SPRING 2019

PREVENTION
P R E VA I L S
A PATH TO PEAK
HEALTH EXERCISE
HEALTHY EATING
REDUCING STRESS
STOP SMOKING
LIVE LONGER

> TRANSLATING CARE

Using technology to leap the language barrier

> GLOBAL HEALTH

Experiences provide important skills for doctors

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 1

 WE ARE DEDICATED TO IMPROVING
AND PROMOTING THE HEALTH OF
INDIVIDUALS AND COMMUNITIES IN
ALABAMA AND THE REGION THROUGH
LEADERSHIP IN MEDICAL EDUCATION
AND PRIMARY CARE; THE PROVISION
OF HIGH QUALITY, ACCESSIBLE HEALTH
CARE SERVICES; AND SCHOLARSHIP.

2
 SPRING 2019

A MESSAGE
FROM THE DEAN

GROWING PAINS
Making Strides to the Future

T he College of Community Health Sciences has

experienced tremendous growth since I first joined
as director of our Family Medicine Residency in 2013.
It has been exciting and rewarding to watch the College
thrive and expand in medical education, patient care
and research.
Last year, CCHS launched a new medical education
track, the only one of its kind in the University of Alabama
School of Medicine system. Our Primary Care Track
prepares medical students to become skilled primary
care physicians by utilizing a longitudinal curriculum in
the third year of medical education. These students are
working with our faculty physicians, providing continuity
of care for patients and learning in diaerent settings
across the core disciplines of medicine, a departure
from the traditional hospital-based model of discipline-
specific clerkships. Twenty-nine students are currently mission to educate and train rural family doctors for
on the track and the program attracted more than 150 the region, and 50% of our graduates elect to serve in
applicants last year. That’s good news as we work to rural areas. We continue to recruit the best and brightest
provide desperately needed primary care physicians for candidates from across the world as our graduate medical
Alabama and the region. education programs have grown. Our residency annually
Our Family Medicine Residency continues to be attracts more than 2,000 applicants for the 16 spots
one of the nation’s leaders in producing well-trained we oaer. CCHS is also nationally recognized for having
family medicine physicians. We have not wavered in our the largest number of fellowships for family medicine
physicians. These are board-certified physicians who

“ W e work to provide
seek additional training after residency – in behavioral
health, emergency medicine, hospital medicine, geriatrics,
obstetrics, rural public psychiatry and sports medicine.
We are exploring additional fellowship opportunities in
desperately needed pediatrics and addiction medicine. This post-graduate
training translates into more medical expertise for the
primary care communities our graduates serve.
Forthefirsttimeinitshistory,CCHSisnowadegree-
physicians for granting college. Students in our Master of Science in

A labama . Population Health Sciences program began in fall 2018,

“ andinfall2019wewilloaerourmaster’sdegreeinRural

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 1

 DEAN’S MESSAGE

and Community Health, which had been housed in UA’s nationwide All of Us Research project, one of the largest
College of Human Environmental Sciences. As with studies ever conducted by The National Institutes of
our fellowships, we will look for opportunities to Health.
oaerWith funding from the US Centers for Disease
additional degree programs in areas most needed across Control and Prevention and the Alabama Department of
campus and throughout the UA system. Public Health, CCHS researchers are working with UA’s
Our ambulatory clinic and hospital encounters Center for Advanced Public Safety to develop a mobile
continue to increase, approaching 150,000 visits during application to help people suaering from hypertension
the previous fiscal year. This included approximately better manage their high blood pressure and communicate
60,000 University Medical Center patient visits at DCH more easily with their providers. The College also received
Regional Medical Center by our hospitalists, who are now continued state funding for two important projects: the
morecloselyalignedwithourmajorteachinghospital UA-Pickens
and County Partnership, led by CCHS and that
working together with DCH to provide quality hospital care is helping address the health status of the county; and
in our Hospital and Neuro-Hospital programs. ACTION, a CCHS and city of Tuscaloosa partnership to
Outpatient visits at the main University Medical Center treat 911 callers with low-level emergency conditions at
on the UA campus in Tuscaloosa totaled approximately the scene, providing financial savings for patients and the
63,000 last year, and patient visits at our other locations city and reducing hospital readmissions.
are also growing. UMC clinics in Northport and Demopolis How are we keeping up with this tremendous growth?
have provided much-needed health care services to these We are starting with infrastructure, and I am dedicated
communities. CCHS is also partnering with hospitals in in my eaorts to provide and ensure that we have the
neighboring counties as the US struggles with a rural necessary bricks and mortar and other systems in place to
continue the projects outlined above, and to make those

“O
currently on the drawing board a reality. With the help of
my leadership team, I am continuously examining and re-
examiningouruseofspace,findingwaystomoreebciently
I R H
ur nstitute for ural ealth and eaectively utilize the resources we have – and we will
look toward expansion in the future.
R esearch is implementing an Keeping up with our growth and the needs of our
...
ambitious growth plan and the patients and communities throughout West Alabama also
requires recruitment and retention of faculty and staa,
efforts have already paid off. including clinicians with more specialized skills. We recently
added an endocrinologist, who provides specialized care
for diabetic patients and those with thyroid disorders. We

“ arelookingtooaeradditionalspecialtyservicessothatwe
can further enhance the care we provide the population of
patients we serve.
hospital closure crisis. There will be challenges ahead, but we are committed
CCHS was awarded nearly $2.5 million in federal and to working each and every day to fulfill the mission of our
stategrantandcontractfundingduringthepreviousfiscal College – to improve the health of communities in Alabama
year, a substantial increase over past years. Submissions and the region.
by our researchers and clinicians were up more than
200%, and funding received increased more than 30%.
ResearcheaortsatCCHShelpedcontributetoUA’sfirst-
ever Carnegie Classification as one of the top doctoral
research universities in the US in 2018.
There is room for growth in our research eaorts and
we are ready. Our Institute for Rural Health Research is
implementing an ambitious growth plan, adding faculty,
research analysts and assistants, post-doctoral and
graduate students – and the eaorts have already paid
-DR. RICHARD FRIEND
INTERIM DEAN,
oa. We are a site for and an important contributor to the COLLEGE OF COMMUNITY HEALTH SCIENCES

2
 WINTER 2018

SPRING 2019 | VOLUME 26 | NUMBER 21

TABLE OF CONTENTS
INTERIM DEAN
Dr. Richard Friend
1 Dean's Message
4 News EDITOR
Leslie Zganjar, MPA
9 Feature - Preventing Placement Disruptions
ASSOCIATE EDITORS
11 Feature - Community Education Kaylin Bowen
Erin Tech
13 PREVENTION: A Path to Peak Health
CREATIVE DIRECTOR
15 Fitness Trends Erin Tech

16 The Best Exercise? Just Move WRITERS

Leslie Zganjar, MPA
17 Find What Moves You with Dr. Ray Stewart
18 Sports Medicine Fellows DESIGNERS
Kaylin Bowen
Erin Tech
20 Millennials Changing Food, Eating Trends Nicholas Jones

21 Hiding in Food, Harming Health COVER PHOTOGRAPHER

Greg Randall
22 Healthy Eating in Your Community
26 Being Mindful of Stress PHOTOGRAPHERS
Greg Randall
Zachary Riggins
27 Working Together UA Photography

29 Lighting Up Electronically
30 Preventable Health Risks and Deaths
ON THE COVER
31 Scholarly Activism Mindfulnessisjustone
thing to consider on your
33 Discouraging Dementia path to peak health. Learn
from UMC providers
34 Geriatricians: A Rare Breed about how to create your
own path to a longer and

Feature - Translating Care

healthier life (page 13).
35

37 Feature - Global Health

41 Snapshots
46 New Faculty
51 Accolades
56 Academia

On Rounds is a semiannual publication of The University of Alabama

College of Community Health Sciences.
Please send address changes and correspondence to Erin Tech,
College of Community Health Sciences, The University of Alabama,
Box 870326, Tuscaloosa, AL, 35487 or erin.tech@ua.edu.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 3

 NEWS

UMC-Northport Recognized as
Patient-Centered Medical Home
University Medical Center-Northport was recently and interim chair of the College’s department of
nationally certified as a Patient-Centered Medical family, internal, and rural medicine, who led the UMC-
Home in recognition of its commitment to place Northport team that met weekly for 18 months to
patients at the center of care and to advance quality in achievetheNCQAcertification.
the health care it provides. Along with UMC-Northport, CCHS also operates
UMC-NorthportjoinstheTuscaloosaUMClocation University Medical Center in Tuscaloosa and UMC-
in receiving the PCMH accreditation. The recognition Demopolis, which together comprise the largest multi-
by the National Committee for Quality Assurance specialty medical practice in West Alabama with more
means medical practices have made a commitment than 150,000 patient visits last year. The practice
to provide health care that is patient-centered, provides primary care-focused health services
accessible, continuous, comprehensive, coordinated in family medicine, internal medicine, pediatrics,
and quality-focused. women’s health, psychiatry, geriatrics, neurology,
“This is an important recognition because research endocrinology and sports medicine.
shows that being patient-centered and having PCMH UMC’s Tuscaloosa location received PCMH
accreditation improves patient care,” said Dr. Richard accreditation for its family medicine and pediatrics
Friend, interim dean of UA’s College of Community clinics in December 2017. Weida also serves as
Health Sciences, which operates UMC-Northport. “As clinical director of the Family Medicine Clinic at UMC
we move into a quality-based reimbursement system, in Tuscaloosa.
it will be important that all of our clinics reach these Some of the categorical benchmarks needed
standards. We are certainly working toward that goal.” to meet PCMH accreditation include: enhancing
The PCMH model uses a health care team, led by access to care and continuity of care; planning and
a primary care physician, that delivers coordinated managing care; identifying and managing specific
and integrated care and that is proactive in providing patient populations; providing self-care support and
preventive, wellness and chronic illness care – all with community resources; tracking and coordinating care;
the patient at the center of the healthcare experience. and measuring and improving performance.
Research shows that the PCMH model builds These eaorts can translate into reminders to
better relationships between patients and their clinical patients about their chronic and preventive care
care team, improves quality of care as well as the needs, more regular screenings, after-hours care,
patientexperienceandstaasatisfaction,andreduces use of electronic health records to improve ebciency
health-care costs. The PCMH has also been shown to of care and to monitor chronic diseases, and use of
help patients be more compliant and more successful multiple channels of communication, including web-
in managing chronic health conditions. based portals for patients to request appointments
“We are leaders in practice transformation,” said andprescriptionrefills.
Dr. Jane Weida, associate professor of family medicine

4
 SPRING 2019

College Partners with Alabama Statewide

Area Health Education Centers

Helping Alabama’s Rural Students Return

Home as Health Professionals

The College of Community of the academy, students receive

Health Sciences has partnered two hours per week of preparation
with the Alabama Statewide Area for the ACT college entrance exam,
Health Education Centers (AHEC) college and career exploration, work
program. AHECs are committed toward certification in phlebotomy
to expanding the health care
and tour local hospitals.
workforce and maximizing
For the past 25 years, the CCHS
workforce diversity, especially
in underserved communities, in Rural Programs have operated as
an eaort to increase access to care and improve the a pipeline system that starts in high school, for juniors
overall health of communities - a mission that is highly and seniors, to prepare students for opportunities in
reflective,andoverlapping,oftheCCHSmission. health care professions following graduation and before
The College began working directly with the West they begin higher education and training. In recognition
Central Alabama AHEC, based in Demopolis, last of the positive impact that AHECs have had throughout
year. The College’s rural scholastic-year programs the state, the College determined that the opportunities
have already transferred to AHEC implementation and for advancement for Alabama students would be
include the in-school Health Careers 101 and the after- exponentially higher with the network that AHEC has in
school Health Profession Academy. place statewide, beyond medical school and including
Health Careers 101 provides health career exploration other health care professions.
workshops and is oaered at five high schools in West “It serves the mission of the College to continue to
Alabama - Francis Marion School in Marion, Selma support the region in terms of leadership in medical
High School in Selma, Robert C. Hatch High School in education through assistance to our area partners,”
Uniontown, Choctaw County High School in Butler, and said Dr. Richard Friend, interim dean of CCHS. “AHEC
Greene County High School in Eutaw. To date, more has become established nationwide, in the majority of
than 300 students at the schools have participated. states, and this is a historic role in which they have deep
Students in the Health Professions Academy are experience and success.”
nominated by their teachers and the program accepts The partnership will extend opportunities to high
12 students from each school, with two students from school students in rural areas of Alabama, enabling
each grade. The academy is oaered at the same high the College to expand guidance and support to rural
schools as Health Careers 101, although Demopolis High students throughout their school careers in a more
School takes the place of Selma High School. As part meaningful way.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 5

 NEWS
PICKENS
COUNTY
20,000 PEOPLE
2 AMBULANCES
Telemedicine Grant Saving
Lives Through Communication
The College of Community Health Sciences was
awarded a $128,664 grant to bring telemedicine capacity
to Pickens County, a rural and underserved county in West provides for improved communication between
Alabamawheremanyresidentssuaerwithchronichealth
conditions and live long distances from the hospital.
The funding will be used to provide telehealth
equipment to Pickens County ambulances and the
Pickens County Medical Center Emergency Department
to enhance communication between paramedics and
emergency room physicians.
“The goal is to improve health and health care by
equipping and training emergency personnel to respond
to and treat emergency situations, and to reduce care
costs by improving their ability to determine an emergency expensive ambulance rides and emergency room visits.
situation from a non-emergency,” said Dr. Nathan Culmer,
assistant professor of Medical Education for CCHS and
lead investigator on the grant.
WorkingwithCulmerare:GlennDavisandTravisParker
of the CCHS Emergency Medical Services Program; Dr.
WilliamCrawford,aboard-certifiedemergencyphysician
and medical director for the Alabama Department of
Public Health State EMS Program; Dr. Todd Smith, a
faculty member from UA’s Capstone College of Nursing;
and Catanya Stager, a graduate research assistant
for the College in Academic Technologies and Faculty
Development. Pickens County Medical Center and the
Pickens County branch of Northstar EMS are partners
6
on the grant.
The technology system that will be implemented
physicians and EMS teams both before or during an
ambulance trip. A clinic workstation will be established
within the Pickens County Medical Center emergency
room that will be fully compatible with the ambulance-
based system.
“Improved communication between health care
professionals at the hospital and paramedics is needed to
maximize the quality of care given to patients at the point
of need,” Culmer said. He said the project also seeks to
reduce the cost of care by preventing unnecessary and
Crawford will provide medical oversight, training and
quality assurance as medical director of the project.
The three-year grant is part of the US Department
of Agriculture’s Distance Learning and Telemedicine
Grant Program, which is administered by the
Rural Utilities Service.
CCHS has a strong relationship with Pickens County
and is partnering with the county on a number of initiatives
to support the healthcare system there.
Pickens County Medical Center is a 56-bed hospital in
Carrollton that serves the county of nearly 20,000 people.
Northstar EMS operates emergency services in Pickens
County via the only two ambulances in the county.
BY LESLIE ZGANJAR

Reducing Infant Mortality
Rates in Rural Areas
Family medicine physicians trained in obstetrics can
have a profound impact on infant mortality rates in rural
areas, according to research conducted by physicians
and faculty of the College of Community Health Sciences.
Their research shows obstetrics services provided
by family medicine physicians in rural Pickens County,
Alabama, resulted in an improved infant mortality rate for
the county, and that the availability of local prenatal care
was also associated with a lower infant mortality rate.
The results were published in The Journal of the
American Board of Family Medicine, July-August 2018
issue. Drs. Jessica Powell, Catherine Skinner, Drake
Lavender, Daniel Avery and James Leeper authored the
article and conducted the research.
The results are especially impactful for Alabama,
a largely rural state. Despite a declining national
infant mortality rate, the state’s rate has shown less
improvement. In 2013, Alabama ranked 49th in the nation
for infant mortality. The College, meanwhile, continues
to work to reverse those numbers, particularly through
its Obstetrics Fellowship, which trains family medicine
Dr. Catherine Skinner is an obstetrics-trained
family medicine physician at University
Medical Center.
*United States Department of Health and Human Services (US DHHS), Centers for Disease Control and Prevention (CDC), National Center for Health
Statistics (NCHS), Division of Vital Statistics (DVS). Linked Birth / Infant Death Records 2016. Rate of 9.03/1,000 births. Ranking last in the nation.
SPRING 2019
physicians in obstetrics care.
According to the journal article, Pickens County had
no obstetrics services, including prenatal care, from
1986 to 1991, and the infant mortality rate was 17.9. The
rate is defined as the number of deaths among infants
less than one year of age per 1,000 live births.
From 1993 to 2002, full obstetrics services, including
prenatal care and delivery, were available in the county
and the infant mortality rate dropped by 60%, resulting
in a rate lower than both the state and national rates
during that period.
Unfortunately, Pickens County lost local labor delivery
services in 2002 when the Pickens County Medical
Center closed its labor and delivery unit, and from 2005
to 2013 only prenatal care was available – provided
by one family medicine physician trained through an
obstetrics fellowship. While the infant mortality rate
increased during this period, the rate was less than the
period when no obstetrics care – prenatal or delivery
services – was available locally.
In 2016
534
Infants Died in
Alabama*
C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 7
 NEWS

Combatting Pediatric Obesity

charts, is a screening method to determine if
children and adolescent-aged patients have healthy
weights, or if they are overweight or obese.
Previous funding for pediatric weight
management eaorts sponsored a physician
specializing in pediatric weight management for a
general session to train the College’s physicians,
residents and medical students. Funding also
enabled the Department of Nutrition Services to
establish a program that brings a produce stand
inside UMC, enabling UMC health providers to
showpatientsdiaerentwaystoincorporateproduce
into their diets.

BY LESLIE ZGANJAR
Suzanne Henson is a registered dietitian who
cares for patients at University Medical Center.
UMC 2017 Pediatric Obesity Rates
A College of Community Health Sciences
program to help combat childhood obesity received
funding from BlueCross BlueShield of Alabama.
The funding will be used to provide ongoing
training for the College’s family medicine residents
in addressing pediatric overweight and obesity
using a patient-sensitive and family-centered
approach. Guest speakers who specialize in
pediatric overweight and obesity will be brought 32% OBESE
in to train residents on how to diagnose pediatric
weight issues.
The College considers the diagnoses of
childhood overweight and obesity critical health
issues,anditseaortstoaddresstheseconcernsare 10% OVERWEIGHT
conducted through the proposed Think, Eat, Move!
Interdisciplinary Clinic housed within University
Medical Center, which is operated by the College.
“Our intent is to provide nutrition education
for the children and adolescent patients and their
parents and caregivers in our clinics so that they
do not enter adulthood with chronic diseases,
such as Type 2 diabetes,” said Suzanne Henson, a 58% AVERAGE
registered dietitian who directs UMC’s Department
of Nutrition Services.
During a one-year period in 2017, UMC’s Family
Medicine Clinic documented the body mass index
for age (BMI-for-Age) in 64% of encounters for
patients ages 2 to 18 years and found that 42% of
the patients were overweight or obese. Ten percent
of the documented BMIs-for-Age were between
the 85th and 94th percentile (overweight), and 32%
were at or above the 95th percentile (obese).
BMI-for-Age, as plotted on pediatric growth

8
Preventing Placement
disruptions
BY LESLIE ZGANJAR
T he last thing foster parents want is to send a
fosterchildtoanotherhome.Butdibcultand
trying behavior, which can be the result of previous
trauma, sometimes makes that unavoidable.
It’s known as placement disruption.
Dr. Nancy Rubin, professor of psychiatry and
behavioral medicine at the College of Community
Health Sciences, believes placement disruption
can be prevented by identifying disruption
predictors, and then intervening with services
already available in the community.
Rubin, also a clinical psychologist at University
Medical Center, which CCHS operates, is
working with other University of Alabama faculty
and social services providers in Tuscaloosa
to implement an intervention intended to help
manage problem behaviors in foster children who
have experienced trauma.
Together with Dr. Debra Nelson-Gardell,
associate professor of social work at UA, UMC’s
Pediatrics Clinic, the Alabama Department of
Human Resources, Indian Rivers Behavioral
Health, Youth Services Institute and community
R ITNEGR 22 00 11 98
WPI N
S
physicians, the group is working to implement
Trauma Systems Therapy for foster children, an
evidence-supported,trauma-specificintervention
that focuses on environmental factors related to a
child’s traumatic experiences.
Rubin and Nelson-Gardell, co-coordinators
of the project, decided to focus the Trauma
Systems Therapy model on foster care placement
disruption, to assist foster children in Tuscaloosa
who have been removed from their homes and
placed in foster homes, and who are in danger
of being removed from those homes and placed
into residential care.
It’s not that these are bad kids, Rubin and
Nelson-Gardell said. “These are traumatized kids.
There are triggers, and then these kids experience
fight, flight or freeze, which are survival states,”
Rubin said.
“If you can see that the behaviors traumatized
children show are a result of their trauma and are a
result of them trying to survive that trauma, that’s
fundamentally diaerent than thinking, ‘You’re a
bad kid,’” said Nelson-Gardell.
C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 9
 F E AT U R E
Dr. Nancy Rubin believes placement disruption can be prevented by identifying disruption predictors, and then
intervening with services already available in the community.
Added Rubin: “We want to take resources that are
already here in the community and combine them in
diaerentwaystogetdiaerentresults.”
Nelson-Gardell was somewhat familiar with the Trauma
Systems Therapy model, developed by Dr. Glenn Saxe of
New York University Medical School and now used in 16
states. She and Rubin got Saxe’s book, Trauma Systems
Therapy for Children and Teens, and started reading.
In August, Rubin, Nelson-Gardell and more than
100 foster parents, social workers, therapists and child
services professionals attended a TST community training
session at the Alabama Fire College in Tuscaloosa.
“
These are traumatized kids.
There are triggers, and then
these kids experience fight,
flight or freeze, which are
”
survival states.
Attendees received an overview and rationale of the TST
model, as well as information about how trauma aaects
brain development and behavior. Saxe provided the
training, which focused on team members functioning
as detectives.
“What I love about this treatment is that we’re looking foundationofwhatmakesTSTbothuniqueandeaective:
at it like we’re detectives. First, we want to make the
environment safe. Then we look for other triggers and
remove those triggers so that the children can calm
10
down and function and learn how to deal with dibcult
situations,” Rubin said. “Environments can’t necessarily
be made stress and trigger free, so children need to be
taughthowtohandledibcultsituations.”
Nelson-Gardell said the approach provides a very
thorough and systematic review of what’s going on
aroundthechild.“Theeaortistochangewhathappened
in the environment that triggered the child so that you can
modify and be aware of that, which will allow the therapy
to help the child better manage their feelings and have
better behavior,” she said.
Rubin said the goal for the first year of TST in
Tuscaloosa,thefirstsuchprograminAlabama,istoserve
25 children. Foster children, typically between the ages of
4 and 18 years, will be referred by DHR, and some in that
group may be at risk of disrupting their home placements.
Tuscaloosa’s TST program has a system of
assessments, program evaluations, in-home trainings and
therapy by the Alabama Youth Services Institute, DHR,
Indian Rivers, and UA researchers and doctoral students.
Foster children might be referred to a mental health care
provider, including Rubin, for regulation-focused therapy.
“We want to settle them down, make sure they have a
safeenvironmentandteachthemskillsthatfocusfirston
the immediate and later on the original trauma,” she said.
The multidisciplinary approach may see as many as 10
people interacting with the child each week, and they are
all part of each child’s case review, which strengthens the
understanding the numerous triggers that can lead to
problem behavior, even if a child’s trauma isn’t known.
 SPRING 2019

Community
Education
initiative of Dr. Thomas Weida, a family medicine physician
and chief medical obcer of University Medical Center,
which CCHS operates and where its faculty practice and
care for patients. He established a similar program while
faculty at Penn State Hershey College of Medicine that
lasted for 16 years and educated hundreds of community
members about health-related topics.
When Weida joined CCHS several years ago, he
couldn’tfindanythinglikeMiniMedicalSchoolalreadyin
the community, so he decided to start a program. OLLI’s

T he College of Community Health Sciences is dedicated course structure made the organization an ideal partner,
to improving and promoting the health of individuals and he said.
communities in Alabama, and one way it works to achieve this “This is a way to get patient information out into our
mission is through education. community, and to get the name of the College out there
But not just education of medical students and familyand to tell people what we do and what all we can do,”
medicine resident physicians. Via community education Weida said.
courses and guest lectures, CCHS is extending access to Eight lectures are given each spring and fall semester,
health education and knowledge to residents of West Alabama. with topics chosen based on both OLLI member requests
The College’s Mini Medical School Program, a partnership and subjects that CCHS faculty physicians believe are
of CCHS and The University of Alabama’s OLLI Program, important for people to better understand.
features lectures provided by College faculty physicians about In 2018, the Mini Medical School Program expanded to
current topics, issues and advances in medicine and health. include quarterly lectures on geriatric topics to residents
OLLI, short for Osher Lifelong Learning Institute, is a member- of Capstone Village, a retirement community located on
led program catering to those aged 50 and older. the UA campus.
Mini Medical School, which launched in 2016, was an “We are about education,” Weida said. “The battlefront

“ The battlefront
of medicine in
the future is not
an antibiotic. It’s
lifestyle. And that
needs education. “
Dr. Thomas Weida
Associate Dean of Clinical Affairs
Chief Medical Officer, University Medical Center

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 11

 F E AT U R E

of medicine in the future is not an antibiotic. It’s lifestyle. patients, other practices in West Alabama can refer
And that needs education.” patients and they, too, can participate in the program. The

“
average age of class participants is 50 years, but there
have been patients as young as 13 years and many in their
Education is key in the 80s, Hammond said.

”
“Education is key in the self-management of diabetes
self-management of diabetes.
and in the prevention of future complications,” she said. “It
Angela Hammond is (the program’s) mission to empower patients to achieve
Nurse Practitioner optimal health by increasing knowledge through education
classes and other learning opportunities.”
InadditiontoMiniMedicalSchool,UMCoaersdiabetes
education classes to UMC patients. The Diabetes Self-
Management Education (DSME) classes are designed to
provide diabetics with skills to help manage their disease
and with lifestyle modification to help improve their
condition. Each class covers a diaerent topic, provides
opportunities for patients to ask questions of UMC health
care providers and allows participants to share tips and
learn from their classmates.
“We live in the (US Centers for Disease Control and
Prevention) designated Diabetes Belt,” said Angela
Hammond, a nurse practitioner at UMC and DSME quality
coordinator. “Our patient population has a high percentage
of diabetics and pre-diabetics, and patient education is very
much needed in order for patients to be active participants
in preventing diabetic-associated complications.”
DSME classes started at UMC in 2010, and in 2012,
the program received the American Diabetes Association
RecognitionandCertification,whichcontinuestoday.
While most patients in the DSME program are UMC

HOW MILLENIALS ARE

CHANGING FOOD TRENDS
Suzanne Henson, RD, LD

PRECISION MEDICINE
Dr. John C. Higginbotham

COLONOSCOPIES
Dr. Drake Lavender

THE VALUE OF VACCINES

Dr. Pamela Payne-Foster

DIABETES
Dr. Ed Geno

SPORTS CONCUSSIONS AND CTE

Dr. Catherine Ikard

12
 SPRING 2019

PREVENTION A PATH TO
P R E VA I L S PEAK HEALTH

W
e often look to medications and
medical treatments to achieve
good health, but prevention can
playavitalroleinstavingoasomediseases
and poor health conditions.
It turns out those healthy habits we always
hear about really can make a diaerence
when it comes to good health, whether
you’re in your 20s and 30s, and even in your
60s and 70s – and research shows it’s never
too late to start.
Eat a healthy diet and exercise, if you
smoke quit, and try and reduce stress.
That’s according to experts at the College of
Community Health Sciences and University
Medical Center.
The College, which provides medical
education and training to medical students
and resident physicians, also operates
UMC, the largest multi-specialty community
medical practice in West Alabama. UMC
also forms the base for the College’s
academic and clinical teaching programs.
On the following pages, CCHS faculty and
UMChealthcareprovidersoaerinformation
about prevention and improving health, and
they provide insights about emerging trends
in health.
Read on to learn how a focus on
prevention and wellness in medical
education and patient care is one way the
College is fulfilling its mission of improving
health in communities.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 13

 PREVENTION PREVAILS

EXERCISE

14
 SPRING 2019

2019
FITNESS TRENDS
Every year, the American College of Sports Medicine surveys thousands of
fitness professionals about health and fitness trends and publishes the results
in the ACSM Health and Fitness Journal. The top 10 fitness trends for 2019:

1 WEARABLE TECHNOLOGY
Usingsmartwatches,fitnesstrackersandheartmonitors.

2 GROUP TRAINING
Workingoutwithmorethanfiveotherparticipants,aswellasonlinegroupworkoutclasses.

3 HIGH-INTENSITY INTERVAL TRAINING

Short bursts of high-intensity exercise followed by short periods of rest.

4 FITNESS PROGRAMS FOR OLDER ADULTS

Cateringtooldergenerationsandprovidinghealthbenefitsthatcomewithbeing
active, including maintenance of bone density and muscle mass.

5 BODY WEIGHT TRAINING

Using your body weight to exercise (push-ups and planks).

6 EMPLOYING CERTIFIED FITNESS PROFESSIONALS

7 YOGA

8 PERSONAL TRAINING
Individualized instruction and goal setting with a trainer.

9 FUNCTIONAL FITNESS TRAINING

Improving activities of daily living by improving balance,
coordination, strength and endurance.

10 EXERCISE IS MEDICINE
Encouraging health providers to get patients on an
exercise regimen and analyzing physical activity at regular
check-ups.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 15

 PREVENTION PREVAILS

THE BEST EXERCISE?

Dr. James Robinson, endowed chair
of sports medicine.
BY LESLIE ZGANJAR
MOVE
JUST
The American College of Sports
Medicine recommends between 22 to
35 minutes of moderate to vigorous
out to the point of exhaustion, daily exercise to lose weight.
Robinson said. He likes to use If cardiovascular health is your
the term activity, noting that goal, “moderately intense activity of
many daily activities – walking, 3 0 minutes a day for five days of the
housework, taking the stairs week” is required, Robinson said. Brisk
instead of the elevator, parking walking, cycling, swimming and even
farther from the door when going dancing elevate the heart rate and
shopping or to work, and getting keep it elevated for a sustained period
up from your desk periodically oftime,whichimprovesbloodflowand

W hat exercise is right for and walking around the obce – the body’s ability to deliver oxygen and
you? That depends on what are ways to be active.
you want to accomplish, said Dr.
energy to working muscles.
Exercise makes it easier for those
If losing weight is your goal,
James Robinson, endowed chair taking in fewer calories, or with type 2 diabetes to control blood
of sports medicine for the College burning more, will do the trick. sugar levels, Robinson said, adding
of Community Health Sciences. Decreasing calories by 500 a that with exercise, muscles get the
Trying to lose weight? day, either by consuming less or glucose they need and the body’s
Maintain cardiovascular fitness? burning more, translates into a overall blood sugar level decreases.
Control your diabetes? While loss of one pound of fat per week. Exercise not only lowers blood glucose
exercise can benefit all of these Losing weight more quickly levels but can help with weight loss and
goals, “each requires diaerent requires burning more calories, lead to improved outcomes, or even
intensities of exercise,” said and that demands high intensity eventual cure of adult onset diabetes.
Robinson, who cares for patients activity or longer exercise periods, There is not an organ system or
at University Medical Center, Robinson said. Aerobic exercise, disease process that is not improved
which the College operates, and such as walking, running, cycling with increased activity, Robinson said.
University of Alabama athletes as and swimming, is a popular type “Everything from osteoporosis to
head team physician for the UA of weight-loss exercise. High mental health can be improved, and it
Athletic Department. intensity interval training, which doesn’t require spending a lot of money
People are often afraid of the alternates between short bursts or joining a gym. All it takes is a little
word exercise, thinking it means of intense exercise and periods time – 3 0 minutes a day, five days a
joining a gym, buying expensiveof lower intensity, is also an week, and this can even be broken up
exercise equipment or working eaective way to burn calories. into separate 10- to 15-minute bouts.”

16
 SPRING 2019

FIND
WHAT
MOVES
YOU
DR. RAY STEWART is a sports medicine
physician at University Medical Center and
assistant professor of family medicine at the
College of Community Health Sciences, which
operates UMC. He is also a team physician for
The University of Alabama Athletic Department. WHAT ARE SOME TIPS YOU HAVE
FOR SOMEONE WHO WANTS TO
WHAT DO YOU DO TO STAY ACTIVE? LIVE A HEALTHIER LIFE?
Cycling. I do mountain biking and road biking, and Whateveryoudo,itneedstobeenjoyableand
I have a stationary bike at home. I mostly do the sustainable. I started taking the stairs instead
stationary bike at home on weekdays and then on of the elevator. I don’t need to park right next to
the weekends I’ll do a road ride or a mountain bike the door at Target. I can park farther away and
trip, usually in the local area. I also do charitable walk. Those little things add up. Finding what
rides. Last year, I did five Century Rides (10 youenjoyandlittlethingsyoucanincorporate
miles) for charity. The rides are on rural roads in throughoutthedaymakesabigdiaerence.
Alabama. It’s very peaceful and they’re all for good
causes. I also occasionally run with my son, who ARE THERE ANY HEALTH-RELATED
is 10 years old. GOALS YOU HAVE ACHIEVED
RECENTLY OR PLAN TO ACHIEVE?
WHAT MOTIVATES YOU TO STAY
ACTIVE? My cholesterol is better than it has ever been.
My blood sugar is controlled without medicine.
A big motivator of being healthy is to be around My cardiovascular fitness level went from
in the future for my kids. My dad passed away average to excellent. I’m planning to do more
at (age) 60 from heart disease, so I want to live thanfiveCenturyRides(thisyear).
longer. I want to give myself the best opportunity
to be around years from now. WHAT IS AN ITEM ON YOUR
BUCKET LIST?
WHAT ARE SOME BARRIERS TO
BEING PHYSICALLY ACTIVE? I want to go to France in the summer during
the tour de France and follow the entire race
Beingadoctor,I’msobusy,justlikeeveryoneelse for the three weeks. It’s a beautiful ride on the
is. I have to make sure I do some type of physical countryside with the scenery. I love cycling so
activityusuallyfirstthinginthemorning. it would be a great trip.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 17

 PREVENTION PREVAILS

SPORTS MEDICINE FELLOWS

CARING FOR HIGH SCHOOL ATHLETES

F amily medicine physicians are often called on to

serve as team physicians for high school sports
Alabama and the region as fellows graduate and establish
their practices.
programs in their communities. To help them fill that Sports medicine fellows also care for patients at the
role, the Sports Medicine Fellowship at the College College’s Dr. Bill deShazo Sports Medicine Center, located
of Community Health Sciences oaers education and within University Medical Center, which is operated by
training in sports medicine care. the College. The center is named in honor of the late Dr.
The year-long fellowship is designed for physicians William F. deShazo, a longtime College faculty member who
who have completed a family medicine residency. introduced a sports medicine rotation into the College’s
During the year, fellows work with local high school curriculum. deShazo also chaired the College’s Department
athletes, as well as University of Alabama athletic team of Family Medicine and directed its Family Medicine
physicians, coaches, trainers and athletes, including Residency. In addition, he served as the team physician
at UA sporting events. for the UA Athletic Department from 1972 to 1985 and as
The fellowship, which launched in 2010, has a personal physician to former head football Coach Paul
impacted community sports programs throughout “Bear” Bryant.

SPORTS MEDICINE CARE

IN YOUR COMMUNITY
The team of sports medicine physicians and fellows at University Medical Center cares for
Alabamacollegiateandhighschoolathletes:

HIGH SCHOOL COLLEGIATE COMMUNITY

Tuscaloosa County High School Athletics THE UNIVERSITY OF ALABAMA Tuscaloosa Hot Hundred Bike Ride

Sipsey Valley High School Athletics Football Tuscaloosa Half Marathon

Gymnastics
Hillcrest High School Athletics Alabama Sports Festival
Softball
Alabama High School Athletic Alabama Boxing Commission
Women’s Basketball
Association All-star games Alabama Fighting Championship/
Swimming
Alabama High School Athletic Mixed Martial Arts
Track
Association All-star championship events Rowing Good Samaritan Musculoskeletal Clinic
Cheerleading and dance teams
Recreation Center club sports
Adapted Athletics
Theatre and Dance Department
SHELTON STATE ATHLETICS

18
 SPRING 2019

HEALTHY
EATING

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 19

 PREVENTION PREVAILS

MILLENNIALS
CHANGING FOOD AND EATING TRENDS

“ We can make
these trends
and things
millennials are
demanding work

“
for everyone.
Suzanne Henson, registered dietitian

BY LESLIE ZGANJAR
Among the trends they are
driving, and grocery stores and other
businesses are working to deliver,
eating take-out, so restaurants and fast-
casual chains have increased healthier
options and delivery services.
She said these developments can
benefit everyone. When people order

M
are convenience, customization and online, they get only what they order;
illennials are driving new trends healthy food. Henson said millennials in grocery stores, there are more
in the food industry, but those want convenient grab-and-go food opportunities to make impulse decisions.
changes can help everyone, from the grocery store, like hard- Restaurants and fast-casual chains have
said Suzanne Henson, a registered boiled eggs and fresh prepared improved their menu options, making
dietitian at University Medical Center meals. They want meal kits that can many of them healthier.
and assistant professor of family, be ordered online and delivered to Even grocery stores have embraced
internal, and rural medicine at the the home, and shopping and food the changes, oaering more simplified
College of Community Health Sciences. delivery services like Shipt, Instacart, foods (low sugar, fewer ingredients),
She said millennials, those born Ubereats and Waitr. They want plant-sourced meat (quinoa burgers) and
between 1981 and 1996, according to food that is natural, organic, locally pre-packaged healthier meals that can
the Pew Research Center, and aged 22 sourced and made with earth friendly be prepared or microwaved at home.
to 37, are the largest segment in the US practices and sustainable packaging. “We can make these trends and
workforceandtheywanttwokeythings: Henson said millennials also spend things millennials are demanding work
healthier food and easier access. more of their budget eating out or for everyone,” Henson said.

20
 HIDING
IN
FOOD,
HARMING
HEALTH
BY LESLIE ZGANJAR
P
eople consume more sugar and salt
than they should and it’s harmful to
their health.
According to the federal 2015-2020
Dietary Guidelines for Americans, people in
the US currently consume more than twice
the recommended daily amount of sugar
and up to four times the amount of salt,
increasing their risk for obesity, diabetes,
high blood pressure and heart disease.
A large portion of the sugar people
consume comes from sugar-sweetened
beverages, including sodas and, particularly
in the South, sweet tea, said Suzanne
Henson, a registered dietitian at University
Medical Center. She said limiting sugary
drinks, and drinking water instead of soda,
means fewer calories and better blood
sugar levels.
Consumption of sugar-sweetened
beverages can also lead to unhealthy
food choices, said Henson, also assistant
professor of family, internal, and rural
medicine at the College of Community
WINTER 2018
Health Sciences, which operates UMC.
“None of us craves an apple or a banana or
an orange when we drink a soda. We want salty
snack foods,” she said.
According to the American Heart
Association, much of the hidden salt people
consume comes from processed and prepared
foods.Hensonsaidsaltistypicallythetradeoa
for convenience.
“When you go into a restaurant, whether it’s
fast food, take out, or sit down, you’re getting
more salt than you realize. If you tend to run to
a sandwich and soup shop for lunch, that’s one
of the highest sources of salt that you can get
eating out.”
Henson said people can reduce the amount
of sugar and salt they consume with careful
attention to food choices, reading food labels
and modifying how they prepare food. Among
her suggestions: use herbs and spices instead
of salt, and replace those spice packages in
rice and pasta pre-packaged meals with low-
sodium chicken broth.
C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 21
 PREVENTION PREVAILS

HEALTHY EATING
IN YOUR COMMUNITY

DIABETES EDUCATION
UniversityMedicalCenter,whichisoperatedbytheCollegeofCommunityHealthSciences,oaersdiabetes
education for patients at all of its locations – Tuscaloosa, Northport and Demopolis. The Diabetes Self-
Management Education course consists of two classes that are three hours each. The classes are taught
by CCHS faculty and UMC providers and cover the following topics: the basics of diabetes – how to
monitor glucose and blood sugar levels, how and where to give insulin shots and how insulin works with the
body; diabetes medications and their potential side eaects; the importance of exercise; and dealing with
depression,amajorsideeaectofthedisease.UMCfirststartedtheDiabetesSelf-ManagementEducation
program in 2011 at its Tuscaloosa location.

MANAGING DIABETES THROUGH FOOD

UniversityMedicalCenteroaersguidedgrocerystoretourstoitsdiabeticpatientsaspartofitsDiabetesSelf-
Management Education course. The tours were added after receiving feedback from patients who wanted
to better apply what they learned in the diabetes education course at the grocery store. UMC nutritionist
Suzanne Henson, a registered dietitian and assistant professor of family, internal, and rural medicine at the
College of Community Health Sciences, which operates UMC, leads the guided tours. During the tours,
patients are introduced to new foods and new ways to use them, and they learn how to decipher nutrition
labels to better understand what is in the foods they buy.

DIABETES DOCTOR
Alabama ranks third in the US for the percentage of adults who have diabetes and is located squarely in
the diabetes belt, according to the US Centers for Disease Control and Prevention. People who live in the
diabetes belt are more likely to have Type 2 diabetes, which is associated with obesity and a lack of exercise.
Now, in addition to diabetes education classes and guided grocery store tours, University Medical Center
oaersspecialtycarefordiabeticandpre-diabeticpatientsviaDr.RobertOsburne,anendocrinologistwho
joinedUMClatelastyear.Endocrinologistsarephysicianswhodiagnoseandtreatdiseasesanddisorders
of the endocrine system, including diabetes and thyroid disorders. Osburne has 35 years of clinical practice
experienceandwasattheSimonWilliamsonClinicinBirmingham,Alabama,beforejoiningUMC,whichis
operated by the College of Community Health Sciences.

22
 HEALTHY EATING
IN YOUR COMMUNITY

BETTER BITES
EmployeesatTheUniversityofAlabamacannowparticipateinafive-sessionnutritionprogramtaughtby
University Medical Center nutritionist and registered dietitian Suzanne Henson. The program, Better Bites,
is oaered by WellBAMA, UA’s signature wellness program for faculty and staa. Better Bites guides UA
employees through ways to improve their food choices and to help them improve their health “one bite at a
time.”Employeeslearntomakesmartchoicesinthesupermarket,tryquick-fixmealsandfillingsnacks,and
learnhowfoodfuelsthebody.Twoserieswereoaeredthisspringandincludedgrocerystoretoursprovided
by Henson, also an assistant professor of family, internal, and rural medicine at the College of Community
Health Sciences, which operates UMC.

HEALTH CARE MEETS FOOD

TheCollegeofCommunityHealthSciencesoaersaCulinaryMedicineelectivecourseforitsmedicalstudents
and resident physicians to teach the important connection between good health and healthy eating. The
course is a partnership of CCHS and The University of Alabama College of Human Environmental Sciences
and includes lectures and interactive cooking demonstrations. The course seeks to better educate medical
students and resident physicians about nutrition and diets so that they can better educate patients and
provide helpful information when addressing chronic disease management and obesity.

U M C FA R M E R ’ S M A R K E T

This summer, the farmer’s

market came to University Medical
Center. UMC joined forces with
Ingram’s Farmers Market and
Garden Center to bring fresh
vegetables to employees and
introduce patients to foods they
might not have tried. The farmer’s
market was located in the lobby
of UMC every other Thursday
throughout the summer.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 23

 PREVENTION PREVAILS

T o highlight the benefits of exercise and healthy

eating, the College of Community Health
Sciencesfiveyearsagolauncheditsfirst-ever–and
possibly the only one of its kind anywhere – Brussels
Sprout Challenge.
On March 2, the College and University Medical
Center, which it operates, held the 5th annual
Brussels Sprout Challenge in downtown Tuscaloosa.
CCHS and UMC host the unique challenge each
year as part of the American Heart Association’s
West Alabama Heart Walk.
Partnering again with Manna Grocery and Deli in
Tuscaloosa, which roasts and donates the Brussels
sprouts served at the walk, UMC and CCHS use the
challenge to promote healthy lifestyle choices – a
healthy diet and exercise – while complementing
the American Heart Association’s mission to build
healthier lives free of heart disease and stroke.
This year, more than 700 people participated in
the Brussels Sprout Challenge.
To complete the challenge, participants have to
eat one Brussels sprout at each mile of the 3.1-mile
walk. Those who complete the challenge by eating
all three Brussels sprouts receive a t-shirt, Brussels
sprout recipes and other items at the completion of
the walk.
The mission of UMC and CCHS is to help
improve and promote the health of individuals and
communities in Alabama and the region.

24
 SPRING 2019

REDUCING
STRESS

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 25

 PREVENTION PREVAILS

BEING MINDFUL
OF STRESS

BY LESLIE ZGANJAR

S
tress is a normal part of life and, it is bringing attention to experiences
at times, serves a useful purpose, occurring in the present moment.
challenging us and helping us grow. “It’s paying attention in a certain way,”
But too much stress over a long said Boxmeyer, who also cares for patients at
period of time can be unhealthy. University Medical Center, which the College
Chronic stress causes wear and tear on operates. “It’s noticing the types of things that
the body, leading to and aggravating more are on your mind, noticing what’s going on
serious health issues. It can cause high blood around you in the present moment, noticing
pressure, abnormal heartbeat, a weaker how your body is feeling – and noticing with
immune system, depression and anxiety. intentionandwithoutjudgment.”
One way to cope is with mindfulness, Focusing on the present is key, she said.
said Dr. Caroline Boxmeyer, professor of Dwelling on the past, or experiencing fear and
psychiatry and behavioral medicine at the insecurity about the future, can be stressful
College of Community Health Sciences. andmakeitdibculttoenjoythepresent.
Mindfulness is talked about and practiced Boxmeyer said mindfulness is a way
more today because research shows that of being, “where you go through your day
it is good for health, Boxmeyer said. “It’s more aware of the present, rather than being
becomingtobethoughtof,justlikeexerciseisfocused on the past or future.
good at making our body healthy, mindfulness “We can never really turn oa our brains,
is a psychological practice that can make us but with regular practice, you can learn to
mentally healthy.” still or calm your thoughts so you’re not as
What, exactly, is mindfulness? Essentially, frantic,” she said.

26
 SPRING 2019

Working
Together
Behavioral health and primary care

BY LESLIE ZGANJAR

P
rimary care physicians are often on the front Collaborative Care Model. The most common
lines of mental health care and among the diagnoses were depression, anxiety and Post-
first providers to identify possible mental Traumatic Stress Disorder, conditions that
health issues in patients. often require systematic follow-up due to their
For that reason, and as a way to extend persistent nature.
access to mental health care services to patients, The patients received between one and four
the College of Community Health Sciences appointments monthly with a social worker and
implemented an integrated model of care at between one and two psychiatric consultations
University Medical Center, which it operates. each month.
The Collaborative Care Model at UMC works Dr. Thad Ulzen, chair of the College’s
by having primary care physicians identify Department of Psychiatry and Behavioral
patients who might be struggling with mental Medicine, said the integration of behavioral
health issues. If a patient agrees, a mental health health and primary care services brings mental
professional evaluates the patient on the same health care expertise in a timely manner to
day, and in the same exam room, where the primary care patients who might otherwise go
patient was seen by the primary care physician. months before receiving care.
Follow-up visits with the mental health and UMC’s chief medical obcer, Dr. Tom Weida,
primary care providers allow for collaboration on said primary care physicians benefit as well
diagnosis and treatment. because they have access to mental health care
Between June 2018 and January of this year, support from mental health care providers.
13 UMC patients were cared for through the

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 27

 PREVENTION PREVAILS

STOP SMOKING

28

LIGHTING UP
ELECTRONICALLY
BY LESLIE ZGANJAR
In 2017,
e-cigarette
use by high
school students
increased
78%
T he number of people in the US who
smoke has declined in recent years,
but the use of electronic cigarettes has
skyrocketed, particularly among the
nation’s youth.
According to the Food and Drug
Administration, e-cigarettes have
become the most commonly used
tobacco product by US teens. While
rates of use generally declined between
2015 and 2017, data for 2018 showed a
sharp reversal of that trend.
E-cigarette use from 2017 to 2018
by high school students (defined by
use on at least one day in the past 30
days), increased 78%, from 11.7% to
20.8%, resulting in 3 million high school
students using e-cigarettes last year.
The FDA noted that the rise in
SPRING 2019
a USB or flash drive, “in keeping
with the adolescent and college-
age wired generation,” Blum said.
The JUUL starter kit includes the
electronic device, a battery charger
that can be plugged into a computer,
andtwodiaerentflavoreddisposable
e-cigarette use is likely due to pods, each of which contains the
the recent popularity of one type same amount of nicotine as a pack of
of e-cigarettes, JUUL, as well as 20 cigarettes.
flavoredtobaccoproducts. “I’m concerned about JUUL
“JUUL is something that didn’t because it has one of the highest
even exist three years ago, and now concentrations of nicotine of any
everybody is doing it,” said Dr. Alan tobacco product,” Blum said.
Blum, professor and the Gerald The makers of e-cigarettes,
Leon Wallace, MD, Endowed Chair who include major
of Family Medicine at the College manufacturers, claim these products
cigarette
of Community Health Sciences, reduce the risks of conventional
and founder and director of The smoking because they don’t produce
University of Alabama Center for the the cancer-causing chemicals that
Study of Tobacco and Society. result from burning tobacco.
E-cigarettes contain a But research recently published in
nicotine-based liquid, not tobacco. the Journal of the American Medical
When the user inhales, a tiny Association showed that, compared
battery-powered device triggers with non-users, teenagers who take
the heating of the “e-liquid” and its up e-cigarettes are more likely to
nicotine, flavorings and propylene transition to conventional cigarettes,
glycol (to produce a vapor). risking a lifetime of addiction to
Unlike the first generation smoking
of and resulting in smoking-
e-cigarettes that have the look and related diseases.
feel of a conventional cigarette, “It’s almost like we haven’t learned
including a red LED light that glows anything from our horrific experience
when one inhales, JUUL resembles with cigarettes,” Blum said.
C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 29
 PREVENTION PREVAILS
PREVENTABLE
HEALTH RISKS AND DEATHS
BY LESLIE ZGANJAR
“I think it’s a tragedy that we’re still talking about
this issue more than 50 years after the US Surgeon
General’s report on smoking showed proof positive
that it [smoking] is the leading preventable cause of
cancer and the leading preventable cause of heart
disease,” said Dr. Alan Blum, professor and Gerald
Leon Wallace, MD, Endowed Chair of Family Medicine
at the College of Community Health Sciences.
Approximately 480,000 smoking-related deaths
occur each year in the US, and those who smoke
often don’t experience illness until 20 to 30 years after
theyfirstlightup,Blumsaid.
According to the National Institutes of Health,
cigarette smoking remains the most avoidable cause
of death. Upward of 90% of lung cancers are due to
cigarette smoking. Half of all heart disease-related
deaths are attributed to smoking, as well as more than
80% of cases of emphysema.
Blum, who also directs The University of Alabama
Center for the Study of Tobacco and Society, which
he founded in 1998, believes the ongoing smoking
pandemic is one of the worst health care failures of the
20th and 21st centuries. “Lung cancer is a man-made
tragedy that we could and should have prevented.”
A big part of the problem is that everyone thinks
the war on smoking and tobacco has been won, he
said. While smoking is banned in many places (the
College and UA have been smoke-free campuses
since 2015), and while the number of US individuals
who smoke has declined from more than 55 million 50
years ago, there were still 34.4 million adults smoking
cigarettes in 2017. More than 16 million Americans
are living with smoking-related diseases, according to
30
Lung cancer is a man-made
tragedy that we could and should
have prevented.
Dr. Alan Blum, professor and
family medicine physician
the US Centers for Disease Control and Prevention.
According to Blum, the best way to stop smoking is to go
cold turkey and buddy up with a friend or relative who has
stopped smoking or who is also trying to stop. Medications
can help some people, but they can be expensive and often
unnecessary, he said.
“Many people make stopping harder than it really is.
A simple oral substitute such as mints, sugarless gum,
unsweetened iced tea, a piece of fruit or kissing can make
stopping [smoking] a pleasurable experience. Doing simple
one-minute relaxation exercises in a quiet room or taking a
quick walk around the block or around the house can help
postpone each cigarette. So, too, can trying never to light up
onawakening,withdrinkingacupofcoaeeorwhiledriving,”
Blum said.
Money saved by not buying cigarettes is huge, he said,
adding that a-pack-a-day habit amounts to $2,000 annually.
Blum also said that smoking a pack of cigarettes a day
translates to more than 72,000 inhalations, over the course
of a year, of carbon monoxide, ammonia and formaldehyde,
as well as more than 40 known cancer-causing chemicals.
The good news is that it’s never too late to stop smoking.
Although risk of lung cancer may not decline for many years,
therearebothimmediateandlong-termbenefitstotheheart,
lungs, eyes, teeth, gums and reproductive system when one
kicks cigarettes, Blum said.
SCHOLARLY SPRING 2019

ACTIVISM
THE CENTER FOR THE STUDY OF TOBACCO AND SOCIETY
BY LESLIE ZGANJAR

T
he University of Alabama Center for the
Study of Tobacco and Society, a part of the
College of Community Health Sciences,
holds the world’s largest collection of original
materials related to the tobacco industry – newspaper
and television coverage, books, rare advertising,
photographs and promotional artifacts that document
promotion of tobacco products and the history of
eaortstocombatsmoking.
WhenhejoinedtheCollege’sDepartmentofFamily
Medicine in 1999, Dr. Alan Blum established the center
totellthestorynotjustofthesuccessesincountering
cigarette smoking and its promotion, but also of the
failures and fear of confronting the tobacco industry.
Blum, who directs the center, is professor and
Gerald Leon Wallace, MD, Endowed Chair in Family
Medicine. He is an expert on the history of tobacco
use, cigarette marketing and the anti-smoking
movement. He also serves as a public health advocate
on the topic of smoking and tobacco use through his
writing of op-eds for newspapers and editorials for
medical journals, original presentations and research
posters at national and international conferences, as
well as museum and online exhibitions created from
the center’s vast collection.
Blum and his staa, including Collection ManagerDr. Alan Blum, professor of family medicine and director
Kevin Bailey and graduate students in The University of the Center for the Study of Tobacco and Society.
of Alabama School of Library and Information
Studies, have created nearly a dozen exhibitions advertisements with celebrity endorsements from world
on tobacco-related subjects, including one in 2014 heavyweight boxing champion Joe Louis and baseball greats
commemorating the 50th anniversary of the landmark Jackie Robinson and Hank Aaron.
US Surgeon General’s Report on Smoking and Health An exhibition released in November 2018, “The Makin’s of
thatconfirmedcigarettesmokingasaleadingcauseof a Nation,” coincided with the 100th anniversary of the end of
lung cancer and other health problems. The exhibition World War I, which introduced a new generation to smoking
debuted at UA’s Gorgas Library before traveling to the via free cigarettes provided to soldiers.
Lyndon Baines Johnson Presidential Library in Austin, Cigarette advertising has been largely out of sight for
Texas, the Texas Medical Center Library in Houston, nearly two decades, since an agreement was signed by the
and the LSU Health Sciences Center in New Orleans. state attorneys general and US cigarette manufacturers to
Online exhibitions produced in fall 2018 include end cigarette billboards and remove tobacco advertising
“BigTobaccointheBigApple:HowNewYorkBecame from television and sponsorship of sporting events. But the
the Heart of the Tobacco Industry…and Anti-Smoking tobacco industry continues to maintain a firm grip on the
Activism,” and “Of Mice and Menthol,” showing 18-34-year-old population with internet-based marketing,
the history of the tobacco industry’s targeting of entertainment sponsorship and retail promotions of new
African Americans. This exhibition featured cigarette products, such as electronic cigarettes, Blum said.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 31

 PREVENTION PREVAILS

LIVE
LONGER

32
 SPRING 2019

DISCOURAGING
DE M E N T I A said Dr. Anne Halli-Tierney, a geriatrician
BY LESLIE ZGANJAR
and director of the Geriatric Clinic at
University Medical Center, which the
College operates. She said a healthy

H
lifestyle can slow or possibly keep
ealthy habits that help you dementia from gaining a foothold.
live longer could also help In a word, prevention – a healthy diet,
reduce your risk of developing exercise for the body and the mind, and
dementia and Alzheimer’s disease social engagement.
when you are older. “People ask me, ‘What do I need
Dementia represents a category of to do to not get Alzheimer’s?’ I say,
syndromes characterized by deficits ‘You need to eat a heart-healthy diet,
in memory, cognitive function and because dementia can be compounded
behavior. Alzheimer’s is the most by cardiovascular events. And, you need
common form of dementia. to be physically active, mentally active
Five million people in the US, or and socially active,’” Halli-Tierney said.
1.6% of the population, had Alzheimer’s “To be mentally active, do something
disease and related dementias in you enjoy that uses your brain. Read,
2014, according to the US Centers garden, knit. Being socially active with
for Disease Control and Prevention. friends and groups keeps your mind
That number is projected to grow to engaged. This is the advice I give
13.9 million people, nearly 3.3% of the patientstostaveoadementia.”
population, by 2060. She said there are medications that
But it’s not hopeless. can slow the progression of dementia
While mild forgetfulness is a part of and Alzheimer’s and stabilize memory,
normal aging, that’s not necessarily the but “we don’t have medications that can
case with dementia and Alzheimer’s, bring back memory that’s been lost.”
C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 33
 GERIATRICIANS
A RARE BREED
BY LESLIE ZGANJAR

A
s of 2017, there were only 62 board-certified Halli-Tierney said about 200 geriatricians graduate from
geriatricians in Alabama and only half a dozen in fellowship programs each year in the US – not nearly enough
Tuscaloosa. Estimates show there’s a need for to sustain the number of retiring practitioners who have
about 200 geriatricians in the state. training to care for older adults. And with baby boomers
“We’re kind of a rare breed,” said Dr. Anne Halli-Tierney, surging toward old age, family medicine and other primary
a board-certified geriatrician who practices at University care physicians will need training in how to manage health
Medical Center and directs its Geriatric Clinic. issues of the elderly.
Nationwide as of 2018, there were only 6,950 board-
certified geriatricians – physicians who specialize in caring
for and managing the health needs of older people. The
As of 2017, there were only
number of geriatricians in full-time clinical work is even
smaller at 3,590. With an older population in the US last year
62 board-certified geriatricians
of 49.2 million, the American Geriatrics Society estimates in Alabama.
that 22,940 full-time clinical geriatricians are needed to meet
the complex health care needs of older adults.
To help improve those statistics, the College of The US Census Bureau projects 2.1% of the US
Community Health Sciences, which operates UMC, began population will be 65 years and older in 2050, up from
a geriatrics fellowship several years ago to provide family 14.9% in 2015.
medicine physicians additional training in caring for the “At CCHS, we are preparing physicians who will go out
aging population. The fellowship program currently includes into communities and practice and impact patients’ lives
two fellows and is led by Halli-Tierney. through direct care,” Halli-Tierney said. “When our fellows
The physician fellows receive specialty training to better graduate, they are able to function eaectively in multiple
understand the complex health issues of the geriatric arenas, whether it be long-term care, end-of-life care or
population and to better assist with those needs. They quality primary care for elders in their communities.”
have opportunities to practice in nursing homes, assisted In addition, patients in some rural areas may not be able
living facilities, hospice and in behavioral health. They also to travel to see a specialist, “so if their primary care provider
maintain a heavy focus on geriatrics care in rural areas in has geriatrics training, this will help the elderly there receive
keeping with the College’s mission to train physicians for the aging appropriate care close to home,” she said.
rural areas in Alabama and the region.

34
 SPRING 2019

TRANSLATING CARE
Using knowledge and technology to leap over the language barrier

HOLA HELO
BONJUR
NIHAO

U niversity Medical Center cares for a diverse

population of patients and for some,
it just provides for a better physician-patient
relationship overall.”
Englishisnottheirfirstlanguage.Inaneaortto Guin began learning Spanish in high school
extend access to health care for these patients, and continued through college, receiving a minor
UMC, which is operated by the College of in Spanish. He doesn’t consider himself fluent
Community Health Sciences, provides on-site but said he does use his Spanish speaking skills
translation and interpretation services. when caring for UMC patients whose native
Patients who might not speak English have language is Spanish.
access to bilingual interpreters and physicians, Along with bilingual physicians, UMC patients
as well as a specialized online system that also have access to a full-time interpreter, Andrea
connects them with interpreters who speak a Castellanos,whoisfluentinSpanish.Shebegan
variety of languages. learning the language when she was seven years
“As a physician, it is very helpful to speak the old and can also read and write in Spanish.
patient’s native language,” said Dr. Russ Guin, And, she is more than an interpreter.
chief resident of The University of Alabama Castellanos works closely with patients to ensure
Family Medicine Residency, also operated by they understand the care they are receiving.
CCHS. “The patient has a better appreciation “For those patients who cannot read or
for the care you are giving them, and I think write – Spanish or English – I help with updating

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 35

 F E AT U R E

“ Our patients feel

comfortable having
someone who they can
speak with and, in a sense,
build a relationship with.

paperwork,fillingoutsign-insheets,renewingMedicaid see the patient and physician and hear the doctor visit.
applications, doing development questionnaires and any If information needs to be translated, or a physical
otherpaperworkthatneedstobefilledout,”shesaid.“Iexam explained, the interpreter can assist. The app
also interpret for patients during the sign-in process with includes interpreters who speak Arabic, German, Italian
receptionists, with the nurse while they get vitals, and for and French, among other languages.
the physician when they see the patient.” “I think it’s really unique that we are able to go into
In addition, Castellanos works with UMC receptionists the patient’s room and be able to use that service if
who might receive phone calls from Spanish-speaking we’re not comfortable being able to speak to them
patients, helping to answer questions of both the callers in their own language,” Guin said. “I think it makes
and the receptionists. She is typically the one who calls patients feel more comfortable when we are able to
Spanish-speaking patients to let them know about speak their language.”
laboratoryresults,appointmentswithaspecialistorjust Like Guin, Castellanos believes that speaking a
to follow up from a doctor visit. And, she translates patient patient’s native language creates a better relationship
medical records and other paperwork from Spanish to between the physician and the patient. “I think our
English, and from English to Spanish if needed. Spanish-speaking patients appreciate and see we
For patients who speak a language other than care for them. Our patients feel comfortable having
Spanish, UMC nurses and physicians have access to someone who they can speak with and, in a sense,
an online video interpretation system – an iPad app build a relationship with.”
that connects directly with a service that provides video
interpreters. Through the app, an online interpreter can

36
 SPRING 2019

GLOBAL
HEALTH SKILLS HELP DOCTORS CARE
FOR RURAL AND UNDERSERVED
COMMUNITIES

I n impovershd nteriaol etings, doctrs often must ecar

for patiens withou het help of medical tes, equipmnt and
medicaton. They might only have edicalm histore and physical
exams to elyr on.

particuly those who might practie in rual and undersv easr

of the US, includg in Alabm, whic is why. DrJane id W wanted
the study and exprinc of globa healt part of The Universty of
Alabm Family Medicne Residency curilm. The esidncyr is
operatd by the Coleg of Comunity Health Sciens.
“Is t’ importan to se doctrs ecar for patiens in a low-incme
onmet,”vir sad ei, W a family medicn physican and asocite
esidncyr ectordi who has traveld interaoly to ovidepr healt
e,car most ecntlyr in Hait. ou “Y have to use listeng skil and
thinkg skil emor becaus you might not have aces to tes.
And you tcan’ just escribp medicatons becaus they might not be
avilbe e.”thr
The skil ear importan evn for family medicn physican who
might not practie in rual and undersv comunites becaus
doctrs ned to ecar for an easinglycr divers US domestic
poulatin tha includes milons of peol not born in the US.
“Experincg alterniv oachespr to healt ecar delivry in
seting of limted ces,our ewhr the diagnos is based primaly
on the medical history and physical exam, ear skil tha ear very
helpfu,” eida W said.
In aditon, having os-cultra exprincs withn medicn
can help physican becom emor cultray competn.
eida W devlop a globa healt curilm in Machr 2017 for
esidntr of the Coleg, and by July of tha year the curilm

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 37

 F E AT U R E
Dr. Jane Weida, associate professor and interim
chair of the Department of Family, Internal, and
Rural Medicine, and associate director of the UA
Family Medicine Residency.
38
launched, with presentations by Weida and several
residents who had made international medical trips
earlier in their residency training (page 39). The UA
Family Medicine Residency is a three-year program
that educates and trains physicians in the specialty of
family medicine and is one of the largest and oldest
such programs in the US.
As part of the two-year Global Health Curriculum,
residents meet at least once a month, often twice
a month, to hear formal presentations from CCHS
faculty and residents on global health topics, including
tuberculosis, water and food safety, malaria, zika,
Ebola and malnutrition.
Residents are required, during either their second
or third year of residency, to spend two weeks working
and providing health care in a developing country.
They also write reflective essays, and present about
their experiences to fellow residents.
At the conclusion of the two years, residents
receive a Certificate in Global Health. Weida said the
certificate looks good on a resume, particularly when
residents apply for fellowships, “and it’s just a really
good experience for residents.”
Residents travel to Ghana, Egypt, Haiti, Cuba and
a domestic Native American site, where CCHS faculty
have global health experience and connections, but
they can also select their own sites.
Weida said she hopes the residency can do more
in Cuba, where UA has an educational exchange
program “and provide medical sites in Cuba in which
residents and faculty can work, and possibly an
exchange program.”
 SPRING 2019

HAITI
Dr. Jane Weida has made a number of trips to Haiti as
part of Family Medicine Cares, a humanitarian program of the
American Academy of Family Physicians. She first traveled
to Haiti shortly after a 7.0 magnitude earthquake in 2010
devastated the country, one of the poorest in the Western
Hemisphere, and hospitals were overwhelmed with patients.
She returned to Haiti in 2015, again as part of Family Medicine
Cares, and the group provided patient care, medical education
andserviceprojects.

EL SALVADOR AND HONDURAS

Chief resident Dr. Elizabeth Junkin made trips in 2016 as
a fourth-year medical student to El Salvador and Honduras.
In El Salvador, she and members of the group she was with
assisted at medical clinics and purchased medications with
donated money – “Ibuprofen, antibiotics, simple things, but
these people don’t have access even to the simple things,”
she said. During her time in Honduras, she worked in a one-
room clinic at a school. “The people there would wait for hours
and hours to see us,” Junkin said. “It’s always a very humbling
experience. It makes you appreciate what you have.”

GUATEMALA
Third-year resident Dr. John Lundeen said his experience
in Guatemala was “eye-opening. There was no clean or
reliable water, food or health care for the people there.” He
accompanied a group that had constructed a compound in the
country with water treatment and electricity plants, a school
and a hospital. “Outside the compound was the most crushing
poverty I’ve seen in my life,” Lundeen said. The American
group set up a clinic in a school in the mountains where he
helped treat everything from dog bites to malnutrition. The
group also provided meals to the local residents “to try and
minimize the suaering that way. There was never enough to
go around.”

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 39

 F E AT U R E

LECTURE TOPICS OF THE CCHS

GLOBAL HEALTH CURRICULUM

Malaria Ebola
Dengue Malnutrition
Tuberculosis Vitamin deficiencies
Round worms Reproductive health
Yellow fever Treating diabetes in
Typhoid fever resource-poor areas

Cholera Treating chronic diseases such as

COPD, asthma and hypertension
Zika in resource-poor areas

40
 SPRING 2019

Residents and faculty from The University of

Alabama Family Medicine Residency last year
attended the American Association of Family
Physicians National Conference in Kansas City –
the largest recruiting event for prospective family
medicine residents. The UA Family Medicine
Residency, which is operated by the College
of Community Health Sciences, gave away
hundreds of stress-relief elephants and footballs,
bags and cups at the conference, but the biggest
hit was mini Dreamland BBQ sauce bottles – a
taste of Tuscaloosa.

The Board of Visitors of the College of

Community Health Sciences includes donors,
alumni, retired faculty and community
physicians who help the College develop
partnerships with Alabama communities
and state and national organizations, secure
financialresources,anddevelopopportunities
for medical students and resident physicians.
The board meets biannually.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 41

 SNAPSHOTS

The College of Community Health Sciences last year unveiled newly renovated meeting and classroom
space to accommodate the growth of CCHS and its medical education programs. Pictured here is the
Community Room.

The College of Community Health Sciences annually awards scholarships and other awards to medical
students, resident physicians, and students in the College’s Rural Health Leaders Pipeline programs.
Names of all recipients are included on plaques that hang in the College’s main building on The University
of Alabama campus.

The College of Community Health Sciences on The University of Alabama campus encompasses
classroomsformedicaleducation,administrativeobcesandUniversityMedicalCenter,thelargest
community medical practice in West Alabama.

42
 SPRING 2019

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 43

 SNAPSHOTS

Physicians and staa from University

Medical Center in Demopolis attended
the city’s Christmas on the River annual
celebration to promote the new UMC
location there. UMC is operated by the
College of Community Health Sciences.

TheCollegeofCommunityHealthSciencesBoardofVisitorsmembers,facultyandstaagatheredfor
the annual fall cocktail party at the Historic Drish House in Tuscaloosa. The house, built by the late
physician Dr. John R. Drish, is a distinctive mix of the Greek Revival and Italianate styles.

44
 S PI N
W R TI N
EGR 2019
8

A vibrant sunset over University Medical Center, a multi-specialty community medical practice
that cares for nearly 150,000 patients annually and is operated by the College of Community
Health Sciences.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 45

 N E W F A C U LT Y

FA C U LT YNEW TO THE COLLEGE

of COMMUNITY HEALTH SCIENCES
DR. MARYAM BIDGOLI
Dr.MaryamBidgolijoinedtheCollegeasassistantprofessorofHealthEconomicsin
the Department of Community Medicine and Population Health and the Institute for
Rural Health Research. Bidgoli earned doctoral and master’s degrees in Economics
from Wayne State University in Detroit, Michigan. She served as a visiting assistant
professor of Health Economics for the University of Connecticut Business School
Finance Department, and has taught a wide range of economics courses, including
microeconomics, health care management, health care industry analysis, statistics
and econometrics, and health economics. She was the recipient of the BlueCross
BlueShield of Michigan Foundation Doctoral Student Award for her proposal, “Health
Shocks and Labor Markets: Cancer in Michigan.” Her professional interests include
health economics, health care management and labor economics.

DR. JOY BRADLEY

Dr. Joy Bradley joined the College as assistant professor in the Department of
Community Medicine and Population Health. She also works with the College’s
Institute for Rural Health Research. Bradley originally joined the College as a post-
doctoral fellow in 2017. She received a PhD in Health Promotion and Behavior from
the University of Georgia. She received her master’s degree in Marriage and Family
Therapy/Counseling from the University of Louisiana at Monroe, and her bachelor’s
degree in Psychology from Albany State University in Albany, Georgia.

DR. CARRIE COXWELL

Dr.CarrieCoxwelljoinedtheCollegeasassistantprofessorintheDepartmentofFamily,
Internal, and Rural Medicine. Coxwell also practices family medicine and obstetrics
and gynecology at University Medical Center locations in Tuscaloosa, Northport and
Demopolis. UMC is operated by the College. Coxwell is a graduate of the University of
Alabama School of Medicine and completed her residency training at The University
of Alabama Family Medicine Residency, which is operated by the College. She also
completed the Obstetrics Fellowship for Family Medicine Physicians, at the College,
which trains family medicine physicians to provide quality obstetrical care and seeks
to address the need for obstetric and gynecological care in rural communities.

46
 SPRING 2019

DR. RANDI HENDERSON-MITCHELL

Dr. Randi Henderson-Mitchell joined the College as assistant professor in the
Department of Community Medicine and Population Health. She also works with the
College’s Institute for Rural Health Research. Henderson-Mitchell previously served
as a research data analyst for the Institute, and before that was a graduate research
assistant with the Institute. She received her PhD and an MBA from The University of

ES
Alabama. She earned a master’s degree in Health Education from Baylor University
in Waco, Texas, and completed her undergraduate degree at Texas Tech University
in Lubbock.

DR. ROBERT OSBURNE

Dr.RobertOsburne,aboard-certifiedendocrinologistwithyears 53 ofclinicalpractice
experience, joined the College as assistant professor in the Department of Family,
Internal, and Rural Medicine. Osburne also cares for patients at University Medical Center,
which is operated by the College. He retired last year from Simon Williamson Clinic in
Birmingham, Alabama, where his practice focused on diabetes and thyroid diseases. He
has also been associated with community hospital internal medicine residency training
for 30 years, including with Baptist Medical Center Princeton in Birmingham, Alabama,
and Atlanta Medical Center in Georgia. Osburne received his bachelor’s degree from
Emory University in Atlanta and his master’s degree in basic medical sciences from
the University of Alabama at Birmingham. He received his MBA from The University of
Alabama and his medical degree from the UA School of Medicine. Osburne completed
an internal medicine residency at Portsmouth Naval Hospital in Portsmouth, Virginia,
and a fellowship in endocrinology and metabolism at the National Naval Medical Center
in Bethesda, Maryland.

DR. MICHELLE PIKE

Dr. Michelle Pike joined the College as a part-time adjunct faculty member in the
Department of Family, Internal, and Rural Medicine. Pike will assist with The
University of Alabama-Pickens County Partnership, led by the College and which
works to place UA students in medicine, nursing, social work, nutrition, psychology
and health education in Pickens County for internships and learning experiences.
Pike is also Emergency Services Medical Director at Pickens County Medical Center.
She completed her undergraduate degree at Truman State University in Missouri,
during which she also earned a paramedic license. She worked on an Advanced Life
Support Unit as a paramedic on critical care and emergency patient transports before
entering medical school at the American University of the Caribbean, St. Maarten,
Netherlands Antilies. She completed her residency training at the UA Family Medicine
Residency, which is operated by the College. She completed the College’s Emergency
MedicineFellowship,whichisprovidedinconjunctionwithRushFoundationHospital
in Meridian, Mississippi.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 47

 N E W F A C U LT Y

DR. JEAN POINTON

Dr.JeanPointonjoinedtheCollegeasassistantprofessorofpsychiatryandbehavioral
medicine. She cares for patients at University Medical Center, which the College
operates, and teaches and supervises the College’s family medicine residents, medical
students and clinical learners. Pointon earned bachelor’s and master’s degrees in
chemical engineering from Mississippi State University. After working for Exxon as
a chemical engineer with positions in the Peoples Republic of China and the United
Kingdom, she earned her medical degree from the University of Texas Southwestern
Medical School in Dallas. She completed residency training at Baylor College of
Medicine in Houston, Texas, and a fellowship at the University of Houston Health
ScienceCenter.Sheisboardcertifiedinchildandadolescentandgeneralpsychiatry
and has extensive inpatient and outpatient experience.

DR. SALAH UDDIN

Dr. Salah Uddin joined the College as a neurology hospitalist. Uddin will care for
University Medical Center patients at DCH Regional Medical Center in Tuscaloosa
and will be part of the teaching team that works with the College’s residents and
medical students. The College operates UMC. Uddin graduated from the University of
Dhaka Medical College in Bangladesh. He completed a neurology residency at John
F. Kennedy Medical Center in Edison, New Jersey, and a post-doctoral fellowship at
StrongMemorialHospitalattheUniversityofRochesterinNewYork.Priortojoining
the College, Uddin was director of Neurology and Stroke at Shelby Baptist Hospital in
Alabaster, Alabama.

DR. ELIZABETH WESTERN

Dr.ElizabethWesternjoinedtheCollegeasapart-timeadjunctfacultymemberinthe
Department of Family, Internal, and Rural Medicine. She is primarily responsible for
teaching and curriculum development for the College’s Rural Medical Scholars Program,
which is exclusively for rural Alabama students who want to become physicians and
practice in rural communities. The program includes a year of study, after students
receive their undergraduate degree, that leads to a master’s degree in Rural Community
Health and early admission to the University of Alabama School of Medicine. Western
received a bachelor’s degree in Chemistry from Middle Tennessee State University, and
a master’s degree and PhD in Organic Chemistry from UA. She received her medical
degree from the UA School of Medicine and completed her residency training at the
UA Family Medicine Residency, which is operated by the College. She was in private
practice in Tuscaloosa for the past six years and currently is also a hospitalist for the
TuscaloosaVeteran’sAaairsMedicalCenter.

48
 SPRING 2019

ANDREA WRIGHT
AndreaWright,MLIS,joinedtheCollegeasassociateprofessorandclinical/technical
services librarian in the Health Sciences Library. Wright is responsible for supporting
evidence-based practice at University Medical Center, which the College operates,
and providing access to the latest research to support patient care. She also
collaborates in research and publishing eaorts at the College, provides instructional
support in research and evidence-based medicine and manages online access
to library resources. Wright earned her master’s degree in Library and Information
Studies from The University of Alabama and a bachelor’s degree in History from the
University of North Alabama. She spent nine years oaering research support and
evidence-based medicine education as a technology and information services librarian
at the University of South Alabama Biomedical Library before serving for a year as a
digital projects librarian at UA. In,4102Wright received a Georgia/National Library
of Medicine Biomedical Informatics Fellowship. Her interests include research and
data management, technology and informatics services in libraries, reducing health
disparities and evidence-based health care.

SEVEN FELLOWS
The College of Community Health Sciences has fellows in its Obstetrics, Geriatrics and
Sports Medicine fellowships.
These fellowships, along with Emergency Medicine, Behavioral Health, Hospital Medicine
andRuralPublicPsychiatry,comprisethesevenfellowshipsoaeredbytheCollege.
Each fellowship is a year-long program designed to provide additional, specialized
training to family medicine physicians.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 49

 N E W F A C U LT Y

OBSTETRICS

Drs. Cheree Melton and Ashley Wambolt are obstetrics

fellows.TheObstetricsFellowship,oneofthefirstofitskindinthe
country, aims to address the need for obstetric care in rural areas.
Obstetrics fellows master high-risk, operative obstetrics and
obce OB/GYN procedures, including ultrasound, colposcopy,
cryotherapy and endometrial biopsies. They also care for patients Melton
at University Medical Center, which the College operates. Melton
and Wambolt are graduates of The University of Alabama Family
Medicine Residency, which the College operates.

Wambolt

G E R I AT R I C S

Drs. Brittany McArthur and Jackie Luker are geriatrics fellows.

The Geriatric Fellowship oaers a variety of experiences, including
collaborating with interdisciplinary teams and working at nursing
home facilities, geriatric psychiatry facilities, hospice and assisted
living facilities. The fellowship also provides opportunities to work
McArthur in rural settings and the fellows care for patients at University
Medical Center, which is operated by the College. McArthur and
Luker are graduates of The University of Alabama Family Medicine
Residency, which the College operates.

Luker

SPORTS MEDICINE

Drs. Michael Bradburn and Aloiya Earl are sports medicine fellows.
The Sports Medicine Fellowship oaers education, training and
certification to family medicine physicians, who are often called to
serve as team physicians for high school sports programs in their
communities. Bradburn completed his family medicine residency at
St. Joseph Mercy Livingston in Howell, Michigan. Earl completed her
residency at The Ohio State University Family Medicine Residency in Bradburn
Columbus, Ohio.

Earl

50
 SPRING 2019

ACCOLADES
Crowther Selected for
SEC Academic Leadership Program
Dr. Martha Crowther, professor of community medicine and
population health at the College of Community Health Sciences,
was selected as a fellow for the 2018-19 SEC Academic Leadership
Development Program.
The fellowship program is an opportunity for faculty to prepare
for advanced academic leadership roles within the Southeastern
Conference. The program brings together faculty fellows from
eachSECcampustoprovidehigher-educationspecificleadership
and management training.
The 91-8 02 program takes place at two diaerent SEC
campuses – Tennessee and Kentucky – and consists of workshops
focused on developing academic management skills. Through this
program, Crowther is participating in The University of Alabama’s
2018-19 class of Leadership University.

Weida Appointed to
Women’s Health Steering Committee
Dr. Jane Weida, an associate professor of family, internal, and
rural medicine at the College of Community Health Sciences, was
appointed to a state committee focused on women’s health.
Weidawasappointedtoatwo-yeartermontheObceofWomen’s
Health Steering Committee.
The obce is part of the Alabama Department of Public Health
and was created in 2002 to educate the public and be an advocate
for women’s health, with an emphasis on preventive health and
healthylifestyles.Committeemembersassistthestatehealthobcer
in identifying, coordinating and establishing priorities for programs,
services and resources the state should provide for women’s health
issues and concerns.
Weida is also serving as interim chair of the Department of
Family, Internal, and Rural Medicine, and is associate director of the
College’s family medicine residency.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 51

 ACCOLADES

Culmer Receives
2019 New Faculty Scholar Award
Dr. Nathan Culmer, assistant professor of medical education and
director of academic technologies and faculty development for the
College of Community Health Sciences, was selected by the Society
of Teachers of Family Medicine Foundation as one of 10 recipients of
the 2019 New Faculty Scholar Award.
Theawardrecognizesleadershippotentialandprovidesfinancial
support to attend this year’s Society of Teachers of Family Medicine
spring conference in Toronto, Canada. As part of the award, Culmer
will provide a presentation at a conference breakfast roundtable.
In his role with the College, Culmer leads the utilization of
educational and simulation technology, as well as distance technology
aspects of telehealth services. He also oversees faculty development.
Culmer received his bachelor’s degree from Utah State University,
a master’s degreee in human communication studies from California
State University-Fullerton, and a doctorate in higher education from the University of Iowa. Before
joiningtheCollege,hespentfouryearsatPennsylvaniaStateUniversitywithresponsibilitiesin
instructional design.

Looney Recognized
for Professional Leadership
Wyndy Looney, director of nursing for University Medical Center,
received the Janet S. Awtrey Award, which recognizes nurse leaders
in practice for their contributions to the nursing profession. The
award is presented by The University of Alabama Capstone College
of Nursing.
Dr. Suzanne Prevost, dean of the College of Nursing, said Looney
has been a collaborative partner and has provided the college
valuable support since she has been at UMC and while she was at
DCH Health System in Tuscaloosa.
Looney joined UMC, which is operated by the College of
Community Health Sciences, in 2017. She serves as chief nursing
obcer and has primary responsibility for implementing quality
improvementactivities.BeforejoiningCCHS,Looneywasmanager
of nursing operations and analytics at DCH, responsible for day-to-
day operations of the Patient Care Services Division.

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 SPRING 2019

Yerby Receives
Lahoma Adams Buford Award
Dr. Lea Yerby, associate professor and vice chair of the
Department of Community Medicine and Population Health at the
College of Community Health Sciences, received the prestigious
Lahoma Adams Buford Peace Award in 2018.
The University of Alabama award is given annually to a faculty
member who, in his or her teaching, research, professional
practice and personal life, has demonstrated exceptional levels
of involvement in mediating human disputes, helping overcome
prejudice,promotingjusticeandestablishingpeace.
Yerby has dedicated her career to research and service of
rural health disparities and health quality outcomes in Alabama,
from supporting policy changes to equitably fund HIV services, to
assessingtheebcacyofMedicaid.Sheiscurrentlystudyingaccess
to autism spectrum disorder screening and early interventions for
rural children.
Her local service in rural health has been concentrated with the Tuscaloosa Campaign to Prevent
Teen Pregnancy, West Alabama AIDS Outreach (now Five Horizons), the Alabama HIV Policy and
Advocacy Committee and Family Counseling Services.
“The weight of getting this award is even more humbling, given our current culture and climate,”
Yerbysaid.“Ifeelanevengreaterweightandresponsibilityofrunningthemarathonforjustice.”

Henson Elected to
National Academy Position
Suzanne Henson, RD, LD, a registered dietitian at University
Medical Center, was elected Alabama’s delegate to the National
Academy of Nutrition and Dietetics and will serve a three-year
term. The academy is the world’s largest organization of food and
nutritional professionals.
In addition to her role with UMC, which is operated by the
College of Community Health Sciences, Henson is also an assistant
professor of family, internal, and rural medicine. She is responsible for
the education, coordination and provision of nutritional information
to resident physicians and medical students, and she assists UMC
patients in the promotion of their health.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 53

 ACCOLADES

Sheppard Receives
Distinguished Service Award
Dr. Robert Sheppard, associate professor of medicine
and founder and director of Hospitalist Medicine
Services and the Hospitalist Medicine Fellowship
for the College of Community Health Sciences, was
awarded the 2019 Distinguished Service Award from
The University of Alabama Medical Alumni Association.
The award is given “for superior accomplishments
and contributions to the University of Alabama School
of Medicine.”
Sheppard was in private practice for 25 years
beforejoiningtheCollegeandbeginningthehospitalist
medicine program at DCH Regional Medical Center
in Tuscaloosa. He has primary clinical teaching
responsibilities for the College’s medical students,
residents and hospitalist fellows.
He has received numerous teaching awards from the
College and the UA School of Medicine, including the Argus Award, Patrick McCue Award,
Golden Stethoscope Award and Best Clinical Instructor Award.
Sheppard received bachelor’s degrees in biology and chemistry from UA and his medical
degree from the UA School of Medicine. He completed residency training in categorical
internal medicine, with a focus on cardiology, at the University of South Alabama Medical
College in Mobile.

College Faculty Recognized

with Argus Awards
Tuscaloosa campus winners of the 2018 Argus Awards:
Students from the University of Alabama School Best Clinical Department
of Medicine named faculty, a resident and clinical Neurology
departments on the Tuscaloosa Regional Campus Pediatrics
winners of the 2018 Argus Awards. Surgery
The College of Community Health Sciences,
which operates The University of Alabama Family Best Clinical Educator
Medicine Residency and University Medical Center,
also serves as the School of Medicine’s Tuscaloosa Dr. Charles Gross, Department of Surgery
Regional Campus and provides clinical education for Dr. Catherine Ikard, Department of Neurology
a portion of third- and fourth-year medical students. Dr. Heather Taylor, Department of Pediatrics
The Argus Awards give medical students the
chance to honor their mentors, professors, courses Best Resident Educator
and course directors for outstanding service to Dr. Russ Guin, The University of Alabama
medical education and clinical training. Family Medicine Residency

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 SPRING 2019

Lavender Elected
to Medical Education Council
Dr. Drake Lavender, assistant professor of family medicine at
the College of Community Health Sciences, was re-elected to
a three-year term on the Council on Medical Education for the
Medical Association of the State of Alabama.
He was also elected chair of the council for 2018-19. In addition
to his faculty position, Lavender also serves in leadership roles in
the College’s medical student education programs.

Chief Residents
2018–2019 Academic Year

Dr. Tiffani Thomas Dr. Elizabeth Junkin Dr. Russ Guin

Three residents of The University of Alabama Family Medicine Residency are serving as chief
residents:Drs.RussellGuin,ElizabethJunkinandTiaaniThomas.Theresidencyisathree-yearpost-
graduate medical education program of the College of Community Health Sciences that leads to board
certificationinfamilymedicine.
Guin, of Northport, Alabama, is a graduate of the UA School of Medicine, based in Birmingham. He
completed his third and fourth years of clinical education at the College, which also serves as a regional
campus for the School of Medicine. After residency, Guin plans to practice outpatient family medicine.
Junkin, originally from Duncanville, Alabama, also earned her medical degree from the UA School
of Medicine and completed her third and fourth years of clinical training at the College. After residency,
Junkin plans to practice family medicine with obstetrics in rural Alabama.
Thomas, of Newburg, South Carolina, received her medical degree from the Medical University of
South Carolina in Charleston. She plans to practice in a rural area after residency. The residents were
elected by their peers for their outstanding clinical and leadership skills.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 55

 ACADEMIA

ACADEMIA
Gregg Receives Funding from
Council
Dr. Abbey Gregg, assistant professor of community medicine and
population health at the College of Community Health Sciences,
received funding for research and travel from The University of
Alabama Council on Community-Based Partnerships.
Gregg received $3,250 from the council’s Seed Funding
Committeeforherproject,“ReadinessforCommunityParamedicine
and Integrated Mobile Health Care Interventions in Alabama’s EMS
Agencies and Hospitals.” She also received $1,000 from the council’s
Academic Conference and Presentation Committee for travel this
year to the Academy of Health Conference in Seattle, Washington,
and the NACCHO Conference in New Orleans.

Bradley Attends Robert

Wood Johnson Foundation Symposium
Dr. Joy Bradley, assistant professor of community medicine
and population health at the College of Community Health
Sciences, participated in a Robert Wood Johnson Foundation
funded symposium that brings together scholars from historically
underrepresentedgroupsworkinginfieldsthatintersectwithhealth
and health care.
The New Connections Symposium Bradley attended, titled “From
ResearchtoAction:TakingYourResearchBeyondtheJournal,”was
held in February at Drexel University in Philadelphia. The RWJF, the
nation’s largest philanthropy devoted to public health, built the New
Connections program to create a broad network of early career
researchers interested in the foundation’s goal of building a national
“culture of health” that enables everyone in society to lead healthier
lives. New Connections currently supports a network of more than
900 underrepresented investigators.
“It’s (the symposium) given me a lot of thoughts about how to communicate my work, how to be
morecommunityengagedandhowaudiencesaregoingtobenefit,”shesaid.

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 SPRING 2019

Geno and Robinson Complete

STFM Fellowship
Dr. Ed Geno, assistant professor
of family, internal, and rural medicine
at the College of Community Health
Sciences, and Dr. Cecil Robinson,
associate professor and director of
learning resources and evaluation
for the College, completed the
2018 Emerging Leaders Class of
the Society of Teachers in Family
Medicine. The competitive STFM
fellowship provides training and
support to new faculty and those
transitioning to leadership roles.
Geno works with the College’s
family medicine residents in minor surgery and hospital medicine
education and training. Robinson works with undergraduate and
graduate medical educators and administrators at the College to
examine, assess and improve education practices, processes and
outcomes. He also works to advance interprofessional education
Above: Geno among health faculty and professionals at UA.
Left: Robinson

Boxmeyer Completes
Leadership Program
Dr. Caroline Boxmeyer, assistant dean for academic aaairs for
the College of Community Health Sciences, completed Leadership
U,aUniversityofAlabamaprogramthatpreparesfacultyandstaa
in leadership positions to assume increasing levels of responsibility
within their organizations and to be forward-thinking – anticipating
future challenges and envisioning opportunities for success.
During the program, participants met with UA leaders to learn more
about the University, its goals and mission and the leadership styles
of UA’s top administrators. Participants took part in professional
development workshops, including at LSU and Auburn University.
“A consistent theme that we learned about leadership is the
importance of focusing on the mission of your organization and
how each department and employee contributes to this mission,”
Boxmeyer said.
LeadershipU,whichbeganinis ,01 2 oaeredbytheUAObceforAcademicAaairs.

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 57

 ACADEMIA

The Gerontologist
Payne-Foster
Dr. Pamela Payne-Foster, a professor of community medicine and
population health at the College of Community Health Sciences,
authored “Preparation and Planning for Future Care in the Deep
South: Adapting a Validated Tool for Cultural Sensitivity,” with
Rebecca Allen, JoAnn Oliver, Morgan Eichorst, Lisa Mieskowski
and Silvia Sorensen, to be published in The Gerontologist.

Book Chapter Publication

Halli-Tierney
Dr. Anne Halli-Tierney, assistant professor of family, internal,
and rural medicine at the College of Community Health
Sciences and a practicing geriatrician at University Medical
Center, published a book chapter, “Ethical issues in palliative
and end-of-life care,” with co-authors Amy Albright, Deanna
Dragan, Megal Lippe and Rebecca Allen in Palliative and End
of Life Care: Disease, Social and Cultural Context, edited by
Rebecca Allen, Brian Carpenter and Morgan Eichorst.

Academic Articles
Halli-Tierney, Williams, Culmer
Drs. Anne Halli-Tierney and Nathan Culmer,
and Nelle Williams, faculty at the College of
Community Health Sciences, co-authored two
articles, “Videoconferencing Psychological
Therapy and Anxiety: A Systemic Review”
and “Videoconferencing Psychotherapy and
Depression: A Systematic Review” with Dr.
Blake Berryhill from The University of Alabama
College of Human Environmental Sciences as
lead author.

58
 SPRING 2019

MASTER OF SCIENCE IN SPRING 2019

POPULATION HEALTH
Population health is the future of health care and integrates clinical and public health practices with data analytics to prevent, reduce and
manage human disease. Our degree program has faculty with backgrounds in business, health policy, medicine, nursing, psychology,
health promotion and public health that will provide our students with the training neeeded to resolve complex health issues in the
evolving landscape of the healthcare system. Our program is suitable for both practicing and future health professionals.

IMPROVE HEALTH AND HEALTH CARE

Depending upon the elective courses you choose and your professional background, you can lead population health clinical practice
management initiatives, conduct your own research and/or design community-based health programs.

You will be better equipped to participate in care delivery redesign and achieve the triple aim of improving patient experiences,
improving health outcomes and reducing health care costs.

FLEXIBLE PROGRAM OPTIONS

The program is based in the College of Community Health Sciences’s Department of Community Medicine and Population Health
and incorporates faculty from the UA Culverhouse College of Business. Classes are offered both in the traditional in-person setting
or online for students who need more flexibility with their schedule. There are slight differences in the elective courses offered
to students in the in-person and online programs. Both full-time and part-time study is allowed, and students have the option of
completing a thesis or capstone project.

Practicing health professionals are encouraged to use the thesis and capstone opportunities to apply their skills to a population
health problem within their own place of work.

FOR MORE INFORMATION VISIT CCHS.UA.EDU/POPHEALTH

C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 59
 HIGHLIGHTS

We invite you to be one in

a million to help speed up
medical breakthroughs. To start your journey, go to Participant.JoinAllofUs.org and:

1 Create an account
The more researchers know about what 2 Give your consent
makes each of us unique, the more tailored 3 Agree to share your electronic health records
our health care can become.
4 Answer health surveys

5 Have your measurements taken (height, weight, blood

Join a research effort with one million pressure, etc.) and give blood and urine samples, if asked
or more people nationwide to create a
healthier future for all of us. After completing these steps, you’ll receive $25.

To learn more and to enroll, contact us at:

allofus@ua.edu | (205)348-6991 | JoinAllofUs.org/UAmedcenter
60All of Us and the All of Us logo are service marks of the U.S. Department of Health and Human Services.
C O L L E G E O F C O MMU N I T Y H E ALT H S C IEN C ES 61
 Nonprofit Organization
U.S. Postage
PAID
The University
of Alabama
P.O. Box 870326
Tuscaloosa, AL 35487-O326

CHANGE SERVICE REQUESTED

62