Sarah Fox - US grants

This community study will assess the impact of an urban outreach series of interventions on the rates of screening mammography for women 65 years of age and over. The three populations targeted for interventions are: 1) primary care physicians who refer patients for mammography; 2) all women 65+ and 3) community radiologists. The primary intervention is a 1-on-1 practice based educational session with physicians that will include the recent California law's coverage of screening mammography; issues related to breast cancer and aging, such as the decreasing utilization of mammography with increasing age; racial discrepancies, such as Black and Hispanic women over age 65 having had far less mammography experience than White women; the older women's general high acceptance of mammography; and the UCLA outreach program in the community to reach women 65+ about these issues. Specially designed educational materials will be provided to these physicians. If the Medicare benefit become effective in January 1991, the new information will be promoted to physicians through hospital CME programs. This intervention will be given to all referring physicians in two experimental communities. The practices in the matched community will serve as the comparison group. The second intervention will increase the awareness of women 65+ in the experimental communities about the California law, increase women's requests to referring physicians for a screening mammogram, and inform and promote mammography through the outreach program with strategies previously determined to be effective with older women of different races. The tertiary intervention will target all radiologists who perform mammography in the experimental communities to continue to contain or reduce costs, and will ensure that all facilities are prepared to process Medicare billings for screening mammograms properly should the coverage become effective in January 1991. Analyses of the proposed interventions will rely on a quasi-experimental design that includes experimental and matched comparison communities for assessing the interventions with physicians, women, and radiologists. The overall goal of this project is to improve mammogram utilization rates in 65+ women by at least 10% over the secular trend determined by the 1990 and 1991 surveys of women 65+. This proposal is requesting the year 2 funds of a 2 year supplement that has been funded and ongoing since October 1989.

This community study will assess the impact of an urban outreach series of interventions on the rates of screening mammography for women 65 years of age and over. The three populations targeted for interventions are: 1) primary care physicians who refer patients for mammography; 2) all women 65+ and 3) community radiologists. The primary intervention is a 1-on-1 practice based educational session with physicians that will include the recent California law's coverage of screening mammography; issues related to breast cancer and aging, such as the decreasing utilization of mammography with increasing age; racial discrepancies, such as Black and Hispanic women over age 65 having had far less mammography experience than White women; the older women's general high acceptance of mammography; and the UCLA outreach program in the community to reach women 65+ about these issues. Specially designed educational materials will be provided to these physicians. If the Medicare benefit become effective in January 1991, the new information will be promoted to physicians through hospital CME programs. This intervention will be given to all referring physicians in two experimental communities. The practices in the matched community will serve as the comparison group. The second intervention will increase the awareness of women 65+ in the experimental communities about the California law, increase women's requests to referring physicians for a screening mammogram, and inform and promote mammography through the outreach program with strategies previously determined to be effective with older women of different races. The tertiary intervention will target all radiologists who perform mammography in the experimental communities to continue to contain or reduce costs, and will ensure that all facilities are prepared to process Medicare billings for screening mammograms properly should the coverage become effective in January 1991. Analyses of the proposed interventions will rely on a quasi-experimental design that includes experimental and matched comparison communities for assessing the interventions with physicians, women, and radiologists. The overall goal of this project is to improve mammogram utilization rates in 65+ women by at least 10% over the secular trend determined by the 1990 and 1991 surveys of women 65+. This proposal is requesting the year 2 funds of a 2 year supplement that has been funded and ongoing since October 1989.

DESCRIPTION (adapted from investigator's abstract): Certain cancer screening tests are effective in early detection, most notably, the tests used for breast, cervical, and colorectal cancers. These tests, all of which are endorsed by the US Preventive Task Force for women over age 50, include mammography, clinical breast exam (CBE), pap smear, and fecal occult blood test (FOBT). In spite of widespread endorsement by credible sources, many women do not systematically receive these tests, especially if they are older women and Hispanic older women. As recently as 1996 in a Los Angeles County study, 58 percent of women aged 60-64, and only 25 percent of those who were Hispanic, reported adherence with mammography screening. In 1997, in a different Los Angeles study, only 32 percent of female patients aged 60-80 were adherent with annual FOBT. Hispanic patients reported a 23 percent adherence rate. Since older women are especially at risk for cancer with increasing age, these screening rates are unnecessarily low. The overall goal of this study is to increase the screening adherence of 60-80 year old women, especially Hispanic women. The investigators propose a randomized trial involving a sample of primary care physicians drawn from 23 contiguous communities in Los Angeles County. The research design incorporates a physician intervention that teaches physician communication and caring skills. These skills have been identified as the most significant predictors of mammography, CBE and FOBT adherence in previous studies conducted by the team. The primary physician outcome measure will be changes in the reported utilization of these skills, combined in the Physician Behavior Checklist (PBC) measure that will be validated in this study. The PBC assesses the effectiveness of the physician in facilitating adherence. Long term objectives include: 1) develop, pre-test and implement a physician intervention designed to increase physician use of PBC skills, 2) determine the screening rates of female patients ages 60-80 and assess how these rates change as a function of the intervention, 3) compare the intervention versus control group to estimate the cost effectiveness ratio of the intervention relative to the control group, and 4) evaluate the effectiveness of the proposed intervention. Few physician and patient communication and relationship skills have been directly linked to patient outcomes such as cancer screening adherence. A brief validated patient measure (for use across medical settings in English and Spanish) such as the PBC will be an important contribution to public health policy. Finally, the physician intervention that is proposed for testing is efficient, feasible, and exportable.

DESCRIPTION: The proposed study is a 5-year randomized controlled community trial to test two interventions designed to promote increased use of colorectal cancer (CRC) screening. The interventions will be tested in 74 churches in Los Angeles County and Honolulu with men and women church members ages 50-75. The interventions comprise a church-level one, Church Leadership Training (CLT) and a member-level one, Targeted Print (TP). CLT targets pastors and other key church leaders through training workshops to increase public health awareness throughout the organization with a focus on promoting CRC screening. This proposal is a competing continuation application that builds on a previous trial in Los Angeles churches that successfully tested a targeted print intervention to increase mammography screening. In this study, TP will target older church members through mailings that address barriers to CRC screening. Low to moderate income Asians, blacks, Hispanics and whites will be the focus population. We propose a 2-site study in Los Angeles and Honolulu using a randomized longitudinal cohort design within each site. 54 churches from Los Angeles and 20 from Honolulu will be randomized into 3 study conditions (2 interventions and a minimal contact control). 2,700 church members from Los Angeles and 1,000 from Honolulu will be followed over 3 years to study the effectiveness and cost-effectiveness of the 2 interventions on regular CRC screening. A church-wide evaluation, consisting of extended interviews with pastors and other key church leaders, will be conducted to develop case studies. This qualitative assessment will contribute to an appreciation of the impact of research studies on church organizations. Several strengths of this study include testing a church-level vs. a member-level intervention to promote CRC screening, the use of extensive church pilot data to establish the feasibility of this study, a design that allows generalizations about the efficacy of church-based health promotion programs, and a quantitative and qualitative approach that broadens our understanding of using urban churches to reach underserved groups.

Millions of people deemed ?essential workers? in the COVID-19 pandemic perform manual labor, such as sorting, cleaning, garbage collection, and recycling. To mitigate risks associated with this work, there is an accelerated push to introduce artificial intelligence (AI) to safeguard the public and workers from disease transmission. Yet, decades of human-computer interaction and organizational communication research shows that the introduction of new technologies into workplaces is not an easy transition; instead technologies transform and displace existing work practices. This research project investigates both beneficial innovations and liabilities arising in waste management industries, as they deploy AI technologies in response to the COVID-19 crisis. It develops a set of best practices for the coordination of human labor and AI to address the pandemic, transforming the future of work. The best practices will be presented as guidance on how to incorporate AI into critical economic institutions to mitigate the negative effects of COVID-19 on public health, society, and the economy. This guidance will regularly be communicated to workers, industry leaders, and the public through an open access toolkit, a workshop series, press releases, and social media. This will potentially benefit essential industries that employ or serve tens of millions of workers, including waste labor, shipping, manufacturing, retail, and food service.

This project will be conducted through a multi-site ethnographic study, examining how two American waste management organizations negotiate the introduction of automated technologies, in an effort to mitigate risks associated with the COVID-19 pandemic. The first involves automated ?floor care? robots at Pittsburgh International Airport. The second involves AI sorting systems in a single stream recycling plant, in Austin, Texas. By studying two sites, the research team is expected to gain comparative insight into how automation is introduced and attuned, according to professional, regional, and institutional norms. Data collection will include ethnographic fieldnotes, interview transcripts, and media materials. Extending theories of technological diffusion and invisible labor, the research team will qualitatively analyze the technology dissemination process, drawing insights from the actions and perspectives of workers as they negotiate the changing shape of their daily work. Through reflexive memos and ?constant comparative? coding, the research will identify patterns of action and build a set of transferable observations. This is expected to yield (1) empirical findings on factors that promote or hinder rapid technological introduction in response to crisis, with specific insights on the human labor required to make automated technologies work (e.g., calibration, troubleshooting, and maintenance), (2) theoretical findings that contribute core understandings of the diffusion of innovation and how workplace technologies are reinvented through use, and (3) design recommendations for a variety of essential work sectors.

This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

This NSF S&CC planning grant contributes to the design and development of new mobility technologies that serve city residents. New mobility technologies are on the rise in cities across the US, with micromobility platforms and autonomous delivery robots occupying the sidewalks of many cities. Amid the enthusiasm around what these devices could mean for the future of transportation and the circulation of essential goods, are concerns about who stands to benefit from these technologies. This research focuses on producing a robust understanding of the unintended harms these devices may introduce and, in collaboration with community members, offer a set of potential opportunities to support resident safety and ensure broad community benefit

Pennsylvania recently passed state-wide legislation classifying personal delivery devices (PDDs) as "pedestrians," bestowing them the same legal rights as human residents. In response, Pittsburgh government officials and residents have come together as a coalition with the aim of developing municipal standards on current delivery devices to ensure continued accessibility of public space, and strategies for planning proactively for future new mobility deployments in the area. Researchers in this project have partnered with the City of Pittsburgh’s Department of Mobility and Infrastructure (DOMI) and established connections with local advocacy organizations to develop community-driven approaches to the deployment and governance of new mobility technologies. Extending methods of impact analysis and equity measures, they draw insights from the actions and perspectives of government officials and residents who are negotiating the changing shape of the city and seeking to define community-driven technology deployments. This planning grant lays the groundwork for a longer-term research with their Pittsburgh partners and other cities, by developing methods and technologies for supporting democratic processes around public PDD deployments.

This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

This multi-institutional collaborative research project seeks to envision, design and engage in worker-oriented research and training related to the proliferation of automation in the hospitality industry, which has been accelerated by the COVID-19 pandemic. Large numbers of hospitality workers, who are majority female and from underrepresented groups, are being displaced by these technological changes. Workers’ positions are currently being augmented with algorithmic management and robotic assistance, replacing some jobs and transforming others that cannot be completely automated — for example, high-touch, face-to-face service interactions which are critical to the success of the hospitality industry. The research team will investigate ways that technological innovations of the future can be developed and implemented with input from the workers who are best suited to understand their benefits and pitfalls. It is expected that this project will positively impact the hospitality workforce by preserving jobs, giving people more job satisfaction, reducing the way technology drives inequality, and developing policies and training programs that will generalize to other high-touch service industries.

This project brings together several disciplines, including hospitality, human-computer interaction, service design, learning science, labor economics, and industrial relations. The research team has partnered with UNITE HERE, the largest hospitality union in the United States, which will provide a unique opportunity to research, prototype, and evaluate the research outcomes in training facilities and hotels, casinos, and food service establishments. The investigator team is structured to achieve multiple convergent goals. This process will have four iterative, overlapping phases: (1) to qualitatively and quantitatively understand the current state of union hospitality workers, hospitality work, and automation technology; (2) to co-design technology deployment models; (3) to identify workforce needs and training materials to prepare for the future; and (4) to evaluate outcomes to understand how they may impact the future of work. The project will address the lack of worker voice on the impact of future automation technology in the hospitality industry, and to make suggestions for enhancing future workers and future work. This project is funded by the NSF Future of Work at the Human-Technology Frontier cross-directorate program to promote deeper basic understanding of the interdependent human-technology partnership in work contexts by advancing the design of intelligent work technologies that operate in harmony with human workers.

This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.