Utah Department Research Articles

The Effectiveness of Face Mask Mandates on COVID-19 Transmission in Utah.

Throughout the COVID-19 pandemic, the effectiveness of face mask mandates was intensely debated. The objective of this study was to describe how face mask mandates at the state, county, and local levels differed in their effectiveness in reducing the number of COVID-19 cases in the jurisdiction where the mandate was implemented and throughout Utah. We used publicly available data from the Utah Department of Health and Human Services. We calculated the effectiveness of face mask mandates (EFm) in each local health district after 3 key mandates: the enactment of face mask mandates in Salt Lake and Summit counties (SLSC) on June 28, 2020, and June 27, 2020, respectively; the enactment of a statewide face mask mandate on November 9, 2020; and the lifting of the statewide face mask mandate on April 10, 2021. Most counties in Utah had a reduction in the growth rate of COVID-19 cases after enactment of face mask mandates. We found an average 11.9% reduction in EFm after the introduction of the SLSC face mask mandates, with 8 of 13 local health districts experiencing a reduction, and an average 12.7% reduction after introduction of the statewide mandate, with 12 of 13 local health districts experiencing a reduction. After mandates were lifted, many counties had an increase in EFm. Face mask mandates were an effective way to reduce transmission of COVID-19 in local jurisdictions and in neighboring jurisdictions in Utah. Our evidence supports the use of face mask mandates as a way to prevent disease transmission and be better equipped to respond to future pandemics.

Volunteer onboarding in times of crisis: Utah's experience during COVID‐19

AbstractThis article is an example of “Lessons from the Field.” In early 2021, a call to action resulted in an unprecedented surge of volunteers for Utah's public health system. This call to action was in support of the rollout of COVID‐19 vaccine across the state and the need to vaccinate the population as quickly and efficiently as possible. In this case study, we describe the events that preceded the surge of volunteers as well as challenges and resolutions to volunteer onboarding. Additionally, we discuss the importance of collaboration between local health departments and the Utah Department of Health and Human Services and describe how the partnership was strengthened by this specific emergency response.

Short and mid-term effect of the streetcar on vehicle-vehicle (and vehicle-pedestrian) crash rate on the adjacent street

IntroductionIntroducing new public transit systems impacts the surrounding built environment, and changes in the built environment can affect travel behavior. Prior research has yet to thoroughly conduct a comprehensive exploration of the influence of new investments in public modes of transit, particularly streetcars, on motor vehicle crashes occurring on adjoining streets, considering other related factors. In particular, the difference between short-term and mid-term impacts of streetcars considering initial break-in periods has yet to be thoroughly conducted. This study focuses on the short-term and mid-term effects of the streetcar on total, injury, and pedestrian-involved vehicle crash rates on the adjacent street, considering traffic volume, traffic speeds, and traffic conflicts (transit ridership, pedestrian volume, and traffic policy). Data & MethodThis paper used the Utah Department of Transportation’s (UDOT) crash count, annual average daily traffic (AADT), iPeMS data, Utah Transit Authority’s (UTA) ridership, manually calculated pedestrian volume from Google Street View, and conducted interviews with UDOT’s experts. In the method, we used three quasi-experimental research designs: (1) before-after without a control group, (2) interrupted time series, and (3) before-after with a control group. In addition, to identify the cause of this impact, we examined multiple dimensions, including traffic volume, traffic speeds, transit ridership, pedestrian volume, and adjustments in traffic policy changes. ResultsAs a result, the establishment of the S-Line streetcar eventually led to a significant decrease in total (short: 11 %, mid: −15 %), injury (short: −9%, mid: −41 %), and pedestrian-involved (short: −25 %, mid: −43 %) crash rates on the adjacent street, especially after the streetcar was fully established (3 years after). In particular, injury and pedestrian-involved crash rates decreased significantly. Also, we found that increased drivers’ awareness and vitality of the street due to the increased transit ridership (short: 43 %, mid: 50 %), increased pedestrian volume (short: 35 %, mid: 75 %), and improvement of traffic signal on the adjacent street can be the main causes. Practical ApplicationsThe outcomes of this study are considered to help establish short-term and mid-term traffic policies that consider public transit improvements such as streetcars.

Resource Allocation in an Uncertain Environment: Application to Snowplowing Operations in Utah

We consider a two-stage planning problem where a fleet of snowplow trucks is divided among a set of independent regions, each of which then designs routes for efficient snow removal. The central authority wishes to allocate trucks to improve service quality across the regions. Stochasticity is introduced by uncertain weather conditions and unforeseen failures of snowplow trucks. We study two versions of this problem. The first aims to minimize the maximum turnaround time (across all regions) that can be sustained with a user-specified probability. The second seeks to minimize the total expected workload that has not been completed within a user-specified time frame. We develop algorithms that solve these problems effectively and demonstrate their practical value through a case application to snowplowing operations in Utah, obtaining solutions that significantly outperform the allocation currently used in practice. Funding: Financial support from the Utah Department of Transportation [Grant 218138]; the National Science Foundation [Grant CMMI-2112758]; and the Mountain-Plains Consortium [Grant 637] is gratefully acknowledged. Supplemental Material: The e-companion is available at https://doi.org/10.1287/trsc.2023.0024 .

Improving Snowplowing Operations in Utah Through Optimization and Visualization

Improving Snowplowing Operations in Utah Through Optimization and Visualization

The US FDA's proposed rule on laboratory-developed tests: Impacts on clinical laboratory testing

ObjectivesTo solicit quantifiable feedback from clinical laboratorians on the U.S. Food and Drug Administration (FDA) proposed rule to regulate laboratory-developed tests (LDTs) as medical devices. Design and MethodsA ten-item questionnaire was developed and submitted to clinical laboratory customers of ARUP Laboratories, a national nonprofit clinical laboratory of the University of Utah Department of Pathology. ResultsOf 503 clinical laboratory respondents, only 41 (8 %) support the FDA's proposed rule. 67 % of respondents work in laboratories that perform LDTs and were therefore asked additional questions regarding the proposed rule. 84 % of these respondents believe that the proposed rule will negatively impact their laboratories, while only 3 % believe that they have the financial resources to pay for FDA user fees. 61 % of respondents anticipate removing tests from their laboratory menus if the proposed rule is enacted, while an additional 33 % indicated that they do not yet know. Only 11 % of respondents believe that they would pursue FDA submissions for all of their existing LDTs if the final rule is enacted. The vast majority of respondents (>80 %) were either ‘extremely concerned’ or ‘very concerned’ about the impact of the proposed rule on patient access to essential testing, financial and personnel resources to comply, innovation, the FDA's ability to implement the rule, and send-out costs and test prices. ConclusionsThe majority of clinical laboratorians surveyed do not support the FDA's proposed rule on LDTs and report having insufficient resources to comply with the rule if it is enacted.

Privacy-preserving culvert predictive models: A federated learning approach

In recent years, transportation agencies have shown a growing interest in the adoption of machine learning (ML) models as a means to improve the efficiency of their infrastructure asset management practices. Their limited inventory can, however, hinder the development of robust ML models. Moreover, transportation agencies may be reluctant to share their raw inventory data with others. To address these challenges, we employed a new ML paradigm, federated learning (FL), and demonstrated its potential in the case study of Utah culvert management. The Utah Department of Transportation (UDOT) only owned a limited culvert inventory, but we were able to obtain additional data from five other state DOTs’ inventories. Rather than employing a conventional centralized ML method, we opted for FL. This approach ensured that while UDOT did not directly access raw data from five other DOTs, it could still benefit from their combined insights. The FL-based model with 80.4 % accuracy showed a promising performance between the two centralized learning models developed based on the consolidated and the Utah-only datasets. The federated approach demonstrates that it is possible to develop high-performance ML models without compromising data confidentiality by centralizing data. This pioneering approach sets a precedent for other transportation agencies, suggesting they can navigate data scarcity and privacy concerns while reaping the benefits of collective knowledge.

Evaluating Signal Preemption Requests in Utah Using Vehicle-to-Everything Dedicated Short-Range Communication Equipped Snowplows

At the start of the 2019 to 2020 snow season, vehicle-to-everything (V2X) systems using dedicated short-range communication (DSRC) were placed on Utah Department of Transportation snowplows and traffic signal controllers on selected state routes. This study was conducted to understand the overall impacts of snowplows using V2X DSRC to request signal preemption. Roadside units (RSUs) were deployed on five corridors throughout the Salt Lake metropolitan area. Similar routes without RSUs were selected as a control and were used in the analysis to quantify results. Each snowplow on these corridors was equipped with an onboard unit (OBU). Based on data collected, analysis was performed on both traffic signal performance and vehicle performance data. Within the traffic signal performance analysis, it was found that the V2X DSRC system was utilized often, with snowplows requesting preemption in more 50% of the occasions they approached a signalized intersection. Of those requests, signal controllers granted preemption in over 80% of cases. On average, signal controller coordination was affected for less than 5 min. The vehicle performance analysis found that the snowplows on equipped routes had travel speeds that were less affected when there was snow than on corresponding not-equipped routes. Vehicle crash data also showed that there was a greater decrease in crashes on equipped routes than not-equipped routes. Anecdotal evidence gathered from snowplow drivers indicated that snowplows stopped less when using signal preemption. Drivers also noted a benefit to overall snow removal operations on corridors equipped with the V2X DSRC system.

GERIATRIC WORKFORCE ENHANCEMENT PROGRAMS AS AAA AGE-FRIENDLY INITIATIVES PARTNER

Abstract The Health Resources and Services Administration funded 48 Geriatric Workforce Enhancement Programs (GWEPs) to partner with community-based organizations in addressing gaps in health care for older adults, promoting Age-Friendly ecosystems, and addressing social determinants of health. This paper discusses three GWEPs collaborative projects with Area Agencies on Aging (AAAs) that deliver community-based programs . The University of Utah’s GWEP, a rural AAA, the Alzheimer’s Association, and the Utah Department of Veterans and Military Affairs provided a hybrid Dementia Caregiver Conference to six counties, reaching 65 in-person attendees and 10 senior centers online. Attendees agreed the content met their educational needs, would positively influence care, and was motivation to form a caregiver coalition. The University of Louisville Trager Institute (Trager), AAA, and Kentucky Coalition for Healthy Communities provided focused regional training and sharing of community resources utilizing the Project ECHO training model for 11 AAA regions, reaching 412 home and community-based services professionals. The University of North Texas Health Science Center, AAA, and emergency management services expanded evidence-based programs in falls prevention, medication safety, and dementia caregiving, serving an additional 23 urban postal codes, rural counties, and over 1,900 individuals. These examples utilize unique community relationships and partnership strategies to identify local needs, maximize older adult and family caregiver engagement, measure outcomes, and achieve GWEP goals to educate diverse, underserved and rural communities.

Geographical impact on prostate cancer genetic testing eligibility: A preliminary study from an academic cancer center.

10618 Background: Germline testing (GT) for prostate cancer (PCa) helps to determine treatment selection and other cancer risk, which guides screening recommendations. Patients with PCa that is high risk group by NCCN and greater stage should receive genetic counseling (GC) referral. There is limited data on differences in genetic services given the rurality of PCa patients. This study aims to determine the geographical distribution of PCa patients meeting GC referral and GT criteria. Methods: A retrospective analysis evaluated data from electronic medical records of PCa patients at an NCI-designated cancer research facility. Data was abstracted from new PCa patients seen in 2019 and 2021, years before and after the COVID-19 pandemic. Data includes demographic information, cancer staging, and pathology results. Regions of urbanicity, urban and non-urban (rural/frontier), were categorized through zip codes and defined by Utah Department of Health and Human Services. Criteria for GT followed NCCN guidelines (v.1.2023). Statistical methods for descriptive and comparative analysis done using Chisquare, Fisher’s exact, and Mann Whitney tests in R*Stats to compare 2019 and 2021 cohorts. Results: Out of 525 PCa patients' initial treatment at HCI in 2019 (n = 346) and 2021, (n = 179) 94% self-reported as White (p = 0.164) with a median age of 66 (p = 0.690) and 51% being employed (p = 0.396) at time of first treatment. Of these, 414 (79%) were from an urban area and 111 (21%) from a non-urban area (p = 0.883). The cohort was primarily from 2019 (66%), with 274 (79%) and 72 (21%) of the PCa patients living in urban and non-urban areas, respectively. In 2021 (34%), 140 (78%) and 39 (35%) patients were from urban and non-urban areas. Criteria for GT were met in 37% (n = 196) of PCa patients (p = 0.595). Regions were independently compared by race, age, employment, and year. No statistical difference across all variables was found (p > 0.05). Geographical regions did not impact GT eligibility. Conclusions: This preliminary study shows that geographical region does not impact GT eligibility in PCa patients seen at HCI during 2019 and 2021. The years analyzed is a proxy for differences in aggressiveness by rurality. The results show 37% of the PCa patients met criteria for GT. No significant differences were identified by geographical region, race, age, employment, or the year of initial treatment. Further research is being conducted to determine if access to PCa GC uptake is impacted by geography and differing service delivery models after criteria for GT has been met.

Street Smart: Developing Relationships to Support Walkable Communities for All.

Background. Physical activity promotion is an essential intervention for the prevention of chronic disease by reducing the risk of cardiovascular disease, Type 2 diabetes, and certain types of cancers, as well as improving brain health. Previous approaches that emphasized physical fitness did not meet the needs of the larger population due to not incorporating integration of movement into daily life. Changes that result in the addition of even small amounts of physical activity, such as through active transportation, can make a big difference in quality of life and longevity. Innovative Approach. To increase opportunities for active transportation, Utah agencies are working across sectors to incorporate physical activity into routine, day-to-day activities that may help to address this challenging public health problem. Human-powered travel is a key component of community design supporting health and healthy behaviors. The Utah Department of Health and Human Services (DHHS) built relationships with partners in order to promote active transportation. Lessons Learned & Recommendations. This article will demonstrate ways in which public health, transportation, and planning agencies can better engage to provide opportunities for all people to be physically active. DHHS addresses the importance of sharing public health data among state agencies, inclusion of under-represented populations in community feedback, and engaging in shared projects that will support the involvement of public health in transportation planning.

Evaluation of Methods for Left-Turn Gap Analysis Using High-Resolution Signal Data

This project evaluates the most underutilized but potentially the most useful automated traffic signal performance measure (ATSPM) tool in decision-making for left-turn phasing at signalized intersections. Lack of data quality control or quality checks and a difficulty in using the currently presented measure on the website have been identified as shortcomings of the “left-turn gap analysis” measure. The purpose of this project is to develop an automated method of flagging intersection approaches in need of left-turn phasing changes based on availability of gaps in opposing through traffic. Through comparison with manually collected data, high-resolution data from selected approaches were validated. The validated sample data were then used to develop a gap analysis tool which, in conjunction with identified automated measures, can identify and flag left-turn locations requiring phasing changes (adjusting between permissive-only, protected-permissive, and protected-only). The tool is currently being migrated to the Utah Department of Transportation ATSPM website to be made available to engineers and consultants in the form of a password-protected online measure.

COVID-19 Stress, Religious Affiliation, and Mental Health Outcomes Among Adolescents

PurposeTo examine the relationship between religious affiliation, stressors due to the COVID-19 pandemic, and mental health challenges in a representative sample of adolescents. MethodsThe sample was composed of 71,001 Utah adolescents who participated in a survey by the Utah Department of Health in 2021. Data are representative of all Utah adolescents in grades 6, 8, 10, and 12. Bootstrapped mediation was used to test indirect effects of religious affiliation on mental health challenges through COVID-19 stressors. ResultsReligious affiliation was related to significantly lower rates of teen mental health challenges as measured by suicidal thoughts, suicide attempts, and depression. For religiously affiliated adolescents, the rate of considering and attempting suicide was nearly half of that of unaffiliated adolescents. In mediation analyses, affiliation was indirectly related to mental health challenges (suicide ideation, suicide attempt, and depression) through stressors from COVID-19, including affiliated adolescents experiencing the following: less anxiety, fewer family fights, fewer school difficulties, and fewer skipped meals. However, affiliation was positively related to becoming sick with COVID-19 (or having COVID-19 symptoms), which was related to more suicidal thoughts. DiscussionFindings suggest that adolescent religious affiliation may be a promotive factor that decreases mental health challenges through a reduction in COVID-19-related stressors, except religious individuals may be more likely to become sick. To increase positive mental health outcomes among adolescents during pandemic times, consistent and clear policies that facilitate religious connections that also align with good physical health measures will be critical.

Analysis of the Utah Department of Health's Living Well with Chronic Pain program.

Wyatt, Waliah; Duarte, Teresa; Falcon, David; Harkin, Cameron; Coombs, Jennifer PhD, PA-C Author Information

Nocoastjazz

Nocoastjazz

Hannah Claire Haines, 1891–1974: Not the Average “Militant Female”

Hannah Claire Haines, 1891–1974: Not the Average “Militant Female”

33906 Dermatology rural outreach clinics are feasible and decrease barriers to care in patients with skin cancer

Rural populations have higher skin cancer incidence and cancer-related deaths, likely due to lack of access to health care, environmental exposures, and lower socioeconomic status. To address the pressing need for specialty care in rural communities, in 2018, faculty from the University of Utah Department of Dermatology established monthly rural outreach clinics in Moab, Utah (population: 5268) and later Rock Springs, Wyoming (population: 23,319). We performed a retrospective chart review to evaluate the impact of the dermatology rural outreach clinics, focusing on patients diagnosed with biopsy-proven skin cancer. Distance to the nearest dermatologist was an average of 122.6 miles (Moab to Grand Junction, CO) and 171.2 miles (Rock Springs to Park City, UT). With the outreach clinics, this was reduced to an average of 14.1 miles (P < .0001) and 18.1 miles (P < .0001), respectively. Skin cancer was diagnosed in 17% (116/682) of all outreach clinic patients (median age 67.7 years, 54.3% male, 100% White, 67.5% Medicare). 58.8% had a personal history of skin cancer. Of the 188 total skin cancers diagnosed, squamous cell carcinoma was most common (52.1%), followed by basal cell carcinoma (41.5%), malignant melanoma (2.7%), and melanoma in situ (3.7%). Forty-two patients (36.2%) received Mohs surgery referrals; 90.5% were completed at the University of Utah. We did not find significant differences between the Moab and Rock Springs clinics. These results highlight the importance and feasibility of outreach clinics in providing access to dermatologic care, specifically in diagnosing and treating skin cancers in rural populations.

Boron in the strata and waters of the Eocene Green River and Uinta Formations, Uinta Basin, Utah

Boron is a naturally occurring element that can be found in the strata and water of the Eocene Green River and Uinta Formations of the Uinta Basin of Utah. Whereas boron is suspected to be a necessary trace nutrient for proper plant and animal growth and development, higher concentrations of boron can be detrimental to living things, but the element is not known to be carcinogenic. Utah has no limit on boron content in drinking water; however, for irrigation purposes a limit of 750 μg B/L (0.75 mg/L) has been established. The Green River Formation (GRF), deposited in ancient lakes in Wyoming, Colorado, and Utah, is well known for its oil shale and saline mineral deposits, particularly the thick, economic trona beds in Wyoming. Such evaporitic mineral deposits are characteristic of a saline lake environment that existed at the end stages of Eocene lacustrine deposition. In Utah they are found in the upper GRF, and to a minor extent in the lower Uinta Formation, where elevated boron is evident. Boron-bearing minerals are present in the Parachute Creek Member of the GRF in Utah, and they occur as secondary silicate minerals in at least 12 wells across Utah’s Uinta Basin. These minerals were first reported by the U.S. Geological Survey in the 1950s. This study determined that the boron mineral occurrences correlate stratigraphically and coincide with the areas delineated for the hypersaline events in the Parachute Creek Member of the GRF. This argues that boron was concentrated with other saline constituents in Lake Uinta and is an indicator of hypersaline conditions. Water quality analyses reporting boron content from surface and subsurface samples were compiled from public databases from the Utah Department of Environmental Quality, the U.S. Geological Survey, and the Utah Geological Survey. This new database consists of 155 samples from 38 sites from the upper part (Parachute Creek Member) of the GRF, and 58 samples from 26 sites from the lower part (Douglas Creek Member) of the GRF. The boron concentration was found to be different for the two GRF parts. The average boron content of the 58 lower GRF aquifer water analyses is 6338 μg/L, while the mean boron content for the 26 individual sites varies from 15 to 205,000 μg/L. The upper GRF aquifer contains at least twice the boron content of the lower GRF, and the average boron content of the 155 analyses of upper GRF groundwater is 18,172 μg/L. The mean boron content for the 38 individual sites varies 40 to 480,000 μg/L. Areas of highboron concentration in groundwater of the GRF tend to coincide with the location of GRF hypersaline paleodepocenters. Groundwater boron content in the Uinta Formation comes from 40 analyses from 36 sites. The average of the 40 Uinta Formation analyses is 3251 μg B/L, while the mean boron content for the 36 individual sites varies from 40 to 24,000 μg/L. For each interval studied, less boron tends to be found in analyses from sites near the outcrop and boron content tends to increase in the studied formations as they are more deeply buried. Additionally, boron content was compiled for surface waters and springs for 3955 analyses from 374 sites in the Uinta Basin. When the mean boron content of these surface water sites was examined by hydrologic drainage unit subareas, it was found that the tributaries in the northern Uinta Basin, north of the Duchesne and White Rivers, contain the lowest mean boron contents, whereas higher mean boron contents are common for the tributaries in southern part of the basin. The boron content of surface water from the southern Uinta Basin drainages also tends to increase northward toward the demarking water courses. The tributaries in the southern part of the Uinta Basin have higher boron contents due to their waters having contact with the boron-bearing, shallow-inclined strata of the upper GRF or member B of the Uinta Formation. The tributaries in northern part of the basin have lower boron contents because they are not in contact with the GRF, have less contact with the member B of the Uinta Formation, and are diluted by greater snow-melt runoff from the Uinta Mountains which bound the basin to the north.

High-Contact Object and Surface Contamination in a Household of Persons with Monkeypox Virus Infection - Utah, June 2022.

In May 2022, the Salt Lake County Health Department reported two real-time polymerase chain reaction (PCR)-confirmed travel-associated cases of monkeypox to the Utah Department of Health and Human Services (UDHHS). The two persons with monkeypox (patients A and B) lived together without other housemates. Both persons experienced prodromal symptoms (e.g., fatigue and body aches). Eight days after symptom onset, patient A experienced penile lesions; lesions spread to the lips, hands, legs, chest, and scalp by day 10. Patient B experienced prodromal symptoms 8 days after illness onset of patient A; patient B experienced a lesion on the foot which spread to the leg and finger by day 11. Although both patients had lesions in multiple anatomic areas, the overall number of lesions was small, and lesions varied in presentation from "pimple-like" or ulcerated, to characteristically well-circumscribed and centrally umbilicated. Both patients had mild illness. The time from symptom onset to resolution was approximately 30 days for patient A and approximately 22 days for patient B.

“Sure a Strong Devil”: Mabel Frazer, A. B. Wright, and the University of Utah Art Department's 1937 Sexual Misconduct Case

“Sure a Strong Devil”: Mabel Frazer, A. B. Wright, and the University of Utah Art Department's 1937 Sexual Misconduct Case