Pausing to Reflect at a Crossroads for CAIRHE

As CAIRHE settles into the first year of Phase II of its NIH COBRE grant, I want to pause a moment, thank everyone who has helped us get this far, and reflect a bit on the next five years.

I am deeply indebted to Allen Harmsen, Ph.D., for founding our center and for recruiting me to MSU in 2015. I was not the only new arrival during our early years. In Phase I, we were able to hire two stellar faculty, Vanessa Simonds, Sc.D., and Monica Skewes, Ph.D., who have since received tenure and continue their amazing community-engaged work within CAIRHE. In addition, we hired Vernon Grant, Ph.D., as an assistant research professor, who will soon receive a K01 grant from NIH after receiving a perfect score on his proposal.

Our center staff also has grown, and I’m so grateful for all of the ways in which they make our center work. Because of their efforts and the dedication of CAIRHE’s faculty researchers, we have made great strides toward becoming a recognized center, both in Montana and nationally. As one of the very few COBRE centers focusing on health equity and using a community-based participatory research framework, we have a lot to be proud of and to live up to in the future!

In the next five years, to expand and sustain our impact, we have set some ambitious goals for the center. First, CAIRHE’s major work will continue to be the promotion of robust health equity research done in partnership with Native and rural communities, and the development of CAIRHE faculty into independently funded researchers. Second, we have continued hiring research professors. Stephen Martin, Ph.D., is now running our Translational Biomarkers Core Lab, and Emily Tomayko, Ph.D., RD, will start January 1 as a center researcher (you’ll meet her in our next newsletter). In addition, we are in the process of hiring a research professor and biostatistician who will run the Montana INBRE Bioinformatics and Biostatistics Core and assist CAIRHE investigators in the design and conduct of clinical trials.

Third, our goals also include expanding our federal and non-federal funding; expanding the types of research faculty we support; continuing to create innovative dissemination products such as books, curricula, and films produced by CAIRHE faculty research; and further developing our Translational Biomarkers Core and Community Engagement Core. The work of creating a sustainable center that can improve the health of our rural and Native populations will only happen in collaboration with our community, clinical, academic, extension, and organizational partners. To that end, we will continue to develop our Health Equity Network partnerships so that the research we do with our communities today can produce benefits more quickly as well as for years to come.

Alexandra Adams, M.D., Ph.D.
Director and Principal Investigator

 

RESEARCH

CAIRHE Receives $10.7 Million to Continue Health Equity Research

From MSU News Service

The National Institutes of Health has awarded a five-year, $10.7 million grant to CAIRHE to continue its mission to reduce health disparities in Native and rural communities through community-based participatory research.

Founded in 2014, the Center concluded its first five-year Centers of Biomedical Research Excellence (COBRE) grant from the NIH earlier this year. Following a competitive renewal process, CAIRHE received its latest five-year grant effective September 1.

Alexandra Adams, M.D., Ph.D., CAIRHE’s director and principal investigator, said CAIRHE has become a major contributor to health equity research in the state in a short time.

“The public health challenges in rural and Native communities across our state are too much for any one entity to address,” she said. “Working with our partner communities, CAIRHE can act as a hub to bring stakeholders together for lasting change and positive health outcomes.”

In its first five years, the center has built a multidisciplinary network of researchers, faculty mentors, and students that spans five colleges and half a dozen departments at MSU. In addition to funding multiple faculty research projects and smaller pilot projects, CAIRHE mentors its junior faculty investigators to become independently funded researchers who hold the highest level of grant funding from the NIH or other national grant-awarding agencies.

In the past year, CAIRHE founded the Translational Biomarkers Core Lab in MSU’s Health Sciences Building, providing state-of-the-art services to assess a wide range of biomarkers related to public health research, including inflammation, oxidative stress, hormones, and nutrition analytes. The Center also introduced the Health Education and Research Bus, or HERB, a 25-foot RV customized as a mobile laboratory for health equity research and outreach in Montana’s remote areas.

Both the Translational Biomarkers Core and HERB are available to other MSU researchers as part of the university’s growing research infrastructure, Adams said.

“Both facilities are unique at MSU and are among the many ways that CAIRHE hopes to distinguish itself over the next five years and beyond,” she said.

CAIRHE has cultivated a statewide and national network of research partners across the public health spectrum—from communities to health care providers and other stakeholders—which it calls the Health Equity Network. One notable outcome of that collaboration is CAIRHE’s recent participation in a special report, C2H2: Impacts of Montana’s Changing Climate on Human Health, being produced by more than 40 partners for release in the summer of 2020.

CAIRHE is part of the Institutional Development Award program at the National Institute of General Medical Sciences division of the NIH under grant award number P20GM104417.

RESEARCH HIGHLIGHTS

Here’s a summary of what CAIRHE’s faculty investigators have been working on during the early fall months.

Monica Skewes, Ph.D. (Development and Pilot Test of Indigenist Relapse Prevention for American Indians), has continued regular visits to the Fort Peck Reservation for Community Advisory Board meetings and other activity, including the setup of a subaward to Fort Peck Community College for 2019-20. She and her research team continue to analyze data and write manuscripts for publication. Recruitment for her project’s intervention will begin next year.

Carmen Byker Shanks, Ph.D., RDN (The UnProcessed Pantry Project [UP3]: A Novel Approach to Improving Dietary Quality for Low-Income Adults Served by Rural Food Pantries), and her team recently published a paper in the American Journal of Public Health about their UP3 Framework: “The UnProcessed Pantry Project Framework to Address Nutrition in the Emergency Food System.” The project also hired a new research dietitian, Cristin Stokes. Currently the team is editing the UP3 Toolkit to prepare for activities in 2020, which will begin with recruitment of participants in January for the intervention to begin in February.

Andreas Thorsen, Ph.D., and co-investigator Maggie Thorsen, Ph.D. (Modeling Rural Perinatal Health Outcomes and Service Systems to Improve Health Equity), have worked with the Montana Department of Public Health and Human Services to obtain a dataset of birth certificates for all births in Montana over a five-year period. They hired three undergraduate research assistants—Kayden Schaff (Nursing), Austin Barnhardt (Nutrition), and Jess Keller (Sociology)—who have compiled additional data on Montana pregnancy services including birth centers and midwives, cost and quality measures for private and critical access hospitals in Montana, and demographic information such as socioeconomic conditions and substance abuse rates across the state. Their paper titled “Management of Diabetes at Community Health Centers: Examining Associations with Patient and Regional Characteristics, Staffing Patterns, and Efficiency” was recently accepted for presentation at the Population Association of America conference in April 2020. They have also submitted several manuscripts for review at peer-reviewed journals.

Kelly Knight, Ph.D., and co-investigator Colter Ellis, Ph.D. (Somatic Mindfulness Training for a Healthy Workforce), conducted five trainings during the fall semester to disseminate their project’s toolkit for addressing secondary trauma, and they are collaborating with the Bozeman City Attorney’s office to provide year-long training and support. Their CAIRHE-funded undergraduate research lab, the Secondary Trauma Intervention Learning Lab (STILL), hosted a table at the MSU Crossroads of Discovery undergraduate research showcase to disseminate study results and toolkit resources. Currently they are finishing a pilot of their newly developed training intervention, Somatic Mindfulness Training, with a sample of undergraduate seniors at MSU. And they have implemented Waves 1-3 of a longitudinal data collection for a pilot randomized controlled trial, Somatic Trauma and Resiliency Training, with Crestwood Behavioral Health Inc. in California.

Lauren Dotson Davis, Ed.D. (A Trauma-Informed Approach for Positive Youth Development for Montana Students), as part of her first-year pilot project, has completed focus groups at Park High School in Livingston, Mont., with encouraging support for an in-school yoga program. She has also finalized her Community Advisory Board so that it now includes not only school and district leadership, but also the Park County community health coordinator and the director of the Health Department. Park High ran a short version of an after-school yoga program this fall to build interest and excitement for the project’s intervention, which will begin in January.

Scott Monfort, Ph.D. (Elucidate Differences in Physical Activity and Movement Patterns in Montana Farmers and Ranchers), is halfway through recruitment for his first-year pilot project study, which has included a trip to Glasgow, Mont., and distribution of study materials at the annual Montana Seed Potato Seminar. His project will be one of the biggest users of CAIRHE’s Health Education and Research Bus (HERB) this year. The project has hired and trained its student research assistants, and the team has acquired new activity monitoring sensors for pilot testing in preparation for data collection this winter.

 

CENTER NEWS

Skewes and Rink Selected for Research Leaders Fellowship

CAIRHE investigators Monica Skewes, Ph.D., and Elizabeth Rink, Ph.D., MSW, have been selected for a prestigious three-year program that supports teams of researchers and community partners who collaborate on community-engaged, equity-focused health research.

Along with their partner, Adriann Ricker of Fort Peck Community College, Skewes and Rink began work this fall as fellows in the Interdisciplinary Research Leaders Program, supported by the Robert Wood Johnson Foundation. Their project, Wichoabdeza: Trauma-informed policy change to improve health in a tribal community, will synthesize research findings about the effects of trauma on health outcomes and use those findings to influence health policies on the Fort Peck Reservation, Rink said.

“Wichoabdeza is one of the first research studies of its kind in the United States that works with tribal communities to develop trauma-informed policies,” Rink said. “In collaboration with Fort Peck community members and lawmakers, we’re working to develop effective, compassionate, and health-promoting policies that acknowledge the many sources of trauma affecting Fort Peck tribal members.”

The Interdisciplinary Research Leaders Program connects scholars and advocates across the country—from every profession and field—to learn from and work with one another in creating more just and thriving communities. Teams of two mid-career researchers and one community leader work on a collaborative research study or project of their choice. Rink and Skewes each have worked on the Fort Peck Reservation for many years, including a past CAIRHE project led by Rink that transitioned to her own R01-grant project, and a current CAIRHE project led by Skewes. Ricker is a longtime collaborator with both Rink and Skewes.

As part of the Interdisciplinary Research Leaders Program, fellows receive $25,000 annually for salary support and other costs, plus research project funding of up to $125,000 for the team. They also receive support from mentors with expertise in research methodologies, community engagement, translation, and specific topic areas, and they develop leadership skills through mentoring, networking, and an advanced leadership curriculum.

“The focus is on solving problems that matter to the community, which aligns so well with the CBPR work we do,” Skewes said. “But it also encourages us to get out of our comfort zones, to lean in to methods or topics new to us, and to learn from other teams doing very different work across the nation. It really is a unique opportunity for the three of us.”

Applications for the next cohort of the program, to address themes of “Community Environment and Health” or “Families and Child Health,” will open January 10 on the program website.

CAIRHE to Co-Sponsor 2020 Montana Healthy Communities Conference

CAIRHE will co-sponsor the Montana Healthy Communities Conference next spring in an effort to bring researchers closer to the communities and stakeholders who face pressing public health challenges across the state.

Presented by the Montana Office of Rural Health and Area Health Education Center at MSU, the third biennial conference will take place April 28-30, 2020, at the Great Northern Hotel in Helena. Agenda and registration information are coming soon to the conference website.

Organizers describe the conference as the first statewide gathering to connect the health care and public health fields with participants in economic development, planning, research, local government, business, historic preservation, and community development.

“There are so many facets to what makes a ‘healthy community,’ and all too often the people who work so hard on community health and prosperity are confined to their silos and not working together, or even communicating,” said CAIRHE Director Alex Adams, M.D., Ph.D. “We hope to be one part of this conference’s effort to break down those silos and get everyone talking about common problems and common solutions for community health in our state.”

CAIRHE has been involved in the development of the conference agenda, and along with fellow co-sponsor Montana INBRE, the Center will host a two-hour Montana Public Health Research Pre-Conference on April 28. The session will be an opportunity for community participants, health care providers, other public health stakeholders, and researchers to discuss community-based research needs and challenges, as well as current community-based participatory research efforts in Montana.

CAIRHE faculty will make presentations during the pre-conference, as well as during a “What Works in Montana” poster session held in the evening of April 28. “We expect to have a large contingent on hand from CAIRHE and INBRE throughout the conference,” Adams said, “but particularly during these research-focused sessions.”

Chelsea Culpon, project coordinator for the Montana Office of Rural Health, said she hopes participants will leave the conference with strategies for creating smart, vibrant, and healthy communities with new and old local partners. New for the 2020 conference will be facilitated design thinking sessions led by Do Tank, a business design firm specializing in high-impact events that engage audiences.

“With tools and connections,” Culpon said, “attendees can maximize impact back home—quickly in the short term and comprehensively and collaboratively in the long term.”

CAIRHE Adds New Projects for 2019-20

CAIRHE has added two new research projects and two pilot projects to its funded research for 2019-20, bringing its total number of projects for the year to six.

Funding began September 1 at the start of CAIRHE’s sixth year as a center. The new research project leaders are Andreas Thorsen, Ph.D., assistant professor in the Jake Jabs College of Business & Entrepreneurship (Modeling Rural Perinatal Health Outcomes and Service Systems to Improve Health Equity), with co-investigator Maggie Thorsen, Ph.D., assistant professor in the Department of Sociology and Anthropology; and Kelly Knight, Ph.D., associate professor in the Department of Sociology and Anthropology (Somatic Mindfulness Training for a Healthy Workforce), with co-investigator Colter Ellis, associate professor in the Department of Sociology and Anthropology. Both teams led CAIRHE pilot projects for the past two years before transitioning to research projects.

CAIRHE’s other two research projects for the year, led by Monica Skewes, Ph.D., and Carmen Byker Shanks, Ph.D., RDN, are currently in their second year.

“We’re delighted that we have such outstanding investigators this year who are well on their way toward major grant submissions of their own within the next one to two years,” said CAIRHE Director Alex Adams, M.D., Ph.D.

In addition, the Center welcomed two new investigators as leaders of first-year pilot projects.

Lauren Dotson Davis, Ed.D., assistant professor in the Department of Education, hopes to improve chronic stress-related behavioral and mental health outcomes for adolescents in rural Montana through the application of a school-based intervention of trauma-informed yoga exercises (A Trauma-Informed Approach for Positive Youth Development for Montana Students).

Scott Monfort, Ph.D., assistant professor in the Department of Mechanical and Industrial Engineering, is examining physical activity patterns among Montana ranchers and farmers as a first step toward addressing the high risk of osteoarthritis among the state’s agricultural workers (Elucidate Differences in Physical Activity and Movement Patterns in Montana Farmers and Ranchers).

Both pilot projects were submitted as applications in April 2019 in response to CAIRHE’s Request for Proposals. Each funded proposal received prior approval from an internal review committee, the CAIRHE External Advisory Committee, and the National Institutes of Health. Pilot project funding is for one year, with the possibility of competitive renewal for an additional year.

Center Will Again Host National NIH Workshop

Next June CAIRHE will host the second presentation of a National Institutes of Health workshop designed to mentor junior investigators from around the country who work with American Indian, Alaska Native, and Native Hawaiian populations.

The latest event, to be held June 8-10 in downtown Bozeman, will build upon CAIRHE’s success with the first workshop, “Bridging the Gap: From Application to Funding,” which was held on the MSU campus in February of this year. That inaugural event involved 10 junior investigators who had previously submitted unsuccessful R01 or R21 grant applications to the NIH under a program called Research to Improve Native American Health.

The 2020 workshop, which will have a new name that is yet to be decided, will take a broader approach and involve more holistic career mentoring for junior faculty who hope to build their careers around community-based research in Native communities. Through increased funding support from the National Cancer Institute, the workshop will be able to serve twice as many faculty participants.

“We’re fortunate that NIH was very pleased with the first workshop held this year, so it’s our intent to use this continuing and increased support to develop an event with even broader appeal,” said CAIRHE Director Alex Adams, M.D., Ph.D. “Once again, it’s our goal that the mentoring from this program will have a lasting impact on health research with Native communities as these investigators pursue their careers.”

CAIRHE External Advisory Committee member Donald Warne, M.D., MPH, will be heavily involved in the workshop’s planning and as a presenter, along with one or more of his colleagues at the University of North Dakota School of Medicine & Health Sciences, where Warne leads the Indians Into Medicine (INMED) program.

“The involvement of Dr. Warne and his team gives instant credibility because of his national reputation, and his participation should attract young Native scholars and others who hope to learn from one of the foremost experts in Native community health,” Adams said.

The workshop will again feature senior NIH-funded faculty mentors from around the country, as well as presentations by NIH program officers from the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute of General Medical Sciences. A call for applications to the workshop will go out in early 2020, with the selection of up to 20 faculty participants completed by mid-Spring.

CAIRHE Requests Proposals for Pilot Projects

CAIRHE has issued its annual Request for Proposals for one-year pilot projects from MSU faculty engaged in public health research. Proposals should be consistent with CAIRHE’s mission of reducing health disparities in Native and/or rural communities, and they should have a high likelihood of leading to independent funding from external (non-MSU) sponsors.

Funding usually ranges from $20,000 to $50,000 for the project year, beginning September 1. The deadline for a required letter of intent is February 3, 2020, with an application deadline of April 1.

“CAIRHE is a multidisciplinary center, so we’re again reaching out to faculty in departments across campus,” said James Burroughs, CAIRHE program coordinator. “Being part of our center offers investigators a wealth of resources to help them on their paths toward becoming independent investigators. And they get to be part of a community of scholars who share the same interests.”

Burroughs said he welcomes inquiries from faculty interested in setting up a no-obligation meeting to discuss the Center and this funding opportunity. “We expect a lot of interest from new applicants this year,” he said.

For the first time, CAIRHE is also offering project development mini-grants to help junior investigators establish partnerships with a community, public health agencies, or clinical organizations, or to help a community find a faculty investigator partner. Those small grants of $5,000 to $10,000, made possible through support from the MSU Office of Research, Economic Development, and Graduate Education, will begin January 1 and run through June 30. The application deadline was December 2. “Depending on the success of this new program, we may offer it again next year,” Burroughs said.

For complete details and instructions, visit http://www.montana.edu/cairhe/rfp.

Stephen Martin Joins CAIRHE as New Biomarkers Lab Director

Stephen Martin, Ph.D., has joined CAIRHE as director of the Translational Biomarkers Core Laboratory, effective September 1. Martin, whose own research investigates the efficacy and mechanisms through which nutrition and exercise interact to mediate healthy aging, also has an appointment as assistant research professor with CAIRHE.

Martin served most recently as a postdoctoral scholar at the School of Biological and Public Health Sciences at Oregon State University. While there, he applied previous training in aging biology and metabolism to determine the mechanisms through which aging influences skeletal stem cell dynamics and bone health.

In his first months on the job at MSU, Martin has worked to finalize protocols in the Core Lab, located in the Health Sciences Building, while also developing prices for analysis and training services. He will relocate permanently to Bozeman in early 2020 from his current home in Oregon.

“It’s great to be at CAIRHE and MSU, and I’m excited to get the Lab up and running,” Martin said. “The Lab will be an excellent resource for researchers at MSU and throughout the country.”

Martin works directly with Core Director Selena Ahmed, Ph.D., and reports to CAIRHE Director Alex Adams, M.D., Ph.D. He received his Ph.D. in exercise physiology from the University of Illinois at Urbana-Champaign, with subsequent postdoctoral fellowships at the University of Wisconsin and Oregon State.

Adams said she has known Martin since her final years at the University of Wisconsin and has admired his work as a promising scientist. “Having his hands-on leadership in this core facility is a big win for CAIRHE and the university,” she said. “We’re confident that the Lab can establish itself as an important service provider in our region in the coming years.”

CAIRHE Profile: Suzanne Held

Name: Suzanne Held, Ph.D.

Home: Bozeman, Mont.

Positions: Professor of Community Health, MSU Department of Health and Human Development; Mentor, Center for American Indian & Rural Health Equity; Co-Director, Messengers for Health; and Principal Investigator, Improving Chronic Illness Management with the Apsáalooke Nation: The Báa nnilah Project (NIH, U01MD010619).

You’ve engaged in community-based research for your whole career, and you often talk about your experience growing up in a nontraditional church as being the basis for your idea of “community.” Can you relate that story again?

I grew up attending Good Shepard Catholic Church in a rural area in Wisconsin with my seven siblings, parents, grandparents, aunts, uncles, and cousins. The church was founded on principles of social justice and equity, and so I was exposed to this from birth on—lucky me. It was a welcoming and generous and unconventional Catholic church. We didn’t have confession or kneelers, and we sang peace songs of the 1960s and ’70s. Sly and the Family Stone’s “Everyday People” was a favorite!

Your work with Apsáalooke (Crow) Nation partners, particularly Alma McCormick, is a great model for investigators just getting started. What does your working relationship with Alma mean to you?

I am so fortunate to work with Alma every day. She is an amazing leader and mentor and coworker. Spending time together has been invaluable—both structured work-task time and unstructured time. I love it when we travel to conferences and have time to slow down and lots of time to visit about life.

As a mentor to CAIRHE faculty since the Center’s beginning in 2014, how would you describe the importance of mentoring to junior faculty? Who have been your most valuable mentors?

I would not be where I am today without my mentors, so I feel that good mentoring is instrumental to success. They have “been there and done that,” and so I can learn from their paths. I have had and continue to have generous mentors including Alma McCormick; my primary mentor that I met during my master’s degree, Dr. Randy Black; and my primary mentors that I met during my Ph.D. program, Dr. Geni Eng and Dr. Linda Burhansstipanov, who has been a mentor to me for the past 25 years. I never let them go as I am never done learning! One thing they all have in common is that they allow my whole self into the mentoring relationship, which I think is vital to my success and mental health.

How do you like to spend your spare time?

With my family doing anything at all. Also, cooking, gardening, reading, and hiking. We got a new puppy this summer, so that has been very fun and enlivening! We stopped at the Livingston shelter on the way home from a trip to Crow and there he was.