Child Health Equity Research

Faculty

Program Directors

Tumaini Rucker Coker, MD, MBA is the Division Head for General Pediatrics, and Professor of Pediatrics at the University of Washington School of Medicine and Seattle Children’s. As a general pediatrician and community-engaged health services researcher, her research focuses on community-partnered pediatric primary care delivery design to promote health equity and eliminate health and healthcare disparities for children and families in low- income communities. Dr. Coker leads a successful and extramurally-funded research program with a focus on community-engaged design, adaptation, testing, and dissemination of preventive care delivery models. She is the former and founding Research Director of the Health Equity Research Program at Seattle Children’s Center for Diversity and Health Equity, and serves as the Co-Director of the University of Washington’s NIH-funded Child Health Equity Research Fellowship. Dr. Coker currently serves as chair for the National Academies of Sciences, Engineering, and Medicine’s Committee on Addressing the Long-Term Impact of the COVID-19 Pandemic on Children and Families, and is a member of the United States Preventive Services Task Force (USPSTF).

Jason Mendoza

Jason A. Mendoza, MD, MPH is Professor of Pediatrics and Adjunct Professor of Health Systems and Population Health at the UW; Professor and Associate Program Head of the Cancer Prevention Program of the Fred Hutchinson Cancer Center; and Associate Director of Community Outreach and Engagement of the Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium. In recognition of his community-engaged, equity-focused research expertise, Dr. Mendoza was (1) the recipient of the Research Award for Community Cancer Education (2009) from the U.T. M.D. Anderson Cancer Center, (2) appointed in 2015 to the National Advisory Committee for the Research in Academic Pediatrics Initiative on Diversity (RAPID) of the Academic Pediatric Association (R25DK096944), and (3) appointed in 2016 as a member of the Psychosocial Risk and Disease Prevention Study Section of NIH. Finally, Dr. Mendoza is Associate Director for Community Outreach and Engagement for the Fred Hutch/University of Washington Cancer Consortium. In this executive leadership role, he founded and leads the Consortium’s Office of Community Outreach and Engagement (OCOE), which is focused on reducing the cancer burden and cancer-related inequities in the Western Washington catchment area via outreach and inreach programming and also by promoting community engagement in research. Populations of high priority for the Consortium include African Americans, Indigenous populations, and rural communities, including Latinos in the Lower Yakima Valley, a rural agricultural region in central WA State. Dr. Mendoza is currently PI or multiple-PI on two R01 and one U01 grants, and is the Program Director of the Community Outreach and Engagement component for the P30 Cancer Center Support Grant awarded to the Fred Hutch/UW Cancer Consortium by NCI.

We have an interdisciplinary group of faculty which oversees the didactic and research training for fellows. There are 2 categories of faculty with some faculty being members in both: Core Faculty (CF) and Mentor Faculty (MF). Core Faculty (CF) provide case-based training through seminars in health equity, public health, epidemiology, community-based participatory research, health services, and research methodology. Mentor Faculty (MF) have specific research funding and expertise in health equity and related areas and supervise trainees’ research experience and projects. Our Mentor and Core Faculty collaborate on both research and mentoring. Only Mentor Faculty are assigned as primary mentors or members of the Scholarly Oversight Committee (SOC) for fellows; faculty who are Core Faculty only are included to provide additional teaching to fellows at program seminars. 

Mentor Faculty (MF)

Donna Denno, MD, MPH (CF, MF) is Professor of Pediatrics, Joint Professor of Global Health, and Adjunct Professor of Health Services. Dr. Denno has extensive research, teaching, advocacy and clinical experience in reaching vulnerable populations with health services and interventions. She is an attending pediatrician and precepts pediatric continuity clinic residents at a community clinic serving a socioeconomically high-risk population in north Seattle. She has taught the core global maternal child health course in the UW School of Public Health for the past eight years. The course is graduate level and has included pediatric fellows enrolled in the School of Public Health graduate courses and programs. Dr. Denno’s research focuses on conditions that afflict vulnerable populations and includes: 1) improving understanding of etiologies and determinants of intestinal infections — an important cause of pediatric morbidity in the U.S. and a leading cause of child mortality globally and 2) understanding the pathophysiology of environmental enteric dysfunction, a neglected “tropical” disease, which is thought to be ubiquitous and an important cause of child malnutrition in low and middle income countries. She has also served as consultant on many occasions for the World Health Organization, including on projects related to generating evidence on how to improve adolescent access to facility- and community-based health services. She serves as a Co-Coordinating Investigator on the Gates Foundation funded multi-country Environmental Enteric Dysfunction Biopsy Consortium. She is also a Co-Investigator in the Gates Foundation funded multi-country/multi-site Childhood Acute Illness and Nutrition (CHAIN) Network. There are numerous opportunities for fellows to participate in Dr. Denno’s research collaborations, including secondary data analysis projects, and primary data collection.   

Bianca Frogner, PhD (CF, MF) is Associate Professor in the Department of Family Medicine and Adjunct Associate Professor in Health Services. She is a health economist with expertise in health service delivery, healthcare workforce, labor economics, health insurance coverage and reimbursement, international health systems, and welfare reform. Dr. Frogner is Director of the University of Washington (UW) Center for Health Workforce Studies (CHWS), and Deputy Director of the Primary Care Innovation Lab (PCI-Lab) in the UWSOM. In 2016, Dr. Frogner served on an Institute of Medicine (IOM) Consensus Study Committee on Educating Health Professionals to Address the Social Determinants of Health. She is PI of 2 Health Resources and Services Administration (HRSA) Health Workforce Research Center (HWRC) grants, one in allied health and the other in health equity. There are opportunities for fellows to participate in studies under the 2 HRSA grants for which Dr. Frogner is PI—under each grant, there are four new studies conducted each year for a total of 8 projects occurring in any given year. These research projects span important health workforce supply and distribution issues that impact the access and quality of care delivered to patients nationally. There is extra emphasis on lower-skilled healthcare occupations as well as considering the impact of the health workforce on improving health equity in patient care. The projects involve the use secondary data or primary data collection, use a mix of quantitative and qualitative methods, and result in policy briefs, reports and peer-reviewed publications. A multidisciplinary team is required to make the projects a success and provide an opportunity to fellows to participate and both contribute their clinical expertise and learn skills from other team members. Another set of opportunities for fellows is with PCI-Lab which involves research collaboration with companies with early stage technologies. These research projects involve collection of data to provide evidence of the value of the technology to primary care settings. Clinical input is critical to these projects.

Catherine Karr, MD, PhD, MS (MF) is Professor of Pediatrics, jointly appointed in Department of Environmental and Occupational Health Sciences and Adjunct Professor of Epidemiology. She serves as Clinical Translation Science Unit Lead for the UW-based Interdisciplinary Center for Exposures, Diseases, Genetics and Environment (NIEHS P30) and runs the pilot studies program for the Pacific Northwest Center for Agricultural Safety and Health (NIOSH U54). Many of her current research programs are part of a longstanding community engaged research partnership with the rural Yakima Valley, which has a high prevalence of immigrant Latinx and native communities. This infrastructure provides ongoing opportunities for fellows interested in working with underserved populations on issues related to environmental and psychosocial health. For example, she currently has 2 PhD students working on a large national pregnancy cohort examining the impact of maternal psychosocial stress and environmental contaminants during pregnancy on middle childhood airway health and neurodevelopmental outcomes. Two of her current PhD students are working on her RCT of home air cleaners and home visiting program for immigrant Latinx farm worker children with asthma. She has 1 PhD student working with the Confederated Tribes and Bands of the Yakama Nation on air quality monitoring and one masters project working on a community engaged research project to enhance environmental health literacy regarding well water testing.  

Nicholas Kassebaum, MD (CF, MF) is Associate Professor in the Department of Anesthesiology and Pain Medicine and Adjunct Associate Professor in Health Metric Sciences and Global Health at IHME of the University of Washington. He has been involved with the Global Burden of Disease (GBD) study and the Cost-Effectiveness Research Teams since 2010 and now leads the GBD Research Team on maternal, neonatal, and child health (MNCH). In this role, Dr. Kassebaum researches the burden of disease and effectiveness of interventions for improving survival and health of women, children, and adolescents. There are multiple opportunities for fellows to conduct secondary data analysis projects using the GBD dataset, which is collected and analyzed by a consortium of more than 3,600 researchers in more than 145 countries. GBD data capture premature death and disability from more than 350 diseases and injuries in 195 countries, by age and sex, from 1990 to the present, allowing comparisons over time, across age groups, and among populations.

Douglas Opel, MD, MPH (MF) is an Associate Professor of Pediatrics, Adjunct Associate Professor of Bioethics and Humanities, Section Head of Bioethics in the Division of Bioethics and Palliative Care at the University of Washington School of Medicine and Associate Director of the Treuman Katz Center for Pediatric Bioethics in the Center for Clinical and Translational Research at the Seattle Children’s Research Institute. Dr. Opel’s background as a general pediatrician and training in bioethics and health services research informs his research on provider-parent communication and medical decision-making. Dr. Opel employs mixed methods to describe and evaluate the effectiveness of provider communication strategies in various pediatric contexts, from health supervision visits to pre-operative visits. His past and current mentorship of fellows and junior faculty in the use of quantitative and qualitative methodologies to study this and other important issues of bioethics in medicine, such as informed consent and shared decision making, will help him guide the CHERPP-T fellows through their training. Dr. Opel will incorporate CHERPP-T fellows in his research through secondary analyses of his existing datasets (e.g. videotaped and audiotaped medical encounters involving parents and their child’s provider) and, when possible, by modifying design and data collection instruments in ongoing studies to accommodate a fellow’s particular research question.

Brian Saelens, PhD (CF, MF) is Professor of Pediatrics and Psychiatry and Behavioral Sciences at the University of Washington and principal investigator at Seattle Children’s Research Institute. Dr. Saelens is trained as a clinical/health psychologist. His work focuses on healthy eating, active living, and obesity prevention and treatment, particularly among youth and families. His research examines strategies to improve the efficacy and reach of family-based weight management interventions for youth with already elevated weight status. He also explores how environmental factors and policies influence physical activity and eating behaviors in children and adults. Dr. Saelens is also the evaluation co-lead on a 5-year CDC cooperative agreement to work with Public Health-Seattle and King County and the Healthy King County Coalition to improve healthy food access, physical activity opportunities, and community-clinical linkages among low income Asian and African-American populations. Dr. Saelens offers opportunities for fellows to participate in research projects in healthy eating, physical activity, and obesity treatment and prevention. These projects will range from individual/family intervention delivery to evaluation of systemic or policy changes that have the potential to impact health behaviors. The focus on obesity-related behaviors and outcomes is inherently a focus on equity given the known socioeconomic and racial/ethnic inequities in healthy food access, obesity, and related health consequences.

Sheela Sathyanarayana, MD, MPH (MF) is Associate Professor of Pediatrics; Adjunct Associate Professor of Environmental and Occupational Health Sciences; and Medical Director, UWMC Newborn Nursery. Dr. Sathyanarayana conducts research focused on how environmental exposures impact perinatal and child health outcomes. She is PI on the recently funded ECHO PATHWAYS center grant that brings together three cohorts to focus on prenatal stress, environmental chemical exposures and child neurodevelopmental and respiratory outcomes. Potential fellow research projects would focus on inequities in environmental exposures including environmental chemical, food, and stress on child development and growth. 

Kenneth Sherr, PhD, MPH (MF) is Professor of Global Health, Adjunct Professor of Industrial and Systems Engineering, and Adjunct Professor of Epidemiology at the University of Washington, and Director of the University of Washington/Fred Hutchinson CFAR Implementation Science Core. His research focus is on supporting the implementation and scale-up of evidence-based interventions in sub-Sharan Africa and developing novel approaches to strengthen primary health care services to improve the delivery of evidence-based guidelines to address the prevalent cases of morbidity and mortality in children under five in resource constrained settings. Dr. Sherr’s experience in systems analysis and improvement for HIV prevention, care and treatment speaks to the core of child health equity issues. Trainees will have opportunities to engage in Dr. Sherr’s work by using existing data for new research questions, or engage more directly in the research (including developing novel data collection approaches, seeking funding for new research projects, collecting primary data). 

Core Faculty (CF)

In addition to the faculty who serve as Mentor Faculty (described above), the following are additional Core Faculty members of CHERPP-T:

 

Brian Johnston, MD, MPH (CF) is Professor of Pediatrics and Associate Division Chief for General Pediatrics at the University of Washington and Chief of Pediatrics at Harborview Medical Center. Harborview Medical Center is the primary care medical home and pediatric resident continuity clinic site for a predominantly low-income, limited English proficiency (LEP), and immigrant population. Through his clinical, advocacy, and research work, Dr. Johnston has developed expertise in injury prevention, the adverse impacts of health inequities, and community-based interventions to address these. Dr. Johnston leads a curriculum track in the UW pediatric residency training program focused on child health and health disparities and is the medical director of the Washington Medical Legal Partnership, a coalition addressing social determinants of health among low income families in Washington. Dr. Johnston will provide teaching to fellows on models of care for marginalized populations, and novel partnerships to leverage community health resources for children in low-income communities.

Charlotte Lewis, MD, MPH (CF) is Professor of Pediatrics and Adjunct Associate Professor of Pediatric Dentistry. Dr. Lewis is a health services researcher whose work focuses on disparities in health and healthcare with emphasis on oral health and dental care access. She has been the recipient of several NIH grants to study the role of physicians in oral health, and to characterize disparities in dental care use and access to dental care for low-income and special needs children. Her work has also examined the role of U.S. emergency department in the care of adults, particularly young adults, presenting with dental problems. Her current research focuses on institutional and surgical volume-related disparities in quality of care and the impact of public insurance and related policy on income-based disparities in dental care utilization among adults and children. Dr. Lewis will provide fellows with teaching on how to use large datasets to address population-based health inequities, using oral health disparities as an example. 

Suzinne Pak-Gorstein, MD, MPH, PhD (CF) is an Associate Professor of Pediatrics and Adjunct Associate Professor of Global Health at the University of Washington. Her career focus is on refugee child health, global health disparities education, and global nutrition. She chairs the Global Center for Integrated Health of Women, Adolescents and Children’s Nutrition Think Tank, and co-directs the global health program of the UW Global Health and Community Pediatric and Advocacy track which earned the Academic Pediatric Association National Teaching Program Award. She mentors pediatric residents in this long-standing curriculum on health equity as they carry out community assessments in rural western Kenya and in local, low-income neighborhoods. She will provide teaching to fellows on global child health inequities.

James Stout, MD, MPH (CF) is Professor of Pediatrics. He has served as PI or Co-Investigator on many externally funded projects focused on reducing health disparities domestically and internationally, including research on the effect of community health workers on health outcomes. Dr. Stout founded and directs a multi-disciplinary group at UW known as Interactive Medical Training Resources (iMTR). He has developed and collaborated on numerous smart phone-based apps and other technology intended to improve pediatric health in low-resource settings, specifically Spirometry 360, an iMTR online training and feedback program, which has been used to train clinicians in over 300 practices domestically and in 10 other countries; and apps including SpiroSmart, which remotely monitors lung function; BiliCam, which estimates newborn jaundice; and ALRITE, which supports clinical decision-making for children under 5 years who are in respiratory distress. Dr. Stout recently served on the Fourth Expert Panel for the National Asthma Guidelines (EPR-4). He will provide fellows with teaching on research using mobile health tools to improve health equity, using his work on technology and mobile health in asthma and newborn jaundice as a case study. 

Early Career Faculty Members of Core Faculty 

We have engaged early career faculty scientists as Core Faculty for the program. These are rising Assistant Professors or early Associate Professors who have external funding, strong research programs, and expertise in an area of health equity research that will be critical for fellows to be exposed to through didactic teaching and experiential learning during the program. We include these junior faculty as Core Faculty and as members of fellows’ SOC, as “junior mentors”, until they enter their mid-career, and at that time will have the experience and exposure to become CHERPP-T Mentor Faculty.  

Wendy Barrington, PhD, MPH (CF) is Associate Professor in the UW School of Nursing and affiliate faculty in the UW Departments of Epidemiology and Health Services. Her research interests include social determinants and health disparities in cancer outcomes; community-based participatory research, advanced methods including causal mediation analyses and multilevel modeling; neighborhood effects; stress; obesity; and dissemination and implementation. Dr. Barrington teaches the graduate course in social determinants of health in the UW School of Nursing, and will provide opportunities for fellows to collaborate with her on her work in using lay health workers in clinical settings to improve care for underserved populations.  

Anjum Hajat, PhD, MPH (CF) is Assistant Professor of Epidemiology at the University of Washington, whose research seeks to understand how social and environmental stressors disproportionately impact disadvantaged populations to cause poor health and health disparities. She conducts research on environmental factors such as air pollution and green space and social stressors such as financial instability and precarious work on health outcomes. Dr. Hajat’s research has implications for policy that may help achieve health equity for disadvantaged populations. Trainees will have access to the data collected by Dr. Hajat’s previous research and the many sources of secondary data she uses in her research. Trainees are encouraged to participate in current research projects by exploring additional research questions.

Casey Lion, MD, MPH (CF) is Assistant Professor of Pediatrics at the University of Washington School of Medicine, an attending physician at Seattle Children’s Hospital, and an investigator at Seattle Children’s Research Institute. She co-directs the Health Services & Quality of Care Research Fellowship within the UW Department of Pediatrics and Seattle Children’s Hospital. She is an NIH-funded researcher focused on improving communication, healthcare experiences, and outcomes for vulnerable children and families, including those with limited English proficiency and low income. She also has expertise in methods related to the rigorous evaluation of quality improvement interventions, with particular focus on the intersection between disparities and quality improvement work. Dr. Lion offers opportunities for fellows to participate in research projects related to improving language access for families with LEP, patient navigation, and rigorous evaluation of real-world interventions to address healthcare disparities.

Emily Kroshus, ScD, MPH (CF) is Research Assistant Professor at University of Washington in the Department of Pediatrics, based at the Seattle Children’s Research Institute in the Center for Child Health, Behavior and Development. The broad goal of Dr. Kroshus’ research is to reduce health inequities related to youth sport participation. She is co-PI of a CDC U01 study to develop and evaluate a pre-game “safety huddle” intervention to increase equitable implementation of concussion education and prevention in low-resource communities. She is also co-PI of a community-engaged grant funded by the Seattle Children’s Hospital Center for Diversity and Health Equity and the University of Washington Latino Health Grant to develop improved approaches to communicating with LEP parents about concussion recognition and prevention within the context of pre-sport participation physical examinations. Dr. Kroshus’ lab  offers trainee research opportunities to explore, in pediatric sport settings, (1) the extent to which evidence-based programs are being successfully disseminated and implemented, (2) community-engaged and theory driven program adaptation work to ensure that evidence-based interventions meet the needs of a given target community, and (3) intervention toolkit development.