Brown, state collaborate on public-health research

COLLABORATING: From left, Brown University Science News Officer David Orenstein, with DOH members Joseph Wendelken, public information officer, and Kristine Campagna, chief, Office of Family Visiting and Newborn Screening. / PBN PHOTO/KATE WHITNEY LUCEY
COLLABORATING: From left, Brown University Science News Officer David Orenstein, with DOH members Joseph Wendelken, public information officer, and Kristine Campagna, chief, Office of Family Visiting and Newborn Screening. / PBN PHOTO/KATE WHITNEY LUCEY

Brown University’s School of Public Health and the R.I. Department of Health have formalized longstanding research collaborations with an agreement that, among other things, will allow students to transition into the public-health workforce with more hands-on experience.

“This partnership … is going to have a significant impact on individual Rhode Islanders and larger health outcomes in our state because it is going to more formally align the resources and wealth of talent at Brown with our public-health interventions,” said Dr. Nicole Alexander-Scott, DOH director.

Many projects, including the identification of and outreach to Rhode Island’s high-risk newborns, predate the MOU’s Aug. 1 execution, yet exemplify its benefits, said SPH professor of epidemiology Stephen Buka. “The doctoral student [on this project] learned great skills and DOH got a deeper understanding of the data; that’s a good match.”

That doctoral student, Jessica Shoaff, concurred. She spent about 18 months reviewing data from 2007-13 to evaluate the newborn-screening program’s efficacy. “It was exciting to work on a project … [where] information would be used and implemented and could help in decision-making.”

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Buka said that the updated, statewide risk-assessment algorithm will determine which infants need which interventions, if any. This initiative “buffs up and modernizes” DOH’s longstanding universal screening of newborns and coordination of services, he said, and will help DOH direct its limited resources to those who need them most.

DOH’s current screening algorithm estimates that 60 percent of the 10,500 babies born in Rhode Island annually would benefit from a check-in from a First Connections home-visiting agency for follow-up monitoring, home services or parenting support, said Kristine Campagna, chief, Office of Family Visiting and Newborn Screening.

First Connections is a DOH program offering free, confidential and voluntary family visits and supports to pregnant women and families with children, from birth through age 3.

“The return on investment of this work is huge,” Buka added. “If we can be doing prevention … from the earliest years on, the savings in dollars and the benefits in child welfare are vast.”

With only one school of public health and one department of health in Rhode Island, SPH Dean Fox Wetle said, “That allows for very close bonding with mutual interests … to make our research … most relevant and timely.

“We have to have a close, working relationship with the agency responsible for public health and epidemiology,” Wetle said. “At DOH, our first-rate faculty … do consultations, analyses and work side-by-side with their staff … and our students provide direct services to DOH.”

DOH staff also help teach, lecture and supervise students’ theses at SPH, where timely research and education is grounded in real-life work, she added.

This represents DOH’s first, but not sole, university partnership; Alexander-Scott said that DOH will continue to collaborate with other institutions, including a collaboration with the University of Rhode Island’s Academic Health Collaborative, announced in mid-October.

Brown’s School of Public Health has no MOU with other state agencies, said Wetle, but has worked with the state’s Executive Office of Health and Human Services on Medicaid analysis.

Through Brown’s Hassenfeld Child Health Innovation Institute, collaborations with DOH on lead poisoning, childhood asthma and pediatric emergency-department use are underway. Both the MOU and the Hassenfeld Institute grew from the fertile ground of people working together for a long time to improve Rhode Islanders’ health, said Hassenfeld Institute Director Dr. Patrick Vivier.

With the Hassenfeld Institute’s broad-based funding, asthma, lead poisoning, injuries triggering emergency department visits and other population-health issues can be evaluated in the same data set by researchers at Brown and with the state, said Vivier, who also directs SPH’s interdisciplinary educational programs.

Rhode Island needs more business leaders committing to the future workforce’s physical, cognitive and social health, said Buka.

“The philanthropic community is an unintended obstacle, because there’s a preference for another program, another service … lots of small [bandages], when what’s needed are systemic changes,” he said.

Campagna agreed: “A little bucket of money for this and a little bucket of money for that” is less valuable than today’s situation with “some great leaders … thinking about the bigger picture, bigger systems and the changes we need.” •

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