Increased specialization within the forestry industry has led to the rise of a distinct industry known as forestry services. Whereas logging historically encompassed this work, a separate population increasingly participates in the remote grooming and tree planting of forest lands. Physically demanding, dangerously hazardous, and low paying, forestry services work in the Pacific Northwest predominantly employs Mexican and Central American immigrants. As an extension of my honors project at the UW School of Nursing, I examined how occupational injury among this group of workers with correlates with attitudes that workers and employers hold about their work environments. Performing a secondary analysis using survey interview data collected by the UW Pacific Northwest Agricultural Safety & Health Center, and the Northwest Forest Worker Center, I identified top risk perceptions and barriers to workplace safety as reported by workers, as well as by a set of employers and supervisors. Not only was there variation in the prevalence of worker injury between different employers, there was also variation in the perceived attitudes about workplace safety. In future research, it will be possible to link the experiences of workers with the attitudes and policies of those who employ them.

Forefront Cares is one of services provided by Forefront Suicide Prevention, a center at the University of Washington School of Social Work. Suicide loss survivors receive care packages and have the opportunity to be connected to mentors, who are also suicide loss survivors and are specially trained to provide support to new loss survivors. The goals of Forefront Cares are to offer support to suicide loss survivors and to help them find resources that are appropriate for their individual needs. The purpose of this study was to examine participants’ perceptions of Forefront Cares, including what is helpful and what could be improved, through an online satisfaction survey which I created. I then sent e-mails to individuals who received a Forefront Cares package between January 2013 and December 2017, inviting them to participate in the study. Those who participated completed a brief anonymous online survey, which involved rating experiences with Forefront Cares. Questions addressed how helpful they found the package they received and what they found most or least helpful. Participants who had a Forefront Cares mentor were asked to rate how helpful that experience was. The data collection ended in mid-April, and I analyzed data with assistance from my mentor. Results will help determine what participants found more and less useful, as well as the acceptability of the Forefront Cares package and mentor process. It is expected that findings will indicate the importance of community support in the grief journey of newly bereaved suicide loss survivors. The creation of the satisfaction survey was intended to be a starting point in establishing ongoing analysis of Forefront Cares, as Forefront currently lacks permanent evaluation tool to assess their services. Information obtained will help improve the Forefront Cares process for future participants.

The population of refugee and immigrant families in Seattle's Lake City neighborhood has grown significantly in the last decade.  Despite the health challenges these families often face, no one has performed a systematic assessment of the health needs specific to this population.  Our project aims to provide preliminary data about the health needs of refugee and immigrant children and families in the Lake City neighborhood, as well as resources available to assist them.  This analysis is timely and relevant for community stakeholders, such as the non-profit Refugee Women's Alliance (ReWA), who are currently expanding services for refugee and immigrant children in Lake City.  We used mixed methods to assess the health and health-related resources relevant to preschool age children of refugee and immigrant groups in the Lake City neighborhood.  These methods included key informant interviews with individuals knowledgeable about the health of refugee and immigrant families in Lake City, as well as analysis of publicly available secondary data.  Interpreting the interviews using relevant secondary data provides a holistic initial picture of the physical, socio-economic, educational, cultural, and community factors contributing to the health and wellbeing of refugee and immigrant children and their families in Lake City.  We anticipate our research findings will reveal a culturally diverse community with distinct needs, as well as many existing community resources—assertions confirmed by preliminary results.  The results of this study will both inform ReWA's early childhood education programming, and give healthcare providers and community organizations in the area a more comprehensive understanding of refugee and immigrant needs.  Because this project has stimulated community interest in further research relating to these populations, this study can also serve as a platform for future work in the area. 

The use of Potentially Inappropriate Medications (PIM) in elderly is common and can lead to increasing risks for adverse drug events, morbidity, and increased utilization of health care resources. Early identification of PIM can improve the quality of care in elders and reduce hospitalizations. This study aims to identify PIM in a sample of N=60 people living with dementia who recently experienced a hospitalization and to evaluate what PIM are most common. We also aim to evaluate correlations between PIM and the number of patient’s chronic conditions and the total number of medications. Our hypothesis is that patients with higher burden of illness (more conditions and medications) can have higher number of PIM. We identified PIMs by evaluating medical records using the STOPP/START criteria. The STOPP/START criteria classify inappropriate medications that should be stopped as well as the appropriate medications that should be started instead.Descriptive statistics was used to describe the sample and the prevalence of PMI, chronic conditions and medications. Correlation analyses was used to explore relationships between the variables. Study findings will inform healthcare providers about the prevalence of PIM and help identify patients who are at higher risk of PIM.

Fetal ultrasounds are frequently associated with joy and happiness for expecting mothers, however, women seeking termination can be subjected to emotional and financial distress due to mandatory ultrasound screenings. My literature review examined how different ultrasound laws and healthcare coverage impacted women in Washington and Texas. These states have very different regulations and coverage for ultrasounds during pregnancy or termination. To do this, I examined laws in each state regarding fetal ultrasounds to see if there were benefits or disadvantages for women choosing to carry their pregnancies to term versus choosing to terminate. My findings showed women seeking termination in Texas undergo a mandatory viewing of their fetal ultrasound before they can access termination, whereas, women in Washington are not required to do so. Payment coverage for ultrasounds also varied between states. Differences in required payment for private insurance and Medicaid disadvantaged women in Texas, but not Washington. My findings showed Texas Medicaid did not cover the mandatory ultrasound before termination, whereas Washington Medicaid covered all termination services. Texas Medicaid was also shown to offer less coverage for women intending to carry their pregnancies to full term than private insurance. Depending upon geographical residence and health insurance status, the ultrasound experience will vary significantly, especially for women seeking termination. With this research, I hope to increase awareness of the effects of mandatory ultrasound laws and gaps in payment coverage for women covered by Medicaid. Drawing attention to this issue and starting a conversation is the first step in moving towards an equitable health care system.