Trainee Projects

Community Health Worker Perspectives on Healthy Lifestyle Counseling and Weight Stigma

Dedeepya’s study

The way that we currently identify and address what we consider elevated weight as an indicator of elevated cardiometabolic risk in a primary care clinic setting is suboptimal due to a variety of barriers including limited time and contact opportunities, risk to therapeutic relationship when raising a sensitive topic in the setting of insufficient trust, lack of access to effective treatment options and referral resources, and limited ability to address many social determinants of health that affect the obesogenic environment. We hypothesize that community health workers (CHWs) could be instrumental in helping to address and facilitate healthy lifestyle changes within a trusted relationship and without some of the constraints found within a primary care clinic.

We plan to use semi-structured interviews to elicit the perspectives of local CHWs on the concept of weight stigma and how it may or may not affect the conversations they have with clients about weight and healthy lifestyle. We will also elicit perspectives on their current standard of care and approach to conversations about nutrition and exercise as well as their ability to connect clients to needed resources and care and address barriers related to social determinants of health. We aim to use this information to eventually develop a curriculum to better prepare CHWs to have sensitive conversations about weight and healthy lifestyle with adolescents and families using non-stigmatizing and strength-based language and informed by updated evidence about the obesogenic environment.

Adapted socioecological model of the obesogenic environment for adolescents with nonbehavioral factors and opportunities for intervention

Dedeepya Konuthula, Research Fellow

Dedeepya is a primary care research fellow at the University of Chicago. She is also a Master of Science in Public Health Sciences for Clinical Professionals student.

Specific Aims

To elicit CHW perspectives on their experiences with addressing weight, health behaviors, and social needs with families, as well as CHW needs for future training.

Tobacco Knowledge, Attitudes, and Services Among Spanish-speaking Community Health Workers

Plamena’s study

African-American women with breast cancer have a disproportionately higher risk of mortality, although their overall incidence of disease is lower. Despite this, advance care planning (ACP) and consequent code status documentation remain low in this vulnerable patient population. These code status orders [i.e., Full code, Do Not Attempt to Resuscitate (DNAR), Do Not Intubate (DNI)] allow consideration of patient preferences regarding the use of aggressive treatments, such as cardiopulmonary resuscitation and intubation. Therefore, this project aims to investigate the racial disparities in code status documentation in women with breast cancer.

Code status transitions: From first to second order

Half of the patients with any code status orders had more than one order. This figure portrays their changes from first to second order.

Plamena Powla, Educational Trainee

Plamena is an educational trainee at the C.H.A.T. lab working on a project related to advance care planning and code status documentation in women with breast cancer.

Specific Aims

To characterize the rates and timing of code status documentation among racial groups.
To examine the temporal changes of code status orders.
To determine which factors affect the presence of code status documentation after first hospital encounter for breast cancer.