Mental Health is Public Health - 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
Mental Health
is Public Health
Saturday, February 4, 2023
UT Health San AntonioTable of Contents
Overview
Introduction........................................................................................................................ 1
Conference Objectives.................................................................................................... 1
Lunch Instructions............................................................................................................ 1
Welcome Letter................................................................................................................ 2
Conference Agenda........................................................................................................ 3
Poster Session Details
Blue Ribbon Awards......................................................................................................... 4
Judges’ Choice Award....................................................................................................... 4
Interprofessional Education (IPE) Award..................................................................... 4
Presentation Summaries & Presenter Bios
Opening Remarks
Mental
Speakers: Melanie Stone, DrPH(c), MPH, MEd
Vasan Ramachandran, MC, FACC, FAHA..................................................................... 5
Keynote: The Social Determinants of Mental Health
Health
Speaker: Ruth Shim, MD, MPH........................................................................................ 5
Breakout Workshop A: Behavioral Health 101 and
Practical Strategies for Providers
Speakers: Bryna Nationa, LMSW, and Cynthia Sierra, LPC...................................... 6
is
Breakout Workshop B: Crisis Response Planning (CRP) for Mental Health
Speaker: David Roberts, PhD, and Feiyu Li, PhD........................................................ 6
Breakout Workshop C: Behavioral Health Integration into
Public
Pediatric Primary Care
Speaker: Roshni Koli, MD................................................................................................ 7
Plenary: State of the State of Texas Public Behavioral Healthcare System................8
Health
Poster Sessions Introductory Remarks
Speaker: Jelynne LeBlanc Jamison, MA.......................................................................... 8
Student Poster Abstracts
Capacity Building............................................................................................................... 9
Clinical Service.................................................................................................................15
Education........................................................................................................................... 21
Outreach........................................................................................................................... 49
Acknowledgements
Planning Committee.......................................................................................................57
Faculty Mentors...............................................................................................................59
Community Partners......................................................................................................60
Sponsors............................................................................................... Inside Back Cover
Index of Student Poster Abstracts....................................................................612023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Mental Health is Public Health
Introduction
UT Health San Antonio is committed to engaging our community to improve health. In support of our university’s
service mission, our students use what they learn both inside and outside of the classroom to empower medically
underserved communities in San Antonio, across Texas and around the globe. The Community Service Learning
(CSL) Program provides a structure to engage faculty, staff and institutional support of these activities.
CSL is a structured learning experience that combines community service with explicit learning objectives,
preparation, mentorship and reflection. Health Science Center students address community-identified needs while
learning about the context in which illness develops, connecting their academic coursework to real-life situations,
and reflecting on their roles as future healthcare professionals. At the Center for Medical Humanities & Ethics, we
believe CSL is ethics in action. We are proud of the leadership that our students exhibit and the promise that they
will become community-connected healthcare providers who work to reduce disparities and enhance access to
care throughout their careers.
The Annual CSL Conference at UT Health San Antonio originated in 2008 as an opportunity to learn from the
CSL experiences of students, faculty, staff, and community partners in San Antonio and across Texas. Each year, the
conference focuses on a theme relevant to service-learning and hosts experts and guest lecturers, provides skill-
building sessions, and showcases CSL projects through students’ poster presentations. Presented by the Center
for Medical Humanities & Ethics in conjunction with an interprofessional planning committee, the conference is free
and open to the community.
Conference Objectives
• To share best practices and scholarship in community service learning with a focus on addressing mental health
as a public health issue.
• To bring together an interprofessional group of University of Texas (UT) Health Science Center students, faculty,
and staff from across the state with community partners to foster service-learning collaborations.
• To highlight existing UT Health Science System community service learning projects and future opportunities
with community partners.
• To recognize and reward excellence in community service learning within the UT Health Science System.
Lunch
Pick up between 11:30 – 11:45 a.m. in Holly Auditorium Foyer
Boxed lunches are provided to those who registered by the January 29 deadline and will be available for pick up in
the Holly Auditorium Foyer beginning at 11:30 a.m. Vegetarian lunches are designated by a green dot on your name
badge; others will have a red dot. Those who did not register in time will be asked to wait, and any extra lunches
will be made available to you after all of the pre-registered attendees receive their lunches.
Enjoy your lunch while attending the Plenary Session in the Holly Auditorium.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Mental Health is Public Health2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Mental Health is Public Health
Conference Agenda
Saturday, February 4, 2023 • UT Health San Antonio
8:00-8:30 am Registration/Breakfast with Community Partners AAB Foyer
Welcome & Opening Remarks
Melanie Stone, DrPH(c), MPH, MEd, Assistant
Director, Community Service Learning, Center for Medical
8:30-8:45 am Humanities & Ethics, UT Health San Antonio Holly Auditorium
Vasan Ramachandran, MD, Founding Dean, School of
Public Health, UT Health San Antonio
Keynote Presentation: The Social Determinants of
Mental Health
8:45-10:00 am Ruth Shim, MD, MPH, Luke & Grace Kim Professor Holly Auditorium
in Cultural Psychiatry and Associate Dean of Diverse and
Inclusive Education, University of California Davis School of
Medicine
Holly Auditorium
10:00-10:30 am Community Partner Session
Foyer
Breakout Sessions (Choose one):
A. Behavioral Health 101 and Practical Strategies ALTC 3.301
for Providers. Bryna Nation, LMSW and Cynthia
Sierra, LPC, Department of Psychiatry and Behavioral
Sciences, UT Health San Antonio
10:30-11:30 am B. Crisis Response Planning (CRP) for Mental ALTC 3.302
Health. David Roberts, PhD, and Feiyu Li, PhD,
Department of Psychiatry and Behavioral Sciences UT
Health San Antonio
C. Behavioral Health Integration into Pediatric ALTC 3.303
Primary Care. Roshni Koli, MD, Chief Medical Officer,
Meadows Mental Health Policy Institute
Holly Auditorium
11:30-11:45 am Break/Pick Up Lunch
Foyer
Lunch Plenary: State of the State of Texas Public
Behavioral Healthcare System
11:45 am -
Trina Ita, MA, Associate Commissioner, Mental Health Holly Auditorium
12:45 pm
and Substance Use Programs, Texas Health and Human
Services Commission
Poster Sessions Opening Remarks
Jelynne LeBlank Jamison, MA, President and Chief
12:45-1:00 pm Holly Auditorium
Executive Officer, The Center for Health Care Services
(CHCS)
Holly Auditorium
1:00-2:30 pm CSL Poster Session with Dessert Reception
Foyer2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Poster Session
Blue Ribbon Award
Note:The Blue Ribbon Winners are denoted by an asterisk in the program book.These posters were selected by an
interprofessional committee who reviewed all submissions and chose the top three outstanding abstracts.
The 2023 Blue Ribbon Winners are:
Project HEART: Promoting Healthy Eating and Activity
through Recreation and Teaching
Student Team: Karen Liu, Jacqueline Moreno, Christina Tilley, Alina Sonesra
Faculty Mentor: Steve Tsai, MD
Community Partner: Bob Hope Elementary School
Enriching Language and Literacy Locally: Rea(DI)ng Uni(VERSITY) Summer 2022
Student Team: Kelly Luu, Rylan Ponthier, Jessi O’Brien, Amy Opersteny, Abby Johnson
Faculty Mentor: Angela Kennedy, SLPD, CCC-SLP
Other Mentor: Casey Taliancich-Klinger, PhD, CCC-SLP
Community Partner: PROSPERA Housing Community Services
Don’t Sugarcoat Diabetes 2022-2023:
Virtual Outreach for Diabetes Prevention among South Texas High School Students
Student Team: Lucas Rivas, Michelle Bao, Sofia Ares Muzquiz, Adrianna Lam, Sammy Russell, Eveylnn Pierrend
Faculty Mentor: Maria Danet Lapiz Bluhm, PhD, RN
Community Partner: UT Health San Antonio Office of Recruitment and Science Outreach
Judges’ Choice Award
The week prior to the CSL conference, hidden judges will rank the posters during the online preview period based
on the merit of the CSL project and the quality of the poster. The judges will then select the Top Poster during the
conference’s Poster Session based on the quality of the presentation. The winner will be announced by email and
awarded a monetary prize.
Interprofessional Education (IPE) Award
Hidden judges will select the poster featuring the Best Interprofessional Project to receive the Annual LINC
Interprofessional Education (IPE). The winner will receive a monetary prize. Second and third place will be awarded
a certificate. Winners will be announced by email.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Presentation Summaries
Opening Remarks
Speakers: Melanie Stone, DrPH(c), MPH, MEd
and Vasan Ramachandran, MD, FACC, FAHA
Melanie Stone, DrPH(c), MPH, MEd, directs the Community Service Learning (CSL)
program through the Center for Medical Humanities & Ethics at UT Health San Antonio. This
innovative program promotes student and faculty engagement with community organizations in
conducting service projects which benefit medically underserved populations in Texas. She is a
Co-Investigator on a multi-year US Department of Health and Human Services grant “Advancing
Health Literacy to Enhance Equitable Community Responses to COVID-19.” Her expertise is
health literacy, and she helps bring health literacy awareness, knowledge, and skills to the future
health care professional workforce.
Vasan Ramachandran, MD, FACC, FAHA, is the Founding Dean of the School of
Public Health in San Antonio, Texas, and a Professor of Medicine and Population Health at UT
Health San Antonio. He is a cardiologist with sub-specialty training in echocardiography and
cardiovascular epidemiology. Dr. Ramachandran served as the Principal Investigator of the
Framingham Heart Study (FHS, the oldest running epidemiology study in the US) between 2014
to 2022. He is also the Principal Investigator of the Risk Underlying Rural Areas Longitudinal
(RURAL) Study (one of the youngest cohort studies in the US).
Keynote: The Social Determinants of Mental Health
Speaker: Ruth Shim, MD, MPH
Session Description: This presentation will examine the social determinants of mental health and mental
illness – that is, those factors stemming from where we grow, live, work, learn, and age that impact our overall
mental health and well-being. With the recent pandemics of structural racism and COVID-19, there has been an
increased focus on the societal problems that cause and sustain mental illness at the population level. Solutions for
taking sustainable action to address the social determinants of mental health will be discussed.
Learning Objectives:
1. Define key concepts associated with the social determinants of mental health.
2. Evaluate the evidence of the impact of social determinants on population mental health outcomes.
3. Identify solutions to effectively address the social determinants of mental health.
Ruth Shim, MD, MPH, is the Luke & Grace Kim Professor in Cultural Psychiatry, Professor
of Clinical Psychiatry in the Department of Psychiatry and Behavioral Sciences at the University of
California, Davis, and Associate Dean of Diverse and Inclusive Education at the UC Davis School of
Medicine. Dr. Shim is a member of the Board of Trustees of the Robert Wood Johnson Foundation
and serves on the Editorial Boards of Psychiatric Services, JAMA Psychiatry, Community Mental
Health Journal, and American Psychiatric Publishing, and is co-editor of the books, The Social
Determinants of Mental Health, and Social (In)Justice and Mental Health. She is an expert on
mental health equity, structural racism in medicine, and diversity, equity, and inclusion in academic medicine.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Breakout Workshop A:
Behavioral Health 101 and Practical Strategies for Providers
Speakers: Bryna Nation, LMSW and Cynthia Sierra, LPC
Session Description: This session will provide a brief overview of common behavioral health diagnoses that show
up in community settings, including signs & symptoms, what they are, and what they might look like. We will discuss
practical strategies for addressing symptoms, aggression and irritability and teach skills that can help individuals with
coping. Finally, we will discuss community resources and barriers to care, including the role of stigma.
Learning Objectives:
1. To Identify common behavioral health diagnoses in community settings
2. To understand available strategies for addressing common symptoms
3. To recognize frequent barriers to accessing behavioral health care and identify community resources
Bryna Nation is a licensed master’s social worker and currently serves as a social worker
MSW at UT Health San Antonio in the Department of Psychiatry and Behavioral Sciences. Bryna
has worked with individuals with behavioral health challenges across the age spectrum, in both
outpatient and inpatient settings since 2013. She currently serves as a clinical trainer of diverse
topics and Evidence-Based Practices related to trauma, substance use, and mental wellness through
facilitating webinars, developing new trainings and eLearning modules, and coordinating various
behavioral health projects. She has immense passion about spreading awareness of behavioral
health conditions to medical professionals and the wider community.
Cynthia Sierra is a licensed professional counselor and serves as a project manager in the
Department of Psychiatry and Behavioral Health Sciences at UT Health San Antonio. Cynthia has
more than 15 years’ experience managing Schizophrenia research projects and providing clinical
services primarily to individuals and families in crisis post hospitalization for suicide ideation and/
or attempt. Currently, she has been involved in managing the International Center of Excellence
for Evidence Based Practices and training clinicians regionally in Cognitive Adaptation Training. As
a clinician, Cynthia has a special interest in working with those individuals that may slip through
the cracks of our mental health system and focus on destigmatizing behavioral health care.
Breakout Workshop B:
Crisis Response Planning (CRP) for Mental Health
Speaker: David Roberts, PhD, and Feiyu Li, PhD
Session Description: This session focuses on Crisis Response Planning (CRP), an evidence-based approach to
reducing suicidal distress and behavior.You will learn example language and techniques to encourage and guide an
individual in a suicidal or other intense emotional crisis. What we say (and how we say it) during a crisis can help
someone choose life. Participants will have the opportunity to sign-up for follow-up opportunities to shore-up CRP skills.
Learning Objectives: Participants will discuss:
1. Why people contemplate suicide
2. Narrative suicide risk assessment
3. Strategies to promote self-management of high level of psychological distress2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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David Roberts, PhD, is a psychologist and Associate Professor of Psychiatry at
UT Health San Antonio. He provides psychotherapy and teaches therapy techniques at
the UT Health Transitional Care Clinic. He also is active in training health professionals
throughout the state in Motivational Interviewing and Crisis Response Planning.
Feiyu Li, PhD, is trained as both a scientist and a practitioner. She
completed her residency and postdoctoral fellowship at UT Health San
Antonio before joining the Division of Community Recover, Research and Training as
a faculty member. Dr. Li specializes in working with adults with serious mental illness,
mood disorders, PTSD, and personality disorders. Her work revolves around providing
community-based care and flexibly using evidence-based treatments to alleviate patients
suffering.
Breakout Workshop C:
Behavioral Health Integration into Pediatric Primary Care
Speaker: Roshni Koli, MD
Session Description: The talk will focus on reviewing existing models of behavioral health care
integration into primary care and the corresponding evidence base for each model. We will focus on
innovative models that have been successful here in Texas, such as the Child Psychiatry Access Network
(CPAN), and why these types of models are crucial in reducing barriers and increasing access to mental
health care. Finally, we will talk about the role of advocacy in ensuring the success of these programs.
Learning Objectives:
1. Identify different models of behavioral health integration
2. Understand the importance of innovative models to meet the mental health needs of our community
3. Describe the role of advocacy in ensuring mental health for all individuals in our community
Roshni Koli, MD, is a board-certified child and adolescent psychiatrist and Chief
Medical Officer for the Meadows Mental Health Policy Institute where she oversees
all medically-focused policy and practice guidance developed at the Institute. In her
previous role at Dell Children’s Medical Center, she led the creation of the only
service line within a children’s hospital in the state of Texas to provide an entire
continuum of pediatric mental health care. Her passion is focused on the development
of collaborative relationships with primary care and specialty care colleagues to
comprehensively address the mental and behavioral health needs of children and adults. Throughout her
career in psychiatry, she strived to achieve a goal of reducing stigma of mental health, increasing access to
mental health care, and working to ensure there is no difference between physical and mental health care
for all children and adults.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Plenary:
State of the State of the Texas Public Behavioral Healthcare System
Speaker: Trina Ita, MA
Session Description: The session will provide an overview of the Texas behavioral health system, it’s funding
sources and the target population served with those funds. Additionally, this session will highlight state outcomes
and the framework under which those services are administered with the goal of raising awareness of state
resources and impact.
Learning Objectives:
1. To understand behavioral health funding for both mental health and substance use services.
2. Understand the framework of services offered for mental health and substance use services in Texas and the
population served.
3. To gain awareness of outcomes and impact associated with state behavioral health funded services.
Trina Ita, MA, is the Associate Commissioner for Mental Health and Substance Use Programs
with the Texas Health and Human Services Commission (HHSC) and the Single State Authority
(SSA) Representative for Texas for the Mental Health and Substance Use Block Grants. Trina holds
a Master of Arts Degree in Community Agency Counseling, and a Bachelor of Science Degree in
Psychology with over 30 years of experience working with diverse populations in the provision
of mental health and substance use services. Ms. Ita has provided addictions counseling as well
as mental health counseling services in private practice and with entities in both the public and
private sectors. In her current role Ms. Ita has purview over the largest array of behavioral health contracted
services in HHSC system ensuring the implementation of mental health and substance use care for children and
adults receiving services in both urban and rural communities across Texas.
Poster Session Introductory Remarks
Speaker: Jelynne LeBlanc Jamison, MA
Jelynne LeBlanc Jamison, MA, is the President and Chief Executive Officer of The Center
for Health Care Services (CHCS), the mental health authority for Bexar County. CHCS’ mission
is to share hope and support recovery with a full spectrum of innovative services that promote
healing and help people live life to their full potential. She previously served as the Executive Vice
President and Chief Delivery Officer for CPS Energy, and prior to that, as Deputy City Manager
for Planning and Development with the City of San Antonio. Jamison is involved with a wide range
of professional and nonprofit organizations, including serving as Chairwoman for the San Antonio
Water System; Trinity University Board of Trustees; CHRISTUS Santa Rosa Board of Directors; San Antonio Medical
Foundation Board; Girl Scouts of Southwest Texas,Vice President, Board of Directors; United Way of San Antonio
Board of Directors; and Past National President of the National Forum for Black Public Administrators.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Student Poster Abstracts
Capacity Building
Adapting Cognitive Processing Therapy
for Asynchronous Text Delivery
Project Discipline: Psychology
Primary Poster Presenter: Bailee Schuhmann
Faculty Mentor: Katherine Dondanville, PsyD, ABPP
Community Partner: Talkspace; Stanford University
Project Location: San Antonio, Texas
Background: The COVID-19 pandemic has exacerbated mental health issues, resulting in a pressing need
to increase treatment availability. Digital mental health (DMH) interventions address barriers to in-person
psychotherapy and increase access. Further, messaging-based therapy is effective, particularly when evidence-based
interventions are used such as Cognitive Processing Therapy (CPT) for post-traumatic stress disorder. Traditionally,
training in CPT has consisted of a 2-3 day workshop followed by six months of weekly consultation calls. To train
providers in messaging-based CPT (CPT-Text), we can leverage a workforce already trained in core concepts of
CPT; however, no training models exist to assist providers in the translation of the therapy to DMH. We developed
a brief, largely asynchronous, simulation-based training to address this gap.
Objectives: We describe the innovative, rapid, and scalable process used to train therapists in CPT-Text.
Methods: Therapists with prior CPT training attend two, virtual 3-hour workshops designed to orient to
CPT-Text, establish rapport, and set goals via messaging. Therapists then engage with a “standardized patient” via
Google Chat to simulate CPT-Text. Therapists receive feedback on their use of CPT elements and familiarize
themselves with the CPT-Text format. Once a therapist is assigned a case, they are provided consultation through
asynchronous messaging with the option for live consultation, as needed. Results: To date, 49 therapists have been
trained in CPT-Text across two cohorts, with an additional 10 anticipated to be trained. Training is completed
in approximately 10 hours over one month. The training model for CPT-Text requires significantly less time and
resources than traditional training models, resulting in lower costs and ultimately reducing burden on the system.
Results: Therapists from across the US were successfully trained to implement CPT-Text, supporting the
feasibility of the training model.
Conclusion: Moving forward, we will use therapy transcripts to determine whether a rapid, low cost/resource
training model results in competent delivery.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Student Poster Abstracts
Capacity Building
Confianza: Preferences For Sources Of Health Information
Among Community Health Workers In The Latino Community
Project Discipline: Medicine
Primary Poster Presenter: Erin An
Other Student Team Members: Mathivarshini Sivachidambaram, Mabel Thai, Arlynn Ambriz, MS,
Mahima Ginjupalli, Ivanova Veras de Jesus, David Leal, Aaliyah Francois, David Nweke
Faculty Mentor: Luz Maria Garcini, PhD, MPH
Community Partner: Health Confianza
Project Location: San Antonio, Texas
Background: A critical step in overcoming the detrimental effects of COVID-19 is to build trust in sources of
health information among diverse communities.
Objectives: The Confianza project is aimed at identifying facilitators to build trust among historically
marginalized Latino communities to build more effective communication avenues in the delivery of health
information.
Methods: 55 Latino community health workers (CHWs) completed a survey consisting of socio-demographics
and questions about health information and cultural and contextual preferences among Latino communities. Data
was gathered in collaboration with our community partners. The subsequent data were analyzed using SPSS.
Results: The preliminary results from the 55 participants (mean age 47.9 years, 94% female) show that 73%
identified as Mexican-American and 13% as from another Hispanic/Latino origin, with 73% who are foreign-born.
16% of participants also identified as Afro-Latino. Results indicated a strong preference for sources of health
information that are delivered directly (face-to-face) from a health provider rather than via online sources across
all ages (81%). The older group (age 50 & over, n=23) had a stronger preference for providers that matched the
ethnic/racial background of participants than the younger group (less than 50, n=29) (X^2= 13.611, p=0.009).
CHWs age 50 & over reported higher trust for Latino/Hispanic health providers when compared to the younger
group (X^2= 13.611, p=0.009). Significant age differences were also found in levels of trust for religious institutions
and leaders. CHWs age 50 & over expressed preference for the role of spirituality/religion on health when
communicating health messages to Latino families than the younger group (X^2=8.559, p=0.036).
Conclusion: Future efforts aimed at fostering trust in sources of health information among Latino communities
should consider age in cultural factors that influence trust, as well as health information delivery preferences.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Student Poster Abstracts
Capacity Building
Homeless Persons Management of Type 2 Diabetes
Project Discipline: Nursing
Primary Poster Presenter: Priscilla Williams
Faculty Mentor: Peter Guarnero, PhD, RN, MSc
Community Partner: South Texas Homeless Clinics
Project Location: San Antonio, Texas
Background: The last point-in-time count for San Antonio in 2020 estimated 2,932 homeless persons.
Subsequent point-in-time counts were canceled due to the pandemic making it difficult to know our current local
situation. The disease process of diabetes places individuals at risk of developing other chronic conditions which
are often associated with complications and poor outcomes (including infection and amputation).
Objectives: Interview 10-20 persons who have experienced type 2 diabetes giving voice to homeless persons
as measured by protective factors and barriers to managing their health. Analyze data and identify categories and
themes collected from qualitative interviews and identify potential interventions that may improve the healthcare
of those experiencing homelessness with managing their type 2 diabetes and inform future interventions.
Methods: A purposive sample of 10-20 participants will be recruited from South Texas Homeless shelters, food
pantries or health care facilities. Interviews will last approximately 45 minutes. Participants will be compensated
for their time with a $15 gift certificate for each interview. This is a qualitative study using content analysis and
grounded theory strategies to collect and analyze data. Categories and themes will be identified using open and
axial coding.
Results: Preliminary findings seem to indicate an emerging pattern of newly diagnosed diabetic homeless
participants and those with an established diagnosis. Those more mature with diabetes had more reflection
of their diabetes trajectory, many had experienced the negative consequences of diabetes, they feared further
complications with diabetes, and strived to maintain their independence.
Conclusion: Interventions aimed at meeting individuals where they are in their disease process may better serve
them. Support groups or diabetes education classes for those experiencing homelessness and diabetes may be
possible interventions. Furthermore, continued efforts aimed at decreasing the burden of homelessness, will allow
this population to focus on their health and potentially improve their health.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Student Poster Abstracts
Capacity Building
Identifying Top Health Priorities Among Afghan Refugees
Project Discipline: Medicine
Primary Poster Presenter: Abigail Davis
Other Student Team Members: Cameron Borens, Colton Blinka, Serena Luke,
Vyas Sarabu, Amena Qavi, Emily Liu, Hope Ganucheau, Luke Ganucheau
Faculty Mentor: Fozia Ali, MD
Community Partner: Center for Refugee Services
Project Location: San Antonio, Texas
Background: Due to the 2021 Afghan Humanitarian crisis, there has been an influx of over 2000 Afghan refugees
into San Antonio, many of whom receive resources (translation services, food, toiletries, and help navigating the
healthcare system) at the Center for Refugee Services (CRS).
Objectives: To determine health priorities of Afghan refugees visiting the CRS.
Methods: Surveys were distributed at the CRS and completed directly by participants or with an interpreter. The
survey assesses basic demographics and topics such as primary source of healthcare, education level, and primary
language. Participants are asked to select their most concerning health problems from a categorical list of options.
Results: According to survey results, 87% of participants were male (n=77) with an average age of 33. All speak
Pashto as their primary language and 37.6% speak an additional language (the most common is Dari, 29.8%). 27.3%
have never attended school, 29.9% have attended some school, 27.3% have a high school diploma, and 15.6%
have partially or completely finished college. 46.8% seek healthcare at the San Antonio Refugee Health clinic. The
most common health concern participants had was “teeth problems” (63.9%). The second most common health
issue was language barriers (44.1%). When comparing self reported health status (poor, fair, good, excellent) to
employment status (unemployed, part time, full time), there was a correlation between better reported health and
higher level of employment (P = 0.005, Cramer V value 0.36).
Conclusion: Survey results show that Afghan refugees in San Antonio are primarily concerned with dental health
and language barriers. Additionally, there is a correlation between reported health status and employment status.
Next steps include initiating collaboration with the dental school for potential dental clinics, organizing English
lessons at the CRS, and creating workshops to help refugees apply for jobs.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Student Poster Abstracts
Capacity Building
Identifying Top Health Priorities
Among Community Members In San Antonio, Texas
Project Discipline: Medicine, Public Health
Primary Poster Presenter: Erin An
Other Student Team Members: Nhat Minh Ho, Damian Crow, Claire Sundjaja, Elizabeth Long,
Camille McSherry,Vanessa Sanchez MD, Madeline Hazle MD, Jessica Jones, Sania Zia, Leslie Omeire,
Charles Yang, Zuha Alam,Yousef Salem, Mahnoor Liaqat, Logan Smoot, Stephen Chen, Lynnlee Poe,
Jonathan Mathews, Laila Alkassar, Tatiana Cordova MD, Shazli Malik, MD; Mariam Sabir, MD; Neil Sood,
MD; Michelle Davis, MD; Sabeen Abdullah, Jason Morrow, MD PHD
Faculty Mentors: Fozia Ali, MD; Elena Jimenez-Gutierrez, MD
Community Partner: Grace Pavilion Community Outreach; Association of Pakistani Physicians of
North America South Texas Chapter; Big Mama’s Safe House
Project Location: San Antonio, Texas
Background: The needs assessment was conducted at three health fairs to understand health priorities in the
community: Grace Pavilion Community Outreach (GPCO) in Windcrest, Association of Pakistani Physicians of
North America South Texas Chapter (APPNASCT) at Muslim Children Education and Civic Center, and Big Mama’s
Safe House (G.R.E.A.T.) in East San Antonio.
Objectives: Identify health priorities among community members in San Antonio, Texas.
Methods: Participants completed a 2-page survey questionnaire, including basic demographics along with open-
ended questions about top health priorities. The subsequent data were analyzed using Stata 17.0.
Results: Survey data was gathered from 165 participants: GPCO fair: 61 participants (93% female, 7% male; 41%
Caucasian, 36% Latino, 19% African-American; mean age 39; mean BMI 32.4). 64% reported having a PCP and 22%
had 1 or more ER visits within the past year. The top 3 health priorities were mental health (67%), nutrition (64%),
and weight problems (41%). APPNASCT fair: 46 participants (61% male, 39% female; mean age 44; BMI 27.7). 89%
reported immigrating from a different country, with Pakistan (24%) and Afghanistan (22%) being the two predominant
countries. 50% reported having a PCP and 14% had 1 or more ER visits within the past year. The top three health
priorities were nutrition (19%), weight problems (17%), and family healthcare (14%). G.R.E.A.T. fair: 58 participants
(47% male, 53% female; 65% African-American, 26% Latino; mean age 55; mean BMI 29.4) The majority reside in East
SA (58%), in which the median household income (78202) is less than SA and Bexar County. There were significantly
higher reports of drugs/tobacco/gang violence in 78202 (79%) than in other areas (44%) (X^2=5.008, p=0.025). The
top 3 health priorities were nutrition (21%), mental health (21%), and family healthcare (12%).
Conclusion: The findings will be shared with the health fair organizers and TAB to help recognize and address
community needs.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Mental Health is Public Health
Student Poster Abstracts
Capacity Building
The Demographics and Healthcare Needs
of San Antonio Refugees Within
the Wake of the 2021 Afghanistan Crisis
Project Discipline: Medicine
Primary Poster Presenter: Fayha Khan
Other Student Team Members: Marcella Snyder, Daniel Zhong
Faculty Mentors: Andrew Muck, MD; Branden Skarpiak, MD
Community Partner: Center for Refugee Services
Project Location: San Antonio, Texas
Background: According to the UNHRC, the Taliban seizure of the Afghan government on September 1, 2021
displaced nearly 3 million refugees, 76,000 of which now reside in the United States. Notably, the Center for
Refugee Services recorded an influx of 3,000 Afghan refugees in San Antonio from 2021 to 2022, which represents
an increased burden on local healthcare systems.
Objectives: The new Afghan refugees have significantly altered the San Antonio Refugee Health Clinic (SARHC)
patient population. To better ascertain their healthcare needs, patient records from September 1, 2021, to
August 31, 2022, were analyzed.
Methods: Using Microsoft Excel, healthcare parameters were analyzed including but not limited to demographics,
interpreter needs, health insurance status, vitals, chief complaints, diagnoses, and treatment plans from 373 charts
(263 unique patients).
Results: The patient population demonstrated a median age of 33 and is predominantly male (n = 174; 66.2%).
Eleven percent (n = 29) of all patients were insured. Of those measured, 41.8% (n = 110) were overweight or
obese, 63.1% (n = 166) were hypertensive, and 30.4% (n = 21) were diabetic. On average, each encounter involved
2.24 chief complaints and 2.01 diagnoses. Besides medical diagnoses, 6.4% (n = 34) and 5.3% (n = 28) of patients
required dental and psychiatric care, respectively. Notably, 59.1% (n = 88) of patients referred for follow-up did not
adhere to future appointments.
Conclusion: Over the aforementioned time period, the clinical presentations to the SARHC were frequently
chronic, non-communicable disease treatment, with common diagnoses including GERD, diabetes, hypertension, and
musculoskeletal pain. Our results indicate that this population demonstrated increased need for interprofessional
care, evidenced by significant levels of dental and psychiatric conditions, the latter often compounding medical
diagnoses. Finally, the high attrition rate for follow-up appointments suggests significant barriers to care that require
further attention.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Mental Health is Public Health
Student Poster Abstracts
Clinical Service
Attrition Rate of Participants in an OTC model POPs Study
Project Discipline: Medicine
Primary Poster Presenter: Kellie Hastings
Other Student Team Members: Prerna Das, Ashley Lao,Victoria Hart, Tooba Ikram, Katherine
Kolp, Bridget Alley, Adrianna Lam
Faculty Mentor: Luke Newton, MD
Community Partner: San Antonio Metropolitan Health District STD/HIV Clinic
Project Location: San Antonio, Texas
Background: In 2018, 29% of Texas pregnancies were reported “unintended.” Many women report the
requirement to see a physician and cost to be barriers for obtaining hormonal contraception. Women of lower
socioeconomic status are impacted more with unplanned pregnancies and access to birth control.
Objectives: POPs Project started in 2018 to increase access to effective contraception by providing free
progestin-only hormonal pills (POPs) and contraception education to uninsured San Antonio women. POPs have
less serious adverse effects, lower cost, and few contraindications, ideal for an OTC birth control.
Methods: Metro Health STD Clinic patients were enrolled in the POPs project. Patients took a pre-educational
knowledge check, received education on birth control and their menstrual cycle, took a post-educational
knowledge check, and received a 3-month supply of POPs every 3 months. At 12 months, patients completed exit
surveys.
Results: The top reasons participants previously stopped using birth control included: too expensive (28.3%),
insurance did not cover (23.3%), and side effects (18.3%). These women had diffculty starting birth control
previously because it was too expensive (44.4%), too diffcult to obtain (30.2%), and they didn’t know how to get
it (19%). Exit surveys show 88.7% said they would like to continue POPs for contraception. Of those who wish
to discontinue POPs, 55% are interested in another form of contraception, including IUD, combined estrogen-
progestin pill, and Nexplanon. Most participants dropped out of the study before the 3 month follow up, 51.5%. At
the 6, 9, and 12 month follow ups, 17.2%, 7.8%, and 6.3% respectively, did not follow up. 17.2% completed the study.
Conclusion: Although cost and difficulty attaining medication were among the top reasons for not using
birth control, when cost was not a factor, patients still left the study early. More data needs to be collected to
understand why participants ended the study early.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Mental Health is Public Health
Student Poster Abstracts
Clinical Service
Evaluating Dermatologic Burdens on Mental Health
in Dermatology Free Clinic
Project Discipline: Medicine
Primary Poster Presenter: Tue Nguyen
Other Student Team Members: Natalya Ponomareva, Bahar Momin, Anaya Shah,
Katerina Papanikolaou
Faculty Mentor: John Browning, MD, MBA
Community Partner: Travis Park United Methodsist Church
Project Location: San Antonio, Texas
Background: Psychodermatology is an emerging field in medicine encompassing dermatology and psychiatry.
Evidence exists that there is a strong association between dermatologic and mental health disorders, working
together to impact our patients’ quality of life negatively. Travis Park is a dermatology free clinic in San Antonio,
Texas that provides dermatologic care to disadvantaged patient populations.
Objectives: This study aims to evaluate the burden of dermatologic diseases on our patients’ mental health and
emphasize the importance of addressing psychiatric and dermatologic comorbidities.
Methods: From August 2021 to April 2022, a nine-item survey was distributed to patients at Travis Park during
clinic hours. Questions assessed the impact of their skin condition on their mental health, confidence, and quality
of life. Quantitative responses included a rated scale from 1 to 5, and qualitative responses included “Strongly
disagree,” “Disagree,” “No preference,” “Agree,” and “Strongly agree.”
Results: A total of 44 survey responses were collected. 27.3% (n = 12) agreed, and 11.4% (n = 5) strongly agreed
that their skin condition has significantly affected their mental health. 43.2% (n = 19) agreed, and 20.5% (n = 9)
strongly agreed that their skin condition has significantly affected their confidence. 36.4% (n = 16) agreed, and
36.4% (n = 16) strongly agreed that improving their skin health would significantly improve their mental health.
On a scale of 1 to 5, 41.9% (n = 18) and 18.6% (n = 8) of respondents ranked the negative impact of their skin
condition on their quality of life as a 4 and 5, respectively.
Conclusion: Many of our patients at Travis Park live with chronic skin conditions that have affected their
confidence and quality of life. Therefore, physicians should consider addressing the psychological impact of patients’
dermatologic concerns by identifying exacerbating factors to improve treatment plans and establish better rapport.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
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Mental Health is Public Health
Student Poster Abstracts
Clinical Service
Intervention for Antipsychotic-associated
Elevation in Body Mass Index
Project Discipline: Medicine
Primary Poster Presenter: Aishwarya Vemula
Other Student Team Members: Delaena Harley, Kenny Johnson, Kelly Lee
Faculty Mentor: Kimberly Benavente, MD
Community Partners: Hill Country Mental Health and Developmental Disabilities (MHDD) Center,
UT Health San Antonio Long School of Medicine
Project Location: San Antonio, Texas;Val Verde County; Uvalde County; Medina County
Background: The Hill Country Mental Health and Developmental Disabilities (MHDD) Center Telepsychiatry
clinic serves patients with serious mental illness and developmental disorders in the underserved rural
communities of Val Verde, Uvalde, and Medina counties. Many of its patients are prescribed second-generation
antipsychotics (SGAs), which can cause weight gain and metabolic syndrome which contribute to increased
cardiovascular morbidity and mortality, reduced quality of life, and decreased medication adherence.Various
strategies to manage these side effects could be implemented at Hill Country MHDD clinic.
Objectives: The aim of this quality improvement project is to increase the implementation of interventions to
address elevated BMI in patients prescribed an SGA by 50% in the Hill Country MHDD Telepsychiatry clinic.
Methods: Healthcare professionals will discuss available interventions for patients with elevated BMI who are
taking SGAs including non-pharmacologic interventions (i.e. discussion of lifestyle modifications), adjustments
to the SGAs ( e.g. reducing the dosage), and pharmacologic adjuvants (e.g. adding metformin). We will utilize an
interdisciplinary approach to implement preventative healthcare measures at multiple patient encounters. As a part
of the non-pharmacologic intervention, patients will be given information packets on Antipsychotics and Weight
Gain, Nutrition, and Exercise.
Results: Electronic medical records will be reviewed to assess the average BMI of patients on SGAs, the
percentage of patients with the “Physical Activity/Nutrition” counseling box checked in progress notes, the
frequency of SGA medication adjustments, and the percentage of patients on SGAs also on metformin over time.
The results of analyses are pending the completion of data extraction.
Conclusion: Results from this study will provide insight into how the metabolic side effects of SGAs impact the
course of treatment. This knowledge will allow for better care of psychiatric patients suffering from the side effects
of antipsychotics. Our future goals involve expanding interventions at our clinic to address the metabolic side
effects of SGAs further.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
18
Mental Health is Public Health
Student Poster Abstracts
Clinical Service
Post Acute Sequela of SARS CoV2 Infection (PASC)
and the Mental Health Burden
Project Discipline: Medicine
Primary Poster Presenter: Ashley Chakales
Other Student Team Members: Sean Rumney, Phillip Yang, Mathi Siva, Kaitlin Waxler
Faculty Mentors: Barbara Robles-Ramamurthy, MD; Summer Rolin, PsyD; Gabriela Gibson-Lopez,
PsyD; Jonathan Gelfond, MD, PhD; Phillip Balfanz, MD, MBA; Melissa Deuter, MD;
Monica Verduzco-Gutierrez, MD
Community Partner: UT Health San Antonio Long School of Medicine
Project Location: San Antonio, Texas
Background: COVID-19 has infected close to 100 million U.S. Americans. There is increasing evidence that a
number of patients with COVID-19 may experience a range of neuropsychiatric symptoms during and persisting
after COVID-19 infection. The clinical and psychosocial impact of COVID-19 infection continues to be investigated,
although the multi-systemic negative impacts on health are well documented. Additionally, disproportionate impact
is expected in certain historically marginalized communities that were signi cantly impacted by the pandemic, such
as Latinos in the U.S. who have been documented to have higher rates of infection than other racial groups.
Objectives: Aimed to determine the the association of trauma within people with PASC symptoms in a Long
COVID clinic.
Methods: This study describes the results of an inter-professional partnership between Psychiatry and Physiatry
through the South Texas Psychiatric Practice-Based Research Network. This is an observational cohort study
(N=214) of patients seen in a Physiatry clinic presenting with sequalae from previous COVID-19 infection. Clinical
data and screening questionnaires, including PCL-5 - a trauma symptom questionnaire - were obtained.
Results: The sample cohort was 71% female, 44% Hispanic, and 46 years old on average. Female gender was
higher (78% vs 65%, p=0.24) in those above median long-haul symptom score. The rate of high PTSD symptoms
was 53%, signi cantly higher than the general population. Long-haul symptom score was positively associated with
PCLC-5 Total score (r=0.2, p< 0.05). A diagnosis of PTSD was also positively correlated with stimulant use (r=0.2,
P< 0.05).
Conclusion: Overall, this data points to a relationship between trauma and COVID-19 PASC symptoms,
warranting further research, as these results have implications for current outpatient clinics, including primary care,
who may encounter patients with Long COVID-19 and thus the need for screening and treatment recommendation
in these settings.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
19
Mental Health is Public Health
Student Poster Abstracts
Clinical Service
Undertreatment of Premature Peripheral Artery Disease Patients:
An Interim Analysis Using the Surgical Premature
Peripheral Artery Disease Evaluation (SPPADE) Registry
Project Discipline: Medicine
Primary Poster Presenter: Gregory Williams
Faculty Mentor: Mohamad Hussain, MD
Community Partner: Harvard Medical School
Project Location: Boston, Massachusetts
Background: Premature peripheral artery disease (PPAD) is atherosclerotic narrowing of peripheral blood
vessels that occurs before the age of 55. The most advanced form of PAD is chronic limb threatening ischemia,
which can lead to limb loss. Lower extremity bypass can be performed in patients with PPAD to alleviate
symptoms and reduce the risk of limb loss. PPAD is under-diagnosed and under-treated, leading to higher rates of
major adverse cardiovascular and limb events.
Objectives: In this study we sought to better understand the cardiovascular risk profile of patients with PPAD
who underwent lower extremity bypass procedures.
Methods: We conducted a retrospective cohort analysis of patients enrolled in the Surgical Premature
Peripheral Artery Disease Evaluation (SPPADE) registry. SPPADE is a multi-center registry of patients with an
established diagnosis of PPAD (2007-2021). In this interim analysis, we report baseline risk profiles (cardiovascular
comorbidities and cardioprotective medication use) of PPAD patients who underwent lower extremity bypass
surgery.
Results: 251 patients were included in SPPADE at the time of this interim analysis. A total of 54 (22%) individuals
had undergone 58 bypass procedures. PPAD patients who underwent bypass had high incidences of hypertension
(HTN), hyperlipidemia (HLD), coronary artery disease (CAD), and Diabetes mellitus type II (DM II). Among
patients with HLD, only 30% (n=11) were prescribed statins. Only 48% of bypass patients were treated with aspirin
(n=26), and 46% with antiplatelets (n=25). Prior to bypass procedure, 13% had suffered from acute limb ischemia
(n=8). A noticeable percentage (28%) also had undergone lower limb angioplasty, stenting, or both (n=15) prior to
surgery.
Conclusion: Although patients with PPAD who undergo lower extremity bypass have high rates of
cardiovascular risk factors, they are often undertreated with cardioprotective medications including statins,
antiplatelets and anti-hyperglycemic. This may lead to elevated rates of cardiovascular complications and lower limb
ischemic events in this vulnerable population.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
20
Mental Health is Public Health
NOTES2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
21
Mental Health is Public Health
Student Poster Abstracts
Education
Advanced Directives 2023
Project Discipline: Medicine, Nursing, Speech Pathology
Primary Poster Presenter: Anna Perhach
Other Student Team Members: Anna Perhach, Stephanie Batch, Ryan Bailey, Ricardo A.Verdin,
Siddharth Prasad, Hildemarie Wiggill, Alaina Kuhn
Faculty Mentor: Jason Morrow, MD
Community Partner: Caring for the Caregiver
Project Location: San Antonio, Texas
Background: An advanced directive is a legal document dictating one’s medical wishes to their family and doctor
in case the individual is unable to speak for themselves. Advanced directives are an important but underutilized
component of advanced care planning, as many individuals in the general public do not know about them or what
they entail.
Objectives: This is an ongoing community engagement project with the purpose of educating the general public
on the basics of advanced directives. Specific aims include: 75% of participants will have a positive opinion of
advanced directives on the postsurvey and 20% increase in self-reported likelihood of completing an advanced
directive in the next six months.
Methods: A one-hour presentation on advanced directives and informational handouts were developed
for distribution at various community centers, senior centers, and libraries. The presentation, presurvey, and
postsurvey assessing attitudes about advanced directive were reviewed by our community partners, Caring for the
Caregiver, and faculty mentor and palliative care physician, Dr. Jason Morrow.
Results: We have 30 respondents. As of 1/7/23, opinion of advanced directives went from an average of 3.92 on
the presurvey to 4.58 on the postsurvey, with 1 being very negative and 5 being very positive, which was a 13%
increase. 43.75% of people planned to get an advanced directive in the next 6 months on the presurvey and 76%
planned to get one in the next six months on the post survey. Time and lack of awareness of the importance of
advanced directives were self-reported reasons for not previously completing a directive.
Conclusion: These results demonstrate improvements in awareness and planning post-presentation. Finding
audiences and establishing initial connections with community partners proved challenging. Going forward, we will
continue to do presentations in the community to spread awareness and education about Advanced Directives.2023: 16TH ANNUAL COMMUNITY SERVICE LEARNING (CSL) CONFERENCE
22
Mental Health is Public Health
Student Poster Abstracts
Education
Analysis of Women’s Cancer Curriculum Implementation
in Brownsville Community Health Clubs
Project Discipline: Medicine, Public Health
Primary Poster Presenter: Nastassia Yammine
Other Student Team Members: Sania Zia, Connie Miranda, Camille McSherry, Theresa Heines,
Monica Martinez
Faculty Mentor: Jason Rosenfeld, DrPH, MPH
Community Partners: Lower Rio Grande Valley Area Health Education Center
Project Location: Brownsville,Texas
Background: UTHSCSA medical students in collaboration with the Lower Rio-Grande Valley Area Health
Education Center and a team of four Community Health Workers (CHWs) have been working to deliver public
health curricula through Community Health Clubs in Cameron County since 2017. A network of Clubs completed
a women’s cancer curriculum.
Objectives: After observing the presentation, attendees will be able to describe the goals, target audience, and
outcomes of the Community Health Clubs Women’s Cancer Curriculum.
Methods: A nine-week curriculum was designed, covering topics of cervical and breast cancer awareness and
prevention. CHWs participated in an in-person training, supplemented by weekly virtual sessions reviewing the
curriculum. Trained CHWs facilitated the curriculum in nine Clubs with 90 members. Pre- and post-curriculum
surveys evaluated the effcacy of the curriculum in increasing knowledge, reducing stigmas, encouraging health-
seeking practices, and raising awareness of resource accessibility. A reflective session was facilitated to gather
feedback, transcribed, and qualitatively analyzed.
Results: Data have been prepared for analysis. Reported results will include participant awareness about women’s
cancers, risk factors including sexual health and family history, and Methods of prevention/screening. Preliminary
survey results indicate the persistence of stigmas and myths despite efforts to dispel erroneous beliefs. Based on
the qualitative analysis, the safe environment of the clubs allowed participants to share lived experiences, sparking
discussions that transcended the written curriculum and strengthened the bonds of club members.
Conclusion: Although more work is required to refine the sessions and address culturally-influenced stigmas,
preliminary analyses of the data indicate the program was effective at strengthening community bonds and
increasing knowledge about pap smear, mammogram, and HPV vaccination recommendation. A common theme
emerged that the most significant learning occurred through sharing of experiences. These findings illustrate that,
while increased knowledge is an important aspect of the clubs, participant satisfaction also draws on feelings of
empowerment and connection.You can also read
