The Division of MCH Workforce Development (DMCHWD) supports interdisciplinary and interprofessional education and training programs that emphasize leadership and family-centered, community-based, culturally competent systems of care. This month, DMCHWD shares interdisciplinary and interprofessional highlights from across the network.
In 1947, the first federally funded long-term MCH training programs at universities were established. The primary goal was to train administrators with a public health and child/family focus for the new programs being developed in states under Title V. Learn more about training-related points in history and more on the MCH Timeline.
UC Berkeley's Cassondra Marshall DrPH, MPH Receives NIH Career Development Award to Support Reproductive Decision-Making among Black and Latina Women with Type 2 Diabetes
UC Berkeley Center of Excellence in Maternal and Child Health
Cassondra Marshall DrPH, MPH, Assistant Professor in Residence in Maternal, Child and Adolescent Health at UC Berkeley School of Public Health, has received a Mentored Research Scientist Career Development Award from the NIH National Institute on Minority Health and Health Disparities. The award will allow Dr. Marshall to achieve her long-term goal of advancing reproductive and maternal health equity through the translation of evidence into practice, focusing on type 2 diabetes among racial/ethnic minorities.
Type 2 diabetes, linked to maternal and neonatal morbidity and mortality, is increasing among women of childbearing age, with Black and Latina women disproportionately affected. Dr. Marshall hopes to develop new evidence-based strategies to implement clinical guidelines for improving reproductive outcomes among adult women with type 2 diabetes.
Dr. Marshall will receive training in person-centered and structurally competent reproductive health interventions, advanced mixed methods, implementation science and stakeholder engagement, and designing and implementing trials in the primary care setting. She will work with an interdisciplinary mentoring team which includes Dr. Hector Rodriguez, health policy expert from UC Berkeley School of Public Health; Dr. Christine Dehlendorf, MD, MAS, family physician and professor at UCSF with advanced training in family planning; Margaret Handley, PhD, MPH, professor of biostatistics and epidemiology at UCSF; and UC Berkeley-trained health services and policy expert Dr. Julie Schmittdiel from the Kaiser Permanente Division of Research.
Says Dr. Marshall, "I am thrilled to receive this career development award that will further my training and equip me with the skills to develop, implement, and evaluate person-centered interventions to advance reproductive and maternal health equity, and to collaborate with community health centers, which provide an excellent setting for this work focused on the understudied intersection of family planning services and chronic disease management."
Angela Miney, BA, Receives AMCHP's Merle McPherson Family Leadership Award
University of Florida College of Medicine Pediatric Pulmonary Center
Angela Miney is the Family Partner of the University of Florida College of Medicine Pediatric Pulmonary Center (UF PPC) and the coordinator of the Florida Family Leader Network (www.floridaleaders.org ). In this role, she works with the Health Resources and Services Administration's Maternal and Child Health Bureau (HRSA MCHB) funded organizations, proving her depth of knowledge regarding family-centered care, engagement, and leadership to related projects. Ms. Miney has accomplished and contributed in many ways to increasing family involvement across AMCHP and Title V efforts. One of the most significant examples was a proposal for Florida to benefit from a network of family leaders and health care champions, with her recommendation at a 2016 statewide meeting of HRSA MCHB funded organizations, that quickly developed into a formal partnership with Florida's Title V CYSHCN Program and the UF PPC to develop and grow such a network. In a few short years, Ms. Miney created the framework, initiated the startup and has overseen the growth of the Florida Family Leaders Network (FFLN) to over 200 members. Currently, the FFLN is an organization committed to supporting CYSHCN with an international reach. Ms. Miney has been a member of numerous committees at the University of Florida College of Medicine and has presented several chronic illness and family-centered presentations, as well as research and publications.
The Transformative Effect of Interdisciplinary Training
University of Minnesota Leadership Education in Adolescent Health
Interdisciplinary training, foundational to the University of Minnesota LEAH program (UMN-LEAH), is the reason the current first-year cohort of fellows chose this fellowship program. These fellows, representing medicine (general and development/ behavioral pediatrics, and family medicine), nursing, social work and kinesiology, came to the fellowship with experience working with other disciplines. Yet this intensive submersion into micro- and macro-level approaches to supporting adolescent and young adult health was beyond what they expected.
"It's intellectually humbling"
UMN-LEAH Fellows participate in a range of opportunities to learn and work together. Hearing how other disciplines approach the same issue is a consistent discussion point. After immersion in a particular discipline's academic training, it can be 'intellectually humbling' to understand that no one discipline has all the answers to what young people need for healthy development. Beyond a simple exchange of perspectives is the possibility to integrate other disciplines' perspectives in a way that is transformative. The formative experiences of collaborative research, teaching one another from their own areas of expertise, learning skills and techniques from clinical care to systems change, helping one another find and express leadership, along with time for reflection has shifted fellows' views of young people's development and how best to support their health. After 9 months together – despite having never met in person – UMN-LEAH fellows have found that their interdisciplinary training coupled with a breadth of experiences offered by the program has expanded their vision of what a future career might look like.
Interdisciplinary Training = More Allies
An interdisciplinary approach opens the door to seeing the overlap of issues and interests. For example, a social work fellow working in foster care found an unexpected partner in an adolescent medicine fellow working with homeless and highly mobile youth. A kinesiology fellow interested in physical activity as central to healthy youth development found shared interests with a developmental/behavioral pediatrics fellow working to find everyday activities for patients with disabilities. Fellows are building life-long relationships across disciplines focused on shared outcomes of health and well-being of young people. As one fellow noted: "Interdisciplinary training creates more allies in the fight!"
National MCH Trainee Blog Authors Reflect on their Interdisciplinary/Interprofessional Work
University of Minnesota Center of Excellence in Maternal and Child Health
The National MCH Trainee Blog is a trainee-led site hosted by the University of Minnesota (UMN) Center for Leadership Education in Maternal and Child Public Health and the University at Albany Maternal and Child Health (MCH) Public Health Catalyst Program. This blog, co-edited by trainees Alexis Chavez (UMN) and Alyssa Pochkar (Albany), is for MCH students from HRSA-funded Centers of Excellence (COEs) in MCH Education, Science, and Practice programs and Catalyst programs to share their MCH research and practice experiences.
Trainee authors have exemplified interdisciplinary/interprofessional work in their involvement with the MCH populations. Ariana Roman, trainee at the University of Illinois-Chicago COE in MCH, and her peers wrote about exploring the relationship between Adverse Childhood Experiences (ACE), parental separation, and youth having higher odds of receiving specialized education plans. Their efforts required collaboration and teamwork, and an interdisciplinary review of community health sciences, epidemiology, and environmental and occupational health research and data.
Natasha Borgen and Cheralynn Corsack, trainees at the University of California, Berkeley COE in MCH, and undergraduate Hailey Windsor, wrote about hosting a student-led Human-Centered Design Workshop focused on answering the question "How might we reframe preconception health to be inclusive and center the current and future health of the community using stage-of-life relevant messaging?" This method allowed for different activities focused on team-building, collaboration, social innovation, and systems change, and helped students practice an approach they could later use in their public health careers. Of the experience they said, "...we learned that [this] is a collaborative approach to problem-solving that not only encourages interdisciplinary team-work, but relies on it. It is a creative process that is grounded in empathy and puts people first; it is a process that is rooted in deep learning through continuous inquiry and a willingness to learn through failure."
New blog posts resume in fall 2021, so check back to learn how MCH trainees from across the nation are contributing to interdisciplinary/interprofessional and other public health efforts.
By Alexis Chavez, Trainee, and Sara Benning, Center for Leadership Education in Maternal and Child Public Health (UMN COE in MCH)
GET MINDFUL: Interdisciplinary Development of a Parent Wellness and Support Group for Parents of Individuals on the Autism Spectrum
University of California Davis Leadership Education in Neurodevelopmental and Other Related Disabilities
Shereen Cohen, Ph.D., is a psychology postdoctoral fellow and LEND trainee at the University of California Davis MIND Institute. As her Leadership project, she decided to develop an online parent wellness and support group for parents of individuals on the autism spectrum. To ensure an interdisciplinary focus, Dr. Cohen worked with two of her fellow LEND trainees, Abiramy Duraiswamy, parent of an autistic adolescent, and Kristen Wallman, M.A., social work intern and parent of two young adults on the spectrum, to create a program grounded in principles of Mindfulness-Based Stress Reduction and Positive Psychology.
Parents of children diagnosed with autism report higher parenting stress than parents of typically developing children, or even parents of children with other disabilities. This population of parents has been under even greater stress since COVID, becoming not only full-time parents but teachers and ABA providers as well. Given limitations of services, it was imperative to offer this group via video conferencing platform. Parents participated in 6 weekly sessions to learn, practice, and discuss tools and strategies for managing stress and improving well-being, with a focus on topics related to self-care, mindfulness, grief, self-compassion, strengths, and resources.
GET MINDFUL has run for two cycles, serving 24 parents. Participants completed self-report measures of parenting stress, family empowerment, and satisfaction with life. Based on preliminary data, participants showed significant reductions in parenting stress, as well as trends toward increases in family empowerment and satisfaction with life, after the group. Participants reported appreciating the convenience of the telehealth approach. Participants also offered feedback and suggestions for improving the group in the future. Modifications are currently underway in preparation for a third cycle.
We intend for this group to continue forward, not only as a resource for parents, but also as a wonderful training opportunity for future trainees. The remarkable diversity of personal and professional backgrounds of the three creators of this group led to a rich and meaningful experience for facilitators and participants alike. The parent perspective, along with the advanced mental health education backgrounds of the facilitators were instrumental in the development and implementation of this program, and we are excited to see the ongoing development with future trainees and participants.
Telehealth in Oklahoma: A New Opportunity
University of Oklahoma Leadership Education in Neurodevelopmental and Other Related Disabilities
The University of Oklahoma Health Sciences Center interdisciplinary JumpStart clinic at the Child Study Center evaluates children under 7 years of age who are at risk for autism spectrum disorder. The JumpStart team includes two OKLEND (Oklahoma Leadership Education in Neurodevelopmental and Related Disabilities) graduates, one who is the Co-Director of the OKLEND program, and one who is a third-year developmental-behavioral pediatrics fellow. The interdisciplinary team also includes a first-year DBP Fellow/OKLEND trainee, a psychologist (who is also a faculty member in OKLEND), an occupational therapist, a speech-language pathologist, and a family partner. A variety of learners observe and assist in this clinic setting; the learners include medical students, residents, and fellows, as well as OKLEND trainees from up to 16 different disciplines.
As the COVID-19 pandemic began, the JumpStart clinic team quickly realized the need to adapt to continue serving children and families despite new restrictions. The team brainstormed about the possibilities and developed strategies that included use of the Developmental Profile and the Tele-ASD-Peds as our primary assessment methods. The team conducted clinic appointments using distance video conferencing software with appropriate consent obtained from the caregivers beforehand. The team had brief preparation sessions virtually the day before the clinic sessions to determine how best to evaluate our patients. During the pandemic, the JumpStart team saw 30 children virtually with 63% of them receiving an autism spectrum diagnosis.
The virtual JumpStart clinic has been effective to continue the work of diagnostic assessment and provide valuable recommendations to the families. An unexpected benefit of the telehealth option was the opportunity to see the children in their home environments where they interacted more naturally with family members. Additionally, families who lived long distances from the clinic were able to avoid the time and expense of transportation, and OKLEND trainees from distant areas of the state were able to participate. The JumpStart clinic team is developing more telehealth assessment options for families. The team also hopes to work together on early childhood developmental assessments in underserved, tribal, and rural communities through telehealth and mobile outreach initiatives.
It Matters – A Parent Panel : It is their journey, not ours. Let's walk beside them.
Rhode Island LEND
Alexia Arriaza, Amanda Silva
Jennifer Franchetti, Margaret Greene-Bromell
It Matters project's goal is to lend perspective to professionals around a family's journey through diagnosis and services. Our hope is that providers take away a different perspective and learn how important it is to look at the big picture, understand the grief cycle and most of all learn how important it is to meet these families where they are.
Because a family's story matters.
It Matters – A Parent Panel will help professionals gain insight into the family perspective. These experiences can be used to learn how to better support families in their own journey. Through this work we hope to build stronger partnerships between providers and families.
The panel will help providers foster stronger trusting connections that will result in a better understanding of the family. In turn this will only improve the supports and resources provided to them.
The resource portion of this panel aims to help providers become more familiar with state resources that are available to families. Often when professionals enter their fields as new graduates, they are often unaware of resources in the state or how to assist families in accessing them.
The It Matters team presents 45–60-minute panel discussion, a viewing of "A Family's Journey," a resource review and then a 30-minute Q & A session at the end.The It Matters participants have been working with state colleges and universities on ways to include this project into their curriculum for teacher candidates and with the schools of social work. Our goal is that this will expand their knowledge on resources available to their future clients, students, and families.
An Interdisciplinary Approach to Tackling Maryland's Child Mental Health Needs
Maryland Behavioral Health Integration in Pediatric Primary Care (BHIPP)
Maryland Behavioral Health Integration in Pediatric Primary Care Telepsychiatry Access Program (BHIPP TAP) is a Pediatric Mental Health Care Access (PMHCA) awardee that provides support to pediatric primary care providers in addressing the behavioral and developmental needs of their patients. BHIPP offers telephone consultation, resource and referral networking, care coordination, telemental health services, training and educational opportunities, and social work co-location in primary care practices in collaboration with Salisbury University (SU) and Morgan State University (MSU).
Since 2012, BHIPP has collaborated with SU to offer regionally specific social work co-location in select MD primary care practices in the Mid and Lower Shore and Western MD. In 2019, BHIPP launched a new partnership with MSU to expand this model to Baltimore City practices and address the unique needs of urban providers and families.
In this model, Master of Social Work (MSW) students are trained and placed in primary care offices to serve as co-located mental health providers. BHIPP collaborates with faculty from SU and MSU to provide training and host monthly consultation calls that allow each student to present a case to a BHIPP consultant for feedback.
Students are embedded in primary care settings and work side by side with the medical team to address barriers to improving patient health. Patients receive mental health evaluations and care faster, without the months of waiting common in many facilities, which often leads people to give up trying to get care for behavioral health issues. BHIPP interns can provide support with screening, case management, and brief interventions for common behavioral health concerns such as ADHD, anxiety, depression, and to support positive parent-child interaction.
In addition to increasing access to evidence-based behavioral health treatment services for patients at the host sites using this interdisciplinary approach, the co-location component of BHIPP also contributes to the development of the local behavioral health workforce.
For more information please visit the Maryland BHIPP website.
29 MN LEND Fellows Complete Year - Online
University of Minnesota Leadership Education in Neurodevelopmental and Other Related Disabilities
Capping a year of learning and interacting almost entirely online, the 29 graduates of the Institute of Community Integration's (ICI) Minnesota Leadership Education in Neurodevelopmental and Related Disabilities (MN LEND) certificate program recently closed out their final ceremony with a few last words of their own.
"I am changed."
"A place where we begin, but not where we end."
"An astonishing amount of information."
"Disability is not the problem. [Lack of] accessibility is the problem."
"You've given me space to learn, and a voice to advocate for families like mine."
"Take this knowledge and pass the mic."
The online gathering celebrated not only the fellows' learning about disabilities and disability advocacy, but also showcased the projects each one pursued during the year. They included fine-tuning a national survey of family caregivers, helping create a roadmap for distinguishing between symptoms of trauma and presentation of neurodevelopmental disability characteristics, and conducting a survey of dentists exploring the extent to which they treat patients with neurodevelopmental disabilities. Another team focused on inclusion efforts at faith-based organizations. Others focused on the intersectionality of disability with characteristics including race and sexual orientation.
"Participating in MN LEND has shaped me as a leader more than I could have anticipated," said Sally Sexton (left), a fellow who helped develop the Minnesota Inclusive Higher Education Consortium, a learning community that aims to expand postsecondary opportunities for students with intellectual disability.
MN LEND is an interdisciplinary leadership training program spanning approximately 14 disciplines across the University of Minnesota, funded by the Maternal & Child Health Bureau.
Minnesota Lt. Gov. Peggy Flanagan, in a recorded message, lauded the graduates for delving into the deep inequities that the COVID-19 pandemic exposed. "I know the past months have been incredibly challenging," she said. "But each and every one of you rose to that challenge."
State Senators John A. Hoffman and Jim Abeler, as well as Deeqaifrah ("Deeqa") Hussein (MN LEND Fellow, 2017–18), a director of special education for Minneapolis Public Schools, attended the event and addressed the graduates.
ICI Director Amy Hewitt acknowledged the difficulties fellows faced in navigating their learning experience and the rest of their lives during the pandemic.
"Despite the barriers and hurdles, I know you've made lasting connections," said Hewitt, part of the MN LEND leadership team. "Your tenacity…and commitment to improving the lives of people with intellectual disabilities is a true sign of the leaders you are and will continue to be."
Andrew Barnes, a University of Minnesota Medical School associate professor and a member of the MN LEND leadership team, urged fellows to take their experiences during the year and turn them into learning opportunities for others.
"Stay alert for a ready and willing student to appear before you," he told the fellows. "Speak to a group. Serve on a board. Write new laws. You'll do all this and more because you are the good in the world, and you are the teachers now."
Interprofessional Approach to Addressing Mental and Behavioral Health Needs in Pediatric Primary Care
KSKidsMAP Pediatric Mental Health Access Program
Interprofessional work is integral to Kansas' PMHCA program, KSKidsMAP. At the heart of the program is the Pediatric Mental Health Team (PMHT), which includes two board-certified child and adolescent psychiatrists, a board-certified child and adolescent psychologist, a board-certified pediatrician, and a licensed social worker care coordinator. Having Dr. Kari Harris, pediatrician, on the PMHT adds validity to the team. She acts as a liaison to KSKidsMAP participants and shares her primary care expertise with the PMHT. Equally important is the team's social worker, Polly Freeman. Polly's expertise has proven to be invaluable in recommending and locating resources for PCPs who participate in the TeleECHO Clinic or request a case consultation. Many PCPs lack social workers in their offices, and Polly's ability to help with the "leg-work" of finding resources has been highly valued by participants. One physician said, "Thank you so much for coordinating this and providing this resource. It is a relief to have this resource – It really makes a difference...really glad we have a plan," in response to Polly's care coordination efforts.
TheKSKidsMAP TeleECHO fosters interprofessional collaboration. Currently, the program has had engagement from social workers (n=5), register nurses (n=3), physician assistants (n=3), nurse practitioners (n=26), pediatricians (n=44), family medicine physicians (n=29), child and adolescent psychiatrist (n=2), general psychiatrists (n=1), clinical psychologist (n=3), counselors (n=3) and telehealth coordinators (n=1). Having this interprofessional makeup allows for rich discussion and learning around each presented case. To date (January 2019 – May 2021), the KSKidsMAP PMHT has provided interprofessional recommendations for 27 patients through TeleECHO and 89 through the Consultation Line. A participating physician sums up the program's aim in this statement, "KSKidsMAP provides the extension of care of a pediatric medical home with the psychiatry expertise to provide the best mental health care to children under one roof." This would not be possible without the interprofessional nature of KSKidsMAP.
Drexel University MCH Catalyst Trainee
I am a MCH Catalyst trainee and completing my Master of Science Family Nurse Practitioner degree at Drexel University. I have always been interested in serving my community, particularly vulnerable populations. This is what initially drew me to the nursing profession, and I was immediately intrigued by Drexel 's Maternal and Child Health minor program. Through this program, I have been able to take classes such as Overview of MCH and Global Issues in MCH. I will continue to take classes for this minor, including Research with Rare, Stigmatized, and Hidden Populations and Perinatal Epidemiology.
Throughout the classes I have taken so far, I have been able to build a strong foundation for the history of MCH in the US, as well as current needs of women and children globally. This knowledge has enhanced my education in the nursing program, as women and children make up a significant portion of our population yet have always been and continue to be underserved globally. The MCH program has helped me form a new lens that I can apply to my practice as a provider to better serve not just individual patients, but my community as a whole. It is my role as a provider to promote wellness. The interdisciplinary training provided through the MCH program has widened my view to look beyond my patient's current situations and see what can be done to help them and others within their community throughout the life course. Additionally, through my education in MCH, I have been able to gain a better understanding of how social factors can greatly affect health concerns. These social factors such as poverty, accessibility of care, safe housing, and racism continue to contribute to inequity in healthcare for the MCH population.
Since beginning my journey in MCH at Drexel, I have become a leader in the Maternal and Child Health Student Organization. This role, and working with others for a common purpose, has helped to provide fresh perspectives and goals for my future career as a provider that incorporates my MCH training. I have built leadership, critical thinking, and problem-solving skills through interdisciplinary training. This will continue to help me grow as a provider and inspire me to use my role to make a difference for my community. I strive to be a provider that promotes change, equal access to care, and play a role in reducing healthcare disparities. I am incredibly thankful to all of my professors and peers who have helped to shape my education in both my major and minor programs.
University of Washington Leadership Education in Adolescent Health Trainees
The Value of Outpatient Contact Time for Adolescents with Restrictive Eating Disorders
Background: The Seattle Children's Adolescent Medicine Clinic trialed a "Coordinated Care Model" in which new patients with concerns for disordered eating or an eating disorder met with a multidisciplinary care team made up of a registered dietitian, medical provider, social worker, and nursing staff over the span of 12 weeks. There are currently no national guidelines outlining recommended registered dietitian contact time in the treatment of adolescent eating disorders.
Josh's leadership project had two main objectives:
- Compare the differences in treatment progress of patients diagnosed with restrictive eating based on "low", "moderate", and "high" dietitian contacts hours over a 12-week period
- Identify potential disparities in dietitian contact time based on patient gender identify, race/ethnicity, and sexual orientation
Data analysis showed the following:
- Patients with higher amount of dietitian contact time reached weight restoration more often than those with lower contact time.
- Patients with more dietitian contact time also had lower rates of hospitalization for an eating disorder.
- More patients with low contact time identified as nonfemale, BIPOC, and queer than those with high contact time
- Reasons for low contact time with dietitians need to be further explored
- Identify strategies to overcome barriers to increased engagement with dietitians.
- Particular attention is needed to understanding lower rates of dietitian engagement by youth identifying as nonfemale, BIPOC, and queer as well as strategies to engage these youth.
A Mixed-Methods Survey on Evolving Providers' Perspectives of Contraception Care for Adolescents During the Covid-19 Pandemic
Background: The novel coronavirus has created unprecedented challenges to the U.S. healthcare system, especially for adolescents. In March 2020, the Washington State Government required healthcare systems to adapt within days how they provided care to meet new social distancing guidelines. Medical professionals and institutions were forced to rethink how to provide adequate sexual and reproductive healthcare to adolescents given the new mandates. For her project, Emily designed a mixed-methods survey of eight questions asking about providers' experiences providing contraception care before and during the pandemic. The survey was sent out in February 2021 to providers at organizations serving adolescent clients within Seattle-King County.
Emily's leadership project had two main objectives:
- Examine practice changes in contraception care by providers during the pandemic.
- Assess provider perspectives on the efficacy and benefit of practice changes in providing contraception care.
Data analysis showed the following:
- Over half of providers did not think or were unsure if they were meeting their patients' needs during the COVID-19 pandemic.
- Many providers reported an uptake in use of telemedicine to minimize in person visits.
- A change in prescriptions—type, duration and how they prescribed the method (e-scripts) -- were frequently reported changes to practice due to the pandemic.
- Lack of patient contact with adolescents was reported by providers as their biggest barrier to provide contraception care.
- A common problem expressed by providers was that even with a new system in place, adolescents were not participating in care.
- Re-survey participants at the end of pandemic to gain insight on how the pandemic may affect the field of adolescent reproductive health post-pandemic.
- Determine clinics challenged by new care systems.
- Identify adolescent populations not receiving care.
- Advocate for accessible and affordable telemedicine options for adolescents.
- Explore relationship between decrease of number of visits, access, and sexual activity.
University of Alabama at Birmingham Leadership Education in Adolescent Health Fellow
I (she/her/hers) am currently a fourth-year graduate student in the Medical/Clinical Psychology Doctoral Program at the University of Alabama at Birmingham. In January 2017, I graduated from Skidmore College with a double major in Psychology and Spanish, and a minor in Honors. In May 2020, I defended my thesis, which explores the impact of acculturation and autism knowledge on autism stigma in Latinx versus non-Latinx White participants. I am currently beginning my dissertation research focused on understanding the presentation and impact of implicit and explicit stigma/bias toward autism spectrum disorder (ASD) across sociodemographic groups, with emphasis on Latinx populations.
Raised in a Latinx family in rural New Jersey, I witnessed the difficulties my family faced in seeking adequate health care and experienced challenges accepting my cultural identity while avoiding stigmatization. As an undergraduate, I realized the impact that stigmatization had on my acceptance of my cultural identity, and began fully embracing my roots.
Academically, I have conducted clinical, cognitive, and social psychology research and later completed a clinical internship with adults with developmental disabilities. This combination of personal, clinical, and research experiences has resulted in my passion to pursue research aimed at understanding the presentation and impact of stigma on underrepresented groups with ASD, particularly focused on Latinx and Spanish-speaking populations. An additional area of interest is the intersectionality of gender and culture in females with ASD. My long-term career goals focus centrally on academic research and direct clinical services.
I plan on continuing my program of research, as well as teaching and mentoring students from underrepresented populations interested in ASD and serving their communities.
Kennedy Krieger Institute MCH Leadership, Education, and Advancement in Undergraduate Pathways (LEAP) MCH Scholars Program
As a young child I always had an interest in medicine. However, at the time I had a limited understanding of what it meant to be a physician and the impact they are able to have not just on the lives of individuals but a community at large. I was given that opportunity when I was accepted into the MCH summer internship at the Kennedy Krieger Institute after my freshman year at the University of Maryland. Here I completed a research evaluation for a nutrition education program and traveled to the CDC for a weeklong orientation. The program operated at state and local levels to increase nutritional awareness and knowledge among individuals with disabilities.
During my time, I developed an understanding of how financial strain and inaccessibility cause a lack of health knowledge for this population. I also traveled to the Maryland State legislature on Developmental Disability Day and accompanied individuals with disabilities who were self-advocates as they advocated and educated local legislators on policies and practices that would help individuals with disabilities live a more healthy, independent, and safe life.
It was my first tangible research opportunity and exposure to health policy. I was able to travel and present my findings at various conferences. The events and discussions that I attended throughout my internship taught me the importance of preventive medicine and its influence on reducing health disparities in the community. It also encouraged me to pursue further research opportunities during my time at Maryland. This internship was the driving force for my desire to locate the intersection that exists between medicine, public health research, and public policy.
On a fundamental level, this internship exposed me to other physicians that look like me and share similar backgrounds and experiences, proving that I had something to offer society and could join their ranks one day. Ultimately, this experience gave me insight into what it means to be a patient advocate, which means to always have your patients' interests at heart and to fight for their voices to be heard at the table. I now enter the next phase of my journey as an incoming M1 at George Washington University School of Medicine this fall on a full tuition scholarship where I look forward to my continued exploration in the mediums of public health and policy alongside medicine
University of Minnesota Leadership Education in Neurodevelopmental and Other Related Disabilities
MN LEND Fellow Builds Trust and Communication Through Animals
As a 2019-20 fellow in the Minnesota Leadership Education in Neurodevelopmental and Related Disabilities (MN LEND) program, Carl Luepker spent time with Hold Your Horses, a Greenfield, Minnesota provider of occupational and physical therapy and mental health services using hippotherapy. The practice employs the gait and movement of horses to assist people with neurological and developmental disabilities or mental health issues.
Luepker, a former elementary school teacher, was deeply impressed as he watched therapists work with victims of sexual assault.
"It was magical to see how they connected with the horses and felt safe," Luepker said. "One thing I learned from Hold Your Horses was how important it is to communicate across species, without words, because words are hard sometimes."
Luepker knows this intrinsically. He lives with issues related to dystonia, a progressive, painful nerve disease that causes muscle spasms and speech difficulties. He has undergone several surgeries, most recently a spinal fusion procedure in January to strengthen his vertebrae.
Still, he is pursuing a master's degree in clinical mental health counseling at Adler Graduate School, and has about a year of coursework left to complete. When he finishes, he hopes to integrate his golden retriever, Luna, into a counseling practice.
"Because, who doesn't trust a golden retriever?" he quips. Having seen first-hand how horses can affect people, he is convinced Luna will make an excellent therapy partner.
"I find renewal myself at the dog park on Saturdays, and have seen children with intellectual disabilities just filled with joy there," he said. "As soon as you enter the dog world, it's just so much better. No one is not having a good time there."
Stepping Back to Move Forward
A mother with a few young children, including one with Down syndrome, was having a difficult day recently. Trying to juggle orthotics that didn't fit properly for one child and some behavioral issues with another was adding up to a lot of stress.
"I just thought, 'What can I do to take some of that load off today?'" said Megan Andre (MNLEND 2019-20), now a pediatric physical therapist with Mary Bridge Good Samaritan Children's Therapy Unit in Puyallup, Washington. While the family was in the office, Andre was able to get the footwear adjusted, avoiding a second trip back to the facility, and completed a referral to the behavioral health department for the other child. For the actual physical therapy appointment, Andre focused on some streamlined exercises that the family could work into their chaotic, pandemic-interrupted routine.
"You have to take into account what the family is going through outside of the clinical environment," said Andre, who completed her residency at Gillette Children's Specialty Care in St. Paul. "It's really easy to get stuck in the professional mindset and only think about the technical aspects of what needs to be accomplished in the appointment."
Combined with her residency training and earlier career experiences with people with a variety of neurodevelopmental disabilities, MNLEND solidified the family-centered care she now delivers, and the understanding that disparities in resources can have a dramatic impact on how therapies are accessed, said Andre, who recently sat for the pediatric clinical specialist exam.
Before becoming a MNLEND fellow, Andre practiced in outpatient pediatric and neurologic physical therapy clinics, developing an interest in working with children learning to walk and eventually presenting a community parent education class.
"LEND was a huge help in cementing that person-first care mentality," she said. "It helped me complete the circle in working with families so that they understand we're not just taking a few extra steps today. We're going to understand why it's important to do these steps and to continue them outside of PT. The goal is to be functional in everyday life, so they can participate more fully in the community."
MN LEND Fellow Wins State Award for Feeding Hungry Families During Pandemic
Winning a state government award last month for getting a food assistance program up and running during the pandemic was an impressive achievement for Mia Donley, (MN LEND 2015-16). What makes it even more impressive was the timing.
Donley, a registered dietician who received a master's degree in public health from the University of Minnesota, joined the Colorado Department of Human Services in March 2020 as an education and outreach coordinator for the Supplemental Nutrition Assistance Program (SNAP).
Just a few weeks later, Donley and a team of others from the DHS and the Education Department were tapped to issue Pandemic-EBT benefits to families of school-aged children who were not able to receive free or reduced-price lunches due to school closures. The electronic benefits were issued beginning in July.
Last month, Colorado Governor Jared Polis announced that the team, including Donley and colleagues Megan Hrdlicka and Max Young, won the Tom Clements Better Government Award for Outstanding Service. The award highlights the work of those who have elevated the performance of state government and strive to leave Colorado's government better than they found it, according to Polis.
In nominating the group, Office of Economic Security Director Ki'i Powell and Food and Energy Assistance Director Karla Maraccini praised the Pandemic-EBT program for "ensuring hundreds of thousands of Colorado children were food secure during the pandemic, going above and beyond their typical workload for months to get the program up and running."
Donley called the experience a crash course in crisis communication, listening skills, and benefits administration.
"We were building the plane as we were flying it, working with community partners to get the word out about the application and other details," she said. "There were a lot of lessons learned, and it brought me back to my time with MN LEND, when I interviewed members of the Somali community who had children with autism and were trying to learn about possible resources. The frustration so many people feel as they try to access benefits is universal. Above all, listening to participants is so important."
As her team now prepares for a second round of the electronic benefits to be dispersed, she said, they will take what they've heard from those participants and use the information to improve the process.
"We have to respect the stress families are under now," she said. "If you have run out of resources, we are sometimes the only place where people can vent their frustration. And I share it. We have to get these families fed."
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