Children with uncontrolled asthma are three to six times more likely to be hospitalized. It is necessary for parents and children to collaborate in order to help the child successfully manage their symptoms, yet few solutions exist to support this parent-child shared management. A novel mobile health application was designed and tested with 54 parent-child dyads in an eight-week pilot randomized controlled trial (RCT). The goal was to see if proper planning, communication and using an asthma monitoring watch would improve symptom monitoring in children with asthma. During this study, the watch detected the children’s asthma-related symptoms as they occurred. On a web application, both the parents and the children were asked to collaborate to enter reminders for medicine, summaries for any symptoms, etc. After 8 weeks, the parents and children completed semi-structured interviews where they reported any improvements in their asthma symptoms and general feedback regarding the app. We conducted qualitative analysis by writing codes based on the patterns observed in the user survey responses analyzed. Finally, we compiled our findings into a code book which serves as a guide for upcoming trials. The interview findings revealed that families found the intervention to be helpful for reducing asthma related flare-ups. However, the sync between the watch and the app, integration of the spirometer results with the app, and making the web application interface more kid-friendly are all recommended refinements to consider before the project is scaled for a larger clinical trial.

With the human life expectancy doubling in only the last 100 years, science has opened us up to this new found idea of longevity and healthy aging. Congruently, people living with HIV have longer life expectancies and can expect to live as long as those who do not have HIV. Healthy aging strategies to navigate living with HIV have only recently developed. The purpose of this study is to explore the associations between physical activity and cardiorespiratory fitness (VO2 peak) in older adults living with HIV. We will conduct a secondary analysis of cross-sectional baseline data of older adults living with HIV, who are participating in the HEALTH randomized clinical trial (ClinicalTrials.gov NCT04550676). This secondary analysis focuses on data involving waist-worn actigraph GT3X/1 monitors, home based actigraphy, and graded exercise tests involving VO2 max that are collected from the ongoing HEALTH clinical trial. We will analyze VO2 max and accelerometry data at baseline between decades of people in their 50, 60, and 70s. This sample is approximately 50 older adults with HIV. We will use descriptive analysis, Pearson correlation coefficient, and Chi-squared test. VO2 max is a valid measure of cardiovascular fitness and aerobic endurance based on the maximal oxygen consumption of individuals during an exercise protocol. This project cultivates an awareness around healthy aging strategies and bio behavioral interventions with a population that has low cardiorespiratory fitness. Both cardiorespiratory fitness and physical activity have been poorly measured using self-report methods in older adults. This secondary analysis uses gold standard objective measures (VO2 Max) to show data points with relation to variability in exercise. This data empowers people living with HIV to engage in strategies to improve their physical function and suggests the need for more bio behavioral interventions to be defined in order to facilitate healthy aging.

Cancer is often a life-changing diagnosis that can be extremely difficult to navigate. Parents diagnosed with cancer face not only the burden of their disease, but also the burden of the disease on their children. In addition, previous research has shown a difference in experience for parents diagnosed with terminal cancer compared to those diagnosed with non-terminal cancer, with or without children. These families need support in communicating with their children. However, there is insufficient research about interventions that support parents' engagement in meaningful conversations about the illness. To begin providing these families with the tools they need to endure a cancer diagnosis, one must first discuss what concerns need to be addressed. The purpose of this study is to examine and contrast parent-reported concerns about the children's response to the parent's cancer for parents with early-stage cancer (stage I-III) compared to late-stage cancer (stage IV). Thirty-six mothers from a recently published clinical trial comprised the sample of parents with early-stage cancer. Parents were eligible if they had one or more dependent children five to twelve years of age and were recently diagnosed with stage I-III cancer. Parents' responses to the question "What questions do you have about what your child is thinking or feeling about the cancer?" were transcribed and inductively coded by these authors using content analysis methods adapted from grounded theory. Peer debriefing and an audit trail were established to protect the trustworthiness of results. Four of the resulting domains from parents with early-stage cancer mirrored those of parents with late-stage cancer and there were two major differences found between the two study samples. Contrasting these study results adds to our understanding of the unique or common needs for parents with early-stage versus late-stage cancer and informs future supportive interventions. 

 Patients with end-stage renal disease (ESRD) are 25 times more likely to be admitted to an intensive care unit (ICU) compared to those without ESRD. About 70% of ICU patients are aged 55 and older. Older ICU survivors may report new impairments in cognitive, physical, and psychological health, referred to as post-intensive care syndrome (PICS). It is unknown whether older ICU survivors with ESRD experience greater severity of PICS symptoms than those without ESRD. We conducted a secondary analysis of pooled data from 2 studies of 51 older ICU survivors. Diagnosis of ESRD was obtained from electronic health records. Assessments from the National Institutes of Health Toolbox (attention, cognitive flexibility, grip strength, dexterity) and Patient-Reported Outcomes Measurement Information System (depression, anxiety) measured PICS symptoms. Wrist actigraphy measured activity and sleep. We conducted independent samples t-tests to compare fully corrected T scores of each PICS symptom between older ICU survivors with ESRD and those without ESRD. Results indicated older ICU survivors with ESRD scored worse on attention (25 ± 10.3) compared to those without ESRD (33.8 ± 6.9), t(48) = 2.76, p = 0.008. Older ICU survivors with ESRD also scored worse on grip strength (24.8 ± 14.9) compared to those without ESRD (39.1 ± 12.6), t(48) = 2.54, p = 0.014. Older ICU survivors with ESRD were less active during the daytime (21.2 ± 10.3 activity counts/minute) compared to those without ESRD (51.9 ± 33.1), t(48) = 2.25, p = 0.03. Older ICU survivors with ESRD slept more during daytime hours (70.5%) compared to those without ESRD (51.2%), t(48) = -2.53, p = 0.015. Older ICU survivors with ESRD may be at risk for PICS throughout recovery from critical illness. Further research with targeted interventions focusing on screening and treating PICS symptoms is needed to improve health in this population.

With the war in Ukraine and President Biden’s announcement in 2022 sponsoring resettlement for 100,000 Ukrainians, approximately 14,000 refugees have entered Washington State. However, there has been insufficient research on the needs specific to this community, such as differing vaccination practices in their home country stemming from inadequate vaccine procurement and mistrust in vaccinations among the general population. Mental health issues also pose a concern in Ukrainian refugees who will need care for PTSD, anxiety, and depression to prevent long-term consequences. The aim of this project is to create a cultural profile for Ukrainian immigrants and refugees for EthnoMed, an ethnic medicine resource website by the University of Washington and Harborview Medical Center to inform healthcare providers in delivering culturally-appropriate care. In exploring the experiences of the community with the U.S. healthcare system and services in Washington, the project will involve identification of community approaches to healthcare and barriers to care, as well as background information about Ukrainian values, beliefs, and perceptions that impact their approaches to health. Research will be conducted in the form of a literature review, conversations with community members, and a review of community surveys conducted by students from the University of Washington in partnership with Nashi Immigrants Health Board – a registered non-profit organization serving Ukrainian communities in Washington – and the WA Department of Health Former Soviet Union workgroup. The profile will be published on the EthnoMed website and will provide healthcare workers with guidance regarding cultural considerations and needs of the community with input from community members. The work is intended to improve the community's use of the healthcare system and services leading to improved health outcomes, and identify barriers that may be improved to support the community's resettlement in the U.S.

The prevalence of diabetes has increased dramatically and affects at least 285 million people worldwide. Diabetes is expected to increase to 438 million over the next eight years. Insulin resistance (IR) is a mechanism involved in the development of Type II Diabetes Mellitus (T2DM) that often appears years before diagnosis. The evaluation of IR holds the promise of earlier identification and mitigation of diabetes risk. Acanthosis nigricans (AN) is an early indicator of IR, marked by the velvety thickening and darkening of the skin in areas including the neck, armpits, knuckles, elbows, and knees. In a prior study, Burke et al. (1999) developed a rating system whereby clinicians rate the presence and severity of AN. In the current study, this system was modified to expand its use to non-clinicians working in research and other non-clinical settings. Specifically, in a convenience sample of 43 mother-child dyads recruited from a larger study, a protocol was devised in which photographs of specific views of the neck were taken for later visual inspection and rating by three trained raters. Ratings were then examined in relation to cardiometabolic risk factors. Results showed body mass index (BMI) and BMI percentile were significantly higher among mothers and children, respectively, who exhibited AN (vs. AN absent) (all ps<.01). Glycosylated hemoglobin A1c did not differ between groups. The development, implementation, and testing of this modified AN rating system is a preliminary step in the creation of an alternative approach to the assessment of AN. It can be implemented without clinical expertise, does not require physical contact, and can be used retrospectively. This tool may be useful to researchers, and public health practitioners, making the early identification of IR and other prediabetic conditions more accessible outside traditional clinical settings and increasing opportunities to enhance cardiometabolic health more broadly.