Metro Detroit Research Articles

Use of a Health Fair to Promote Health Equity of the Hispanic Community in Metro Detroit

This study analyzes the demographics, general health characteristics, and barriers to healthcare of the Metro Detroit Hispanic community through a health fair survey. Data was collected using a descriptive, 25-question self-reported survey in English and Spanish administered to 19 health fair attendees. Of total respondents, 92% identified as Hispanic and 76% Spanish-speaking. Descriptive analysis was conducted on several variables, including prevalence of medical conditions, health behaviors, and barriers to care. Participants reported a high prevalence of serious chronic conditions including diabetes (29%) and hypertension (29%). Significant barriers included a lack of medical insurance (72%), no primary care physician (67%), and language (24%). Other notable barriers were medication and food insecurity (50% and 67%, respectively). Our findings illustrate the power of a health fair in reaching a local, underserved Hispanic population, and underscore the need for targeted efforts in improving Hispanic health equity and access in Metro Detroit.

Census Tract and Neighborhood Racial Change and the Locational Decisions of Financial Services in Metro Detroit

Scholarship on the geography of US retail financial services consistently finds racialized patterns in the locations of traditional (e.g. banks, credit unions) and higher-cost or alternative (e.g. payday lenders, check cashers) financial services. While scholars tend to offer explanations based on spatial void and market segmentation hypotheses, we theorize these racialized patterns as consistent with a social reproduction of investment and divestment. We use a novel, longitudinal dataset that follows census tract- and neighborhood-level changes in racial demographics and financial services in Detroit during the pre- and post-Recession periods. Changes in the locations of financial services follow changes in racial demographics, which occur in addition to the well-documented practice of targeting or avoiding tracts and neighborhoods based on their racial majority. These racialized patterns are heightened in the post-Great Recession period.

Tracking Chlamydia and Syphilis in the Detroit Metro Area by Molecular Analysis of Environmental Samples.

This paper describes one of the first studies applying wastewater surveillance to monitor Chlamydia and Syphilis and back-estimate infections in the community, based on bacterial shedding and wastewater surveillance data. Molecular biology laboratory methods were optimized, and a workflow was designed to implement wastewater surveillance tracking Chlamydia and Syphilis in the Detroit metro area (DMA), one of the most populous metropolitan areas in the U.S. Untreated composite wastewater samples were collected weekly from the three main interceptors that service DMA, which collect wastewater and discharge it to the Great Lakes Water Authority Water Resource Recovery Facility. Additionally, untreated wastewater was also collected from street manholes in three neighborhood sewersheds in Wayne, Macomb, and Oakland counties. Centrifugation, DNA extraction, and ddPCR methods were optimized and performed, targeting Chlamydia trachomatis and Treponema pallidum, the causative agents of Chlamydia and Syphilis, respectively. The limit of blank and limit of detection methods were determined experimentally for both targets. Both targets were detected and monitored in wastewater between December 25th, 2023, and April 22nd, 2024. The magnitudes of C. trachomatis and T. pallidum concentrations observed in neighborhood sewersheds were higher as compared to the concentrations observed in the interceptors. Infections of Chlamydia and Syphilis were back-estimated through an optimized formula based on shedding dynamics and wastewater surveillance data, which indicated potentially underreported conditions relative to publicly available clinical data.

The impact of health disparities on peripheral vascular access outcomes in hospitalized patients: an observational study

BackgroundPlacement of peripheral intravenous catheters (PIVC) is a routine procedure in hospital settings. The primary objective is to explore the relationship between healthcare inequities and PIVC outcomes.MethodsThis study was a multicenter, observational analysis of adults with PIVC access established in the emergency department requiring inpatient admission between January 1st, 2021, and January 31st, 2023, in metro Detroit, Michigan, United States. Epidemiological, demographic, therapeutic, clinical, and outcomes data were collected. Health disparities were defined by the National Institute on Minority Health and Health Disparities. The primary outcome was the proportion of PIVC dwell time to hospitalization length of stay, expressed as the proportion of dwell time (hours) to hospital stay (hours) x 100%. Multivariable linear regression and a machine learning model were used for variable selection. Subsequently, a multivariate linear regression analysis was utilized to adjust for confounders and best estimate the true effect of each variable.ResultsBetween January 1st, 2021, and January 31st, 2023, our study analyzed 144,524 ED encounters, with an average patient age of 65.7 years and 53.4% female. Racial demographics showed 67.2% White, and 27.0% Black, with the remaining identifying as Asian, American Indian Alaska Native, or other races. The median proportion of PIVC dwell time to hospital length of stay was 0.88, with individuals identifying as Asian having the highest ratio (0.94) and Black individuals the lowest (0.82). Black females had a median dwell time to stay ratio of 0.76, significantly lower than White males at 0.93 (p < 0.001). After controlling for confounder variables, a multivariable linear regression demonstrated that Black males and White males had a 10.0% and 19.6% greater proportion of dwell to stay, respectively, compared to Black females (p < 0.001).ConclusionsBlack females face the highest risk of compromised PIVC functionality, resulting in approximately one full day of less reliable PIVC access than White males. To comprehensively address and rectify these disparities, further research is imperative to improve understanding of the clinical impact of healthcare inequities on PIVC access. Moreover, it is essential to formulate effective strategies to mitigate these disparities and ensure equitable healthcare outcomes for all individuals.

Disparity in the Under-Utilization of Novel P2Y12 Inhibitors in ST-Elevation Myocardial Infarction Following Percutaneous Coronary Intervention.

The most recent guidelines (European Society of Cardiology (ESC) and American College of Cardiology/American Heart Association (ACC/AHA)) all favor prasugrel/ticagrelor over clopidogrel in the setting of acute coronary syndrome (ACS). We therefore sought to investigate which P2Y12 inhibitors were being prescribed in our community hospital setting upon discharge among patients undergoing percutaneous coronary intervention (PCI) in the setting of ST-elevation myocardial infarction (STEMI). We identified patients presenting to two Metro Detroit Michigan hospitals with STEMI between January 1, 2018, to December 31, 2021 using the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) PCI registry. The primary outcome was the choice of P2Y12 inhibitor prescribed on day of discharge following hospitalization for STEMI, and baseline characteristics were compared including race, sex and type of insurance. A total of 366 patients presented to these two Metro Detroit hospitals from January 1, 2018, to December 31, 2021. Female and non-White patients were more likely to be discharged on clopidogrel than ticagrelor or prasugrel (odds ratio (OR): 1.56, confidence interval (CI): 0.99 - 2.45, and OR: 1.43, CI: 0.91 - 2.25, respectively), however, did not reach statistical significance. Patients without private insurance presenting with STEMI were more likely to be discharged on clopidogrel (OR: 1.83, CI: 1.22 - 2.74), which did reach statistical significance in our cohort. In this retrospective single-center study evaluating BMC2 registry, we demonstrate a clinically significant disparity in prescribing patterns based on insurance, with trends for disparity based on gender and ethnicity.

The Michigan Men's Diabetes Project Randomized Clinical Control Trial: A Pilot/Feasibility Study of a Peer-Led Diabetes Self-Management and Support Intervention for Black Men With Type 2 Diabetes.

Black men are disproportionately affected by type 2 diabetes (T2D) and experience higher diabetes-related complications than non-Hispanic White men. To address the complex barriers in diabetes self-management for Black men, we implemented a 3-month peer-led and empowerment-based Diabetes Self-Management Education (DSME) and Support (DSMS) intervention in Metro Detroit. Twenty-five Black men ≥55 years of age with self-reported T2D were randomized to the intervention group (n=12)-10 hr of DSME and 9 hr of DSMS-or enhanced usual care (EUC) group (n=13)-10 hr of DSME. Peer leaders (n = 3) were trained by certified diabetes care and education specialists (CDCESs) to cofacilitate the support sessions. Outcomes (hemoglobin A1c [HbA1c], diabetes self-care activities, and diabetes distress) were assessed preintervention and postintervention. In the intervention and EUC groups, mean HbA1c decreased by 0.20% (p = .52, SD = 0.99) and 0.13% (p = .68), respectively. General diet (p = .03, M change: 1.32, SD = 1.71) and blood glucose monitoring (p < .05, M change: 0.50, SD = 0.74) scores improved among those in the intervention group. General diet scores also improved in the EUC group: mean change: 1.77, p = .08, although changes were not statistically significant. Changes in diabetes distress scores differed based on the number of sessions attended, with a significant decrease in those attending 7 to 12 sessions (n = 7), >50%, (p = .003, M change: -5.71, SD = 3.20). Implementing a peer-led DSMS program for Black men was feasible, adopted, and led to positive changes in outcomes. Scaling up the intervention and assessing sustainability is warranted.

Evaluation of an HIV homecare program for lost-to-follow-up populations: a mixed methods study in Detroit, Michigan

BackgroundMaintaining people living with HIV (PLWHIV) in clinical care is a global priority. In the Metro Detroit area of Michigan, approximately 30% of PLWHIV are out of care. To re-engage lost-to-follow-up patients, Wayne Health Infectious Disease clinic launched an innovative Homecare program in 2017. In addition to home healthcare delivery, the program included links to community resources and quarterly community meetings. We aimed to evaluate Homecare’s impact on participants’ ability to stay engaged in HIV care and reach viral suppression. We included data from PLWHIV and their healthcare workers.MethodsWe used a convergent mixed-methods design, including first year program record review, semi-structured interviews, and a validated Likert scale questionnaire rating illness perception before and after Homecare. Interview data were collected from 15 PLWHIV in Metro Detroit and two healthcare workers responsible for program delivery. Semi-structured interviews focused on obstacles to clinic-based care, support networks, and illness perceptions. Interview data were transcribed and analyzed using a thematic approach. A fully coded analysis was used to create a conceptual framework of factors contributing to Homecare’s success. Means in eight categories of the Brief Illness Perception (IPQ) were compared using paired T-tests.ResultsIn the first year of Homecare, 28 of 34 participants (82%) became virally suppressed at least once. The program offered (1) social support and stigma reduction through strong relationships with healthcare workers, (2) removal of physical and resource barriers such as transportation, and (3) positive changes in illness perceptions. PLWHIV worked towards functional coping strategies, including improvements in emotional regulation, acceptance of their diagnosis, and more positive perspectives of control. Brief-IPQ showed significant changes in six domains before and after Homecare.ConclusionHomecare offers an innovative system for successfully re-engaging and maintaining lost-to-follow-up PLWHIV in care. These findings have implications for HIV control efforts and could inform the development of future programs for difficult to reach populations.

Poverty Stigma: Assessing the Surveillance of and Psychological Reframing by WIC Recipients

ABSTRACT The current study examines the poverty stigma experienced by Women, Infants, and Children program recipients during grocery store transactions. Through in-person interviews with 32 WIC recipients in metro Detroit, the study examines perceptions of the social context, strategies to manage stigma, and the social psychological consequences. The findings highlight the resilience of interviewees and the need for public assistance programs to address not just practical needs but also the social psychological well-being of recipients. This research contributes significantly to understanding poverty stigma, especially within the context of WIC food assistance. Policy implications are discussed.

460 Changes in Lipid Profiles with Progression of Pregnancy in Black Women

OBJECTIVES/GOALS: Pregnant African American (Black women) have higher rates of adverse pregnancy outcomes compared to other races and routine monitoring of lipid levels is not currently in practice in prenatal care. We hypothesized that lipid profiles would show variation across pregnancy indicative of specific requirements during gestation and fetal development. METHODS/STUDY POPULATION: We used an untargeted lipidome analysis approach to investigate lipid metabolism with the progression of pregnancy. Pregnant Black women were recruited at prenatal clinics in Midwest (Metro Detroit, Michigan and Columbus, Ohio), women under 18 or above 45 years of age were not enrolled due to metabolic changes associated with these age groups. Women signed the consent forms and plasma samples were collected at 8-18 weeks at (T1), 22-29 weeks (T2) and 30-36 weeks (T3) of pregnancy. Samples from sixty-three women (mean age 27.41 ± 5.61 years) who had term birth (completed 37 weeks of pregnancy) were subjected to “shotgun” Orbitrap high resolution/ accurate mass spectrometry. Mixed-effects models were used to quantify systematic changes in relative lipid abundances over time using R lme4 and ggplot2 packages. RESULTS/ANTICIPATED RESULTS: Total lipids and some major lipid classes showed a significant increase with the progression of pregnancy. Phospholipids and glycerolipids exhibited a gradual increase throughout pregnancy, while sphingolipids and total sterol lipids displayed a more pronounced increase at the T3 timepoint. Acylcarnitines, hydroxy acylcarnitines and Lyso phospholipids levels significantly decrease from T1 to T3. One of the interesting finding was that non-esterified fatty acids decreased from T1 to T2 and increased again from T2 to T3, suggesting a possible role for these lipids during the later stages of pregnancy. The fatty acids showing this trend included key fatty acids- Linoleic Acid, Arachidonic Acid, Alpha-linolenic acid, Eicosapentaenoic acid, Docosapentaenoic acid, Docosahexaenoic acid. DISCUSSION/SIGNIFICANCE: Mapping lipid trends during pregnancy could lend support to a precision health approach to reduce perinatal health disparities among pregnant Black women. The findings from this study will be used to identify biomarkers and study associations with social and environmental factors responsible for adverse perinatal outcome in pregnant Black women.

Pediatric hemolysis in emergency departments: Prevalence, risk factors, and clinical implications.

This study aimed to analyze the prevalence, risk factors, and clinical implications of hemolyzed laboratory samples in the pediatric emergency department (ED), a subject on which existing data remains scarce. We conducted a multi-site observational cohort analysis of pediatric ED encounters in Metro Detroit, Michigan, United States. The study included participants below 18 years of age who had undergone peripheral intravenous catheter (PIVC) placement and laboratory testing. The primary outcome was the presence of hemolysis, and secondary outcomes included identifying risk factors for hemolysis and assessing the impact of hemolysis on PIVC failure. Between January 2021 and May 2022, 10,462 ED encounters met inclusion criteria, of which 14.0% showed laboratory evidence of hemolysis. The highest proportion of hemolysis occurred in the infant (age 0-1) population (20.1%). Multivariable regression analysis indicated higher odds of hemolysis for PIVCs placed in the hand/wrist in the toddler (age 2-5) and child (age 6-11) subgroups. PIVCs placed in the hand/wrist also demonstrated higher odds of failure in infants. Hemolysis in the pediatric ED population is a frequent complication that occurs at similar rates as in adults. PIVCs placed in the hand/wrist were associated with higher odds of hemolysis compared to those placed in the antecubital fossa. Clinicians should consider alternative locations for PIVC placement if clinically appropriate. Further research is needed to better understand the clinical implications of pediatric hemolysis.

The use of procedural kits may reduce unscheduled central line dressing changes: A matched pre-post intervention study.

Unscheduled dressing changes for central venous lines (CVLs) have been shown to increase the risk of bloodstream infections. The objective of this study is to determine if the use of an innovative dressing change kit reduces the rate of unscheduled dressing changes. This pre-post interventional study took place at a large, academic, tertiary care center in metro Detroit, Michigan, the United States. We assessed the impact of the interventional dressing change procedure kit on the rate of unscheduled dressing changes for adult patients who underwent placement of a CVL inclusive of a central catheter, peripherally inserted central catheter, or hemodialysis catheter. Data was collected for the pre-intervention cohort through electronic health records (EHRs), while data for the post-intervention cohort were collected by direct observation by trained research staff in combination with EHR data. The primary outcome was the rate of unscheduled dressing changes. Secondary outcomes included rate of unscheduled dressing changes based on admission floor type, etiology of unscheduled dressing changes, and central line-associated bloodstream infections (CLABSIs). The study included a convenience sample of 1548 CVLs placed between May 2018 and June 2022 with a matched analysis including 488 catheters in each of the pre- and post-intervention groups. The results showed that the unadjusted rate of unscheduled dressing evaluations was significantly reduced from the pre-intervention group (0.21 per day) to the post-intervention group (0.13 per day) (p < .001). The adjusted rate ratio demonstrated the same trend at 1.00 pre- and 0.60 post-intervention (p < .001). Stratifying the analysis based on the highest level of care showed that the intervention was effective in reducing the unadjusted rate of unscheduled dressing evaluations for both the advanced and regular medical floor subgroups pre- to post-intervention; the advanced subgroup had an reduction from 0.22 to 0.15 per day (p = .001), while the regular medical floor subgroup had a reduction from 0.21 to 0.09 per day (p < .001). CLABSIs were similar in both groups (0.6% vs 0.8%; p = 1.00) in pre- and post-intervention groups, respectively. Procedural kits for central line dressing changes are effective in reducing unscheduled dressing changes and may have a role in reducing CLABSI. Further studies assessing the impact of dressing change kits on cost, procedural compliance, and the precise impact on CLABSI are needed.

Relationship between psychological distress and manifest behaviors of young adults in the Detroit Metro area during a COVID-19 wave

Relationship between psychological distress and manifest behaviors of young adults in the Detroit Metro area during a COVID-19 wave

Como Lo Hicimos: The Success of Latino/a Businesses in Michigan

Using data from the same oral history interviews used by Coronado and Martinez (2018), this study describes the success of some Latino businesses operating in Michigan. It is based on interviews with 32 Latino and Latina business owners (LBOs) conducted by researchers at the Julian Samora Research Institute (JSRI) at Michigan State University from 2011 to 2012 in three Michigan cities: Saginaw, Lansing, and Metro Detroit. This study describes the ways and means by which these business owners started their businesses and the success and possible expansion of their activities at the time of the interviews. Almost all had humble start-up operations, relied on their own or family savings, had relatives who owned or operated a business, lacked access to formal financial markets, and had limited knowledge about government programs supporting small businesses. Success was based on hard work and persistence, the pursuit of opportunities, and the use of technology. Most give back to their communities and have expansion plans, either by securing government funds or bank loans.

Locating Arab Americans in Greater Detroit: An Overview of MENA Archives in Southeast Michigan

ABSTRACT Southeast Michigan is home to one of the largest, most highly concentrated populations of people of Middle Eastern and North African (MENA) descent in the United States. This case study includes summaries of MENA-related collections at four separate repositories: the Bentley Historical Library at the University of Michigan, the Arab American National Museum, the Dearborn Historical Museum, and Eastern Michigan University Archives. This region not only provides unparalleled archival holdings, but researchers and archivists are actively working with local MENA communities to create future collections. In this study, staff from each of the four profiled institutions have contributed a summary that links collections across institutions and illustrates the importance of visiting two or more sites to fully understand the region's Arab American community. The authors reveal how researchers can find a rich collection of artifacts and photographs, oral histories, personal papers and organizational records, published materials, and government documents all within a half-hour drive of the Detroit Metro Airport. These collections, which are local, national, and international in scope, make metropolitan Detroit a crucial research site for historians, anthropologists, sociologists, and other scholars examining the life and culture of MENA communities across the United States.

Community Solutions to Increase the Healthfulness of Grocery Stores: Perspectives of Immigrant Parents.

Grocery store environments are recognized as one of the most crucial community settings for developing and maintaining healthy nutritional behaviors in children. This is especially true for disadvantaged ethnic minority families, such as immigrants, who reside in the Detroit Metropolitan area and have historically experienced inequities that result in poor health outcomes. Rates of obesity and type II diabetes have affected Detroit 38% more than the rest of the state and nationwide. In 2019, almost 54% of children aged 0-17 in Metro Detroit lived in poverty, and 21.6% experienced food insecurity, compared with the state level of 14.2%. Moreover, nearly 50% of ethnic minority children in Metro Detroit consume sports drinks, and 70% consume soda or pop in an average week. The primary purpose of this study was to explore immigrant parents' perspectives on (1) how in-store Sugar-Sweetened Beverage (SSB) marketing impacts the purchasing behaviors of parents and the eating behaviors of toddlers, and the secondary objective was to (2) determine strategies to reduce SSB purchases and consumption within grocery environments from the viewpoints of immigrant parents. A qualitative multiple-case study design was used to achieve the aims of this study. Semi-structured individual interviews were completed with 18 immigrant parents of children aged 2 to 5 years old who were consumers in 30 independently owned full-service grocery stores within the immigrant enclaves of Detroit, Dearborn, Hamtramck, and Warren, Michigan. Three key thematic categories emerged from the parents' narratives. These themes were: (1) non-supportive grocery store environments; (2) acculturation to the American food environment; and (3) strategies to support reduced SSB consumption among young immigrant children. The findings of this study revealed widespread SSB marketing targeting toddlers within the participating independently owned grocery stores. Even if families with young children practiced healthy nutritional behaviors, the prices, placements, and promotion of SSBs were challenges to establishing and sustaining these healthy eating habits. The parents believed that planning and implementing retail-based strategies in collaboration with families and considering families' actual demands would assist in managing children's eating patterns and reducing early childhood obesity.

Commemorations and outreach: Shi‘i leaders of metro Detroit take on theCOVID‐19 pandemic

AbstractOn March 11, 2020, the World Health Organization declared the coronavirus (COVID‐19) outbreak a global pandemic, spurring dramatic changes in public health policies, travel between countries, and (trans)national economies, as well as in religious and political institutions. In the United States, in particular, the pandemic provoked and revealed an increasingly fraught relationship between scientific, religious, and political sources of information and leadership—an American “crisis of authority” wherein many Americans distrusted scientific and medical establishments. This article explores how Shi‘i Muslim institutions and leaders of metro Detroit navigated these competing authorities, even as their communities faced entrenched societal inequities, including anti‐Muslim racism (Islamophobia). Through interviews with Shi‘i religious leaders in Dearborn, Dearborn Heights, and Detroit, supplemented by digital and in‐person ethnographic research at five major Shi‘i mosques, we show how major Islamic centers and leaders argued for the efficacy, safety, religious value, and legality of COVID‐19 medical guidance and led extensive community outreach initiatives to help their struggling communities. Supported by religious scholars in Iran, Iraq, and Lebanon, their guidance offered messages of hope and resilience, as well as an emphasis on the community preservation and selflessness (caring for others) exemplified by the Family of the Prophet. They also emphasized how religious and scientific knowledge intersect, as per the sacred texts of Islam (the Qur'an and hadiths). Their approach compels us to better understand how sources of religious authority can tether vulnerable communities to forms of (legitimate) knowledge in times of upheaval, divisive politics, and misinformation.

Enhanced Measurement of Sugar-Sweetened Beverage Marketing to Young Immigrant Children in Grocery Store Environments.

The marketing of Sugar-Sweetened Beverages (SSBs) within grocers is an obesogenic factor that negatively impacts children's nutritional behavior, specifically for people from racial and ethnic minority groups, such as immigrants. We aimed to develop and employ a methodology that more precisely assesses the availability, price, and promotion of SSBs to young immigrant children within independently owned grocery stores. A case comparison design was used to explore the differences in the grocery store landscape of SSB marketing by conducting an enhanced Nutrition Environment Measures Survey-SSB (NEMS-SSB) within 30 grocery stores in the Hispanic and Latino enclaves in Southwest Detroit, in the Arab and Chaldean enclaves in North-central Detroit, and in Warren, Hamtramck, and Dearborn, in comparison with 48 grocers in Metro Detroit. Unsweetened, plant-based, and organic toddler and infant beverages, as well as questions about marketing, were added to the original NEMS to capture the promotion tactics used in marketing SSBs. NEMS-SSB scores revealed that, in the immigrant enclaves, there was a significantly higher availability of SSBs in grocery stores (-2.38), and they had lower prices than those in the comparison group (-0.052). Unsweetened, plant-based, and organic beverages were unavailable in 97% of all participating grocery stores across both groups. Signage featuring cartoon characters was the most frequent in-store SSB marketing tactic across both groups. Widespread SSB marketing toward toddlers within the grocery stores in immigrant enclaves could be linked with the higher early childhood obesity prevalence among the immigrant population. Our findings can assist local and national organizations in developing and implementing healthy eating interventions. This study must be repeated in other immigrant enclaves across states to provide comparable results.

Enhancing the workforce in construction: robotic concrete printing in Detroit

The technological advancement of robotic automation in construction allows for the identification of a renewed design agenda at the intersection of professional practice, academic research, higher education, and the cultural context in which innovations take place. This paper outlines research conducted in the field of large scale digital robotic additive manufacturing at Lawrence Technological University, College of Architecture and Design, in collaboration with the artchitecture firm Daub and the start-up Citizen Robotics in Metro Detroit. The creation of a prototype for a temporary installation is used to assess the building feasibility of a home scheduled for completion in 2023, in which a portion of the exterior will be 3D printed.

A sound isolation case study for Detroit Metro Airport's TSA K-9 unit break room

The renovation of Transportation Security Administration offices at Detroit Metro Airport included a new K-9 break room for handlers to file reports and for their furry partners to decompress between explosives detection sniffing patrols. Post-renovation, the (human) occupants complained of excessive noise due to luggage conveyer belts located in the ceiling plenum. Soundscape Engineering conducted an assessment to determine feasible noise mitigation solutions to increase acoustical comfort in the break room. The primary noise source was the spiral power turn conveyer and its four motors. With the implementation of gypsum-backed ceiling tiles, an insertion loss of 17 dBA was realized. Despite the NC 57 environment in the room, the noise reduction earned rave reviews from its bipedal users. This paper discusses the budgetary, performance, and scheduling considerations for the barrier ceiling solutions and the resulting improvements obtained in the K-9 break room.

Tale of Two Counties With the Same Telehealth Story: Experience with Cancer Genetics Testing During COVID-19 at a Community Hospital

Introduction: With the onset of the COVID-19 pandemic in 2020, the utilization of telemedicine now offered an alternative diagnostic and treatment resource to providers in many areas of medicine including oncology and cancer genetics. This care option paired with genetic testing labs’ ability to send saliva-based DNA collection kits to patients, enabled our community hospital in Detroit to offer diagnostic testing without the patient coming to a healthcare setting for a host of reasons. Social determinants of health have been found to influence success with telehealth, and this study sought to analyze how successful telehealth cancer genetics care was throughout the Detroit Metro area. Methods: Patient demographics for in person visits six months before COVID were analyzed, and then compared with demographics of patients during the 2020-2021 pandemic period where visits were telehealth. Results: Pre-pandemic there were , 192 unique patients seen in person with the top three cities patients were from were Detroit (12.1%), Clinton Township (8.3%), and Saint Clair Shores (10.4%). During the pandemic, with telehealth as the major modality, the top three cities were Macomb (7.2%), Detroit (7%), and Clinton Township (7%). Detroit is in Wayne County, while St.Clair Shores and Clinton Township are in Macomb County. Per the US Census Bureau Macomb county has a median income of $64,641 and Wayne county has a median income of $49,359, and poverty level in Macomb county is 9.2% versus in Wayne the level is 20%. Conclusions: This paper outlines the challenges of initiating a telemedicine program in an urban community area and highlights the benefits of a concierge service in serving cancer patients who may have economic and historically poor perceived technologic abilities.