Programs and Communities

Maricopa County, Arizona, anchor to the fastest growing megapolitan area in the United States, is located in a hot desert climate where extreme temperatures are associated with elevated risk of mortality. Continued urbanization in the region will impact atmospheric temperatures and, as a result, potentially affect human health. We aimed to quantify the number of excess deaths attributable to heat in Maricopa County based on three future urbanization and adaptation scenarios and multiple exposure variables.

Two scenarios (low and high growth projections) represent the maximum possible uncertainty range associated with urbanization in central Arizona, and a third represents the adaptation of high-albedo cool roof technology. Using a Poisson regression model, we related temperature to mortality using data spanning 1983–2007. Regional climate model simulations based on 2050-projected urbanization scenarios for Maricopa County generated distributions of temperature change, and from these predicted changes future excess heat-related mortality was estimated. Subject to urbanization scenario and exposure variable utilized, projections of heat-related mortality ranged from a decrease of 46 deaths per year (− 95%) to an increase of 339 deaths per year (+ 359%).

Projections based on minimum temperature showed the greatest increase for all expansion and adaptation scenarios and were substantially higher than those for daily mean temperature. Projections based on maximum temperature were largely associated with declining mortality. Low-growth and adaptation scenarios led to the smallest increase in predicted heat-related mortality based on mean temperature projections. Use of only one exposure variable to project future heat-related deaths may therefore be misrepresentative in terms of direction of change and magnitude of effects. Because urbanization-induced impacts can vary across the diurnal cycle, projections of heat-related health outcomes that do not consider place-based, time-varying urban heat island effects are neglecting essential elements for policy relevant decision-making.

The City of Phoenix Street Transportation Department partnered with the Rob and Melani Walton Sustainability Solutions Service at Arizona State University (ASU) and researchers from various ASU schools to evaluate the effectiveness, performance, and community perception of the new pavement coating. The data collection and analysis occurred across multiple neighborhoods and at varying times across days and/or months over the course of one year (July 15, 2020–July 14, 2021), allowing the team to study the impacts of the surface treatment under various weather conditions.

Underserved communities are disproportionately impacted by climate change, and current inequities present in our emissions-heavy transportation system only exacerbate these burdens. As of 2019, transportation accounted for 29% of total GHG emissions in the United States. Electric Vehicles (EVs) present an opportunity to lower emissions associated with transportation, as EVs emit zero tailpipe emissions. We define electric vehicles as cars, bikes, scooters, buses, and rail systems. As transitions to EVs occur, action can be taken to adopt more equitable practices within the transportation space, specifically in historically underserved communities.

In partnership with The City of Phoenix’s EV Department, and with additional support from the Housing Department, the EV Changers team developed a transportation-oriented survey to be distributed to the Edison-Eastlake Community (EEC) in Phoenix. Efforts to understand the EEC’s needs will lend to more efficient, connected, and accessible transportation in the upcoming transportation electrification movement.

Purpose: To examine the implementation of a web-based depression care management training program to increase home health nurses’ knowledge and attitudes regarding depression.

Background and Significance: The Centers for Disease Control and Prevention reported in 2015 that the incidence of major depression in elderly receiving home health service rose to 13.5% compared to less than 5% with those not receiving care in the community.

Materials and Methods: An intervention program was offered to a convenience sample of home health nurses caring for elderly in the community. The Depression CARE for Patients AT Home (depression CAREPATH), which is an evidenced-based online training program consisting of didactic resources about depression screening and depression care management and e-learning modules. Participants were given a pre and post survey to assess their knowledge of the material. Additionally demographic information was obtained via self-report.

Results: A total of 8 out of 18 home health nurses participated in the study. All were females; 13% Caucasian and 88% were Asian. There’s an average of 37 years old (SD 14.7, range 23-58) and had 3 years of experience (SD 2.07, range <1-6). The mean depression CAREPATH knowledge total pre-test score was 15 (SD 1.85, range 13-18), while the mean total post-test score was 18.13 (SD 0.99, range 17-19). There was a difference in the depression knowledge test scores at baseline. All the participants obtained a passing score for the post-test (80%). The mean R-DAQ total pre-test score was 71 (SD 13.37, range 53-71) and mean total post-test score was 68, (SD 3.48, range 62-70). The professional confidence in depression attitude indicated agreement post intervention, except with the feeling comfortable in working with physical illness than mental illness (pre intervention 62.5%, post intervention 100%). Participants agreed that home health nurses are well placed and more confident in assisting patients with depression (pre Depression Care Management 3 3 intervention 75%, post intervention 100%). In addition, participants felt more confident in assessing suicide risk post intervention in patient s presenting with depression. Based from Wilcoxon Signed-ranks test, there was a statistical difference, z = -2.536, p= .01, between the depression knowledge pre and post-test scores, which indicates that there is an increase in depression knowledge after the intervention. However, there was no significant difference, z = -.846, p = .397 between the depression attitude, which indicate that there is no change in depression attitude after the intervention.

Conclusion: For this sample, depression knowledge was increased post intervention, however, increase in knowledge did not significantly alter the depression attitude. Further study in a larger more diverse sample is needed for this intervention.

Aim: To reduce the fear of falling in an elderly population by teaching ‘Tai Chi for Falls Prevention’ classes twice a week for 12 weeks.

Background & Significance: Falls continue to be the leading cause of injury-related deaths of Arizonans who are 65 years or older - well above the national average. It is predicted that by 2030, national medical spending for this population will total over $31 billion, yearly. Tai Chi is revered for being a beneficial form of simple, low-impact exercise, which the CDC endorses for its falls risk reduction benefits.

Methods: The intervention consisted of 60-minute classes occurring twice a week for 12 weeks. Participants were English-speaking, between 65-85 years old, and able to ambulate independently. Appropriate pre-screening tools were used before applicants consented. Their Fear of Falling (FoF) was measured using a fall risk perception tool at the beginning, middle, and the end of the project. This ordinal data was analyzed with Friedman ANOVA using SPSS 25

Outcomes/Results: After enrolling five total participants, only three completed the project. This severely limited data analysis of their FoF, resulting in a statistical significance (p = 0.68), deeming the intervention ineffective - Despite observable downwards trending FoF scores.

Conclusion: The acceptance of the null hypothesis is attributed to the low enrollment and high attrition rate. Also, the only data measured was quantifiable, subjective data. Future projects could add objective data to reinforce the benefits of Tai Chi. This might reinforce the validity of Tai Chi as a practical recommendation due to its cost-effective simple interventional design and effectiveness for prevention of accidental falls. Increased focus on improved recruitment & retainment strategies should be prioritized for similar projects in the future.