMI, and prenatal care may also lead to better “best practices” in high risk pregnancies. Previous studies have looked at the susceptibility of yeast cultures to antibiotics, however, there is concern that yeast are becoming more resistant to these treatments. Knowing if resistance or recurrent yeast infections have changed will be important to determine how treatment of positive cultures should be handled in the future. Activities Collect maternal and fetal characteristics for infants born under 1000 grams from medical records. Preliminary analysis of data to determine amount of missing data. Collection of variables from electronic medical records involving positive yeast cultures, and entry into a shared database. Practice Experience Progress and Challenges 1.Collection of over 50 cases of ELBW data from pre-EHR medical records. 2.Identification of missing data, with discussion on how to proceed. 3.Communications with Quest Lab to determine account numbers for positive yeast culture identification. 4.Collaboration with physicians and principal investigators to determine what and where data should be collected from. Competencies Achieved Patterns of insurance, marital status, and amount of prenatal care became apparent during collection for ELBW study.These patterns portray how access to healthcare may differ for the metro-area and may affect different health outcomes. Use of the medical records office to extract data from pre-EHR medical records, as well as, communicate and retrieve data from laboratory used for yeast cultures. Collection of data from handwritten medical records leaves a lot of room for subjective data collection, so clarifying specific instances and patterns of data entry with colleagues became important.

Program Services Intern at March of Dimes Shannon Cassady Practice Experience Dates:July 2013- May 2014 Organization March of Dimes is a national nonprofit organization committed to give babies a stronger, healthier start. The organization funds research to reduce prematurity as well as offers community grants to support programs and moms across the nation. Project I assisted with the Missouri Task Force on Prematurity and Infant Mortality. I assisted with advocacy and research related to the final report recommendations. Role in Organization/Project Reviewed the literature and various data sources in Missouri to determine current rates related to adverse birth outcomes. Reviewed literature for effective interventions and policy-changes to provide support and evidence for proposed bills during the legislative session Created reports that can be used to communicate the purpose and reasoning for the proposed bills to various audiences (i.e. Legislators, public, health care professionals). Public Health Context Healthy People 2020 states reducing premature births, low birth weights and infant mortality. In Missouri, 11.5% of births are preterm births and the infant mortality rate is 7.1 per 1000 live births. Both of these rates lag behind current national rates and the goals set by Healthy People 2020. The final report provides recommendations that should be use to look for areas of improvement by either program initiatives or policy changes. The recommendations have been used as support for the proposal of legislation that would establish perinatal regionalization as well as for opposing legislation that would cut insurance for low-income mothers, infants and children. Activities Researched the current state of Missouri as it relates to prematurity and infant mortality. Researched effective interventions and policies based on the recommendations. Disseminated information to be used in the final report and as evidence for policy changes Practice Experience Progress and Challenges The final report was delivered to the legislature in January of 2014. This report has been used to support the introduction of HB 1898, which will establish perinatal regionalization if it passes. Being able to communicate results and their significance to a broad audience is essential if the report will be used by different groups for different purposes. It is important all parties involved understand the implications of the findings. Competencies Achieved Interpreting results and communicating them effectively to various audiences. Recognizing public health and clinical significance and implications from review of literature. I gained experience with how the legislative system works to pass bills and how non-profits become involved with advocacy for different bills.

SSM Behavioral Health Services- Youth & Family Outpatient Services Nick Collins Practice Experience Dates:May, 2014 – August, 2014 SSM DePaul Health Center Also known as St. Vincent's. SSM Behavioral Health Services at DePaul is among the largest, most experienced and most comprehensive psychiatric facilities in the Midwest. They offer intensive outpatient/day programs for adults with various psychiatric needs, including chemical dependency and persistent mental illness. The health center offers an outpatient program for adolescents (12-17 yrs.) and their families. My Project Work collaboratively with social workers to look at current processes of the Youth & Family Outpatient Services Program and ways to enhance the program Address lack of health promotion materials to highlight the program My Role Behavioral Health Intern Research current topics that affect adolescents Create and disseminate newsletters to participants of the program Create a logic model and process evaluation grid and write a report on them Observe both parent and youth weekly group sessions Clean and present data on outcomes from participants Public Health Context Depression in adolescents is a growing issue as current statistics show that 11% of adolescents have a depressive disorder by age 18. Populations that are currently enrolled in the program are high-risk and include youth that are ages 12-17 and their families. Working to improve processes and evaluate a program that is attempting to assist youth with a high risk of depression can help this issue. Disseminating the newsletters can give parents and youth involved with the program an opportunity to learn about current issues and ways to deal with them. Activities Create a logic model for the Youth & Family Outpatient Services Program Create newsletters for the program Perform process evaluation of the program Practice Experience Progress and Challenges 1.Two newsletters were created and disseminated. 2.A logic model and process evaluation grid were completed and reports were written on both. 3.Working in a department with professionals that do not have public health backgrounds can be challenging but being able to educate them and learn from them as well helped to overcome that challenge and working with these professionals assisted in making the internship a great experience. Competencies Achieved 1.Communicate complex information into formats, both written and oral, that are understandable to target audiences, e.g., policy makers, administrators, general public, etc. I created documents including a logic model and process grid and was then able to write reports and present them to social workers. 2.Protect confidential data and information, and obtain informed consent for participation in public health interventions, services, and research projects. I sat in on multiple group sessions and had to obtain consent to do so while collecting data. 3.Identify existing effective evidence-based programs and materials appropriate to organization needs. I researched articles on ways to improve negative situations with adolescents and used relevant articles for inclusion in newsletters.

Outcomes Analysis for Patients Treated at Ranken Jordan Brittany Corley Practice Experience Dates:May 2014- July 2014 SLUCOR/Ranken Jordan SLUCOR is the secure data center here at SLU They offer analysis for those in the community needing it for a fee Ranken Jordan is a pediatric bridge hospital in Saint Louis They treat Children with medical complexities. Outcomes Analysis Identified outcomes of those Medicaid patients treated at Ranken Jordan Role in Organization/Project Data Analyst Create variables and datasets needed for testing Create code book to pass down to those after me on project Paper/Presentation Development Ensure records are kept up to date for paper creation Help create monthly presentation with Ranken Jordan Public Health Context More than 2 million Medicaid covered children are medically complex These 2 million children are some of the most costly people in the health care system These medically complex children typically also place a significant burden on their families and those caring for them Ranken Jordan is the only hospital in the Saint Louis Area which specifically treats these medically complex children Since the start of research into these children there has been a push tolower costs related to treating the medically complex children. Activities Analyzed primary data from Missouri Medicaid claims Researched outcomes normally looked for in these medically complex children Collaborated with a team of other students Practice Experience Progress and Challenges 1.Several future presentations are set to come out of this research including a Poster at APHA 2.Working with people of different educational and research backgrounds can prove difficult 3.Creation of publishable materials was big part of this project and will hopefully be used in the future Competencies Achieved 1.Able to interpret results, make appropriate inferences based on results and recognize public health and clinical implications of results Had to be able to explain results found in data analysis to the appropriate people at Ranken Jordan. 2.Ask appropriate questions, clarify assumptions and apply data when making decisions. When findings were not the expected results or outcomes we had to clarify what Ranken Jordan expected from us. 3.Identify leading public health problems, key risk factors and methods for collecting, analyzing, and reporting surveillance data for these health issues. Had to identify and explain the various validity problems that are a product of using ICD-9 claims data for our surveillance data. Also had to understand how to truly understand and use this data correctly.

Tech Over Teen and Vertex Telehepatology Kathryn Dickhut Practice Experience Dates:May, 2013 – December, 2014 Saint Louis University Saint Louis University (SLU) is a higher education institution Studies covering many aspects of public health are conducted at SLU – College for Public Health and Social Justice Integris Health Integris Health is a leading healthcare provider in Oklahoma Nazih Zudhi Transplant Institute (NZTI) is a world class transplant center located at Integris Baptist Hospital in Oklahoma City, OK Tech Over Teen (TOT) Development and analysis of weight management software for obese adolescents Vertex Evaluation of a first-generation, grant-driven Telehepatology program at NZTI My Roles Data collection and analysis o Conduct interviews for both TOT and Vertex projects o Conduct qualitative (TOT & Vertex) and quantitative (TOT) analysis Project Management o Organize interview prep work, assign tasks to team members, manage data and subsequent work (TOT) Presentation development o Literature reviews and summaries (TOT & Vertex) o Writing of abstracts (TOT & Vertex) o Compile evaluation results into midterm and final reports (Vertex) o Create and present poster at Washington University obesity symposium (TOT) o Continued work on poster presentation at ATA 2014 (TOT & Vertex) Public Health Context Adolescent Obesity: TOT o According to the CDC, the percentage of obese teens, 12-19 years, increased from 5% in 1980 to 18% in 2010. In 2010, more than 1/3 of children in the US were overweight or obese. o Consumer Health Technology (CHT) may be a promising way to provide self- management support tools for overweight/obese teens. o CHT has been used to assist in the treatment and management of diabetes, obesity and weight management, and hypertension. o Up to 90% of children and adolescents use a mobile phone. o CHT has great potential in the self-management of chronic diseases, and there is research supporting the importance of User-Centered Design for the adoption of technology by the intended users. Telemedicine and HCV: Vertex o The incidence of Hepatitis C (HCV) in the state of Oklahoma is more than 3 times the national average. o HCV causes liver damage and can lead to liver transplantation. o Oklahoma also has limited primary care physicians practicing in the state (2.13 physicians per 100 people). o Specialty care, in any state, tends to be located in metropolitan centers, leaving vast rural populations with limited access to specialty care. o Rural populations in states such as OK, NE, ND, SD, etc. face long distances, prolonged absences from jobs, and increased travel costs in order to see a specialist, not to mention the costs and time required for additional visits o Telemedicine, in general, provides these rural and vulnerable populations with better access to specialty care, such as Hepatology. TOT Activities Collect and analyze primary data Disseminate information to public health practitioners Vertex Activities Develop interview protocols, collect and analyze primary data Research the role of telemedicine in community benefit Practice Experience Progress and Challenges One poster presented; two posters and a journal article in progress (TOT & Vertex) Continuation with next phase interviewing (TOT) Scheduling meetings with team members across the US made easier with Fuze (TOT & Vertex) Learning to use and incorporate new programs (Dedoose, Basecamp, EndNote) took some time Managing the work and deadlines of other team members Competencies Achieved Communication of information to individuals and groups with varying levels of knowledge and experience, both verbally and written (TOT & Vertex) Leadership and management via project management of TOT Phase 2 interviewing Collecting information from individuals (overweight teens) and organizations (Integris/Vertex project) Analysis and application of information gathered through qualitative and quantitative methods Protection of interviewees while creating evaluation reports and poster presentations Interpreting qualitative and quantitative results (TOT & Vertex) Analysis and reporting of barriers and facilitators to the adoption of telemedicine and the adoption of weight management software for adolescents Exploring new approaches to delivering care for vulnerable populations

American Water Courtney Faust Practice Experience Dates:July, 2014 – September, 2014 American Water Largest Publicly Owned Water company in the United States Filter and distribute potable water Clean and manage waste water\ Largest regulated water and wastewater service provider in Pennsylvania. o 2.2 million served in PA annually o 92% surface water used My Project Assist with editing and maintaining source water protection plan and increasing committee size Implement the day to day collection of water quality samples Implements programs to ensure environmental compliance Water Quality Supervisor Directly in charge of overseeing water treatment plant in regards to chemical treatment Provides technical direction on water quality, treatment, permitting and regulatory compliance issues. Oversees plant and laboratory procedures for testing and sampling to ensure company and regulatory requirements are met. Ensures that customer complaints or inquiries are properly addressed to attempt to resolve any issues. Public Health Context Maintaining water quality to ensure the public receives safe water Testing for bacteria in water to be sure there are no harmful organisms Changes are made to treatment process when necessary to maintain quality Assurance is a main function within this position. The public is kept updated with any and all new and relevant information about their drinking water and anything wrong with it. Policies are adapted as necessary. An example is from this summer, the Revised Coliform Rule took place, making it more protective.This changed the amount of samples that needed to be taken if one tests positive for Coliform bacteria. My Activities Assist in resolving treatment issues Testing for Coliform Bacteria Monitoring water quality and adapting treatment process when necessary Actively learning about water treatment process Practice Experience Progress and Challenges My process was a little unique because I have moved back and forth between two different locations. In Norristown, I spent time learning about the treatment process. In Birdsboro, I was able to collect water samples and run a variety of tests on them. My main challenge in this internship was learning the different computer programs utilized to monitor the plant but also to input data. After a couple weeks, I was much more proficient. Competencies Achieved 13.2 Identify and communicate strategies for preventing and controlling hazards within the biological, cultural, and behavioral context of populations. 2.2 Demonstrate ability to make choices and use problem-solving. 4.1 Ask appropriate questions, clarify assumptions, and apply data when making decisions. 12.2 Communicate statistical analysis and results. 14.1 Identifying leading public health problems. 15.2 Define the components of an agency emergency management plan.

Model Program for Training Nursing Students to Staff a Closed POD Jodi Fox April, 2014 – August, 2014 City of Saint Louis Department of Health Local Health Department Saint Louis University entered into a Memorandum of Agreement with the City of St. Louis Department of Health to operate as a Closed Point of Dispensing (POD) during events that require mass prophylaxis. Model Program for Training Nursing Students Working with SLU School of Nursing (SLUSON) faculty on mass dispensing curriculum that is built into the SLU SON program. An innovative approach to partner with public health on emergency response readiness. My Role Researching NACCHO application requirements Designing performance standards and measures to monitor processes and outcomes Designing data collection tools for program evaluation Review Literature Develop paper sections Attend training Attend Closed POD planning meetings. Public Health Context Recent disease outbreaks have focused increased attention on the continued need for local public health authorities to provide affected individuals and communities with rapid, reliable access to prophylactic medications. Local Health Departments have been tasked with developingcomprehensive mass prophylaxis plans to ensure that theirpopulations have timely access to necessary medications in the event of a public health emergency SLUSON has implemented a program to mitigate the tremendous challenge facing the City of St. Louis Department of Health in preparing for mass prophylactic events. This program reduces staffing challenges for dispensing medications during an event. Activities Preparing this project for submission to the National Association of County and City Health Organizations (NACCHO) as a national model program Develop concept paper for submission to the State. Practice Experience Progress and Challenges 1.Learning to use the Realopt software was challenging, but allowed meto gain experienced using an important tool. 2.Working on the concept paper has allowed me to strengthen my written communication skills. 3.Preparing the MERS-CoV AAR was a great experience that allowed me to be more involved in the exercise. Competencies Achieved Designing data collection tools and performance standards allowed for data collection that can be used for evaluating and improving the training curriculum. Attending exercises and drills and planning meetings improved my ability to prepare for public health emergencies by collaborating and forming relationships with a variety of emergency response organizations. Communicated complex information into written formats, that are understandable to target audiences through writing concept paper for nursing curriculum.

Mallinckrodt Pharmaceuticals: Industrial Hygiene Katherine Guck October 2013 – May 2014 Mallinckrodt Pharmaceuticals Projects My Role at Mallinckrodt Public Health Context Activities  Mallinckrodt Pharmaceuticals is a well-established company, founded in St. Louis in 1867. Their St. Louis Plant is their largest facility, covering 42 acres.  Manufacturer of specialty pharmaceuticals, including many generic drugs and imaging products.  Mallinckrodt has a dedicated Environmental, Health, and Safety (EHS) department, as well as a corporate EHS office.  My internship was with the St. Louis Plant’s Senior Industrial Hygienist, assisting in her job tasks and shadowing her during various job duties.  The main goals of Mallinckrodt’s EHS activities are to ensure that the plant is operating within all regulatory guidelines, that workers are safe and protected from occupational hazards, and that the environment is protected during our operations.  My work was mainly with the industrial hygiene side of EHS, which focuses specifically on the health of workers. At a pharmaceutical plant, much of our effort is focused on assessing and reducing exposure to chemicals or product.  General Industrial Hygiene Assistant  Assist my preceptor in air sampling, noise monitoring, and other industrial hygiene assessment tasks  Organize, update, or re-design industrial hygiene databases, resources, and Excel data sheets  Develop PowerPoints and trainings for various groups of employees throughout the plant  Industrial hygiene is a large part of worker safety, particularly in certain occupational fields. Standards and guidelines are set in place by a variety of organizations, including:  Occupational Safety and Health Administration (OSHA)  NationalInstitute for Occupational Safety and Health (NIOSH)  American Council of Governmental Industrial Hygienists (ACGIH)  These organizations all contribute to the knowledge base that decides what level of exposure to a particular chemical is safe for a worker to have, to ensure long-term worker health and safety.  The work at Mallinckrodt is putting these standards and guides into place to make sure that our employees are safe and healthy, including far after they retire.  Industrial hygiene at this level is dedicated to putting these standards into actual practice – checking to ensure that your protection you have in place is effective, and that all employees see safety as an important part of every job they do.  I assisted in many different projects during my time at Mallinckrodt, including:  Air/noise/light monitoring and sampling, to assess for hazards and exposure limits  Creating and leading training for employees on personal protective equipment, gas monitors, and chemical exposures  Assisting my preceptor with organizational and database development and management  Troubleshooting, minor repairs, trainings, and general work on MultiRAE gas monitors and RKIs  Shadowing my preceptor during her duties within the plant Progress & Challenges 1)A chemical manufacturing environment was a brand new experience for me, so it was a very big culture shock to enter the plant and start working. Gaining exposure to this type of experience is very important for my future work in industrial hygiene. 2)It is very hard to get things done sometimes, especially in a busy manufacturing plant. Often, my preceptor and I would need to do specific things within the plant, but we would not be notified by the building running what we needed to monitor, or it would be done in the middle of the night. 3)There are many different types of people within the company, and it was challenging at first for me to be in a very diverse environment that is very different from my normal college/university settings. Competencies Achieved 1.1 – Communicate complex information into formats that are understandable to target audiences 2.2 – Demonstrate ability to make choices and use creative problem solving 3.2 – Use the public health information infrastructure to collect and process data, and translate data into information for application to public health programs 4.1 – Ask appropriate questions, clarify assumptions, and apply data when making decisions 8.1 – Identify and articulate the value of integrating strategic concerns, operational issues, and organizational performance 13.2 – Identify and communicate strategies for preventing/controlling hazards within the context of populations

SSM Health Care – Emergency Management Jonathon Gutzeit Practice Experience Dates:September 2013-May 2014 SSM Health Care SSM Healthcare is a Catholic, not-for-profit health care system that operates in four Midwestern States. It began with five religious Sisters who journeyed to St. Louis in 1872 from Germany to be of service to people in need. In line with its founding ideals the system today boasts the mission of: “Through our exceptional health care services, we reveal the healing presence of God.” Like many other health care systems, due to recent downsizing, the emergency management duties are distributed among a number of individuals within the organization. That said, the overarching goal is still do have the healthcare system as a whole as prepared as possible for any event. Water Project The water project is intended to provide each of the St. Louis area hospitals with information regarding their water usage. In addition, the project has the goal of determining how the various departments in each hospital would be affected by some of the most common water emergencies (i.e. boil water order, low water pressure, total water outage). Finally, the project takes aim to provide each hospital with a plan that can be used in the hospital’s Emergency Operations Center (EOC) listing actions that need to be taken for a specific water emergency. My Role  Plan Creator Review CDC guidelines found in “Emergency water supply planning guide for hospitals and health care facilities” Review existing water plan literature Create water-use tool Present tool and receive feedback from hospital leadership Revamp tool in light of feedback Pilot tool at one system hospital Analyze data from completed tools Process data into usable format by hospital Public Health Context Emergencies happen on a near daily basis, in some form or fashion. In order to provide for the community when such events do occur it is important that the health care institutions within that community be prepared for as many potential events as possible. Planning and plan development is a main way hospitals, and health care systems in general, prepare themselves for potential impacts By assessing how different water emergencies may affect functioning before they happen provides the hospital with the means to develop capacities to meet patient/community demand during any water emergency In addition, such planning ensures patient, and more largely community, safety as it provides knowledge of what services can/cannot be rendered given the emergency on hand Activities Water Analysis Tool Creation Data Analysis of Completed Tool System Emergency Management Meetings STARRS Public Health Committee Meetings Infection Prevention Committee Meetings Hospital Presidents Meeting Special “Product Analysis” Project Practice Experience Progress and Challenges Pilot hospital data analysis complete Further tool feedback obtained and noted Pieces in place for larger tool dissemination and subsequent plan creation for each individual system hospital Great experience providing insight into the inner workings of the realm of corporate health care Obtained valuable knowledge/information regarding how emergency management functions within the body of a larger organization Competencies Achieved 1.1: Communicate complex information into formats understandable to target audiences 2.1: Make choices and use creative problem-solving 3.1: Solicit information from and sharing among individuals and organizations 4.1: Ask appropriate questions and apply data when helping make decisions 8.2 Define basic concepts of strategic planning and plan implementation and evaluation 15.1: Work with and through people in emergency response organizations

BJC Center for Clinical Excellence John Heafner Practice Experience Dates:Dec. 2013- May 2014 BJC HealthCare: Center for Clinical Excellence (CCE) The CCE is a shared service of the BJC HealthCare System, which includes 12 hospitals. As a shared service of the BJC system, the CCE works as a “trusted advisor” to the hospitals. Enhancing Oversedation Mitigation This project entailed working with one of the CCE pharmacists, risk managers, and epidemiologist to address issues surrounding oversedation events. The end goal of the project was to create a program that could be implemented at a hospital for pilot testing. BJC Medical Group Project Team Member I contributed to work at the various stages of the project. The HCD process is a team process that tries to get the input of as many stakeholders as possible throughout each phase. As a team member I helped conduct interviews, worked on group downloads and synthesis, participated in brainstorming sessions, and helped create prototypes for pilot testing. Public Health Context Preventable Harms are currently a major issue within hospitals accounting for 230,000-400,000 deaths each year Preventable Harms are inherently avoidable mistakes that put patient’s lives at risk and oversedation is one of many preventable harms that occur within hospital settings Designing an educational intervention around the issue of oversedation cultivates an environment of safety within the hospital ---------------------------------------------------------------- The Human Centered Design process utilizes tools similar to a needs assessment and qualitative coding, which are important pieces of the program planning process and qualitative research Project Components The oversedation project consisted of performing background research (literature review and best practice review). I also worked with CCE experts, who collaborate with individuals in the various hospitals on patient safety issues. Created a presentation for key stakeholders (the Oversedation Prevention Task Force, risk managers, and CCE leadership) The BJC Medical Group project consisted of conducting patient interviews, performing group downloads after interviews, generating overarching themes from the interview process, and creating prototypes for pilot testing. The process also include pilot testing one or two of the prototypes, but this final stage did not occur during my time at the CCE. Practice Experience Progress and Challenges Challenges: o Navigating a large healthcare system during a time of drastic change in the healthcare industry nationally o Appropriately presenting data to convey the importance of doing work around oversedation Progress: o Created a project that is ready to move forward once it has the backing from the appropriate audiences o Learned more about the intersection of public health and medicine o Gained valuable experience presenting and modifying my work to meet the needs of the organization Competencies Achieved 1.1 Communicate complex information in formats, both written and oral, that are understandable to target audiences, e.g. policy makers, administrators, general 2.2 Demonstrate the ability to make choices and use creative problem solving 2.3 Know, support, and use team development methods 3.1 Solicit input from and information sharing among individuals and organizations 4.1 Ask appropriate questions, clarify assumptions, and apply data when making decisions 8.1 Identify and articulate the value of integrating strategic concerns, operational issues, and organizational performance 9.1 Identify existing effective evidence-based programs and materials appropriate to organizations needs 12.2 Communicate statistical analyses and results at a level appropriate to those either experienced or inexperienced in quantitative methods public, etc. 14.2 Able to interpret results, make appropriate inferences based on results and recognize public health and clinical implications of results BJC Medical Group Patient Experience This project consisted of following the Human Centered Design (HCD) process along with utilizing simulation modeling to generate possible alterations to the BJC Medical Group practices to improve patient experience. Project Lead for Oversedation Mitigation Work As the project lead, I dictated the content and direction of this work; however, I did directly report to and depend on my preceptor, a CCE risk manager, and a CCE pharmacist to help guide my efforts.

Center for Cancer Prevention, Research and Outreach Sumaya Hammami Practice Experience Dates:October, 2013 – May, 2014 Saint Louis University Saint Louis University is an institution of higher education located within St Louis. Saint Louis University in coordination with the Center for Cancer Prevention, Research and Outreach are currently evaluating a breast cancer program Activities Helped developing an impact evaluation plan Attended meetings and observed how collaboration helped sharing information Design a brochure Breast Cancer Outreach The aim of this evaluation is to determine the impact of the newly designed and implemented breast cancer outreach protocol. My Role Design a brochure o I designed the brochure to increase prostate cancer awareness in African American men. Evaluation of a program o I helped writing an impact evaluation plan for a breast cancer outreach program Public Health Context Breast cancer is the number one cancer among women and early detectionis the key for successful treatment. The Saint Louis University Center for Cancer Prevention, Research and Outreach (CCPRO), The Breakfast Club, Inc. (BCI) and the Saint Louis University Show Me Healthy Women program (SMHW) conducted a breast cancer screening outreach events. The evaluation of the breast cancer screening outreach protocol aims to : Conduct an impact assessment to determine the screening protocol’s impact on key outcomes, including knowledge, beliefs, and screening/ other follow- up behaviors. Practice Experience Progress and Challenges 1.Brochure that will answer some prostate cancer frequently asked questions: what is a PSA score, what are the condition that can cause a high PSA score etc.. 2.Communication with different organizations can be difficult. 3.Learning how to write an impact evaluation Competencies Achieved Assess the extent to which health promotion strategies are accomplishing their intended goals through the application of appropriate methods of evaluation. Solicit input from and information sharing among individuals and organizations. Evaluate programs for cultural appropriateness and implement changes to increase appropriateness for diverse backgrounds.

Missouri State Alliance (MSA) Derek Hashimoto Practice Experience Dates:October, 2013 – June, 2014 Missouri State Alliance The Missouri State Alliance (MSA) is comprised of 24 Independent YMCA corporations with 71 branches which work together in order to make a collective impact.The purpose of the MSA is to utilize the combined strengths of all Missouri YMCA’s to deliver on our commitment to youth development, healthy living, and social responsibility in our communities and throughout the state.Through statewide organization, cooperation and communication, the State Alliance assists member associations in their work of public policy advocacy, professional development, as well as other strategic initiatives approved by the State Alliance. Project Advocate for policies addressing childhood obesity within the state of Missouri My Role Coordinated and facilitated meetings with the Department of Health and Senior Services (DHSS) to educate stakeholders and advocates around current breast feeding legislation. Evaluated policies on Healthy Eating and Physical Activity (HEPA) standards. Promoted HEPA standards within local YMCA’s. Identified evidence-based programs and materials addressing childhood obesity. Public Health Context Childhood obesity in the state of Missouri is 31% for children ages 10-17. Childhood obesity is a strong predictor of adult obesity and is associated with an increased risk to various chronic diseases. Missouri has taken an initiative in order to lower childhood obesity within the state by: Informing the community about the benefits of increases in healthy eating. Informing the community about the benefits of increases in physical activity. Implementing and enforcing policy and environmental changes to support healthy eating and physical activity. Engaging parents and other stakeholders to promote health and wellness in schools, families, and communities. Activities Created a strategic plan Developed a logic model Developed a communication plan Created a policy brief for HB 1320 Collaborated with the YMCA’s community transformation grant to identify strategies and partners. Created a crosswalk and infographic for a comparison between HEPA standards and Taking Steps to Healthy Success Practice Experience Progress and Challenges 1.Creating the logic model and strategic plan were useful for the alliance in order to help them see the starting pointe and what the future should bring. 2.The communication plan addressed how the alliance can disseminate information on obesity prevention bills to law makers, lobbyists, and community members. 3.Crosswalk and infographic were used to inform YMCA stakeholders 4.The timeline for my internship changed frequently due to scheduling conflicts. Competencies Achieved (8.2) Created a strategic plan and logic model for the state alliance. (9.2) Created a crosswalk for a comparison between HEPA standards and Taking Steps to Healthy Success. This lead to a meeting with Joyce Hoth and Megan Klenke to discuss our approach to stakeholders. (11.3) HB 1320 was passed and breastfeeding mothers can be exempt from jury duty in Missouri. (1.1) Communication plan addressed how the alliance can disseminate information on obesity prevention bills to law makers, lobbyists, and community members. (5.1) Followed HB 1320, supported HB 1320, created a policy brief, attended MOCAN meetings, and researched and became familiar with a breastfeeding bill that will be sponsored by Sen. Schaaf in early 2014. (9.1) Collaborating with Joyce Hoth from the YMCA with her community transformation grant to identify strategies and partners, and suggest a media campaign.

The Magdala Project Ani Heaton 06/2014– 08/2014 The Magdala Project A service of Charita Praha under Charita Czech Republic and Charita International, the Magdala Project operates a network of safe houses and counseling centers throughout the Czech Republic to reach victims of domestic violence and human trafficking. They also coordinate street work outreach to prostitutes, collaborate with other services of Charita Czech Republic and are developing primary prevention programs for these issues. Respektujeme Si We Respect Ourselves and Each Other, a primary prevention educational program for adolescents about gender-based violence and human trafficking My Role in Organization/Project  Behavioral Science and Health Education Researcher o Formative research on domestic violence, gender-based violence, and human trafficking  Research on evidence-based practices for primary and tertiary prevention activities  Investigate granting and funding opportunities  English language assistant o English-language proposal and grant writer, editor Public Health Context  The Czech Republic is a source, transit, and destination country for human trafficking. The U.S. State Department, when classifying the Czech Republic as such, states that the country is lacking in primary prevention programming for this human rights issue.  According to stopnasili.cz, the leading Czech informational website on domestic violence, 38% of women living in the Czech Republic will face domestic violence in their lifetime.  According to a variety of studies from the UK and the US, adolescents between the ages of 14 and 16 are at the greatest risk for experiencing gender-based violence.  The total number of Czech children living in institutional care in the year 2013 was between 21,000 and22,000.  This population has been identified by state social workers and NGO directors as being at the highest risk for entering into the sex trade and experiencing gender-based violence. My Activities  Literature searches and research on prostitution, domestic violence, gender-based violence, and prevention in adolescents  Development of a primary prevention educational program for at-risk youth  Participated in staff meetings to develop programming  Revised and developed outreach materials to make them more culturally competent and health literate  Assistance with service delivery in the organization  Research for the development of future program services  Networking with professionals in the Charita Praha network Practice Experience Progress and Challenges  Experience collaborating with an international organization that exists within an international network of organizations  Putting my program planning and evaluation planning skills to use  Learning a new language, country, culture & history  The language presented a challenge, as well as the tragedy of the life stories of clients Competencies Achieved 11.3 Exploring the impact of policy on behavior change and other outcomes 11.1 Describe the concepts of health, health promotion, health education, and community participation as relevant to the organization 3.2 Utilize the public health information infrastructure to collect and process data and translate data into solving public health problems 1.Evaluate existing effective evidence-based programs and materials effective to organization’s needs. 2.Identify socio-demographic, cultural, and political issues related to the organization’s audience and stakeholders. 7 Cultural Competence: planning programs in such a way as to meet the needs of a variety of stakeholders/people from different backgrounds 6.2 Protect confidential information and data 6.1 Develop public health programs and strategies in ways that are responsive to diverse cultural values and traditions of cultures being served. 3.1 Solicit input from and information sharing among individuals and organizations 5.2 Explain how private and public organizations operate and interact within the community. 1.Identify and articulate the value of integrating strategic concerns, operational issues organizational performance. 2.Define basic concepts of strategic planning, and plan implementation and evaluation. 9.3 Assess critically evaluation reports and contribute to design of effective evaluation methods.

Access to Sexually Transmitted Infections in St. Louis Audrey Herring Practice Experience Dates:April, 2014 – August, 2014 Organization SSM is a 525 bed teaching hospital system founded by the Franciscan Sisters of Mary. This faith-based, not-for-profit health care system is located in Richmond Heights, MO and is dedicated to serving the health needs of the community through collaborative efforts. In its 2012 Community Health Needs Assessment, SSM identified high-priority needs, including diabetes, access to care, and sexually transmitted infections. In collaboration with the County and City Departments of Health, SSM is focused on establishing sexually transmitted infection screening services in emergency department visits as well as providing preventive education. Project Learned patterns of accessibility to sexually transmitted infection screening services in the Greater St. Louis area. Researched and infection rates of Latino populations as well as methods of prevalence calculations Provided supporting activities for the SSM STI community benefits project Role in Organization/Project As an intern at SSM my role included learning and understanding the accessibility of screening services located in the St. Louis area. To critically evaluate epidemiologic methods of calculations, and comparison. To provide support for community leaders in charge of the community benefits project. Public Health Context In 2012, SSM conducted a community needs assessment to help identify and target major health needs of the St. Louis community (SSM), and listed sexually transmitted infections as a top priority for the healthcare system’s community benefits project. From 2000 to 2010 rates of sexually transmitted infections increased approximately 26% in the St. Louis area, which is currently ranked number two in the nation, clearly marking this as a large health concern. What is less clear is how certain populations, especially the Latino community, compare to other similar communities. More often than not, a simple comparison of prevalence rates is used to answer this question. However, we evaluated whether or not using prevalence rate, where base population serves as the denominator, is truly an appropriate statistic in comparing sexually transmitted infections between Latino communities. Comparing prevalence in this way does not consider how many are actually being screened, and thus may not be an accurate representation of the sexually transmitted infection climate. When population base is used as the denominator, we cannot distinguish between low disease prevalence and low screening numbers. This possibility for misrepresentation may have large health implications if low screening numbers are interpreted as low prevalence rates. In this situation, screen positive rates, with total number screened in the denominator, would be better representation. However, information regarding total screening numbers is currently not regularly tracked or accessible. As a result, this calls for better tracking and accessibility for sexually transmitted infection screening information. Activities Researched sexually transmitted infection rates of Latino populations in metropolitan areas similar to St. Louis and compare to rates of Casa de Salud Met with St. Louis community leaders including, SSM, County Health Department, Urgent Care, City Health Department, State Department of Health, and Gracehill, to discuss patterns and issue of STIs. Attended community meetings Provided help and support for SSM STI projects. Practice Experience Progress & Challenges This internship gave exposure to common challenges regarding data access and availability. For example, we determined a need to better understand the reach of screening services in the St. Louis metropolitan area, or how many are accessing the services. However, we realized that information regarding total screening numbers is not readily available, or regularly kept track of and thus identified a gap in information access and availability. In addition, this was also an opportunity to understand and critically evaluate the challenge in epidemiologic methods, such as the use of denominators. What number used in the denominator of calculations can change your interpretation of a health problem, and have large public health implications. More importantly, this experience emphasized how building organizational relationships is pertinent to navigating the public health infrastructure. I had the opportunity to create connections and coordinating meetings with different STI focused community leaders in St. Louis. From meeting with County Department of Health, City Department of Health, Urgent Care, FQHC’s like Gracehill, as well as State Department of Health, are important relationships to maintain in order to access information and data, as well as establishing protocol and procedures for the SSM community benefits project. Competencies Achieved 1.1 Communicate complex information into understandable, written and oral formats. 3.2 Use the public health information infrastructure to collect and process data and translate data into information for application to public health problems. 4.3 Identify the organizational relationships in the delivery of health services in a community and the patterns of health access among individuals and within various communities. 5.2 Explain how public and private organizations operate and interact within a community 12.2 Communicate statistical analyses and results at a level appropriate to those either experienced or inexperienced in quantitative methods. 14.1 Identify leading public health problems, key risk factors and methods for collecting, analyzing, and reporting surveillance data for these health issues.

City of St. Louis Department of Health – CEH/CHIPR Angelya Higginbotham September 2013 - March 2014 Children’s Environmental Health (CEH) Promotes the health and well-being of St. Louis area children through the Asthma Friendly St, Louis, Smoke Free St. Louis Kids and Lead Safe St. Louis. Center for Health Information, Planning, and Research (CHIPR) Ensures the health and safety of St. Louis citizens through variousbureaus and projects. Heavy Metal Project/Emergency Response Planning HMP – Targets pregnant women seen at local FQHCs to educate them on the dangers of lead poisoning and to ensure their homes are lead-free when their baby is born. ERP – Continuous updating of emergency response plans, facilitating exercises, and maintaining stockpiles of resources. My Role CEH Act as a liaison between clients of local FQHCs, CEH, and the Building Division for the Heavy Metal Project Review Literature Participate in various outreach events (Asthma Ready St. Louis Surge, MisLead) CHIPR Updated emergency contact lists Reformat Emergency Response Plan Annexes Inventory/stock items in Emergency Response Storage Room Update exercise schedule and submit paperwork to federal entities. Public Health Context In 2011, 2.2% of children who received blood lead level (BLL) testing were found to be lead poisoned. This far exceeds the 0.8% prevalence in Missouri and 0.6% prevalence in the United States. The Heavy Metal Project and outreach events such as the MisLead screening aim to educate the community and work to lower BBL numbers in St. Louis. Children in St. Louis living with asthma is estimated to be three times higher than the national average. African- American children are disproportionately impacted.The Asthma Ready St. Louis Surge Project was able to provide 64 African-American children and their families with evidence-based learning to facilitate better asthma management. Completing literature reviews on various topics and sharing this information assists in the development and enhancement of public health programs. The development and maintenance of Emergency Response Plans is essential to ensuring prompt and efficient action during a disaster. Activities Liaison between FQHC clients, CEH, and Building Division for the Heavy Metal Project. Literature reviews Ensure emergency response procedures and resources were updated and adequate. Participate in various outreach events (Asthma Ready St. Louis Surge, MisLead, Health Insurance Marketplace information sessions, Flu Clinics). Practice Experience Progress and Challenges 1.The Asthma Ready St. Louis Surge event provided 64 African-American children and their families with evidence-based asthma education to promote. 2.Department Emergency Response Plans were reformatted to meet the requirements for accreditation. 3.Miscommunication between various agencies during a large-scale outreach event can and will create chaos. 4.Able to apply lessons learned in the classroom to real- world situations. 5.Outreach events that are tailored to the demographics and socioeconomic status of the target audience are more likely to be effective. 6.Received certification as an Application Counselor for the Missouri Health Insurance Marketplace. Competencies Achieved Communicate complex information to target audiences. We were able to educate the public on asthma control, lead-poisoning and prevention, and the Missouri Health Insurance Marketplace through various outreach events. Worked with and through various emergency response organizations to enhance disaster response. Updating the emergency response contact list, attending closed POD training at SLU, and completing an inventory of mass shelter kits ensures that the community is prepared to respond to mass casualty event. Explain how public and private organizations operate and interact within a community. Coordinating the Heavy Metal Project, Asthma Surge event, the screening of the MisLead documentary, and the Walgreens Flu Clinics required constant interaction and communication with various entities to ensure all events achieved their purpose.

Epidemiology Team Internship at Kantar Health Michael Joseph Practice Experience Dates:June, 2014 - September, 2014 Organization Kantar Health is a pharmaceutical consulting firm that works with clients all over the world. One of the main products is EPI Database. This database is comprised of disease estimates for the G7 countries. Kantar Health also offers custom deliverables to clients looking at a specific disease or population. Project Update Epi Database with new diseases and new estimates based on the latest literature. Work in collaboration with the other members of the Epi Team to complete custom projects. Role in Organization/Project Epidemiology Team Intern o Perform literature reviews on diseases o Write newsletters and methodologies for Epi Database. o Support the full-time members of the Epi Team with custom projects o Work closely with Japanese counterpart to incorporate Japanese data into Epi Database. Public Health Context Evidence Based Decision making is critical in the private sector as much as it is needed in the public sector. Rare or orphan diseases, like scleroderma and Cushing’s Disease, are on the rise in the United States. Better medications are needed to keep up with these trends. It is important to understand how the private sector utilizes epidemiology in order to create better partnerships between the public and private sector. Dissemination of critical epidemiology information to pharmaceutical companies is critical to forecast future health outcomes. Activities Collaborate with Japanese counterpart, Synix, to add Japanese data to Epi Database. Create and analyze new methodologies to determine rare disease prevalence and incidence on Epi Database. Practice Experience Progress and Challenges I completed four updates to Epi Database. Two were new indications that required a methodology report. One completed custom project for a pharmaceutical company interested in a rare disease in the United States. Competencies Achieved MPH 1.1 Communicate complex information into formats, both written and oral, that are understandable to target audiences, e.g., policy makers, administrators, general public, etc. While working on a custom project, I was tasked to disseminate complex public health information in a presentation to members of a pharmaceutical company. EPI 14.1 Identify leading public health problems, key risk factors and methods for collecting, analyzing, and reporting surveillance data for these health issues. In the process of updating Epi Database, I was responsible for analyzing and discerning relevant disease data from several national registries. MPH 3.2 Use the public health information infrastructure to collect and process data, and translate data into information for application to public health problems. In order to update Epi Database, I had to perform multiple literature reviews spanning several different databases. I had to evaluate the validity of the methodology and results of each relevant study.

The Evaluation of the Expansion of the St. Vincent Greenway Nicole Kensinger February 2014 - May 2014 Organization This internship took place at the Prevention Research Center in St. Louis under the supervision of Aaron Hipp, PhD. Primary Project Evaluation of St Vincent Greenway Expansion: An intervention evaluation with a non-intervention comparison site. My Role in the Evaluation  Data manager, statistician and analyst  Manuscript writer Public Health Context According to the CDC, adults need 150 minutes of leisurely or 70 of vigorous activity a week to maintain a healthy weight. Children need even more exercise, approximately 60 minutes every day. Half of adults and children do not meet recommended guidelines. Our aim was to address if expansion of a greenway or outdoor trails, through certain neighborhoods in St. Louis, would provide access so that children and adults would report more weekly physical activity after 1 year of use. The physical activity could come from commuting (walking or biking) or leisure activities on the greenway (playing Frisbee etc.). Assigned Tasks I assisted in data management, cleaning, statistical analysis, interpretation and manuscript preparation. Practice Experience Progress and Challenges Initially, we found that physical activity actually decreased among the control and intervention sites. However, using difference in difference comparison we found that physical activity decreased less in the intervention site than in the control. Therefore, while holding many factors constant, the intervention acted as a buffer in preventing an even more sedentary lifestyle. Competencies Achieved  Interpretation of data and making decisions for data interpretation  Problem solving, by using new and complex methods of analysis  Communication of findings to political bodies and stakeholders

The Maternal, Child & Family Health Coalition Sarah Knaust December 2013 - May 2014 The Maternal, Child and Family Coalition The Maternal, Child and Family Health Coalition (MCFHC) is an intermediary organization that provides leadership to impact significant community-wide improvement in maternal and child health. MCFHC is a trusted convener of diverse community stakeholders around issues of maternal and child health. The Perinatal Resource Network The mission of the PRN is to promote increased accessibility to high quality, family centered mental health and substance abuse services, create standards of care, provide educational outreach and professional development, as well as advocate for healthy women, positive birth outcomes and nurturing parenting relationships. Public Health Context Approximately 10-20% of women experience depression either during pregnancy or in the first 12 months postpartum, yet less than half of OB/GYN physicians used a standardized screening tool for mental health on prenatal women. Perinatal depression, intimate partner violence, and substance use commonly co- occur; screening and referral to services for all three is necessary to identify issues early and prevent adverse outcomes. These associations are not always recognized and therefore are not successfully treated. When the connection is missed risks of treatment failures, suicide, incarceration, re- victimization, and repeated use of social and health services are increased. Progress and Challenges Through my internship experience, I learned how to apply concepts to real world situations; i.e. focus group planning, grant writing, meeting facilitation, etc.One challenge I faced was working with a committee on decision making, which slowed down efficiency.Overall, it was a great opportunity to apply classroom knowledge and network with community stakeholders. Competencies Achieved 3.2 Use the public health information infrastructure to collect and process data, and translate data into information for application to public health problems 4.3 Identify the organizational relationships in the delivery of health services in a community and the patterns of health access among individuals within communities 14.1 Identify leading public health problems, key risk factors and methods for collecting, analyzing, and reporting surveillance data for these health issues The Community Focus Group I coordinated the Community Focus Group to inform the workplan for the Perinatal Resource Network (PRN). The goals of the Community Focus Group were: to recruit point people for this effort, to set the stage for this as a different kind of collaborative effort, to create some new connections and insights for the participants.After the focus group, I coded all of the recorders’ notes and found themes. I presented the results and compared the community focus group with the executive focus group for the PRN.

Cardiology Outcomes Research at VA St. Louis Health Care System Cynthia Marshall Practice Experience Dates:June, 2013– May, 2014 VA St. Louis Research & Development VA St. Louis R&D has been improving Veterans’ lives for over 85 years. Only research program focused on pioneering research to improve the health and well-being of our nation’s Veterans. Contributes significantly to advancing Medical Sciences benefiting the entire nation and the world through innovation and discovery. Heart Rate Response & Outcomes The purpose of this study was to investigate the relationship among arm exercise heart rate response, abnormal stress test findings, coronary revascularization, and mortality in patients who could not perform leg exercise. My Role Data Analyst o Data management, cleaning, and mergers. o Create a codebook including all current and past variables. o Create statistical models as needed to answer research questions. Data Abstraction o Abstract demographic and clinical data from patient medical records. Poster Development o Develop a poster for presentation at the June 2014 American Heart Association’s Quality Care and Outcomes scientific sessions. Public Health Context Cardiac stress tests are used in medicine to measure the heart’s ability to respond to external stress and to detect any abnormal blood flow to the heart. Traditionally these tests are used to detect heart defects which may be corrected by utilizing revascularization procedures. Currently. attainment of 85% age-predicted peal heart rate during leg exercise is widely accepted and emphasized in clinical textbooks as a condition for adequate diagnostic stress test sensitivity though our research indicated that this is not necessarily be true. Improvement in standards of cardiac stress testing could improve patient outcomes and improve overall patient quality of life. Activities Abstract data from VA cardiology patient medical records. Form research question and complete data analyses to answer question. Submit research abstract to national scientific meeting Complete research poster for presentation at the American Heart Association’s QCOR sessions. Practice Experience Progress and Challenges 1.A codebook has been created to improve data management practices and to describe all variables in the current dataset. 2.Interpretation of medical personnel shorthand in patient medical records was challenging at first.With practice and training, gained a knowledge of medical terminology and shorthand. 3.Improved upon classroom SAS skill set and have become very comfortable with coding in SAS and interpreting results. 4.Poster has been developed to be presented at a national prestigious scientific meeting. Competencies Achieved Communicate complex information into formats that are understandable to target audiences. Developed a poster for presentation that is written to be easily be understood by both statisticians and clinicians. Protect confidential patient data and information. Utilized practices to protect sensitive patient information including locking all draws and cubicle door and keeping my badge on me at all times. Communicate statistical analyses and results at a level appropriate to those consuming information. Able to communicate statistical results in a way easily understood by all mindsets of the members of my team and my peers.

Disaster Preparedness in Pike County, Missouri Jennifer Miinch Practice Experience Dates:May 2014 – August 2014 Pike County Health Department Home Health and Hospice (PCHDHHH) A local public health agency that provides a variety of health care services to the residents of Pike County, MO. PCHDHHH is one of the few agencies to integrate Home Health and Hospice within the agency. Emergency Response Plan Identified gaps in emergency response plan Formed collaborations with other agencies to strengthen the emergency response plan My Role in Emergency Response Plan Paper/Presentation development o Review current plan o Compare with other local public health agency’s plans o Suggest revisions to the current plan o Maintain collection of reference sources o Present changes to Administrator Collaborations with Neighboring Counties o Work with Lincoln County Emergency Planner o Discussed how to increase involvement in countywide MRC Public Health Context Missouri is susceptible to both natural and manmade disasters that vary in frequency and intensity. Emergency/Disaster preparedness is critical to reduce morbidity and mortality especially within the at-risk populations. The at-risk population for Pike County are the secluded individuals and the handicapped individuals. Hazard Risk Assessments should be used to tailor the Emergency Response Plan to the needs of the community. This information needs to be shared with the community. Activities Reviewed current emergency response plan for PCHDHHH as well as county-wide plan. Used the 15 Capabilities provided by the CDC to make revisions to PCHDHHH’s emergency response plan. Practice Experience Progress and Challenges The Emergency Response Plan has been revised extensively. All 15 CDC Capability work plans have been developed so that each contract period the revisions can be made at that point. One major challenge that I faced was working with other community agencies and their differing view points on what needs to be integrated in the Emergency Response Plan. Competencies Achieved Work with and through people in various emergency response organizations to enhance their ability to respond to disasters We worked with Lincoln County Health Department and the Communication Task Force Define the components of an agency emergency management plan I worked extensively on revising the Emergency Response Plan and became very familiar with it.

Alzheimer’s Association: Program Services Data Mapping Bethany Morrison January, 2014 - May, 2014 Alzheimer’s Association St. Louis Chapter Chapter started as single support group in 1981. Today it’s one of the 20 largest chapters in the nation, serving 38 counties in MO and IL. The projected impact in this service area includes 66,000 persons with dementia and 198,000 care partners. Mission: Eliminate Alzheimer’s disease through the advancement of research; provide and enhance care and support for all affected; and reduce the risk of dementia through the promotion of brain health My Role Data Analyst o Retrieve and organize data o Establish Chapter database Map Development o Create maps for all program services o Create population demographic maps o Create health-related information maps Presentation and Summary Reports o Present project to Chapter’s Performance Improvement Committee o Develop step-by-step guide for using QGIS o Summarize program services and population demographic maps and recommendations for the future Public Health Context In 2013, an estimated 5.2 million Americans of all ages had Alzheimer’s disease. The prevalence of Alzheimer’s and other dementias is expected to escalate rapidly in the coming years as the baby boomer generation ages. Alzheimer’s disease is the sixth-leading cause of death in the United States and the fifth-leading cause of death for individuals aged 65 and older. o While deaths from other major causes have decreased significantly, deaths from Alzheimer’s disease have increased significantly. From 2000 to 2010, there was a 68% increase in deaths attributed to Alzheimer’s disease. In 2011, 15.2 million family members and friends provided 17.4 billion hours in unpaid care to individuals with Alzheimer’s and other dementias. This care has an estimated value of $210 billion. Caregivers often experience high rates of emotional and physical stress, increased likelihood of chronic conditions, and financial and work- related challenges. Assessment of St. Louis Chapter’s current program services and outreach efforts across all 38 counties at the zip code level provides baseline information and informs the organization’s future decision-making The Alzheimer’s Association and the CDC developed The Healthy Brain Initiative: The Public Health Road Map for State and National Partnerships, 2013-2018, which outlines how state and local public health agencies and partners can promote cognitive functioning, address cognitive impairment among individuals living in the community, and help meet the needs of care partners. Project Activities Communicated with Chapter staff about their interest and developed project objectives. Identified, retrieved, and organized the necessary program services data into Chapter database. Established QGIS foundation for future projects. (e.g. created shapefiles and geocoded data) Compiled population demographics and health-related information (e.g. Alzheimer’s deaths, Medicaid costs for persons 65+). Disseminated summary reports to St. Louis Chapter and National Alzheimer’s Association. Practice Experience Progress and Challenges Created summary report with information about the project process, maps, and recommendations for the future Developed a guide for how to use QGIS Learned new mapping program (QGIS) and skills (geocoding specific address information) that will be great tools for future experiences. Effectively presenting dense information, in both written and oral formats, to audiences with varied backgrounds can be difficult and requires clarity and precision Maps will aid St. Louis Chapter in resource decision-making and provide new insight for the program services department Competencies Achieved Use the public health infrastructure to collect and process data, and translate data into information for application to public health problems o Collected and processed data from the National Alzheimer’s Association, St. Louis Chapter, and Missouri Department of Health and Senior Services Identify the organizational relationships in the delivery of health services in a community and the patterns of health access among individuals and within various communities o Attended Alzheimer’s Association training sessions at local health departments Interpret results, make appropriate inferences based on results and recognize public health and clinical implications of results o Summary report on program services and population demographics mapping preliminary findings and recommendations for the future St. Charles and St. Louis Support Groups

Clinical Epidemiologist, BJC Healthcare Terrence Murphy Practice Experience Dates:November, 2013 – April, 2014 BJC Healthcare 13-hospital non-profit medical system based in St. Louis Missouri Largest single healthcare service provider in Missouri 28,000 employees 3,500 staffed beds 500,000 ER visits Projects Robot-assisted v. conventional laparoscopic v. open surgical applications Chlorhexidine gluconate bathing to prevent surgical site infections Aluminum-containing deodorant Fiducial markers for oncology patients Aortic valve replacement techniques Research Methodologist Evidence Reviewer o Assist with PICO question formation o Conduct systematic literature searches o Quality assess clinical research o Synthesize high quality research o Make evidence-based recommendation for BJC Healthcare system. Public Health Context Missouri is39 th in overall health rankings o High prevalence of smoking o Low immunization coverage in children o High cardiovascular and cancer death rates Comparative Effectiveness Research (CER) o Emphasized in 2010 with the passing of the PPACA o Patient-Centered Outcomes Research Institute BJC experiencing decreases in reimbursement, challenging for a major provider o Immediate $50 million reduction in supply cost o Prioritization of cost-effective treatments Activities Systematic literature search using medical databases (Medline, CINAHL, EMBASE, Cochrane) Dissemination of findings o Best practice reports o Literature review o Rapid evidence reviews Practice Experience Progress and Challenges 1.Poster presentation at Washington University School of Medicine’s CER conference 2.Internal dissemination of 8 major evidence reviews 3.Learning new programs (RevMan) 4.Communicating effectively with clinical and non-clinical staff Competencies Achieved 4.3 Identify the organizational relationships in the delivery of health 14.2 Able to interpret results, make appropriate inferences based on results and recognize public health and clinical implications of results 14.3 Describe the key facilitators and barriers for use of epidemiologic data. 9.1 Identify relevant evidence-based programs and tools 6.2 Protect confidential data and information 1.1 Translation and dissemination of Public Health information

Center for Cancer Prevention, Research, and Outreach Chinonyelum Nwosu Practice Experience Dates:November, 2013 – May, 2014 Organization CCPRO seeks to help underserved populations in North St. Louis City and County by providing resources to address disparities in cancers, such as breast cancer and prostate cancer Project Prostate Cancer Intern/Evaluation Team Role in Organization/Project My role was to work with the evaluation team on the prostate cancer project. I helped with the IRB, developed a data management protocol, put together a list of survey measures, developed an educational brochure, created the dataset, and presented information to the team. Public Health Context The project was focused on showing the importance of continuing prostate screening for men at high risk. The project assesses decisional regret and the impact of educational outreach on making the decision to be screened for prostate cancer, as well as knowledge of prostate cancer and its risk factors. The project identifies the key aspects that drive behavioral intention and measure them in a high risk group of men, which will open avenues for intervention and education to make high risk men more aware of prostate cancer. By increasing awareness men are in a better position to deal with prostate cancer and to avoid adverse health effects. Activities Create and revise documents Develop a dataset Create a comprehensive list of survey measures Develop a brochure Practice Experience Progress and Challenges The greatest challenge and learning experience was the revision process. Throughout this experience I revised a lot of different documents and it helped me learn to be more specific and precise. Competencies Achieved Use the public health information infrastructure to collect and process data, and translate data into information for application to public health problems Demonstrate ability to make choices and use creative problem-solving Communicate complex information into formats, both written and oral, that are understandable to target audiences, e.g., policy makers, administrators, general public, etc.

Weir Minerals Lewis Pumps Masoom Patel June, 2014 – August, 2014 Weir Minerals Lewis Pumps Manufacturing company located in St. Louis, MO Manufactures custom made chemical pumps primarily in the sulfur chemical industry Weir is the parent company that owns Lewis Pumps under its minerals division Projects Write up an industrial hygiene report draft for sampling that was conducted and recommended PPE Participate in multiple audits to ensure compliance with environmental health and safety policies My Role Industrial hygienist o Work on industrial hygiene related tasks Auditing assistant o Prepare for audits o Take notes o Conduct audits Public Health Context The industrial hygiene sampling report creates a detailed assessment of the working conditions at the site. Likewise the audits result in the assessment of all the EHS policies and procedures in place. Though the simple summary andIH report we are able to offer assurance to the shop employees that they are working in safe conditions. If there are any hazards we are able to assure that we have found them and created the measures needed to fix them. The audit scores assure us that our procedures are adequate to carry out the EHS policies in place. The EHS committee meeting notes on input allow for policies (smoking policy) to be created that better protect the health of workers. Activities Write simple summary of IH findings Create an action items list with notes during company audit Conductthe internal audit for preparation for the ISO and OHSAS recertification audit Take notes at EHS committee meetings Practice Experience Progress and Challenges During my time I ended up learning how to write an industrial hygiene report and was able to participate on two different audits. I learned that while audits are extremely boring, they are very necessary to make sure everyone is safe. The biggest challenge I faced was writing that report, but I was able to get though it by seeking out examples and online resources to help guide me though the process. Competencies Achieved 8.2 - Developed list of action items after company audit which is used for planning, implementing and evaluation corrections to standards. Developed, implemented and evaluated a personal internal auditing plan. 13.2 - Planned the use of anti-vibration gloves and an implementation strategy to reduce hand arm vibration syndrome. 4.1 - Asked questions about company policies before applying data to a new procedure on glove usage. 2.2 - Research the different types of gloves and picked the best option and determined which notes on audits

St. Louis City Health Department: HIV/AIDS Surveillance Unit Kristin Quinn Practice Experience Dates:July, 2013 – April, 2014 St. Louis City Health Department St. Louis City Health Department is a government entity HIV/AIDS Surveillance Unit is nested inside the Communicable Disease The areas that are covered St. Louis City, County, and counties in IL Project My specific project that was worked on was the Validation Study. Results found that the system used for data entry and data transmission is over 90% effective Role in Organization/Project Data Entry: o Entered data into EHARS: CD4s and Viral Loads o Updated patient files Validation Study: o Coded the data o Analyzed data using SPSS Public Health Context HIV/AIDS stigma plays a major role in increased infection rate 1 in 3 new infections in Missouri are youth 13-24 years old Half of the people living with HIV will be over the age of 50 by 2015 St. Louis City has a 554.3 per 100,000 prevalence rate HIV/AIDS is declining amongst infants globally HIV/AIDS surveillance is important because over a million individuals are affected Globally children are left as orphans because of parents dying from HIV/AIDS infections Activities Daily activities included entering CD4 counts as well as Viral Loads into the Electronic HIV/AIDS Record System or EHARS Patient data update Attended Outreach events Practice Experience Progress and Challenges Surveillance is necessary because it gives numbers to back up speculations. The surveillance unit maintains EHARS so that other public health programs can do outreach events (e.g. Active surveillance, health fairs, etc.) Competencies Achieved Exposure to governmental entities and managerial organization Data analysis and data interpretation ARCGIS training Data presentation in forms that are easily understood Health education World AIDS Day 2013 (AIDS Quit)

St. Louis Children’s Hospital Usha Rawat Practice Experience Dates:June, 2014 – September, 2014 St. Louis Children’s Hospital St. Louis Children’s Hospital CHAO Department annually provides more than 25,000 children with free medical and health education programs. Services include asthma education and treatment, dental exams and restorative care, and a mobile medical clinic providing vaccinations, growth analysis, and screening for blood lead level, scoliosis, iron deficiency anemia, vision and hearing impairment. Health education services include home and vehicle safety education, car seat installation and pedestrian safety education. Program Evaluation Literature Review Training Community Program Visits Final Presentation HKE Asthma Absenteeism Analysis 2013-14 HKE Screening BMI Healthcare Disparities Research Professional Development Class My Role Includes program evaluation activities such as measuring and reporting outcomes for community based health programs, literature reviews and community assessment. I had opportunities to shadow other community health programs and participate in interdepartmental teams and work with community partners. Data analyst o Clean and manage data o Apply descriptive and inferential statistics Paper/presentation development o Review literature o Develop paper sections o Maintain reference databases Public Health Context As of 2007, Missouri ranks as 27 th in overall prevalence of overweight and obesity among adolescents, with 31% of children considered overweight or obese While each school year’s mean level of attendance varies somewhat by school, it is important to note the districts where the percentage of hours presents in 2013-2014 in Table 3. When analyzed by school, we see a statistically significant difference in the mean attendance rates for Bel-Nor Elementary and Normandy middle schools for HKEA program participants. In low-income area of St. Louis, prevalence were similar in 1992 and 2004 for current asthma (18% and 20%) and frequent wheezing without diagnosis (24% and 26%), despite higher 2004 percentage below poverty level (40% versus 18%). The preschool obesity rate is better than US average level. The value is 13.2 percentage which is lower than the average range: 13.9 to 16.1 percentage.Whites in STL has a higher BMI than MO average for children 24 to 59 months. In St. Louis City, male children gets more exposure to ER due to injury and poisoning. The ER rate for male is 148.7 visits per 10000 population under 15 years old. However, the rate for female is 115.3 visits per 10000 population under 15 years. Overall, the value for St. Louis City Children is among the average value from 115.1 to 137.0. In St. Louis City, African-American children gets more exposure to ER due to injury and poisoning. The overall value is St. Louis City is among average from 115.1 to 137.0 (123.2). Activities The HKE Asthma team tracks the absentee rates of each student enrolled in their program as an outcome of the program. The HKE Screening program collects height and weight for schools and provides the raw data to them. We are interested in knowing the feasibility of creating a BMI report for each school. We are also interested to see if schools in certain zip codes have a higher rate of BMI The CHAO team is interested in seeing how we are contributing to the work of limiting disparities in access and quality of healthcare. Practice Experience Progress and Challenges Advancing skills in other programs (i.e. SPSS, Tableau) will be helpful for future experiences. Competencies Achieved Use the public health information infrastructure to collect and process data, and translate data into information for application to public health problems. Identify and articulate the value of integrating strategic concerns, operational issues and organizational performance Identify existing effective evidence- based programs and materials appropriate to organization needs. Articulate basic concepts of probability, random variables, and distributions, and apply descriptive techniques commonly used to summarize data. Communicate statistical analyses and results at a level appropriate to those either experienced or inexperienced in quantitative methods. Able to interpret results, make appropriate inferences based on results and recognize public health and clinical implications of results.

Kantar Health Erin Sanders Practice Experience Dates:September, 2013 – April 2014 About Kantar Health Kantar Health is a global consulting organization that provides evidence-based decision support to pharmaceutical, biotech, device, and diagnostic companies. As part of their services, Kantar Health offers expertise in oncology, forecasting, and epidemiology, including resources such as Epi Database® and CancerMPact® Patient Metrics. My Role at Kantar Health As an intern at Kantar Health, my primary role was to assist with updates to Epi Database®.I also contributed to custom projects on an as-needed basis. My Project – Epi Database® Epi Database® provides epidemiology data for up to 190 indications in 13 countries worldwide.My role was to research recent epidemiology literature, data sources, and disease registries to provide updated calculations of incidence and prevalence for various diseases in the United States, France, Germany, Italy, Spain, the United Kingdom, and Japan. Indications I worked on during my time at Kantar Health included polycystic ovarian syndrome, anorexia, hospital procedures, peptic ulcers, hot flashes, cystic fibrosis, asthma, otitis media, and amyotrophic lateral sclerosis. An example of the final Epi Database® product provided for clients Public Health Context The Epidemiology team at Kantar Health provides population-based information on disease epidemiology to pharmaceutical companies across the world.This enables these companies to identify their patient base and how best these patients can be served.Improving the treatments available to these patients positively impacts public health. My Activities Complete literature reviews Data analysis Written reports of calculation methodologies Communicating with team membersand colleagues locally and overseas Practice Experience Progress and Challenges As part of my position at Kantar, I communicated with colleagues in Japan via email to identify local sources for Japan epidemiology.Through this experience, I learned a lot about how to communicate epidemiological issues with people who do not share my training and education or the same first language. Competencies Achieved 1.1 Gain experience disseminating epidemiological information to a target audience 3.2 Learn how to use and apply sources regarding diseases and their epidemiology 1.When analyzing and critiquing studies, learn what questions to ask and how to determine which studies are appropriate/reliable sources 2.Learn more about how private sector addresses public health problems and epidemiology 2.Interpret results and make appropriate inferences about them and their clinical implications 3.Determine limitations to performing epidemiological studies and obtaining data necessary to answer questions

Asthma Coaching Program Evaluation Caroline Schaefer Practice Experience Dates:January, 2014 – May, 2014 Organization The Child Health Advocacy and Outreach (CHAO) department of St. Louis Children’s Hospital delivers programs that focus on health promotion, injury prevention and offer community health services in order to keep kids health and safe and build strong communities in the St. Louis area. Project To evaluate the effectiveness of the Asthma Coaching program in reducing the severity of asthma and increasing knowledge about the disease for asthma diagnosed children. Role in Project My role was to collect all data regarding patient information and patient hospitalizations from various resources. I would then use that data in statistical analysis to determine if clients of the asthma coaching program saw a reduction in the number of emergency room visits and/or inpatient admissions. Public Health Context According to the Centers for Disease Control and Prevention, 1 in 11 children in the United States had asthma in 2010. Asthma is a very serious disease that requires constant management. In 2009, asthma caused 479,300 hospitalizations and 1.9 millions emergency department visits.1 in 5 children with asthma went to an emergency department for asthma related care in 2009. By promoting proper education and care, the Asthma Coaching Program provided by CHAO can reduce the number of asthma related deaths, hospitalizations, emergency department visits, and missed days of school in St. Louis area children. Activities Collected data using the BJC network of clinical records Found reimbursements paid by Missouri Medicaid Analyzed the before coaching and after coaching number of hospitalizations for each client Practice Experience Progress and Challenges I gained experience in dealing with large datasets and data that was not originally intended for analysis. I was able to sit in on formative meetings where program implementers and evaluators worked together to develop evaluation tools Learned that when communicating my results to other members, the language needs to be less scientific or statistical Competencies Achieved Communicate complex information into formats both written and oral, that are understandable to target audiences Use public health information to collect and process data Communicate statistical analyses and results at an appropriate level Able to interpret, make appropriate inferences based on results and recognize public health and clinical implications of results Identify existing effective evidence-based programs and materials appropriate to organization needs

Role of Protective Environment on Risk of Invasive Mold Infection in Cancer and Transplant Patients: A Case-Control Study Alexandra Schwach May 2013 – May 2014 Barnes Jewish Hospital Barnes-Jewish Hospital (BJH) is the largest hospital in Missouri. An affiliated teaching hospital of Washington University School of Medicine, BJH is a member of one of the nation’s largest health-care organizations. Invasive Mold Infections & Protective Environments Assess the role of protective environment rooms on invasive mold infections in immunocompromised cancer patients, transplant recipients, and other severely neutropenic patients. Responsibilities Literature review o Identify known and possible unknown risk factors for invasive mold infections. Data analyst o Utilize informatics for data acquisition. o Use Microsoft Access to create and build comprehensive study database. o Perform statistical data analysis using both SPSS and SAS. Infection prevention (IP) intern o Shadow IP specialists in daily duties. o Attend team meetings and infectious disease rounds. o Participate bi-monthly at Infection Prevention and Epidemiology Consortium. Public Health Context BJH is renewing their facilities, including upgrades to the Siteman Cancer Center. Currently, not enough PE exist to accommodate all cancer, transplant, and prolonged neutropenic patients at the hospital. Invasive mold infections (IMI) increase the risk of mortality in immunocompromised and neutropenic individuals. Results from this study will inform IP specialists and their superiors as to the need for positive pressure capabilities in all rooms within the new cancer center, to reduce mortality from IMI. Activities Conduct independent case- control study using BJH informatics and electronic medical records. Research current guidelines and background to examine benefit of placing patients with prolonged neutropenia in protective environments (PE). Practice Experience Progress and Challenges The sheer amount of risk factors that impact both cases and controls has prolonged the data acquisition aspect of the study. Learning new programs (i.e. Microsoft Access) and statistical concepts (i.e. propensity score matching) will be helpful for future experiences. An abstract was created and accepted to be presented at the Graduate Student Symposium. Competencies Achieved Use public health information infrastructure to collect and process data. Conducted extensive literature review and compiled data from electronic hospital records and informatics. Identify leading public health problems, key risk factors, and methods for collecting and analyzing data. Examined current knowledge and sought to increase understanding of risk factors for IMI. Explain roles of public and private sectors in meeting needs and priorities. Participated in IP meetings and attended Infection Prevention and Epidemiology Consortiums.

Washington University School of Medicine Shivan Shetty Practice Experience Dates:April, 2014 – August, 2014 Washington University School Of Medicine Washington University is an institution of higher education located within St. Louis. Several research studies involving the public health of St. Louis and other areas are currently under way throughout the university. The School of Medicine in coordination with Siteman Cancer Center are currently assessing disparities in cancer education, prevention, and treatment. Drake Team Projects Prostate Cancer Cohort Study BMI Prostate Cancer Recurrence Prostate Cancer Community Partnership Barriers to Tissue Research Public Health Intern Works with Prostate Cancer Cohort reviewing patient charts (Allscripts, BJC Clindesk), conducting follow-up phone calls and data entry, as well as some recruitment and consenting. Participates in the Prostate Cancer Community Partnership by attending meetings and helping with educational outreach (Community Research Fellows Training Program). Assists in data analysis, interpretation, and manuscript preparation Public Health Context With approximately 233,000 new cases to be diagnosed in 2014, prostate cancer is the most common cancer among American men following skin cancer. Prostate cancer recurrence affects about 20% of men within 10 years of their radical prostatectomy as their initial treatment. Most men who have been diagnosed with prostate cancer have high survival rates, however it is important for researchers to understand what genetic and modifiable factors encourage or prevent prostate cancer and prostate cancer recurrence. Assessment of cancer disparities adds to the growing body of literature regarding prostate cancer and prostate cancer recurrence. Dissemination of research results via publication aids in the advancement of treatment and prevention of prostate cancer across the country. Specifically, these results will allow healthcare providers to better counsel their patients. Activities Recruit men for PSA screening at 100 Black Men’s the Community Health Day. Lead Breakout sessions for Community Research Fellows Training (CRFT) Program. Extract data from patient charts, conduct follow up phone calls to collect data, and then process data and input in data capture software to be later analyzed. Co-author manuscript to be submitted for publication Conduct literature review and review qualitative interviews to understand barriers and facilitators to tissue research. Practice Experience Progress and Challenges 1.Two publications have been drafted for publication. 2.Learning new programs (i.e. REDCap, Allscripts, BJC Clindesk, SAS) will be helpful for future experiences. 3.Reviewing patient charts and conducting follow up phone calls was difficult at first, but I quickly became comfortable. 4.Leading CRFT program break out sessions challenged me to come up with better ways of explaining public health concepts to community members. Competencies Achieved Communicate complex information in formats, both written and oral, that are understandable to target audiences. o I assisted in the examination of the interaction of BMI and smoking by interpreting results of its effect on prostate cancer recurrence. Identify the organizational relationships in the delivery of health services in a community and the patterns of health access among individuals and within various communities. o I gained understanding of the importance of the Prostate Cancer Community Partnership by participating in educational outreach and community health fair. Use the public health information infrastructure to collect and process data, and translate data into information for application to public health problems. o I gained experience working with BJC health information systems. I was exposed to primary data collection and data processing through the prostate cancer cohort study.

Washington University School of Medicine Weight Management and Eating Disorders Research Lab Allison Sierocki Practice Experience Dates:February, 2014 – May, 2014 Organization Washington University School of Medicine Weight Managementand Eating Disorders Lab Wilfely Lab Projects Staying Fit & Healthy Body Image Program Role in Organization/Project Research Intern Recruited organizations to assist with participant enrollment Handled data collection and management Created of new databases for analysis Responsible for manipulating, transferring, merging, and managing data in excel Conducted additional various tasks for the Director of the lab Public Health Context STAYING FIT Obesity is an epidemic in this day an age. Taney CO, Missouri has the highest rate of childhood obesity in the state.Staying Fit is an interactive, online, evidence-based, early intervention and prevention program. It is designed to promote childhood weight loss and weight maintenance for middle school students in Taney County, MO (Forsyth and Hollister schools). Wilfely Lab has validated the efficacy of internet based interventions for the prevention of excess weight gain in overweight adolescents and obesity related eating disorders and attitudes. Importantly, this project focuses on creating a sustainable partnership with community organizations through OWN it that will enhance the efficacy of the intervention, and widen its impact. HEALTHY BODY IMAGE Wilfely lab operates under the pretense that obesity and eating disorders go hand in hand. This program uses the Stanford- Washington University Eating Disorders Screen tool, as well as, a tailored online evidence based internvention(s) for the individuals from the 26 different colleges/universities. Those who are enrolled will have tested positive for a DSM-5 clinical or subclinical eating disorder. They are randomly assigned to either traditional care or the new intervention, in order to assess the impact of the new intervention. Project Aims Staying Fit The main goal is to promote weight loss or maintenance as well as healthy eating and activity in the Forsyth and Hollister middle schools. 2) Engage caregivers in healthy lifestyle behaviors. Without parental involvement the program will not be sustainable or significant. 3) Build strong community partnerships that will ensure sustainability of the program Healthy Body Image Aims to determine that the technologically-enhanced, guided self-help program will produce quantifiable and significant enhancements in access, costs, and results for eating disorder intervention over usual care. Practice Experience Progress and Challenges Recruited 794 participants across the 26 colleges/universities Created surveys and tools to be utilized in later stages of program implementation Cleaned and merged data files in excel for ease and ability of future analyses Conducted numerous literature reviews, and cleaned papers and tables for publication Competencies Achieved 1.1 Communicate complex information into formats, both written and oral, that are understandable to target audiences, e.g., policy makers, administrators, general public, etc. 2.3 Know, support and use team development methods. 3.2 Use the public health information infrastructure to collect and process data, and translate data into information for application to public health problems 6. 2Protect confidential data and information, and obtain informed consent for participation in public health interventions, services, and research projects 8.1 Identify and articulate the value of integrating strategic concerns, operational issues and organizational performance 11.1 Describe the concepts of health, health promotion, health education, and community participation {especially as relevant to organization]. 13.2 Identify and communicate strategies for preventing and controlling hazards within behavioral context of populations. 14.1 Identify leading public health problems, key risk factors and methods for collecting, analyzing, and reporting surveillance data for these health issues.

SSM Environmental Safety and Emergency Preparedness Erica Suhling, M.P.H. Student Practice Experience Dates: May 2014-November 2014 SSM Health Care St. Louis A network of 7 hospitals within the St. Louis region. Facilities include: St. Mary’s Health Center, Cardinal Glennon Children’s Medical Center, St. Joseph Health Center, St. Joseph Health Center- Wentzville, St. Joseph Hospital West, St. Clare Health Center, DePaul Health Center Mission: Through our exceptional health care services, we reveal the healing presence of God. Chemical Analysis Project Reviewed Plant Operations’ chemical inventory to determine products hazardous to their health. Advised the removal of 17 products and controlled use of 57 products at all 7 facilities. My Role Environmental Safety and Emergency Preparedness Intern Complete hazardous chemical analysis of 7 facilities’ Plant Operations’ chemical inventory. Participate in emergency preparedness planning, drills, and exercises. Participate in environment of care rounding to ensure compliance at all locations with Joint Commission standards and in preparation for TJC surveys. Public Health Context Industrial hygiene and employee health play a large part in ensuring an effective working healthcare environment. Assessment of the healthcare environment is the first step to understanding how to effectively improve employee and patient health. Working to improve policies and processes as an ongoing process when risk assessments are completed. Disseminating and keeping employees informed of how they can control their exposures to harmful chemicals as well as create a safer environment for the patients. Healthcare emergency preparedness ensures the continuity of health services to the community in a stressful time. Activities Provided recommendations for Plant Operations to ensure use with PPE to reduce exposure. Reviewed completed preparedness drills and exercises to ensure compliance with TJC. Participated in Environment of Care rounding to prepare for TJC surveys. Practice Experience Progress and Challenges Hazardous chemicals were removed from the plant operations inventory and replaced with a less hazardous similar product. Trying to get individuals to understand why they cannot use the hazardous chemicals anymore and to work to actually remove them from the facility was a challenge. Progress was made in cleaning out many facilities Plant Operations’ chemical inventory when they realized they did not use many of the products in the first place. Competencies Achieved MPH 3.2- Use the public health information infrastructure to collect and process data, and translate data into information for application to public health problems. I analyzed chemical inventory data for each SSM STL facility to identify products that pose a significant health hazard. MPH 13.2- Identify and communicate strategies for preventing and controlling hazards within the biological, cultural, and behavioral context of populations. I did environment of care rounding and responded to employee concerns regarding safety and environmental health. MPH 15.2- Define the components of an agency emergency management plan. I evaluated drills and exercise to ensure they met the hospital EM plan.

Washington University in St. Louis – Emergency Management Erin Touchette August, 2013 – May, 2014 Organization Washington University (WU) in St. Louis is an institution of higher education in St. Louis. There are two Directors of Emergency Management – one for the Medical School Campus and one for the Danforth Campus. Extensive emergency notification system for entire campus. Everbridge Part of WU’s platform for emergency notifications includes Everbridge. This system used email, text and phone calls to notify individuals of pertinent information relating to emergencies. Other Projects 1.Primary project was populating fields in Everbridge 2.Comparison of Hazard Vulnerability Assessment and Emergency Risk Management for the university 3.Creating social media pages and injects for a large exercise with BJC Hospitals 4.Creating and facilitating a table top exercise for WU Public Health Context Emergency management on a large university such as WU, is very important in order to keep the students, faculty and staff safe in all types of emergencies, including tornadoes, earthquakes, shooter on campus, chemical spills and bioterrorism.Many areas within the campus are limited in technology, meaning that the Wireless Internet or cell phone service is not always available.Therefore, multiple methods of communications are necessary to reach as many individuals as possible. Population of Everbridge Fields Names, addresses and contact information Building and lab contacts Groups (ex: Crisis Management Team, Resident Assistants) Emergency messages dependent on situation at hand Practice Experience Progress and Challenges 1.Everbridge is rolling out for campus-wide use in June, 2014. 2.Facilitated a table top exercise for spring 2014 – data center failure. 3.WU is in process of hiring an architectural/engineering firm to help determine the shape of various building for extreme wind/earthquake events.This resulted from the HVA/ERM assessment of WU. Competencies Achieved Many parts of the job required keeping information confidential – HVA/ERM assessments, business continuity information/status Working with various organizations to enhance WU’s ability to respond to disasters – monthly meetings with BJC, meetings with WU’s Crisis Management Team Communicate complex information into both written and oral formats – writing and facilitating the table top exercise for the university.This required much research about how the data center affects the entire community and how it could be damaged.

BJC School Outreach and Youth Development (SOYD) Alicia Towery March, 2014 – May, 2014 BJC and SOYD BJC HealthCare is a nonprofit healthcare organization made up of 12 hospitals and other community health locations. SOYD is a shared service department supporting the surrounding communities of the 12 hospitals in which they serve Programs offered in K-12 school setting. Focusing on the six high risk health behaviors identified by CDC Role in Organization/Project and Activities Assistant to Program Evaluator and Curriculum Manager o Reviewing completed program reports to flag questions that are not producing intended output. Recreating logic models that show how inputs and activities produce intended outcomes. o Networking with other groups and potential coalitions who provide community benefit to offer services and become more well known. Public Health Context The CDC assessed health of adolescents and found six priority areas for youth health-risk behaviors: tobacco use; substance abuse; poor nutrition; lack of physical activity; risky sexual behaviors; and safety-intentional or unintentional injuries. SOYD educates and empowers youth on primary prevention strategies based on the above health-risk behaviors. This is based on need through community needs assessments and upon requests of schools in and around the St. Louis/Missouri area. SOYD uses student pre and posttest surveys and student and teacher evaluations to evaluate effectiveness of the programs. Also involving SOYD in CHIP (and other) meetings to partner with community benefit groups. Practice Experience Progress and Challenges 10 logic models have been created for the long term SOYD programs These models will help in the reshaping of the evaluation plan Having staff who have little knowledge on evaluation plans and logic models can be difficult in completing final program reports SOYD has staff development to help inform staff on the above and to better promote support on program evaluation Competencies Achieved Know, support, and use team development methods o Getting to know SOYD staff and curriculum and sitting in on networking meetings Assess extent to which health promotion strategies are accomplishing their intended goals o Logic models and flagging questions Describe concepts of health, health promotion, health education, and community participation o Discussing the importance of logic models and evaluation with staff who are not familiar with them

Medical Neglect and HCV intervention in St. Louis City Jails (Committee for Prisoner’s Rights) Kanika A. Turner February, 2014 – May, 2014 Family Care Health Centers Federally Qualified Health Center located in Carondelet Neighborhood Provides comprehensive primary health care services to low-income residents Aimed to improve health of community and reduce barriers to health care Committee for Prisoner’s Rights (CPR) aims to guarantee that appropriate health care, safety, and good governance exist in St. Louis city jails Medical Neglect and HCV Interview people with experiences with St. Louis City Correctional System. Interviews will be used for advocacy towards policy officials and city jail officials to help ensure policy development for improved medical treatment Goals of project are to assist with adequate intervention of acute and chronic disease management and transition to care for prison inmates with protocol and policy development Assist with project development of Hepatitis C prevention in city jails Develop materials for jail staff to help decrease incidence of Hepatitis C spread by prevention, protection, and safety. My Role Develop consent form for use for interviews Interview previous St. Louis City inmates for personal stories related to medical mistreatment, and interview professionals who have experiences with St. Louis City Correctional System Literature search for medical mistreatment in prisons and jails Literature search for evidence based practices for current Hepatitis C interventions in prisons and jails Assist with development of goals and missions for CPR Meet with community leaders and key informants in St. Louis City Public Health Context Literature search on medical neglect in prison or jails resulted in very little information. Using information from interviews has the potential to influence policy makers to advocate for better practices for acute and chronic disease management and transition to care. CPR is currently working on legislation to advocate for mandatory reporting of crimes that take place in jails as seen in prison system. This can be the start of developing legislation to target medical mismanagement. One in six prisoners are infected with HCV, and more than 10 million Americans cycle throughout prisons and jails yearly. This is the perfect opportunity to target this epidemic by decreasing spread within and outside prison/jail populations by early identification and treatment. Activities Interview previous St. Louis City inmates about medical mistreatment, and interview professionals who have experiences with St. Louis City Correctional system Assist with development of consent form Analyze data for policy development Meet with community leaders for information sharing Assist with development of Hepatitis C materials for city jails Research information about medical neglect and Hepatitis C in jails and prisons Attend all committee and professional meetings Practice Experience Progress and Challenges Scheduling interviews and contacting previous inmates for medical neglect project was difficult. Some problems were phone disconnections, no voicemail services for inmates, inmates were not clinic patients, and difficult for non-clinic patients to safely contact me. We resulted in mailing letters to clinic patients, creating an email address, and development of an outreach flyer to assist with communications efforts. CPR is a new organization. I was able to attend the very first meeting and assist at the very beginning. Committee participation varied throughout. Some of the problems that exist will resolve as the committee continues. After meeting with the health services administrator for St. Louis city jails, there was no interest in allowing outside health professionals to enter jails to teach HCV materials. They were willing to review materials. Competencies Achieved Protect confidential data and information, and obtain informed consent for participation in public health interventions, services, and research projects Developed informed consent for project based on research and HIPAA compliance Obtained consent from interviewees Solicit input from and information sharing among individuals and organizations Attended all meetings and actively participated with community organizers and key informants Evaluate programs for cultural appropriateness and implement changes to increase appropriateness for diverse backgrounds Literature search on evidence based practices for Hepatitis C in prisons and jails Created materials based on prevention, protection and safety as identified at Massachusetts Correctional Facility

Barnes-Jewish HealthCare Matt VanNatta Practice Experience Dates:May 2014 – September 2014 Thank You: Debbie Mays, Ashleigh Goris and Dr. Zink Internship Organization: Barnes Jewish Healthcare Department of Emergency Preparedness and Safety Projects: Developed a mass prophylaxis module to cover the existing mass prophylaxis system. Developed a system wide emergency operations template for hospitals to use to personalize their own emergency operations plan. What I Did: Literature reviews on mass prophylaxis systems and emergency operations plans. Outlined the emergency operations plan and mass prophylaxis steps. Developed emergency operations under guidance of preceptor. Outlined the steps for the mass prophylaxis module and developed organism specific question pages for the mass prophylaxis process. Attended meetings. Analyzed data and attend conference calls on emergency infectious disease matters. Improvements and Hardships I progressed very well into teamwork mindset and communicating very well between coworkers. I was happy to get a lot of hands on experience with projects that I love to do. I got more comfortable as time went on with asking questions and being on my own. Some challenges for me was being patient for answers since the people I worked with were very busy, sometimes it would take a couple days for responses or advice on a project. It took time to adjust to the new environment. Competencies Achieved: 10.2- Apply knowledge of biology to development and implementation of disease prevention programs 15.1- Work with and through people in various emergency response organizations 2.3- Know, support, and use team development methods 1.2- Use innovative methods to communicate public health lessons learned 4.3- Identify the organizational relationships in the delivery of health services 15.2- Define the components of an agency emergency management plan Role With Projects: Outlined and developed an emergency operations plan template and mass prophylaxis module to be used instead of the existing module. Attended closed POD, infectious disease and emergency response team meetings. Public Health Viewpoint: Mass prophylaxis is all about serving the largest population possible in the most efficient way possible. Mass prophylaxis systems for a closed POD can help reduce bottlenecks for those attending the POD and allow for quick dispensing of medications given a certain exposure. The emergency operations plan helps the hospitals understand resources available in a given disaster situation and how to get through a disaster situation effectively therefore minimizing morbidity and mortality to the hospital staff and patients/families. The emergency operations plan delves into public health concepts of mitigation, preparedness, response and recovery during a disaster and how to go about the processes effectively. The infectious disease conference calls from the CDC was informing healthcare personnel on serious matters such as Ebola and MERS- CoV and what should be done in order to keep their hospital staff and patient population safe.

Oral Health and Prenatal Care in St. Louis County Kinnara Vasamsetti Practice Experience Dates:Feb. 2014-May 2014 St. Louis County Department of Health The John C. Murphy Clinic is 1 of 3 county clinics Specifically addresses women and children in all health services provided The clinics are looking to develop tracking system of all patients utilizing all health services Dental Health Demographics To assess demographics of all pregnant women seen from 2008-2013 To utilize analysis to create groundwork for tracking system My Role Data analysis o Clean up data and protect all HIPAA classified information o Utilize demographic statistics for each socioeconomic factor given for all prenatal women seen at dental clinic Presentation development o Interpreting data to communicate with non-public health officials o Review literature o Create presentation and questionnaire Public Health Context Inadequate oral health care before and during pregnancy can lead to negative health effects in both mother and child o Development of periodontal disease can have adverse affect on pregnancy outcomes o Treatment for this disease increases negative outcomes (Morgan, Maternal Fetal Neonatal Med, 2009) Public health dentistry limited in scope of understanding environmental, social, behavioral and economic impact on health care delivery (Russell, ADEA Summit) Decreased emphasis/ negative perception on importance of oral health care during pregnancy limits patients receiving care (Ressler-Maerlender, Women’s Health, 2005) Activities Research relevant dental issues in terms of prenatal care o Identify potential plausibility of dental treatment and positive prenatal outcomes Analyze medical records collected by the Department of Health from 2008-2014 Interpret and disseminate results to department directors Practice Experience Progress and Challenges Final presentation has been delivered with preliminary demographic information Limitations with variables available through electronic health records System coding caused discrepancies in numbers Further advanced skills in SAS as well as introduced to SQL databases Competencies Achieved Identified leading public health problems, key risk factors, and methods for collecting, analyzing, and reporting surveillance data for these health issues o Able to see pertinent dental health issues through literature review for pregnant women Communicate statistics at a level appropriate to those either experienced or inexperienced in quantitative methods Multiple meetings with dental health director allowed for complex data to be distributed in simpler terms

Carpenters’ District Council of Greater St. Louis and Vicinity (CDC) Carpenters’ Joint Apprenticeship Program (CJAP) Jenna Vavra Practice Experience Dates:November 13, 2013 - May 13, 2014 CDC Originating in 1882 by Peter J. McGuire, the CDC represents 21,600 carpenters throughout Missouri, Kansas, and Southern Illinois. Their mission is to negotiate fair wages, provide comprehensive benefits packages, and offer programs to best service members. CJAP Over approximately four years, CJAP acts as an apprenticeship program for new, upcoming carpenters. This program provides trades training, safety training, and collaborates with low-income schools and prisons to offer skills development that are useful in finding full-time employment. Safety Director Intern Interacted with local contractors and employees in developing a safety culture, safety policies, and promoting training Research on OSHA and MSHA regulations to disseminate information to contractors and union members My Role Researched and made descriptions of OSHA and MSHA regulations to be disseminated to contractors and union members Helped develop and critique fall protection presentation and safety communication videos Participated in Safety Training classes at CJAP Interaction with instructors and apprentices Received OSHA 30 certification Site-visits to surrounding training schools in the St. Louis area, major traffic sites (i.e. Boone’s Bridge), and local construction sites to observe safety practices Public Health Context Carpentry is well known as a high-risk occupation Total 2012 U.S. occupational fatalities (4,383) is down from 2011 (4,693). However, construction fatalities have risen from 781 in 2011 to 817 in 2012 (Bureau of Labor Statistics, 2013) The CDC plays a major role in implementing OSHA 10, substance abuse testing, and requirements for all active members to complete eight hours of annual safety training Safety training helps increase safe work practices and create safety cultures on worksites, which helps decrease injuries on worksites CJAP provides safety equipment examples for apprentices during courses assuring that quality safety training is being given Policy development within the CDC, like no cellphones while driving, helps prevent accidents before, during, and after work hours for all members and workers within this organization Activities Construction site-visits and safety consultations Participation in classes at CJAP Checking member compliance with annual 8-hour safety training Safety luncheons and informal OSHA hearing Research on OSHA and MSHA regulations Practice Experience Progress and Challenges Received OSHA 30 certification and other safety training It was difficult learning and understanding carpentry terminology and trying to communicate my classroom knowledge with construction workers Interaction with various workers (construction workers, business agents, fellow safety professionals) helped shape communication skills More experience in the construction field and communicating with workers and contractors would improve conveying the importance of safety on job-sites Competencies Achieved Better understanding of communication of different agency regulations with contractors and other safety professionals Solicit input from and information sharing among safety professionals, and OSHA and MSHA employees Ask appropriate questions, clarify assumptions and apply data when making decisions Explain how public and private organizations operate and interact within a community Applying knowledge of public health and occupational health to promote safe work practices and compose job-site Safety Plans

EMERGENCY PLANNING Internship at Washington University in St. Louis in collaboration with Clayton Fire Department DATA COLLECTION JAN - MAY 2014 WASHINGTON UNIVERSITY IN ST. LOUIS (WUSTL) Washington University is an institution of higher education located in St. Louis, MO. University emergency management is responsible for planning, mitigation, response, and recovery as well as mass communications during an incident. Emergency management is partnering with Clayton Fire Department (CFD) to update their pre-planning program database. my role DATA ANALYSIS Collection, organization, management POLICY DEVELOPMENT Literature review, hazard thresholds My Project Update the CFD pre-planning database by doing building walk-throughs and soliciting information from zone maintenance managers and other departments. Determine high hazards on campus through collaboration with Environmental Health & Safety. Other Activities Perform annual review of university disaster plan, compare to federal standards, draft new annexes and edit existing annexes. Attend PandemicPrep.org forum, WUSTL Crisis Management Team meeting, and Local Emergency Planning Commission meetings. Participate in large-scale regional exercise based on a mall shooting scenario. Attend FEMA-certified course “Social Media for Natural Disaster Response and Recovery”. CONTEXT The CFD is the responding fire department for the large majority of incidents on WUSTL’s Danforth campus. The CFD has purchased pre-planning software which compiles building and site diagrams, along with other critical information into an electronic database of pre-incident plans. These plans are then stored on mobile computers that can be accessed on the way to an incident. Pre-incident plans help accomplish three important objectives: 1)Firefighters can be informed sooner about what conditions may exist within a building they are about to enter 2)The Incident Commander will know more about the building construction and any hazardous materials so he or she can make informed decisions about what actions to recommend 3)Firefighters can have better direction on where to go once inside, especially when visibility is reduced by smoke The CFD has information about most buildings on the Danforth campus, but none of the information has been updated since 2011. This is a problem because there are a number of new buildings as well as buildings than have been renovated in the last three years. Ultimately, updating this database assures proper services. Furthermore, it is beneficial to both the CFD and WUSTL because it will help the firefighters do their jobs better and lead to increased life safety and better outcomes for WUSTL buildings in the event of a fire. PROGRESS & CHALLENGES 1) A spreadsheet for the collection of pre-planning data was created and stored on WUSTL’s emergency management server. 2) Data was collected and entered into the WUSTL spreadsheet and the CFD database for 80+ buildings on the Danforth Campus. 3) A review of the University Disaster Plan was performed and new annexes were drafted for the next addition. 4) Learning technical terms for fire safety equipment was challenging for the first few weeks, but researching information helped me learn. 5) Pushback from the facilities department who believed that this project should be conducted by and large by the CFD themselves and not drain WUSTL resources was a challenge that required more effort on our end. COMPETENCIES ACHIEVED Work with and through people in various emergency response organizations to enhance their ability to respond to disasters. Participated in large-scale regional exercise based on a mall shooting scenario. Worked with and monitored emergency planning and operations for ThurteenE student group’s annual carnival. Assisted CFD in updating pre-planning database to enhance their response ability. Use the public health information infrastructure to collect and process data, and translate data into information for application to public health problems. Collected data for CFD pre-planning database by doing building walk-throughs and soliciting information from zone maintenance managers. Define the components of an agency emergency management plan. Performed annual review of the university Disaster Plan. Learned the style and different components of the plan and made changes or edits where necessary.

Saint Louis University Office of Institutional Research Jordan S. Wilson Practice Experience Dates:January, 2014 – June, 2014 Office of Institutional Research A resource for accountability, planning, and academic management decision-making by conducting institutional research, reporting to internal and external audiences, and by evaluating special University initiatives. Projects Geodemographic Household Income Create a statistical model to predict missing income values for SLU students Market Segmentation Create clusters based on High School data to predict, where SLU has a high probability of attracting students My Role Principal Investigator o Determine where to find the data  Find relevant literature  Find a reliable affordable source for the data o Determine how to analyze and present  Clean and mange data  Conduct the statistical analysis  Determine the best way to present the data Public Health Context Project 1: Geodemographic Household Income o Purpose was to find a way to predict missing income data for SLU students. o On a bigger scale the purpose of project 1 was to increase the amount of income data OIR has on SLU student so that it would become available to use within an analysis. From a public health stand point we know that income is a big factor that leads to health disparities o So by creating a model that can predict missing income values, we may better be able to identify population of students that are at risk for health disparities. Activities Perform Literature Review Find and analyze data Present results of data Practice Experience Progress and Challenges 1.Two different projects were worked on within this internship 2.Project 1: Geodemographic Household Income a report was created but will not be pushed, due to the insignificant findings 3.Project 2: Market Segmentation is still a work in progress. Finding adequate data is prolonging the research Competencies Achieved Ability to decide upon and properly explain statistical test was improved through this internship byhaving to discuss every decision I made Ability to ask clear and concise question about assumption and statistical test was greatly improved by being in a department that stressed true understanding of statistical methods Ability to interpret results was improved by having to run analysis from start to finish and draw conclusions from every test that was run.

Department of Obstetrics, Gynecology and Women's Health, Saint Louis University Ting Xiao M.P.H. Student Practice Experience Dates:September 2014 – December 2014 Department of Obstetrics, Gynecology and Women's Health Located in the St. Mary's Health Center Campus. Leading position in clinical activities teaching and research of Obstetrics and Gynecology in Midwest, putting all women's health care issues as priority. My Project Work collaboratively with colleagues to study the species distribution of yeast isolates of Vulvovaginitis patients in order for seeking more effective treatment. My Role Research Intern Assist with literature review in different projects. Data cleaning and management, Data analysis and interpretation Creating background information reports, Creating tables using analysis results Public Health Context Vulvovaginal candidiasis affects 70% to 75% of women at least once during their lives, 5-8% of adult women have recurrent vulvovaginal candidiasis. Over 11% of the study population in this program are recurrent vulvovaginal candidiasis patients, most of the yeast isolates are C,albicans. Preliminary results showed that recurrent vulvovaginitis is associated with depression, and according to previous studies, depression can impair immunity, which would putting the patients to higher risk of getting vulvovaginitis again, so trying to find more evidence to confirm this vicious circle is vital. Then we should figure out strategy to break this circle in order to prevent recurrent vulvovaginitis. Activities Literature review. Manage the dataset for final analysis. Preliminary analyze the data and accurately interpret the results, formatting them into tables. Practice Experience Progress and Challenges Additional variables were created in the original data for better data management and analysis. Most contents in the project require certain medical knowledge and literature were not easy to find in a very systematic way as many well-studied topics in public health. Self-learning and development of searching skills are important. Competencies Achieved MPH 5: Appropriately utilize qualitative and quantitative data in order to effectively address public health problems. I applied statistical methods to study the health status and problems of the yeast infection populations for future intervention. MPH 9: Apply principles of ethical reasoning, human rights, and cultural competence when working with and in organizations and communities. I learned how to protect the privacy of patients and to maintain the confidentiality of the identifiable data in the research. MPH 2: Recognize the ecological nature of determinants of health that include biological, behavioral, social, environmental, economic, and political factor. I did literature review to learn risk factors of different levels that influence the vaginal microbiology of women.

Prediction of Cardiovascular Mortality at St. Louis VA Health Care System Yan Xie Practice Experience Dates:March, 2014 – August, 2014 The Veterans Affairs (VA) Research and Development Program Has been improving Veterans’ lives for over 85 years The only research program focused on pioneering research to improve the health and well-being of the nation’s Veterans Have over 125 active studies in diverse areas of scientific investigation including basic sciences, translational research, clinical trials, and clinical epidemiology Prediction of Cardiovascular Mortality The study is to build a scoring system from an arm exercise test for patients unable to process a treadmill exercise test, predict their hazard rate and give appropriate intervention. Role in Organization Data analyst o Clean and manage data o Conduct different analyses o Prepare and interpret analysis results to colleges Programmer o Built data entry system for chart review o Built website for Clinical Epidemiology Center Public Health Context Treadmill exercise tests are powerful for prediction of all-cause mortality and cardiovascular disease, but are unobtainable in at least 50% of patients because of disabilities precluding lower extremity exercise Pharmacologic nuclear imaging stress tests necessitate administration of ionizing radiation, require much greater equipment and personnel resources, and are several times more expensive and time- consuming than exercise electrocardiography Arm exercise stress testing is a potentially cost-effective alternative for lower extremity disabled individuals in predicting cardiovascular mortality Activities Experience in proposal development, study design, conduct power calculation and worked on study protocol Build predictive models including hazards, logistic, linear and non-parametric models Created score system from test outcomes to predict mortality and different events that occur and evaluate by discrimination and calibration. Practice Experience Progress and Challenges A seminar about model comparison has been prepared One publication about the study is currently in progress Data entry system for chart review has been built Website was built to guide investigators requesting data from VA database Competencies Achieved Understandclinical and health related project, including the proposal and study protocol, learned how to use limited resources to achieve the aim Experience in administrative data, have more knowledge about data security, learn the method and policy about protect data More familiar with SAS programing, doing analysis effectively by SAS macros and reduce steps that were not necessary Have better understanding on team working with colleagues without statistical background

BJC HealthCare Center for Clinical Excellence Data Analytics Intern Laura Yarber Practice Experience Dates:December, 2013 – June, 2014 Organization BJC HealthCare serves residents primarily in the greater St. Louis, southern Illinois and mid-Missouri regions. BJC serves the health care needs of urban, suburban and rural communities and includes 13 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice. Project Examples of ad hoc projects include data analysis for a falls risk assessment tool, and data collection and analysis for a preliminary ambulation compliance study.My major project involved hypoglycemia prevention for inpatients. Role in Organization/Project The first four months of my internship were spent working on ad hoc projects.During this time, I was also working on writing up the hypoglycemia study design and data pull request.Once the hypoglycemia project data came in, the remainder of my internship was spent working on cleaning and analyzing the data, creating tables and graphs, and putting everything together into a written report and PowerPoint presentation.I worked on the project independently, but met with my preceptor and the project lead to get input and clarify the direction that the project was taking. Public Health Context This project focused on hypoglycemia in a hospital setting. Hypoglycemia is considered an avoidable harm event. This means that with proper education and procedures, hypoglycemic events should be rare in hospitals.One way to help reduce such events is to understand who is most susceptible to having one. Based on biological plausibility, our study focused only on those who were on an anti-diabetic agent.Our first question was whether having a prior event increased the odds of having a future event (within the year).We found a strong positive relationship between having one event and having a subsequent event (RR: 7.46).Intuitively, this supported the use of an alert system to notify the diabetic educator when a patient who had had an event within the past year entered the system. However, based on the data, it does not appear that the alerts were successful at preventing future events. However, given the small sample size and limited “post- intervention” time frame, it would be interesting to see the results from a larger population over a longer timeframe. Activities My major activities included: Assisting with study design Collecting data Inputting data Cleaning data Writing code in SAS to analyze data Preparing written and oral reports from data Practice Experience Progress and Challenges One major challenge faced during this internship was the transition from one preceptor to another. My original preceptor left midway through my internship to take another position.Fortunately, we knew that she would be leaving and were able to have transition meetings with my new preceptor, and overall, the transition went very smoothly. Competencies Achieved I feel that all six of the competencies that I set out to achieve were accomplished in varying degrees.By creating and presenting findings from the hypoglycemia project, I was able to work on competencies 1.1 and 12.2, which both have to do with communicating results in formats appropriate for the audience. The biology competencies that I set out to work on (10.1 and 10.2) were achieved in a lesser manner, as I ended up working mostly independently on the hypoglycemia project. However, I was able to do background readings to learn more about diabetes and blood sugar. I feel confident that I was able to interpret the results from the hypoglycemia study and recognize the clinical implications (14.2). Unfortunately, I don’t feel that I was able to make much progress on 14.3, facilitators and barriers to the use of epidemiologic data in decision making, as it was outside of the scope of my project work.

Pertussis Cases and Informational Flyer West Nile Virus/Mosquito Surveillance Program Jefferson County Health Department Jeff Young March 2014 - May 2014 Jefferson County Health Department Jefferson County Health Department, located in Arnold, MO and Hillsboro, MO Epidemiology – Reportable Diseases Environmental – Mosquito/West Nile Virus Surveillance Program My Project Analyzed trends in pertussis cases 2002-2013 Analyzed trends in weather patterns; other mosquito- related findings 2002-2013 My Role Two projects – Pertussis and Mosquito Surveillance Pertussis – crafted an informational brochure that was distributed to school nurses and day care facilities via a server list for the entirety of Jefferson County Mosquito Surveillance – analyzed data from the past decade on WNV-positive mosquitoesand put together a recommendations report to help direct the program in the future Public Health Context Pertussis has become an increasing public health concern over the last two decades because of new vaccines, the anti-vaccine movement, and the susceptibility of different populations (specifically age groups) based on the nature of the disease and the interactions present between young children in day cares and at school. Since 2002, mosquitoes have been testing positive for West Nile Virus, and Jefferson County has seen a small number of human cases.Because of the virus being present in the mosquito population, humans are at risk and the work done with this data targeted how to improve the surveillance program as well as working on a better way to predict increases in human cases so that care for those patients can be more effective in treating the disease. My Activities Analyze pertussis data from Jefferson County 2002-2013 and make flyer to be distributed Put together an informational report regarding the West Nile surveillance program in Jefferson County Practice Experience Progress and Challenges Pertussis informational flyer finished and distributed This flyer will help limit the spread of pertussis and increase knowledge about the disease and its vaccines Informational report delivered to Jeff Co HD Environmental department regarding updating and improving the WNV surveillance program Competencies Achieved Communicate complex information in formats, both written and oral, that are understandable to target audiences Apply knowledge of biology to development and implementation of disease prevention, control and management programs Identify and communicate strategies for preventing and controlling hazards within the biological, cultural, and behavioral context of population Identify leading public health problems, key risk factors and methods for collecting, analyzing, and reporting surveillance data for these health issues

Public Health Context: Challenge: Maternal Child Family Health Coalition (MCFHC) Practice Experience Tracy Zander MCFHC: Mission is to improves birth outcomes, promote healthy families, and build healthy communities by uniting and mobilizing the St. Louis region The MCFHC is dedicated to improving the health of mothers and babies, particularly in neighborhoods disproportionately affected by poverty and poor birth outcomes The MCFHC is recognized as a leader in addressing infant mortality, increasing vaccination rates and decreasing health inequities for underserved children and their families. Acknowledgements: This work and experiences were made possible by the supportive and influential staff at the MCFHC (Kendra Copanas, Lora Gulley, Kira Switzer, Ken Sowell, Delores Hardwick, Jill Thompson, Kate Kasper, Jerri Michael, and Kim Jackson) and especially my preceptor, Julie Moyer (pictured right). May-July 2014 March-April 2014 January-Febrauary 2014 FIMR Report: Research existing FIMR reports Assist in strategizing of report Conduct extensive literature searches Compile narratives for findings Incorporate MO state data St. Louis Philanthropic Grant: Wrote grant narrative for TRIUMPH initiative Child Advocacy Day : Attended Child Advocacy Day with staff members at the Maternal Child Family Health Coalition at the capitol in Jefferson City Interacted with legislators to inform and promote the TRIUMPH initiative Attended workshops on policy development TRIUMPH and FIMR Strategic Planning: Assist in the planning and preparing meetings to move initiatives forward Collect and analyze reflections/outcomes Child Trust Fund Grant : Wrote grant narrative for TRIUMPH initiative MICA Data Analysis: FIMR report TRIUMPH data at strategic planning meeting Presented to TRIUMPH funders COMPETENCY 8.2 Define basic concepts of strategic planning and plan implementation and evaluation [relative to placement organization]. COMPETENCY 5.1 Explain the legal and political processes of developing policy at the national, state or local levels [including application in Practice Experience site]. One challenge was designing a logic model for the TRIUMPH initiative in the Philanthropic grant proposal.This was difficult because the project total exceeded the maximum grant funds. Careful review and detailed discussions were had by various staff members to reach a consensus. (Final model displayed above). Guided Progress Reports/Role/ Associated /Competencies :

Missouri Foundation for Health, Responsive Portfolio Intern Kathryn Zetzer November 2013 – May 2014 Missouri Foundation for Health is an independent philanthropic foundation dedicated to improving the health of people in our region. MFH works as a changemaker, educator, and partner to promote community health and increase access to care for the uninsured and underserved. Responsive Portfolio is charged with supporting community health priorities, establishing mechanisms to respond to those priorities, and building effective relationships with community-based organizations and efforts. My Role Data analyst o Clean and manage data o Apply descriptive and inferential statistics Grant reviewer o Reviewed grant applications o Conducted site visits Report development o Review literature o Present findings at team meetings Public Health Context The regional snapshot report will provide data at the county, regional and state level that emphasizes the many factors that impact health. The data included in the report focuses on health outcomes, health factors as well as policies and programs to provide a comprehensive understanding of the state of health in Missouri’s counties. The snapshot compares counties within each MFH identified region, and then each region to give a thorough understanding of health needs in Missouri. Providing specific assessment documentation is needed to make informed and strategic funding decisions within the foundation. Strategic funding allows funders to look for opportunities forsystemic change, instead of temporary fixes. Activities MFH Regional Snapshot Report Nonprofit Mergers and Acquisitions Review Grantmakers Innovative Funding Review Special Grants and Mini Grants applicant preparation and review Invited applicant site-visit Practice Experience Progress and Challenges The MFH regional snapshot report that I created is currently being printed for distribution. The data that I collected and sorted will be used to inform funding throughout the MFH service region. I learned advanced level Microsoft Excel techniques and become proficient in the Gifts database. I overcame time restraints by flexing my time to accommodate both of my positions at the foundation. Competencies Achieved 1.Communicate complex information into formats, both written and oral, that are understandable to target audiences. 2.Use innovative methods to communicate public health lessons learned. 3.Articulate and model Stewardship of organizational resources. 4.Demonstrate ability to make choices and use creative problem-solving. 5.Solicit input from and information sharing among individuals and organizations. 6.Use public health information infrastructure to collect and process data. 4.1 Ask appropriate questions, clarifying assumptions and applying data when making decisions. 11.1 Describe health, promotion and community participation as relevant to the organization. 14.1 Identify leading public health problems, key risk factors and methods for collecting, analyzing, and reporting surveillance data for these health issues. Organization Logo, if desired

Washington University Public Health Division LGBT Smoking Cessation Research Isaiah Zoschke May 2014 to September 2014 Organization Washington University Public Health Division working with Dr. Grant Farmer Project Researching smoking cessation lengths and quit rates for LGB populations, publication writing, crafting a community needs assessment tool, creating Missouri community resource database My Role in Organization/Project As Dr. Farmer's intern, I did a lot of the foundational work for the research publication and much of the community engagement. I networked with local LGBT organizations via Saint Louis Pride and through personal connections. We were invited by Adam Rosen to present our findings at Saint Louis PLFAG. I also used my behavioral science skills to craft a needs assessment tool that will be disseminated to the local organizations we discovered. Public Health Context Tobacco use accounts for nearly one fifth of deaths nationwide and is a large contributor of morbidity and mortality throughout the world. Minority populations, including lesbian, gay, bisexual and transgender (LGBT) communities are at higher risk for smoking than the general population. Quit rates and cessation lengths are longer among LGBT individuals as compared to heterosexual counterparts. Research has demonstrated that LGBT youth suffer from disproportionately higher rates of acute respiratory disease than their heterosexual counterparts, and LGBT individuals in general have a higher prevalence of risk-factors for smoking related diseases, such as heart disease, lung cancer, and HIV. Elevated stress due to minority status, higher rates of mental disorders, stigmatization, discrimination, targeted tobacco marketing, and lack of effective health care may explain the higher rates of smoking among LGBT communities. Stress, substance use, and substance abuse are higher among LGB populations compared to national averages, which may explain higher smoking rates as well. The odds ratio smoking among LGBT individuals, as defined by sexual activity or identity, is 1.5 to 2.5 compared to heterosexual counterparts Activities Background research for paper, outlining article, assisting with statistical model development, creation of needs assessment tool, and creation of community resource database Practice Experience Progress and Challenges I progressed dramatically in my skills for doing background research for public health publications and writing for academic journals. I learned about the article review and submission process. I was instructed on SAS statistical software techniques and about building logistic regression models. I built my skills doing community needs assessments. I was challenged by the arduous publication submission process. Competencies Achieved Communication and Informatics o Lit search, publication, and organization resource list Systems and Critical Thinking o Made clinical setting and policy suggestions in paper Behavioral science core o Assessed the strength and weaknesses of current smoking cessation programs Epidemiology core o Interpreted biostatistical analysis results Cultural Competence o Evaluated current smoking cessation programs for cultural competence Ethics and Professionalism o Made suggestions for responsive and culturally relevant smoking cessation programs in paper Public Health Biology o Discussed the major determinants of smoking among LGBT individuals

Saint Charles County Department of Community Health & Environment Andrew Adams June 2014-September 2014 Organization St. Charles County Department of Community.

Similar presentations

Presentation on theme: "Saint Charles County Department of Community Health & Environment Andrew Adams June 2014-September 2014 Organization St. Charles County Department of Community."— Presentation transcript:

Similar presentations

About project

Feedback

Log in

Auth with social network:

Saint Charles County Department of Community Health & Environment Andrew Adams June 2014-September 2014 Organization St. Charles County Department of Community.

Similar presentations

Presentation on theme: "Saint Charles County Department of Community Health & Environment Andrew Adams June 2014-September 2014 Organization St. Charles County Department of Community."— Presentation transcript:

Similar presentations

About project

Feedback