University Times

The Graduate School of Public Health (GSPH) has gone into the match-making business — for Pitt, UPMC and Carnegie Mellon University researchers interested in conducting school-based research on public health and medical issues in Allegheny County.

The School Based Research and Practice Network, housed in GSPH’s Center for Public Health Practice, advises researchers on projects at all stages of development — from concept and design, to Institutional Review Board (IRB) requirements, to training in the challenges and pitfalls of how to conduct school-based research and fieldwork — said network principal investigator Samuel Stebbins, who is director of the Center for Public Health Preparedness.

Founded in 2008 in partnership with Pitt’s Clinical and Translational Science Institute (CTSI), the main objectives of the network are to:

• Develop a list of public health issues most in need of research in the county’s school districts;

• Train researchers on working in schools/communities;

• Match researchers with school districts and individual schools, and

• Disseminate translational science to school and community settings.

Stebbins said network staff surveyed superintendents at 41 of the 44 school districts (including the Roman Catholic Diocese of Pittsburgh) in Allegheny County to determine their interests, and held focus groups with principals and senior staff in 33 of the school districts.

The survey, which was funded by CTSI, identified 68 research topics of significant interest to the school districts.

With a population of 1.2 million and a wide variety of school district sizes and environments, the county provides a useful laboratory for school-based research, Stebbins said.

“Some schools are very urban, some are rural, some are suburban, some are mixed, so there’s a lot of diversity and variety out there. In that sense, they have differing needs, but they also have different things they can bring to the research process,” he explained.

“Say you’re developing strategies to improve physical activity. You won’t know until you try it whether a strategy will work better in a city setting or a rural setting. They’re very different environments.”

To date, the network has overseen more than 15 health-related research projects involving more than 65 schools in Allegheny County.

“A number of researchers have come to us with projects that are already funded and already have IRB approval, and they’re looking for sites,” he said. “Other folks have come to us all the way at the beginning of the process where they just have an idea: For example, ‘I’d like to study how to reduce obesity in fourth-graders.’ So we ask: ‘What have you looked at so far? Where are you looking for funding? Who are you working with?’ And then help them design the project so it’s as school-friendly as possible.”

The main focus of the network is on public health and health issues, Stebbins said, as opposed to the kind of research typically generated at the School of Education and the Learning Research and Development Center.

“For example, the survey results show a lot of interest at the schools in technology effectiveness. That’s not something we would focus on. We didn’t tell them in advance that we would focus on health issues. We wanted to learn everything they were interested in,’” he said.

Other interests expressed by the school officials included student motivation, student assistance programs, special education and the appropriate amount of testing. “Those are all very important areas, but somewhat out of our focus. We share those with the School of Education, in case researchers there want to focus on it.”

But wellness and student well-being turned out to be the No. 1 interest on the survey, listed by almost half of the superintendents. “That’s really a mixture to some extent of physical activity, proper nutrition, obesity and stress; stress in the home environment, for example. There is a general perception among the schools, and this is stating the obvious, if you have students who are otherwise healthy and active and able to focus on their work, they’re going to do better,” Stebbins said.

Other health themes commonly mentioned in the survey included mental health concerns such as school phobia, anxiety, harassment/bullying, depression, ADHD and drug/alcohol abuse, as well as diabetes, he said.

The school-based network grew out of the success of a GSPH research project — the  Pittsburgh Influenza Prevention Project (PIPP) — conducted in 2006-09 and funded by the Centers for Disease Control and Prevention. GSPH Dean Donald Burke was the principal investigator and Stebbins was the co-P.I.

PIPP implemented a program of non-pharmaceutical interventions for the prevention of influenza in 10 Pittsburgh district elementary schools. “The schools were very interested in that because we thought we could reduce the number of days that kids were absent,” Stebbins said.

Five of the 10 schools received intensive prevention education as well as disease identification services; five control schools received only disease identification services.

The research data showed teaching children and families about health habits that prevent the spread of disease, such as hand-washing and use of hand-sanitizers, covering the mouth when coughing and staying home when ill, coupled with early identification, measurably helped reduce the spread of influenza.

Six research papers related to the PIPP project already have been published or are in press.

“Working with schools is so rewarding, because there are so many good things you can do. There are many good research questions that you can answer in a laboratory setting, but that doesn’t help you with how they work in real life. Working with the schools is a real-life setting. Kids will tell you if something works or doesn’t work. Parents will tell you. Teachers are interested,” Stebbins said.

“For the PIPP project, there was a fantastic mix of research. We studied the kids in the schools, for their absentee records and lots of other things, to see when they were sick, how they got sick, what their symptoms were.

“But we also did home visits. If the kid was home sick, we had staff who went into the homes and did nasal swabs and brought them back to the lab and tested them for influenza. So we also got nice biomedical confirmation or not of the flu,” he said.

“At the end of our study we knew fairly quickly the answers to two things: Not only can our intervention prevent flu and lessen absenteeism, but also that little kids can do the intervention. That’s the win-win you hope for.”

Stebbins said several school districts outside western Pennsylvania contacted him about the PIPP project findings, with an eye toward duplicating its success.

“That’s why I love doing this type of research, because it’s directly applicable to the community and broad swaths of people. What the NIH (National Institutes of Health) says is there’s an awful lot of research that never makes it into the practical world and helps people. That’s my feeling as well. I think we need more community-based research. I love this network is because it’s explicitly in the community and generates immediate results,” Stebbins said.

The School Based Research and Practice Network recently published “A Research Agenda for Schools in Allegheny County: A Policy and Practice White Paper” that provides an overview of the network and details its projects, goals and recommendations (available at www.cphp.pitt.edu/report/Default.aspx).

For more information on the network, contact Stebbins at 412/383-2400 or stebbins@pitt.edu.

—Peter Hart