UW CHWS March 2023 Newsletter
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Message from the Director
2023 is our Center’s 25th anniversary! Our partner WWAMI Rural Health Research Center, is marking its 35th anniversary. If you are attending the Annual Research Meeting of AcademyHealth in our hometown of Seattle, save Saturday, June 24 for our celebration of a quarter century of research excellence.
We’re excited that our team is growing during this anniversary year. A new research scientist who is a recent UW School of Public Health graduate and postdoctoral fellow from the UW School of Nursing joined our team, and we are also recruiting for a new senior faculty member and a program coordinator. Additional team members help us respond rapidly and engage effectively with stakeholders, including our local and national policymakers focused on health workforce issues. We’re also excited about connecting with each other in person – something we’ve missed while working at home throughout the pandemic.
Have a joyful spring season!
Bianca Frogner, PhD
Director, UW CHWS
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Team Member Highlights
UW CHWS Investigators are Recognized Leaders in Health Workforce Field
 Congratulations to Tracy Mroz, PhD, OTR/L, FAOTA whose work mentoring women doctoral students, postdoctoral fellows, junior faculty and research staff was recognized by the UW School of Medicine Excellence in Mentoring Women Faculty Award. Dr. Mroz is one of two awardees chosen based on recommendations from peers and mentees received by the Dean’s Standing Committee for Women in Science and Medicine. She is Associate Professor in the UW Department of Rehabilitation Medicine, Co-Director of the new UW Advancing Health Services & Policy in Rehabilitation (ASPIRe) Lab, and a long-time investigator in UW CHWS, leading studies on the allied heath workforce in long-term care. Read about what this award means to Dr. Mroz.
 Rachel Prusynski, DPT, PhD, joins the Editorial Board as Associate Editor for Social Media for the Physical Therapy and Rehabilitation Journal, the official, peer-reviewed journal of the American Physical Therapy Association. Dr. Prusynski is Assistant Professor in the UW Department of Rehabilitation Medicine, Co-Director of the new UW ASPIRe Lab, and investigator of UW CHWS leading studies on the therapy workforce in skilled nursing facilities.
 Janice Sabin, PhD, MSW has joined the Global Forum on Innovation in Health Professional Education Working Group of the National Academy of Medicine that will focus oneducation and workforce development and various forms of bias to address maternal health disparities. Dr. Sabin, Research Associate Professor in the UW Department of Biomedical Informatics and Education, has been leading a number of studies on implicit bias across multiple health professions as an investigator at UW CHWS. Read about her perspectives on implicit bias in a recent edition of Science Magazine.
 Bianca Frogner, PhD, Director of UW CHWS and Professor in the Department of Family Medicine, joined the leadership committee of the new Advancing Workforce Analysis and Research for Dementia (AWARD) Network led by the University of California, San Francisco. The AWARD Network aims to advance research on the health workforce that serves people living with dementia, with support from the National Institute on Aging.
UW CHWS Welcomes New Team Members
 We are excited to welcome Shahida Shahrir, PhD, who joined the UW CHWS team as a research scientist in March. Dr. Shahrir is a recent doctoral graduate from the Health Systems and Population Health Department in the UW School of Public Health. She also serves on the Clallam County Board of Health.
We also welcome Kyla Woodward, PhD, RN, a postdoctoral fellow in the UW School of Nursing’s Research in Nursing and Global Health (RiNGH) funded by the National Institute for Nursing Research who also completed her doctorate at UW. Dr. Woodward is engaged in multiple UW CHWS projects examining the career mobility of health care workers and workforce diversity.
Learn more about the UW CHWS team here.
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UW CHWS Research Highlights
Tracking and Strengthening the Oral Health Workforce in Washington State
Accessing oral health care in rural, low-income, and Tribal settings has been an ongoing challenge as poor oral health issues can result in visits to emergency rooms and may be a precursor to various acute and chronic conditions. Senior Deputy Director Sue Skillman moderated a panel hosted by the Health Resources & Services Administration (HRSA) Office of Intergovernmental and External Affairs (IEA) Region 10 webinar to discuss oral health resources, including the dental therapy model in tribal communities.
UW CHWS’ Washington State Oral Health Workforce (WOHW) Tracking Program continues to offer relevant information that can be used to identify education, practice and policy needs. WOHW funding comes from both Delta Dental of Washington and the Washington State Legislature. Data describing education, workforce size and distribution, and demand for oral health occupations in the state are posted on the dashboard as they become available. WOHW will survey Washington’s dental assistants later this Spring to learn more about their practice characteristics and pathways into the profession.
Preparing the Physician Workforce in Rural Communities
UW medical school alumni who had trained as medical students in rural areas were almost twice as likely to set up practices in a rural location according to a new UW Medicine study published in the Journal of the Association of American Medical Colleges. “This study provides a promising connection between the Rural Underserved Opportunities Program (RUOP) and the medical graduates’ decision to work in rural areas”, said lead author Arati Dahal, UW CHWS Research Scientist. Read more about the story here.
Family medicine graduates from rural residency programs were more likely than those from urban programs to report feeling prepared in hospital care and women’s health, according to a collaborative study published in the journal of Family Medicine involving UW CHWS researchers Samantha Pollack, Holly Andrilla, and Davis Patterson and the American Board of Family Medicine (ABFM) with funding through the WWAMI Rural Health Research Center (RHRC). In the same journal issue, the WWAMI RHRC team with ABFM reported on research that also found small but persistent differences in academic performance between rural versus urban family medicine residents.
Opportunities to Expand the Primary Care Nursing Workforce
Nursing curricula typically focus on acute care competencies. A collaborative evaluation study published in Nursing Education Today led by UW CHWS researcher Kyla Woodward and co-authored by Paula Kett found that enhancing ambulatory care nursing skills in didactic content and clinical experiences improved undergraduate nursing students’ perceptions of self-efficacy as well as actual performance.
Postgraduate nurse practitioner (NP) programs (typically referred to as residencies or fellowships) located in rural communities may be an avenue to encourage recruitment and retention of nurse practitioners into rural practice. The relatively few rural NP residencies show potential for expanding rural primary care practice, according to a study published in the Journal of Rural Health led by Washington State University College of Nursing colleague Louise Kaplan, and co-authored by UW CHWS researchers Samantha Pollack, Sue Skillman, and Davis Patterson, with support from the UW’s RuralPREP Program.
Strengthening the Long-Term Care Workforce
 Skilled nursing facilities shifted to the Patient Driven Payment Model (PDPM) for reimbursement of care for Medicare patients that coincided with the start of the COVID-19 pandemic. A recent study with CHWS investigators and ASPIRe Lab Co-Directors Rachel Prusynski and Tracy Mroz, along with UW CHWS Director Bianca Frogner, found a 6.5% drop in therapy staff the week after the payment model change and then another smaller subsequent drop early in the pandemic with trends fluctuating over time. Therapy staffing levels did not return to pre-PDPM levels by March 2022. Read more about the study findings and commentary by the editor of the Journal of the American Geriatrics Society here.
 Hesitancy about the COVID-19 vaccine may have contributed to staffing challenges in long-term care settings, such as skilled nursing facilities, during the pandemic. UW CHWS researchers Kris Ma, Sue Skillman, and Bianca Frogner are partnering with the UW Population Health Initiative with funding from Merck to undertake a mixed-methods study involving nursing staff in long-term care among other settings to help understand the key drivers of vaccine hesitancy and the changes in immunization rates across the US. Read more about the project here.
The long-term care workforce plays an important role in caring for patients living with dementia. The challenges facing workers in both skilled nursing and home health settings were discussed with an overview by Director Frogner at the 2023 National Research Summit on Care, Services, and Supports for Persons Living with Dementia and Their Partners/Caregivers convened by the National Institute on Aging.
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UW CHWS Informing Policymakers and Health Care Leaders
 UW CHWS findings from the Washington Health Workforce Sentinel Network informed, and were summarized in, the 2022 Washington State Health Workforce Council report to the state’s Governor and Legislature. The Sentinel Network findings as well as additional findings from UW CHWS analyses of education and training preparation of behavioral health providers in Washington were referenced in the Washington Workforce Board 2022 Behavioral Health Workforce Assessment.
Annual Report of Health Workforce Research Center Activities
 The Health Workforce Research Centers (HWRCs) funded by HRSA have been investigating issues of COVID-19, health workforce burnout, telehealth and more. The activities of UW CHWS’ HWRC on Allied Health and Health Equity and other HWRCs are highlighted in a 2022 Annual Report published by the Health Workforce Technical Assistance Center. Access the report here.
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Presentations by UW CHWS Researchers
Frogner BK. Health Workforce Trends. Keynote Presentation at Bridging Pharmacy Education and Practice Summit, Joint Commission of Pharmacy Practitioners. Washington, DC. Nov 3 2022.
Frogner BK. National Health Workforce Trends. Discussion with Washington State House Committee on College and Workforce Development. Virtual Event. Nov 10 2022.
Lee D, Sabin J, Mohammed SA, Kett P, Frogner BK. Inequitable Care Delivery for COVID-19 Positive People of Color and People with Disabilities. American Congress of Rehabilitation Medicine Annual Meeting. Chicago, IL. Nov 11 2022.
Fullerton R, Skillman SM. Health Workforce Apprenticeships. National Conference of State Legislatures Base Camp. Virtual Event. Nov 15 2022.
Guenther G, Kett P. Birth Doulas Addressing Systemic Racism in Underserved Communities. Health Workforce Technical Assistance Webinar. Dec 15 2022. [Full webinar available here]
Stubbs BA. The Washington Health Workforce Sentinel Network Fall 2022 Update. Washington Health Workforce Council. Virtual Event. Dec 8 2022. [Recording available here]
Frogner BK. National Health Workforce Trends. The Future of State Workforce Policy in Palliative Care. Center to Advance Palliative Care and the Solomon Center for Health Law and Policy at Yale Law School. Virtual Event. Dec 20 2022.
Frogner BK. Health Workforce Trends: Implications for the Therapy Workforce. Grand Rounds Speaker, Department of Rehabilitation Medicine. Jan 10 2023.
Skillman SM (Moderator). Improving Access to Oral Health Care for Rural, Tribal and Underserved Communities. Health Resources & Services Administration Office of Intergovernmental and External Affairs Region 10. Jan 12 2023. [Full webinar available here]
Frogner BK. Tackling Labor Force Shortages in Health Care Virtual Roundtable. Committee for Economic Development of The Conference Board. Virtual Event. Jan 25 2023. [Summary report available here]
Frogner BK. Setting the Stage: What We Know (and Don’t Know) About the Dementia Care Workforce. National Institute on Aging National Research Summit on Care, Services, and Support for Persons with Dementia and Their Care Partners/Caregivers. Virtual Event. Mar 22 2023. [Learn more about the event here]
Frogner BK. The Shortage in Healthcare Personnel and Labor Force Issues. The Murphy Institute at Tulane University. New Orleans, LA. Mar 24 & 25 2023.
Visit our website for a complete list of presentations.
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Publications by UW CHWS Researchers
Kaplan L, Pollack SW, Skillman SM, Patterson DG. Is Being There Enough? Postgraduate Nurse Practitioner Residencies in Rural Primary Care. J Rural Health.2022. doi.org/10.1111/jrh.12729. [UW RuralPREP]
Prusynski RA, Humbert A, Leland NE, Frogner BK, Saliba D, Mroz TM. Dual impacts of Medicare payment reform and the COVID-19 pandemic on therapy staffing in skilled nursing facilities. J Am Geriatr Soc. 2022;1‐11. doi:10.1111/jgs.18208
Ornelas IJ, Schwartz M, Sabin JA, Frogner BK. Using experiential education in health professions training to improve health equity: Lessons learned from interviews with key informants. J High Educ Outreach Engagem. Dec 2022;26(3):73.
Woodward KF, Kett PM, Willgerodt M, Summerside N, Hart J, Buchanan DT, Cunitz TC, Birkey C, Zierler BK. Using an Academic-Practice Partnership to Enhance Ambulatory Care Nursing Skills. Nurs Educ Today. Dec 2022;119:105585.
Peterson L, Morgan ZJ, Andrilla CHA, Pollack SW, Longenecker R, Schmitz D, Patterson DG. Academic Achievement and Competency in Rural and Urban Family Medicine Residents. Fam Med. 2023;55(3):152-161. [WWAMI Rural Health Research Center]
Pollack SW, Andrilla CHA, Peterson L, Morgan ZJ, Longenecker R, Schmitz D, Evans DV, Patterson DG. Rural versus Urban Family Medicine Residency Scope of Training and Practice. Fam Med. 2023;55(3):162-170. [WWAMI Rural Health Research Center]
Al Achkar M, Dahal A, Frogner BK, Skillman SM, Patterson DG. Integrating immigrant health professionals into the US healthcare workforce barriers and solutions. Forthcoming in J Immigr Minor Health.
Frogner BK, Skillman SM, Patterson DG. The workforce needed to address population health. Forthcoming in Milbank Q.
Lee D, Kett P, Mohammed S, Frogner B, Sabin J. Inequitable care delivery toward COVID-19 positive people of color and people with disabilities. Forthcoming in PLOS Global Public Health.
Visit our website for a complete list of publications.
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