The Division of Public Health Sciences opens doors for investigators across disciplines to connect and collaborate on projects affecting clinical care and outcomes. Faculty are dedicated epidemiologists, statisticians, behavioral scientists, economists, health communication scientists and more who address a range of current and future population health challenges. Their aim is to prevent cancer and other diseases, promote population health and improve quality and access to health care in the region. The division offers a competitive Master of Population Health Sciences degree program for training in population-based clinical outcomes research in order to educate the next generation of leaders in this field.
Our Year In Numbers
18
MPHS graduates
14
MPHS students
29
faculty
305
publications
142
clinical research studies
$8,867,562
research funding
Division of Public Health Sciences | 2022 Annual Report
Engaging Patients through Collaborative Care
The Center for Collaborative Care Decisions is a newly established team of researchers and community collaborators with an admirable clinical mission: to improve the quality of health decisions and health equity. The Center promotes this cause by engaging patients and the public using clear communication, quality evidence and patient-centered goals of care. Mary Politi, PhD, is the Director of the Center for Collaborative Care Decisions as well as a health psychologist and behavioral scientist. Her primary research interests include health communication and shared decision making.
Demystifying Cancer Genomic Sequencing
Reducing health disparities is a key focus of the Division of Public Health Sciences. The Washington University Participant Engagement and Cancer Genome Sequencing (PE-CGS) Center, part of the NIH Cancer Moonshot initiative, aims to develop strategies to engage participants and communicate genomic sequencing information and subsequent cancer treatment options to patients and their families. The project hopes to not only gather data on specific cancers affecting certain demographics, but to help patients make informed healthcare decisions based off their individual genomic data.
Highlights
CLINICAL
The Division of Public Health Sciences has implemented a clinical trial to reduce disparities in lung cancer screening. I-STEP (Increasing Screening Through Engaging Primary Care Providers) is a joint research endeavor between BJC Collaborative and Washington University investigators focused on increasing referrals for and improving the quality of lung cancer screening. From 2019-2021, the I-STEP clinical trial helped clinicians identify eligible patients and refer them for lung screening. A second I-STEP study – led by Aimee James, PhD, MPH, Michelle Silver, PhD, ScM, Graham Colditz, MD, DrPH – is now underway to understand barriers and facilitators to increasing lung screening, inequities in awareness and screening, and how different types of lung nodules can be most effectively managed.
RESEARCH
In the Fall 2022 semester, Erika Waters, PhD, MPH, and Bettina Drake, PhD, MPH introduced a new course to benefit students in the MPHS program. “Health Disparities and the Structural and Social Determinants of Health” prepares students and physicians in training to address health care disparities through the exploration of how structural and social determinants of health (SSDoH) produce and maintain health disparities in patient populations. Students learn from experts and guest lecturers whose work focuses on how SSDoHs impact disparities across each phase of disease. The course culminates in a research proposal demonstrating the student’s ability to identify strategies for assessing and addressing health disparities in their own research and apply this learning to real clinical situations.
EDUCATION
The Master of Population Health Sciences (MPHS), offered by the division, is a degree program for clinicians seeking training in clinical research methods. Its quantitative curriculum emphasizes the role of epidemiology and biostatistics in clinical effectiveness and outcomes research. This year, three surgical residents – Sydney Beache, MD, MPHS, Martha McGilvray, MD, MSt, MPHS, and Keenan Robbins, MBBS, MPHS – graduated from the MPHS program. The MPHS program helps surgical residents find a research project or lab that fits their interests, providing opportunities for clinical research methods training during their lab years. The program encourages clinicians to develop strong research careers and boost their research quality and productivity.
Engaging Patients Through Collaborative Care
The Center for Collaborative Care Decisions is a newly established team of researchers and community collaborators with an admirable clinical mission: to improve the quality of health decisions and health equity. The Center promotes this cause by engaging patients and the public using clear communication, quality evidence and patient-centered goals of care.
Mary Politi, PhD, is the Director of the Center for Collaborative Care Decisions as well as a health psychologist and behavioral scientist. Her primary research interests include health communication and shared decision making. Politi’s work helps patients and the public understand health information, explore what is important to them when making health decisions and collaborate to make evidence-informed decisions that meet their needs.
Ashley Housten, OTD, MSCI, OTR/L, serves as co-director of the center and specializes in occupational therapist training. Housten’s research focuses on the Mary Politi, PhD. dissemination and implementation of decision support tools to improve health behaviors and outcomes, particularly among populations that experience health-related inequity.
Clinical and Research Advisors also make up part of the team at the center. The Community Advisory Board further contributes to decisions and administration.
Stakeholder engagement is a core principle of the center’s work. Including end users such as patients and clinicians when designing, testing, implementing and disseminating work ensures that the tools and resources meet the needs of all involved. Collaborators at the center include stakeholders of broad representation and diverse backgrounds. They also work to compensate stakeholder communities for their time and engagement in way that is fair, equitable and consistent across people.
Collaborative projects are at the crux of the learning and knowledge-making at the center. Current projects include decision making about stage I lung cancer treatment, implementing shared decision making for breast cancer using a coproduction learning collaborative and financial burden among Black men making prostate cancer treatment choices. These research endeavors seek to improve the way that patient-clinician decisions are made and thus increase the positive outcomes of medicine over a range of clinical specialties.
The center has multiple resources for training, development and implementation that are valuable to both clinicians and patients. It offers training programs and external resources for providers seeking to better understand or implement the process of shared decision making into their practice. The center also provides research guidance for those looking to develop their own projects on the impact of shared decision making, patient decision aids or other measures of patient-centered care intervention and education.
Demystifying Cancer Genomic Sequencing
Reducing health disparities is a key focus of the Division of Public Health Sciences. The Washington University Participant Engagement and Cancer Genome Sequencing (PE-CGS) Center, part of the NIH Cancer Moonshot initiative, aims to develop strategies to engage participants and communicate genomic sequencing information and subsequent cancer treatment options to patients and their families.
The project hopes to not only gather data on specific cancers affecting certain demographics, but to help patients make informed healthcare decisions based off their individual genomic data. Public Health Sciences faculty hope that this project can begin to address disparities in cancer genomic studies. Historically, most participants in such studies have been white male patients, resulting in little available data applicable to women and people of color. Collecting genomic sequencing data on these underrepresented groups can help both physicians and patients make treatment decisions based on more specific and accurate data.
Graham Colditz, MD, DrPH, the Niess-Gain Professor of Surgery and Division Chief of Public Health Sciences, serves as Principal Investigator for the project. Key figures in outreach efforts include Erin Linnenbringer, PhD, MS, and Bettina Drake, PhD. Linnenbringer, an associate professor in the division, focuses on returning information to patients and families to help them understand their genetics and specific cancers. Drake, a professor of surgery, focuses on a community-based approach to engagement.
Rather than simply educate patients about the study and ask them to participate, Drake’s team will seek to understand the patients’ concerns, values and the sort of information they would like to receive after having their tumors sequenced.
Ryan Fields, MD, Kim and Tim Eberlein Distinguished Professor and Chief of Surgical Oncology, leads participant engagement by identifying patients with targeted cancer types and determining which patients may be interested in participating.
Demystifying the results of genomic sequencing can help physicians determine what lead to the formation of tumors and help patients better understand their options for treatment. “The take-home message is that we have built on over a decade of experience through PECaD and engaging our community partners to establish the center and continue to learn more about genomic testing and return of results for our partners,” says Colditz.