UA, Partners Aim to Improve Health in Tuscaloosa County

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An effort led by The University of Alabama aims to improve health, prevent chronic diseases and reduce health disparities in Tuscaloosa County children and their families with the highest burden of chronic disease.

Funding from the Centers for Disease Control and Prevention’s Racial and Ethnic Approaches to Community Health, or REACH, program to the Capstone College of Nursing supports a community coalition among UA, Alabama Department of Public Health, Tuscaloosa Public Library, Tuscaloosa County School System and a family healthy weight program to enhance existing resources, address Tuscaloosa County’s health needs and reduce health disparities.

Assistant professors Drs. Janet Brown and Leigh Ann Bray Dayton received over $784,000 for the first year of the five-year REACH program.

Program Goals

Over the five years of the program, UA will coordinate with community partners to implement proven public health strategies for:

• Accessible healthy food choices – promoting food service and nutrition guidelines while also expanding access to existing fruit and vegetable voucher incentive and produce prescription programs.
• Safe and accessible physical activity – recommending ways to connect pedestrian, bicycle or transit transportation networks to everyday destinations.
• Family healthy weight programs – improving access to effective, family-centered, culturally relevant health behavior and lifestyle treatment programs.
• COVID-19, flu and other routine vaccines – increasing awareness, confidence, demand and access to routinely recommended adult vaccines for racial and ethnic groups experiencing disparities in immunization, including uninsured adults.

During the first year of the REACH program, the professors will assess family and community needs to better understand how to connect families to resources and determine what changes could be made in the area to encourage a healthier lifestyle.  

Heart disease, cancer, diabetes and stroke are among the most common causes of illness, disability and death in the United States. They are also leading drivers of the nation’s $4.1 trillion in annual health care costs. These chronic conditions and the factors that lead to them are more common or severe for some racial and ethnic groups.

As one of 41 communities across the country included in the REACH program, the University professors plan and carry out local, culturally appropriate programs that address a wide range of health issues among racial and ethnic minority groups where health gaps remain.

UA Expands Behavioral Health Services for Rural Alabama Youth

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TUSCALOOSA, Ala. – The University of Alabama is confronting the shortage of behavioral health services for youth in rural Alabama with more than $3.7 million in federal funding.

UA’s College of Human Environmental Sciences and the Center for Substance Use Research and Related Conditions in the Capstone College of Nursing are leading the program supported by the Health Resources and Services Administration. Awards from HRSA’s Rural Communities Opioid Response Program – Child and Adolescent Behavioral Health support the establishment and expansion of sustainable behavioral health care services for children and adolescents aged 5-17 years who live in rural communities, and to prevent substance misuse.

“Children and adolescents in rural communities are among the most vulnerable due to limited resources and limited access to behavioral health and substance use services,” said Dr. Deborah Casper, CHES associate professor who secured the funding. “Our goal is to promote health, opportunity, passion and equity through the development of sustainable, collaborative, community resources for children, youth and families in rural Alabama.”

The UA “Health. Opportunity. Passion. Equity.,” or H.O.P.E., project will provide evidence-based, strength-based and trauma-informed behavioral health and substance use services along the entire continuum of care, including prevention, treatment and recovery, to children and adolescents in Pickens County and surrounding areas.

By working with public school systems, the direct prevention, treatment and recovery services available through H.O.P.E. are projected to reach over 5,000 youth and families in West Alabama. The program will offer services in Pickens County the first year, adding other nearby counties over the four years of the project period.

“The H.O.P.E. project will greatly impact the community by expanding much-needed mental health services and resources to a disadvantaged adolescent population,” said Dr. Letisha Scott, CCN clinical associate professor and member of H.O.P.E. project team. Dr. Scott will oversee the screening and referral of youth attending participating schools that do not have SMART® clinics.

Training and mentorship opportunities for school personnel, professionals and paraprofessionals as well as strengthening community partnerships will increase the communities’ capacity to identify at-risk youth and provide the much-needed services that are virtually nonexistent in these rural communities.

The H.O.P.E project will work in collaboration with CSURRC whose mission is to promote the health and well-being of individuals and communities affected by substance use disorders and related conditions in Alabama and beyond.

“CSURRC is honored to support this important work, as center affiliated scientists and students continue to proactively address substance use and mental health problems in our state,” said Dr. Mercy Mumba, CSURRC director and associate professor of nursing.

Along with Casper, Scott and Mumba, the interdisciplinary team on the H.O.P.E. project includes CHES faculty Dr. Blake Berryhill, associate professor; Dr. Karly Downs, assistant professor, and Dr. Tricia Witte, associate professor; as well as Dr. Hee Yun Lee professor and Endowed Academic Chair in Social Work (Health), and Dr. Laura Hopson, associate professor in the School of Social Work; and Dr. George Mugoya, associate professor in the College of Education.

UA Reaching Rural Areas to Improve Cardiovascular Health

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TUSCALOOSA, Ala. – The University of Alabama is spearheading an effort to reduce the risk for cardiovascular disease in West Alabama.

With $6 million from the Centers for Disease Control and Prevention spread out over the next five years, UA faculty, staff and students will work with local health care providers to implement programs and resources designed to reduce risk factors for heart attacks, strokes and other issues stemming from poor cardiovascular health. The work will focus on nine counties around the University that include rural and underserved areas of the state.

“UA has strong community-based researchers and strong relationships with communities in West Alabama,” said Dr. Sharlene Newman, executive director of the Alabama Life Research Institute. “We will tackle this problem from multiple directions with hope that the planned programming will result in fewer residents with uncontrolled high blood pressure and high cholesterol as well as fewer smokers.”

The Alabama Life Research Institute at UA is leading the coalition of researchers and practitioners from the Capstone College of Nursing and the Institute of Data Analytics in the Culverhouse College of Business.

“The West Alabama Cardiovascular Health Program will allow us to partner with each community to increase access to care and improve health literacy with a community-specific focus on hypertension prevention and treatment,” said Dr. Paige Turner Johnson, associate professor and the Saxon Chair for Rural Nursing. “Together we can empower them to write their own story of well-being to create a healthier tomorrow.”

Alabama has some of the highest rates of hypertension in the country, ranked at 47 with 42.7% of the population having a diagnosis, and with Alabamians having a 10-percentage point higher hypertension rate than the national average, according to America’s Health Ranking.

The West Alabama Cardiovascular Health Program will offer services that assist communities with controlling blood pressure and cholesterol by helping people take medication regularly and guiding their diet and exercise. UA will also provide smoking cessation programming.

The program will also bring together local health care workers and community leaders to identify issues affecting health and provide a list of resources to address those barriers.

Through a collaboration with One Alabama Health Record, the team will also increase the use of health information systems to monitor and address the cardiovascular health of the targeted counties.

The program will allow for research on local community needs, how to best use health information data to improve community health and what interventions work best for each community.

“All of this is necessary to develop effective change,” Newman said. “Serving our state and conducting research are necessarily intimately intertwined.”

Along with Newman and Johnson, the West Alabama Cardiovascular Heath Program includes Dr. Christina Ezemenaka, assistant professor of nursing; Dr. Wanda Martin Burton, assistant professor of nursing; Dr. Letisha Scott, clinical assistant professor of nursing; and Dr. Matthew Hudnall, associate professor of management information systems and associate director of the Institute of Data and Analytics.

UA Receives $3.5 Million to Confront Nursing Faculty Shortage

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The University of Alabama Capstone College of Nursing is addressing the need to grow and diversify Alabama’s nursing education workforce with the support of more than $3.5 million in funding from the U.S. Department of Labor.

Dr. Susan Welch, associate professor with the Capstone College of Nursing, secured the funding from the department’s Employment and Training Administration’s Nursing Expansion Grant Program that supports innovative partnerships and strategies that expand and diversify America’s pipeline of qualified nursing professionals. Specifically, these grants will increase the number of nursing instructors and educators.

The American Association of Colleges of Nursing reports that only 17.3% of full-time nurse educators in the U.S. are from minority backgrounds. Additionally, one-third of the current nurse educator workforce is projected to retire by 2025.

Welch’s project, BAMA DIstance, aims to increase and diversify the number of nurse educators in Alabama through sustained partnerships between CCN, historically Black colleges and universities, and academic institutions with nursing student populations from underrepresented groups.

The project will recruit Bachelor of Science in Nursing-prepared nurses in Alabama to earn a Master of Science in Nursing degree with a nursing education specialty. Throughout the course of their studies, the program will support participants’ transition from clinical experts to clinical nurse educators.

“The National Academies of Medicine’s ‘Future of Nursing’ calls on nursing schools to address the nurse educator shortage from diverse populations to advance health equity,” said Welch. “BAMA DIstance aims to prepare a diverse population of registered nurses to enter the nursing education workforce, both addressing the nurse educator shortage and transforming the landscape of health care in our state.”

The U.S. Department of Labor Employment and Training Administration will award funding through the Nursing Expansion Grant Program to 25 public-private partnerships in 17 states.

UA Center to Address Substance Use Disorders and Health Equity

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TUSCALOOSA, Ala. – The University of Alabama will be home to a new research center dedicated to the prevention, treatment and management of substance use disorders.

The Board of Trustees of The University of Alabama System approved the Center for Substance Use Research and Related Conditions to focus across the lifespan of conditions to include integrated behavioral health, mental health and more.

Housed in the Capstone College of Nursing and in collaboration with the Alabama Life Research Institute, the mission of the CSURRC is to promote the health and well-being of individuals and communities affected by substance use disorders in Alabama and beyond through innovative, state-of-the-science and culturally responsive research that reduces health disparities, improves health equity and addresses social determinants of health.

“Across the country and in our state, substance use disorders are a critical public health concern made more challenging by limited resources in the areas of prevention, treatment and recovery, particularly in rural areas with poor access to health care,” said Dr. Suzanne Prevost, dean of the Capstone College of Nursing. “The focus of this center fits perfectly with the College, particularly our graduate programs preparing nurse practitioners, nurse administrators, nurse educators and nurse researchers to address the needs of rural communities in Alabama and throughout the U.S.”

The center’s scope is congruent with the state’s priority to combat the substance and opioid use pandemics, as well as the federal government’s initiatives to help end addiction long term, said Dr. Mercy Mumba, associate professor of nursing and center director.

“The center will provide a unifying unit for faculty, students and staff who are interested in substance use research and related conditions,” she said. “Having a center will further strengthen existing interdisciplinary collaborations among these researchers, while at the same time fostering new collaborations.”

Mumba has 10 years of experience as a researcher and scientist, with an extensive background and expertise in substance use disorders. Her funding portfolio of over $15 million represents research and programs all focused on substance use disorders and related conditions.

Another major goal of the center is to support the training of the next generation of researchers, scientists, educators and clinical practitioners. The CSURRC will strive to inspire undergraduates to conduct research, as well as to train graduate and postdoctoral fellows across campus.

“Dr. Mercy Mumba is the ideal nurse-researcher and leader to direct this work and mentor the many students and faculty who will collaborate through the CSURRC to develop and test solutions for the substance use crisis,” Prevost said.

In 2020, over 95,000 individuals died from drug overdoses in the U.S., and almost two-thirds of those deaths were opioid overdoses. Alabama has the highest per-capita opioid prescription rate in the nation at 120 prescriptions per 100 persons, double the national average.

University of Alabama receives $1.8 million to improve patient care in rural Alabama

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The University of Alabama’s Dr. Nathan Culmer (College of Community Health Sciences) and Dr. Todd Smith (Capstone College of Nursing) have received $1.8 million in funding this year from the United States Department of Agriculture Rural Development’s Distance Learning and Telemedicine grant program. This funding will significantly increase the Emergency Medical Services’ telemedicine capabilities in rural Alabama, connecting 49 ambulances with approximately 18 hospitals across 19 rural counties in Alabama.

“With this network of telemedically-equipped ambulances and emergency departments in rural Alabama communities, we anticipate better response times to and from patient sites, improved quality of care at the point of need, and reduced financial burden for both patient and provider,” said Dr. Smith. “Dr. Culmer and I feel that we have created a critical infrastructure of EMS telemedicine capabilities that will enhance patient care and outcomes in medically underserved communities across our state.”

Once fully implemented, the project will offer access to higher quality and more efficient patient care by transporting patients to the most appropriate healthcare facility or enabling emergency department personnel to determine that a patient should remain on site, potentially reducing unnecessary hospital transports and 30-day readmissions. Additionally, it will provide for the transmission of more detailed medical and video data directly from EMS providers to emergency physicians and advanced practice providers in emergency departments. With this advanced data and telemedical communications, patients with possibly life-threatening conditions can be transported to the most appropriate facility in the least amount of time, which could save lives and improve quality of life.

“Our earlier research found that telemedicine capabilities in emergency situations had not been widely implemented across the U.S., and especially in rural communities. In fact, we recently found only 13 previous studies directly related to prehospital telemedicine, most of which did not adequately address concerns related to quality, cost, and patient satisfaction,” said Dr. Culmer. “A project on this scale will not only enhance the quality of care for rural Alabamians but will provide data for future research in this critical area.”

This project will be implemented in the following Alabama counties: Bibb, Clarke, Clay, Cherokee, Choctaw, Coosa, Covington, Escambia, Greene, Hale, Lamar, Marengo, Monroe, Perry, Randolph, Sumter, Tallapoosa, Washington and Wilcox.  In 2020, these rural counties had a total of 56,346 EMS calls and 26,056 individuals were transported to a hospital emergency department.

 “Residents in rural Alabama often have limited transportation access due to geographic barriers, which can mean longer distances for ambulance travel, limited communication between first responders and physicians, and a limited number of ambulances spread over a wider geographic range,” said Dr. Elwin Crawford, Alabama State EMS Medical Director. “These factors ultimately yield longer wait times before a patient receives care in hospital facilities, poorer health outcomes, extended transition times, and less patient and provider satisfaction.”

“This project, along with other ongoing initiatives in our state, will do a great deal to address healthcare discrepancies in our rural communities.”

The USDA Rural Development’s Distance Learning and Telemedicine program helps rural communities use the unique capabilities of telecommunications to connect to each other and to the world, overcoming the effects of remoteness and low population density.

Photo captions: TOP: Drs. Nathan Culmer and Todd Smith. BOTTOM: Hale County EMS, represented by Duane Baines, Kade Roberts and Bailey Crawford, will implement the project, connecting telemedically-equipped ambulances and emergency departments in the communities they serve.

Bartlett Awarded $1.2 Million to Build Diversity in Nursing and among Nurse Scientists and Faculty in Alabama

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Dr. Robin Bartlett, Associate Dean for Research at the Capstone College of Nursing, and her team have received notice of a $1.2 million Science Education Partnership Award (SEPA) from the National Institute of General Medical Sciences (NIGMS) of the National Institutes of Health for their project, Health Sciences & Technology Academy-Alabama (HSTA-AL). The goal of HSTA-AL is to build a pipeline for underrepresented students to the field of nursing, teaching them to become change agents in their communities.

“Our nation is in dire need for more nurses, particularly nurse scientists, nurse faculty, and RNs from rural areas and diverse racial and ethnic backgrounds,” said Dr. Bartlett. “To change this dynamic, we must encourage students from underrepresented populations to enter the field of nursing before they graduate from high school.”

According to the American Association of Colleges of Nursing, nearly 40% of the U.S. population are Black, Indigenous, and people of color, but these groups comprise only about 20% of the nursing workforce and 16% of full-time nursing faculty.

Dr. Bartlett continued, “Nurses from underrepresented and diverse communities have the potential to become change agents in their communities, employing their understanding and expertise to address health inequities that lead to poorer health outcomes among underserved populations.”

This five-year program seeks to replicate West Virginia’s SEPA-supported Health Sciences & Technology Academy (WV HSTA), but with adaptations specific to the needs of rural Alabama (the program will initially focus its efforts in Hale and Pickens Counties). HSTA-AL aims to support inclusion in nursing, nurse faculty and nursing science roles by opening the doors to higher education for underrepresented high school students.

The SEPA funded WV HSTA has been in existence for more than 25 years and has graduated nearly 3000 students from the program, with an 89% graduation rate among those who matriculate to college. WV HSTA graduates often go on to pursue advanced degrees, and many choose nursing as a profession.

“We will build on WV HSTA’s successes, tailoring HSTA-AL to meet the unique needs of Alabama high school students,” said Dr. Bartlett. “We look forward to opening these students up to the possibilities of a biomedical career, especially a career in nursing.”

“The Hale County School System has a passion for providing opportunities for all students, not only in their education endeavors but also in life. This program will do both,” said Mr. Michael Ryans, Superintendent of Hale County Schools. “I believe that long-term, sustainable change will be accomplished through this program. Together, we can improve the health of Hale County residents while educating and preparing our youth to become the health care professionals of tomorrow.”

Steps taken to encourage students to pursue undergraduate degrees will include (but not be limited to): hosting summer camps on nursing, citizen science and rural health disparities; offering after-school clubs to engage students in community-based participatory research; and providing professional development to HSTA-AL in-service and pre-service teachers.

UA’s Capstone College of Nursing HSTA-AL team includes: Dr. Bartlett, Drs. Mercy Mumba, Paige Johnson and Michele Montgomery, and Mrs. Brandi Lester. Dr. Betty Key from Samford University is also a member of the team, as are Ms. Bethany Hornbeck and Dr. Ann Chester from Apis Creative and Drs. Alan and Sherron McKendall from West Virginia University.

Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health under SEPA Award Number R25GM142027. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

What is HSTA-AL?

Mumba Awarded NIH Grant to Aid in Reversal of Opioid Crisis

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Dr. Mercy Mumba, Assistant Professor at the Capstone College of Nursing, grew up in Zambia, where nursing was not a well-respected profession. After moving to the United States, Dr. Mumba earned her Bachelor of Science in Nursing from the University of Texas at Arlington. Only two years after graduating with her BSN, she entered a BSN to PhD program; and four years later she graduated with a PhD from UT Arlington’s College of Nursing and Health Innovation. A passionate researcher, Dr. Mumba has a number of funded grants, most of which concentrate on preventions and treatment of substance abuse disorders and their co-morbid psychiatric mental health conditions.

Dr. Mumba and her team have received notice of an award from the National Center for Complementary and Integrative Health (NCCIH) at the NIH for their proposal entitled “A Mindfulness and Peer Mentoring Program to Improve Adherence to Medication Assisted Treatment for Opioid Use Disorders.” This five-year project, funded through The Helping to End Addiction Long-Term (HEAL) Initiative, is the only one funded from the state of Alabama. This award is one of 375 grant awards across 41 states made by the National Institutes of Health in fiscal year 2019 to apply scientific solutions to reverse the national opioid crisis. Below, we asked Dr. Mumba to share some insight into this project.

Please describe the purpose and goal of this project.

The purpose of this project is to improve adherence to medication-assisted therapies for opioid use disorders, such as buprenorphine and methadone, among others by utilizing a combination of mindfulness-based relapse prevention and peer support specialists.  We are also trying to see if this intervention helps with reducing relapse, cravings, depression, anxiety and stress.

What are the plans and goals of each phase of the project?

In Phase 1, we will be piloting the feasibility and acceptability of this new intervention that we developed to see if it works and to see if people with opioid problems think that this is something they can participate in if it was available. We will also be examining the preliminary efficacy of the intervention in decreasing relapse, cravings, depression, anxiety and stress.

Please elaborate on the mentoring aspect of this study. Why mentoring is important to you?

There is a growing body of evidence showing that using peer mentoring in substance use recovery produces better outcomes. This is because patients have an accountability partner as well as a role model to look up to in their sobriety journey. The road to recovery is often difficult and can be lonely. Therefore, utilizing peer mentoring can improve social engagement, reduce isolation and provide a sense of belonging for individuals recovering from addiction.

What does this grant mean to you and your team?

Our team is excited about the opportunity to increase access to evidence-based treatment modalities for individuals with opioid use disorders. Alabama is one of the hardest hit states when it comes to the opioid crisis and yet, we also have serious problems when it comes to access to care. We believe that our grant is providing a much-needed service and has potential to reduce morbidity and mortality related to opioid misuse.

How do you hope this study will inspire or influence other nurses or researchers in the field?

I think this study challenges all of us to look at individuals with opioid use disorder from a holistic perspective. There are many issues that contribute to addiction and substance abuse; however, when we look at treatment options, they sometimes tend to neglect all the other problems that may have contributed to the addiction in the first place. This is why we believe that addressing co-morbid mental health and other psychiatric disorders in this population is an integral part of promoting sustained recovery.

Dr. Mumba is the principal investigator and program director. Her co-investigators include Drs. Andrea Glenn (Psychology), George Mugoya (Educational Counseling), Rebecca Allen (Psychology), David Albright (Social Work), Lori Davis (Tuscaloosa VAMC), Joshua Richman (Tuscaloosa VAMC) and Ms. Austin Butler (Alabama Community Care).

Research reported in this publication was supported by the National Center for Complementary & Integrative Health of the National Institutes of Health under Award Number R61AT010802. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.