CEPH 2020-2021 Digital Newsletter

CENTER FOR EXCELLENCE IN PUBLIC HEALTH June 2020 – August 2021 | Research, Scholarship, Highlights

Center for Excellence in Public Health TABLE OF CONTENTS Message from the Director…………………………………………………………………………….. 1 Presentations, Reports, Publications……………………………………………………………………. 3 Center Highlights………………………………………………………………………………………. 8 Page 2

Center for Excellence in Public Health Center for Excellence in Public Health | MESSAGE FROM THE DIRECTOR | Sending greetings from the Center for Excellence in Public Health (CEPH). It’s my pleasure to write this message on the occasion of the first CEPH newsletter! It has been quite a year for public health. During the pandemic, we collectively experienced heartbreaking losses and yet at the same time the public health community stepped up to provide support wherever it was needed. And, while our national response to the pandemic was initially hampered by the historical lack investment in our public health infrastructure, the experience underscored the importance of doing so and specific areas for improvement which are currently being addressed with increased funding. CEPH efforts quickly shifted in response to Covid-19. We developed plans for virtual programming where needed and shifted our work to support communities experiencing the greatest needs. We were able to accomplish planned efforts, take on additional funding and bring on new staff- all while working remotely. Even with the challenges we faced, we succeeded in working toward our vision of a world where everyone has fair and just opportunities for health. I couldn’t be prouder of CEPH and all that we have accomplished over the past year! The following pages present some of our highlights and accomplishments for the past year. Wishing you well, Michele Page 1

Center for Excellence in Public Health | PRESENTATIONS, REPORTS, PUBLICATIONS | Supplemental Nutrition Assistance Program-Education (SNAP-Ed) Publications • Puma JE, Young M, Foerster S, Keller K, Bruno P, Franck K, Naja-Riese A. The SNAP-Ed Evaluation Framework: Nationwide Uptake and Implications for Nutrition Education Practice, Policy, and Research. J Nutr Educ Behav. 2020;(000)000:1-7. doi: 10.1016/j.jneb.2020.10.015 Presentations • Rodriguez K, Bruno P. Design, Implementation, and Results of a Joint Cross-State Evaluation on the Impacts and Adaptations Made to SNAP-Ed Programming During COVID-19. Presentation at: Association of SNAP Nutrition Education Administrators Annual Conference; February 2021; Virtual Conference. • Hannah Ruhl, Obesity Prevention Coordinator, coordinated with two Maine SNAP-Ed local Nutrition Educators to provide a training on Policy, Systems and Environmental Change (PSE) initiative implementation and sustainability in schools for the Iowa SNAP-Ed program July 2021 • Bruno P. Best Practices for Measuring Environmental Level Indicators in the SNAP-Ed Evaluation Framework. Presentation at: Association of SNAP Nutrition Education Administrators Annual Conference; February 2021; Virtual Conference. • Bruno P. Moving Forward by Looking Back: National Results from the SNAP-Ed Census of Intervention, Evaluation and Reporting Activities, 2017 to 2021. Presentation at: Association of SNAP Nutrition Education Administrators Annual Conference; February 2021; Virtual Conference. • Bruno P, Ruhl H, Rodriguez K, Dushuttle P. Five years of public health approaches: The expanding implementation of Maine SNAP-ed's policy, systems and environmental (PSE) change initiatives. Presentation at: American Public Health Association Annual Meeting; October 27, 2020; Virtual Conference. • Pamela Bruno, MPH, Moving Forward by Looking Back: National Results from the SNAP-Ed Census of Intervention, Evaluation and Reporting Activities, 2017 to 2021.Annual ASNNA Conference. February 21, 2021. • Hannah Ruhl, MPH, presented Social Marketing Campaigns: Amplifying SNAP-Ed Reach and Outcomes. Annual ASNNA Conference 2.21 • Tasha Gerken-Nelson, MS, RD, Lori Kaley, MS, RDN, LD, MSB and Emily Adrienne Estell, RDN, MPH co-authored and Emily presented Virtual Discussion Forums as a Training Tool Building SNAP- Ed practitioner engagement and capacity through skill sharing and brainstorming especially during times of great change. Annual ASNNA Conference. February 21, 2021. • Pamela Bruno, MPH, co-authored and presented Best Practices for Measuring Environmental Level Indicators in the SNAP-Ed Evaluation Framework. Annual ASNNA Conference. February 21, 2021. • Kira Rodriguez, MHS, and Pamela Bruno, MPH, co-authored and Kira presented Design, Implementation, and Results of a Joint Cross-State Evaluation on the Impacts and Adaptations Made to SNAP-Ed Programming During COVID-19. Annual ASNNA Conference. February 21, 2021. • Hannah Ruhl, MPH, and Shaunda Neptune, MS, RD co-authored and Hannah presented PSE successes in Pick a better snack schools at the Iowa SNAP-Ed Workshop in collaboration with the National Association of Chronic Disease Directors (NACDD) on January 27, 2021. • Hannah Ruhl, MPH, presented Five years of public health approaches: The expanding implementation of Maine SNAP-Ed's policy, systems and environmental (PSE) change initiatives on a Page 3

Center for Excellence in Public Health panel at the American Public Health Association 2020 Annual Meeting and Expo on October 27, 2020. • Tasha Gerken-Nelson, MS, RD, Hollie Legee-Cressman and Laura Quynn presented Beyond the Classroom with SNAP-Ed in the Garden at the 2020 Maine Public Health Association Conference on October 15, 2020. • Bruno P, Rodriguez K, Gerken-Nelson T, Kaley L, Imbert I, Estell EA, Horowitz L, Dushuttle P. The Future of Clinical-Community Linkages – Nutrition Education Takes Root in Maine’s Underserved Communities through a Learning Partnership with SNAP-Ed. Poster presented at: Society for Nutrition Education and Behavior Annual Conference; July 22, 2020; San Diego, CA (Virtual). • Maine SNAP-Ed collaborated with other CEPH staff on a poster presentation titled The Future of Clinical-Community Linkages – Nutrition Education Takes Root in Maine’s Underserved Communities through a Learning Partnership with SNAP-Ed at the Society for Nutrition Education and Behavior (SNEB) 2020 Annual Conference on July 22, 2020. The poster outlines the collaborative learning experience of University of New England students enrolled in the honors track CUP AHEC Scholars Program who partner with Maine SNAP-Ed Nutrition Educators to explore concepts of food insecurity and leveraging clinical-community linkages. Poster link: https://www.jneb.org/cms/10.1016/j.jneb.2020.04.105/attachment/65bbfcdc-5f67-4a36- 8f0e-0ae9bdf6f8b5/mmc12.pdf Video presentation link: https://www.youtube.com/watch?v=zve5YTm6-h4&feature=youtu.be Reports • The Maine SNAP-Ed 2020 Annual Infographic was published that encapsulates the challenges, three-pronged solution-oriented approach, and the results of the work completed by statewide staff in fiscal year 2020. Available at: https://www.mainesnap-ed.org/maine-snap-ed/reports- and-publications/ • The Maine SNAP-Ed 2020 COVID-19 Infographic highlights the innovative programming solutions and community and sector-level supports provided across Maine to address food insecurity and promote healthy food choices and promote physical activity during the pandemic. Available at: https://www.mainesnap-ed.org/wp-content/uploads/2021/03/infographic-COVIDimpact- MaineSNAPed-508.pdf • The Maine SNAP-Ed Annual Report FY 2020 highlights the impact and reach of statewide Maine SNAP-Ed programming and includes Spotlights such as Wabanaki Public Health interventions in Maine’s tribal communities and how Maine SNAP-Ed supported local communities during the COVID-19 pandemic. • Pamela Bruno, MPH, co-author and writing team member on the position paper Recommendations for Implementing the Nutrition Education and Obesity Prevention Grant Program (SNAP-Ed) Provisions of the 2018 Farm Bill: A Position Paper of the Association of SNAP Nutrition Education Administrators (ASNNA). • The SNAP-Ed 10 Tips for Adults nutrition education curriculum developed, tested and evaluated by Maine SNAP-Ed staff at UNE has been accepted and published as a practice-tested, evidence-based intervention on the nationally recognized SNAP-Ed Toolkit: Obesity Prevention Interventions and Evaluation Framework website at https://snapedtoolkit.org/interventions/programs/10-tips-for-adults/ Page 4

Center for Excellence in Public Health Workforce Development Programs Presentations • Imbert, I, Rodriguez K, Buck L and Gunderman J Creating Immersive Rural Health Experiences for Future Health Providers. Presentation at 2021 National AHEC Organization (NAO) Biennial Conference, Virtual/Online (July 2021). • Rodriguez K, Cragin L, Hanson S, Williams T, and Binienda J. Showing our Impact with One Voice: NAO CORE Annual Data Collection & Reporting. Presentation at 2021 National AHEC Organization (NAO) Biennial Conference, Virtual/Online (July 2021). • Jen Gunderman presented on the topic of vaccine hesitancy to three Maine CDC Public Health District Coordinating Councils February 9 (Midocast), March 12 (Penquis), April 27 (Central), 2021. • Holden S, Dufresne R, Caldwell M, Northern New England Clinical Champions Program. Presented at: Governor Mills Opioid Response Summit & Seminars; July 2020; Virtual Presentation • Kelly C, Blaisdell L, Gunderman J, Hagan J. Misconceptions in Public Health. Presentation at: Maine Public Health Association Annual Meeting; October 16, 2020; Virtual Conference. • Jennifer Gunderman presented public health response to COVID-19 as part of UNE Planetary Health Alliance series. February 3, 2021 • Jennifer Gunderman presented public health and infodemics as part of UNE Planetary Health Alliance series. October 15, 2020 Substance Use Prevention Program (SUPS) Publications • Fournier D. Maine Voices: Keep pot away from young Mainers as stores start selling it to adults. Portland Press Herald. October 10, 2020. • Jevons L. Maine marijuana grow laws. June 7, 2021. Presentations • Soma T, Van Deusen J, Holden S, Samuelson C. Medical and Physician Assistant Student Trainings on Opioid Use Disorder (OUD) and their Impact on Stigma Toward People with OUD. Poster presented at: Governor Mills 3rd Annual Opioid Response Summit; July 15, 2021; Virtual Conference. • Ireland, R., Beverage, N., Jevons, L. Maine Substance Use Prevention Services Program. Partners in Prevention: Working to Empower Maine Communities and Citizens to Help Reduce Prescription Medication Misuse. Poster presented at: Governor Mills 2nd Annual Opioid Response Summit; July 23, 2020; Bangor, ME (Virtual). • Balogun, T, Soma T, O’Brien L. Tobacco use among Maine youth: Perceptions and self-efficacy of healthcare providers on prevention efforts. Poster presented at: American Public Health Association Annual Meeting; October 24, 2020; Virtual Conference. • Balogun T, Soma T, O’Brien L. Perceptions of Maine Health Care Providers on Youth Tobacco Use and Prevention Efforts. J Maine Medical Center. 2021;3(2):1-8. doi: 10.46804/2641- 2225.1076. • Beverage, N., Fedorchak, D. How to have successful and productive meetings: facilitation techniques and coalition building webinar. February 11, 2021. • Ireland, R., Rogers, R. Substance abuse prevention skills training. March 31, April 2, 6, & 8, 2021. Page 5

Center for Excellence in Public Health • Springel R, Ireland R. Stimulant Drugs: Use and Addiction to Stimulants Is the Other Drug Crisis in Maine; What is Being Done About It To Curb It. Maine Calling. July 26, 2021. • Brown, C., Frankl, V., Ireland, R., Scott, M. Prevention through safe storage. Co-Occurring Collaborative Serving Maine webinar. August 31, 2021. Reports • Maine Substance Use Prevention Services Program. Maine, Methamphetamine, and National Patterns of Use. https://www.substanceuseprevention.org/wp-content/uploads/2021/04/Maine- Meth-Data-Kit-2021.pdf. Published April 2021 • Maine Substance Use Prevention Services: Working Together in Prevention 2020 Annual Report. https://www.substanceuseprevention.org/#annualreport. Published May 2021. • Maine Substance Use Prevention Services Success Stories https://www.substanceuseprevention.org/#successstories o Healthy Acadia Passing Policies for a Healthier Workplace. October 2020. o Healthy Communities of the Capital Area. Statistically Significant: Young Advocates Flip the Script on LBGTQ+ Data. November 2020. o Healthy Community Coalition of Greater Franklin County Engaging Franklin County with Local Youth MIYHS Data. May 2021. o Kennebec Behavioral Health Young Adults Focused on Substance Use Prevention. August 2021. Collaborative Learning Evaluation Publications • Mokler DJ, Cohen Konrad S, Hall K, Rodriguez K, St Pierre S, Thieme VS, Van Deusen J. Learning Together: Interprofessional Education at the University of New England. J Am Osteopath Assoc. 2020;120(8):509-515. doi:10.7556/jaoa.2020.084 Research Publications • Grummon AH, Petimar J, Zhang F, Rao A, Gortmaker SL, Rimm EB, Bleich SN, Moran AJ, Franckle RL, Polacsek M, Simon D, Greene JC, Till S, Block JP. Calorie Labeling and Product Reformulation: A Longitudinal Analysis of Supermarket-Prepared Foods. Am J Prev Med. 2021 Sep;61(3):377- 385. doi: 10.1016/j.amepre.2021.03.013. Epub 2021 Jun 5. PubMed PMID: 34103209; PubMed Central PMCID: PMC8384707. • Petimar, J., Zhang, F., Rimm, E. B., Simon, D., Cleveland, L. P., Gortmaker, S. L., Bleich, S. N., Polacsek, M., Roberto, C. A., & Block, J. P. (2021). Changes in the calorie and nutrient content of purchased fast food meals after calorie menu labeling: A natural experiment. PLoS medicine, 18(7) • Baquero B, Anderson Steeves E, Polacsek M, De Marco M, Chapman L, Leone LA, Simon C. Evaluating the implementation and impact of a healthier checkout program at a regional convenience store chain. Public Health Nutr. 2021 Aug;24(11):3520-3529. doi: 10.1017/S1368980021001488. Epub 2021 Apr 6. PubMed PMID: 33820587. Page 6

Center for Excellence in Public Health • Zatz LY, Moran AJ, Franckle RL, Block JP, Hou T, Blue D, Greene JC, Gortmaker S, Bleich SN, Polacsek M, Thorndike AN, Rimm EB. Comparing Online and In-Store Grocery Purchases. J Nutr Educ Behav. 2021 Jun;53(6):471-479. doi: 10.1016/j.jneb.2021.03.001. PubMed PMID: 34116742. • Zatz LY, Moran AJ, Franckle RL, Block JP, Hou T, Blue D, Greene JC, Gortmaker S, Bleich SN, Polacsek M, Thorndike AN, Mande JR, Rimm EB.Comparing shopper characteristics by online grocery ordering use among households in low-income communities in Maine. Public Health Nutr.2021 May 25;:1-6. doi: 10.1017/S1368980021002238. [Epub ahead of print] PubMed PMID: 34030759. • Emond JA, Fleming-Milici F, McCarthy J, Ribakove S, Chester J, Golin J, Sargent JD, Gilbert- Diamond D, Polacsek M. Unhealthy Food Marketing on Commercial Educational Websites: Remote Learning and Gaps in Regulation. Am J Prev Med. 2021 Apr;60(4):587-591. doi: 10.1016/j.amepre.2020.10.008. Epub 2020 Dec 10. PubMed PMID: 33309448. • Hecht AA, Perez CL, Polacsek M, Thorndike AN, France RL, Moran AJ. Influence of Food and Beverage Companies on Retailer Marketing Strategies and Consumer Behavior. International Journal of Environmental Research and Public Health. 2020; 17(20):7381. Page 7

Center for Excellence in Public Health | CENTER HIGHLIGHTS | Workforce Development Week of June 15, 2020 Jennifer Gunderman, MPH delivered a presentation on public health surveillance to an array of approximately seventy public health and health care professionals on May 21. Her talk “Infectious Disease Surveillance” was a part of a series hosted by the Maine Public Health Association. The Maine AHEC Network received CARES ACT funding to address COVID 19. The funding will focus on providing COVID 19 related training to health care professionals and students as well as conduct assessments on the impact of COVID 19 on minority and rural communities. Jennifer Gunderman, Elizabeth Mann, and Micaela Maynard completed the Project ECHO Immersion training in May. By completing the training, the Center for Excellence in Public Health will be able to coordinate and host Project ECHO sessions. Supplemental Nutrition Assistance Program-Education Two success stories written by a UNE MPH graduate student working with the Center for Excellence in Public Health (CEPH) were published to the USDA’s SNAP-Ed website. One story focused on the addition of fresh produce, recipes, and other resources to Commodity Supplemental Food Program (CSFP) for food insecure seniors in western Maine. The other story featured the successful partnership between Maine SNAP-Ed and Good Shepherd Food Bank in Androscoggin County, which resulted in the screening of about 5,000 patients for food insecurity and the subsequent connection to resources to reduce hunger. These success stories, in addition to two others, were completed by Gabrielle Lanich, during her practicum with CEPH in the spring of 2019 and were published on the SNAP-Ed Connection in May 2020. After graduating, Lanich was hired as a SNAP-Ed nutrition educator with Cornell Cooperative Extension. Pamela Bruno, Senior Research Associate with the SNAP-Ed program, oversaw Gabrielle’s work as her preceptor. Please reach out to Pamela at [email protected] with any questions about this success story. Week of July 10, 2020 Substance Use Prevention Services The LGBTQ+ SupportME Network has launched a new website to increase awareness of Maine’s LGBTQ+ youth communities. It provides educational resources, promotes allied organizations and pathways to connect LGBTQ+ youth to broader networks. Many members of regional Maine Prevention Services, Substance Use Prevention Services community organizations and UNE’s own Nick Beverage, provided website development assistance were a large part of the creation of the website and content, and were able to include substance use prevention messaging in the creation. You can visit it at: LGBTQ+SupportME.org. Page 8

Center for Excellence in Public Health Workforce Development Week of July 17, 2020 Friday at 4PM and 6PM Jen and Adina were part of the News Center Maine's Tick Week. It included highlights of AHEC's CUP Scholar Program and what the program has done around tick education program in schools. https://www.newscentermaine.com/article/news/health/tick-and-lyme/a-prevention- message-thatis-becoming-a-lasting-habit-not-only-for-students-but-their-family-members- as-well/97-23a7f905-35e2-46f8-94ae-045109dce6fa Workforce Development Week of July 24, 2020 Northern Light/Eastern Maine Medical is the new Eastern Maine AHEC Regional Center. Working closely with the Maine AHEC Program Office at UNE, the Eastern Maine AHEC Regional Center will implement programming with high school students, health profession students, and current healthcare workforce to alleviate health workforce shortages in rural and underserved areas of the state. Jennifer Gunderman was interviewed by the Bangor Daily News about the state’s COVID 19 rates. The article can be found at: https://bangordailynews.com/2020/07/16/opinion/editorials/maine-is-doing-many- thingsright-to-control-the-spread-of-coronavirus/ Week of August 6, 2020 Substance Use Prevention Services UNE’s Center for Excellence in Public Health presented two virtual posters at the Governor’s Opioid Response Summit held on July 23, 2020. Poster presentations were from the Maine Substance Use Prevention Services (SUPS) program and the Northern New England Clinical Champions Program (NNE-CCP). UNE’s SUPS program is part of the Maine Prevention Services, an initiative of the Maine Centers for Disease Control and Prevention. The focus of opioid misuse among the SUPS community partners is to: • Promote prescription drug safe storage and disposal; • Educate about the harmful impacts of misusing prescriptions; and • Promote the bi-annual National Prescription Drug Take Back Days. By working together utilizing data-driven efforts to meet community needs, we work to reduce access to prescription drugs and change the norm that it is acceptable to misuse them. We work upstream to help reduce the burden of opioid misuse and treatment on communities. “This year’s virtual Maine Governor’s Opioid Response Summit was no small feat given the challenges of the global pandemic and shows that people have not forgotten the pervasive impact substance misuse has on the health, safety, and success of individuals, families, and communities. At a time when so much seems out of our control, it was empowering to hear from so many who are working in innovative ways to overcome the opioid epidemic and improve public health.” – Becky Ireland, Senior Program Coordinator, UNE Maine Substance Use Prevention Services. For more information regarding Maine SUPS click here. Page 9

Center for Excellence in Public Health UNE’s Northern New England Clinical Champions Program (NNE-CCP) strengthens primary care’s solutions to opioid use disorder through a collaborative program that trains community-based primary care physician and physician assistant “Champions.” These clinicians engage in health care transformation projects centered on Opioid Use Disorder and Substance Use Disorder in their sites and communities. With a two-year commitment, these Clinical Champions develop competencies in leadership, team-based integrated health care, quality improvement, population health, social determinants of health, health policy, and education. With the ongoing support of UNE, invited content experts, and two esteemed mentors, Champions participate in regular virtual learning collaborative meetings, cultivate and enhance teaching capacity for future preceptorships, and ultimately complete a healthcare transformation project at their site. “UNE is proud to offer an innovative program that directly supports primary care providers who are actively treating people with substance use disorder. It’s a privilege that we are able to offer this unique opportunity to New England’s healthcare safety-net.” – Selma Holden, MD, MPH, Assistant Professor at COM and Project Director of UNE’S NNE-CCP. Workforce Development The Northern New England Clinical Champion Program (NNE-CCP) graduated their first cohort of Clinical Champion Leaders in July 2020. The NNE-CCP is a HRSA grant-funded opportunity for PAs, DOs, and MDs wishing to develop new or support existing Opioid Use Disorder (OUD) or Substance Use Disorder (SUD) programming for their patients and communities at their clinical sites. The first cohort of Champion participants included emerging clinical leaders from federally qualified health centers located in Maine, New Hampshire and Vermont. NNE-CCP graduates also included alumni from UNE’s College of Osteopathic Medicine and Physician Assistant Program. As a culminating requirement of the NNE-CCP, Clinical Champions are to complete a healthcare transformation project at their respective sites under the guidance of the NNE-CCP mentors, Selma Holden, MD, MPH, MS, and Lisa Letourneau, MD, MPH. Completed projects from this cohort addressed the following topics: community-based, referral sources, implementation of a Naloxone program, expanding screening tools, increasing access to MAT services, among others. UNE’s Center for Excellence in Public Health is proud to recognize this first cohort of clinical champions as they continue in their practice to address OUD and SUD in their communities. “The growth of myself as a leader and advocate for patients with OUD/SUD. Helping to breakdown stigma and educate colleagues and staff members and seeing their growth as well was a very nice surprise.” – NNE-CCP graduate. Substance Use Prevention Week of August 28, 2020 In late August, the Maine Center for Disease Control and Prevention Marijuana Workgroup (Supported by Substance Use Prevention team members from CEPH) released a Marijuana Education Toolkit. (https://preventionforme.org/wp content/uploads/MaineCDC_Marijuana_Toolkit_Final.pdf). This toolkit will be available as a prevention resource, as communities prepare for the opening of retail marijuana stores in October. The toolkit was developed over the past eight months, with input from community organizations, the Maine CDC, UNE, as well as the Office of Marijuana Policy. The toolkit includes fact sheets for targeted audiences, including pregnant and breastfeeding mothers, employers, and parents. Page 10

Center for Excellence in Public Health Workforce Development Week of September 4, 2020 We are welcoming Sam Gazecki as our AmeriCorps volunteer. Sam is from Los Angeles, CA and a graduate from Bates College in Maine. As a Healthy Minds Alliance AmeriCorps volunteer with the Maine AHEC Network at UNE, he will be implementing mental health first aid training and building partnerships with Maine organizations focused on mental health. Substance Use Prevention Week of October 16, 2020 SUPS op/ed piece posted in the Portland Press Herald Saturday. The link is below. https://www.pressherald.com/2020/10/10/maine-voices-as-stores-start-selling-pot- toadults-lets-keep-it-away-from-teens/ Research Michele Polacsek, Professor in the Westbrook College of Health Professions and Director of the UNE Center for Excellence in Public Health, is part of a team of researchers that just published a commissioned literature review on how trade promotions by food and beverage manufacturers influence retailer marketing strategies and ultimately consumer purchasing behavior and attitudes. This publication is part of a special issue on retail strategies to support healthy eating in the International Journal of Environmental Research and Public Health (ISSN 1660-4601). The article is titled: Influence of Food and Beverage Companies on Retailer Marketing Strategies and Consumer Behavior. Background: In January 2020, The Center for Science in the Public Interest (CSPI), The Food Trust, Johns Hopkins Bloomberg School of Public Health, and Healthy Eating Research (HER) convened a Healthy Retail Research Convention in Washington D.C. Attendees included food industry representatives, researchers-including UNE’s Dr. Polacsek, and nonprofit organizations. The objective of the meeting was to develop a national healthy retail research agenda by: 1) determining the effectiveness of government policies, corporate practices, and in-store pilots in promoting healthy eating; 2) identifying gaps in the healthy food retail literature and generating questions for future research, with an intentional focus on reducing health disparities and improving equity; 3) highlighting best practices for partnering with retailers and food manufacturers on healthy retail research; 4) facilitating relationships between retailers and researchers to implement and evaluate retail interventions; and 5) identifying existing datasets, ongoing work, and new opportunities for retail–research partnerships. Importance of the study: The retail food environment plays an important role in shaping dietary habits that contribute to obesity and other chronic diseases. Food and beverage manufacturers use trade promotion—incentives paid to retailers—to influence how products are placed, priced, and promoted in stores. The review found evidence that manufacturers can shape consumer behavior and, ultimately, diets. The 74 studies included in this review suggest that trade promotion practices have a considerable effect on product placement, pricing, and promotion, and, in turn, on a range of customer outcomes, including purchase volume, spending, and attitudes. Findings point to a particularly strong relationship between price promotions and consumer behavior and differential impacts by product type and consumer characteristics. Study findings provides valuable insight that can guide efforts by policymakers, public health practitioners, and food retailers to design retail environments that promote healthy eating. The authors conclude that public health practitioners and policymakers could consider policies that regulate promotion of unhealthy products by targeting each of the four trade promotion practices identified in the study. The study and subsequent publication was supported by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation. Training support for Amelia Hecht was provided through the Johns Hopkins Center for a Livable Future-Lerner Fellowship. Page 11

Center for Excellence in Public Health Workforce Development Week of October 30, 2020 Group. Jennifer Gunderman has been elected to the National AHEC Organization Board of Directors. The National AHEC Organization represents a network of more than 300 AHEC program offices and centers that serve over 85% of United States counties. The NAO mission is to help its members achieve the AHEC mission through advocacy, education, and research. The AHEC mission is to enhance access to quality health care, particularly primary and preventive care, by improving the supply and distribution of healthcare professionals via strategic partnerships with academic programs, communities, and professional organizations. Jennifer will serve a 2 year term as a representative from the Program Office Contingency Jennifer Gunderman was a panel presenter at the Maine Public Health Association. On October 16 she presented as part of the “Misconceptions in Public Health” panel, specifically discussing the COVID-19 infodemic. The panel also included Carol Kelly (moderator, Pivot Point), Laura Blaisdell, MD, MPH (Public Health Consultant), Jen & John Hagan, (Maine Climate Table). The panel discussed how misconceptions impact public health work and how to communicate public health messages effectively. Week of November 6, 2020 Supplemental Nutrition Assistance Program-Education The Maine SNAP-Ed implementing team at the Center for Excellence in Public Health (CEPH) presented at the American Public Health Association (APHA) annual meeting last month as part of a national panel on SNAP-Ed policy, systems, and environmental (PSE) change initiatives. CEPH staff presented findings from their study examining implementation and impact of PSE public health initiatives over a five-year period. The presentation was entitled “Five Years of Public Health Approaches: The Expanding Implementation of Maine SNAP-Ed’s Policy, Systems, and Environmental (PSE) Change Initiatives.” ArcGIS was used to geocode primary sites impacted by Maine SNAP-Ed for each PSE strategy where at least one change was adopted from 2015 to 2019. Population reach of the strategies was demarcated and aggregated to demonstrate cumulative impact over time, illustrating how public health approaches like community gardens, clinical-community linkages with nutrition education, and farmers market initiatives reach Mainers experiencing low income. The analysis and findings were linked to a national evaluation framework to add to practitioner learning and uptake of national, aggregable indicators. Hannah Ruhl, MPH, was the presenting author. As the program’s obesity prevention coordinator, Ruhl described how capacity to implement evidence-based PSE change strategies has increased over time and how supporting professional development is critical to program success. Senior research associates Pamela Bruno, MPH, and Kira Rodriguez, MHS, led the program evaluation. Rodriguez designed and conducted the GIS analysis project. Page 12

Center for Excellence in Public Health Research Week of December 9, 2020 Michele Polacsek, Professor and Director of the UNE Center for Excellence in Public health, is senior author on an article in the American Journal of Preventive Medicine published this week. The article “Unhealthy Food Marketing on Commercial Educational Websites: Remote learning and Gaps in Regulation” discusses the common use of “educational game” websites for remote learning, and provides examples of food marketing (e.g., video ads for McDonald’s Happy Meals) with some games. Importantly, the article presents a letter the authors wrote to the Children’s Food and Beverage Advertising Initiative (CFBAI), the major industry self-regulatory group that oversees child-directed food and beverage marketing in the US, about the food marketing that was observed. The commentary also highlights a critical issue to communicate to the public: childhood obesity rates are excessively high and increasing, child-directed food marketing promotes highly caloric foods and drinks and sways children’s preferences and intake towards those marketed foods, and teachers and parents are turning to high-quality, engaging websites and apps to supplement remote learning. Clearer guidance is needed to prevent food and drink marketing on websites and apps promoted as educational or used to supplement remote learning. Such actions would complement other school wellness policies prohibiting food and drink marketing in schools. The USDA is one party that could act on this issue. Research Week of January 2, 2021 Michele Polacsek PhD MHS, Director of the UNE Center for Excellence in Public Health (CEPH), and Thomas Meuser PhD, Director for Center for Excellence in Aging and Public Health (CEAH) along with Debra Brucker PhD, Research Associate Professor, University of New Hampshire, and Alyssa Moran ScD MPH RD, Assistant professor at the Johns Hopkins Bloomberg School of Public Health have completed a Brief presenting survey findings from a sample of older Maine residents regarding their food security and purchasing behaviors during the COVID-19 pandemic. Although the survey was not representative of the older Maine population as a whole, findings demonstrate that older residents with disabilities may be suffering greater food insecurity and face more barriers to healthy eating than do other residents. These populations may require tailored support in acquiring preferred foods and to successfully navigate online ordering and delivery, for example. Week of January 15, 2021 Supplemental Nutrition Assistance Program-Education Pamela Bruno, MPH, senior research associate in the Center for Excellence in Public Health (CEPH), co-authored a research brief published in December in the Journal for Nutrition Education and Behavior (JNEB). The publication, titled The SNAP-Ed Evaluation Framework: Nationwide Uptake and Implications for Nutrition Education Practice, Policy, and Research, provides the first census of national use of an evaluation framework designed to evaluate the US Department of Agriculture’s (USDA) Supplemental Nutrition Assistance Program - Education (SNAP-Ed) program. SNAP-Ed is the largest and most diverse community nutrition and obesity prevention program in the country and is administered in Maine by UNE’s CEPH through a contract with the Office for Family Independence at the Maine Department of Health and Human Services. The research brief summarizes Bruno’s efforts with national colleagues to assess the baseline uptake of the framework across all SNAP-Ed implementing agencies in all 50 states, the District of Columbia, Guam, and the US Virgin Islands. The framework includes 51 indicators designed to provide outcomes for each level of the Social Ecological Model and at the population level. It was introduced in 2017. The research brief quantifies the initial uptake of the framework to showcase the breadth and depth of SNAP-Ed Page 13

Center for Excellence in Public Health programming and evaluation activity across the country and to provide a baseline for future studies examining national application of the framework. https://www.sciencedirect.com/science/article/pii/S149940462030693X Week of February 12, 2021 Supplemental Nutrition Assistance Program-Education The Center for Excellence in Public Health (CEPH) had a strong presence at the national annual meeting of SNAP- Ed implementing agencies held virtually from February 1st through 3rd. Maine SNAP-Ed, implemented by the university through a contract with Maine’s Office for Family Independence, addresses food insecurity and obesity prevention in low-resource communities across the state. The funding comes for the USDA and is granted to over 160 agencies in all 50 states, the District of Columbia, and the Territory of Guam. Implementing agencies include universities, non-profits, state health and agriculture departments, and tribal-serving organizations. The Association of SNAP Nutrition Education Administrators (ASNNA) brings member implementing agencies together annually to stay abreast of policy issues and advance best practices. Public health approaches to alleviate hunger are especially important during the pandemic, and adapting interventions to address COVID-19 was a theme of the conference, along with equity in programming and planning. CEPH staff presented on work related to social marketing and media, program evaluation, COVID-19 impact on program delivery, and virtual training strategies. Panel presentations highlighted work completed this past year through research and practice collaborations with academic peers from ten partnering universities, sharing lessons learned and emerging evidence. CEPH’s Senior Research Associates Pamela Bruno and Kira Rodriguez presented on their work, as did Hannah Ruhl, the program’s Obesity Prevention Coordinator, and Emily Estell, a nutrition educator from UNE’s Coastal Healthy Communities Coalition at the College of Osteopathic Medicine. The following panel and poster presentations were shared at the 2021 ASNNA virtual annual conference: • Pamela Bruno, MPH, co-authored and presented Best Practices for Measuring Environmental Level Indicators in the SNAP-Ed Evaluation Framework, featuring evaluation tools and methods for measuring outcomes related to policy, systems, and environmental changes designed to create healthy local communities. • Kira Rodriguez, MHS, co-authored and presented Design, Implementation, and Results of a Joint Cross-State Evaluation on the Impacts and Adaptations Made to SNAP-Ed Programming during COVID-19, highlighting findings from a five-state collaborative evaluation of pandemic impact on SNAP-Ed programming. • Hannah Ruhl, MPH, co-authored and presented Social Marketing Campaigns: Amplifying SNAP-Ed Reach and Outcomes, demonstrating how campaigns can be used within multilevel interventions, with examples of evaluation methods and outcomes. • Emily Adrienne Estell, RDN, MPH co-authored and presented Virtual Discussion Forums as a Training Tool Building SNAP-Ed practitioner engagement and capacity through skill sharing and brainstorming especially during times of great change, a poster sharing the value of structured virtual practitioner support for skill building and program improvement. Page 14

Center for Excellence in Public Health Week of March 5, 2021 Supplemental Nutrition Assistance Program-Education Lori A. Kaley, MS, RDN, LD, MSB, is the Program Manager for Maine SNAP-Ed at the Center for Excellence in Public Health at the University of New England. Lori was a contributing author to Communicating Nutrition: The Authoritative Guide, an essential resource for nutrition students, interns and current nutrition professionals, published by the Academy of Nutrition and Dietetics in 2020. Lori co-authored both Chapter 7: “Nutrition Communicators Clearly Communicate Science” and Chapter 39: “Business Communication Demonstrates Professionalism.” Maine SNAP- Ed, implemented by UNE through a contract with Maine’s Office for Family Independence, uses evidence-based direct education curricula, multi-level community-based policy, systems and environmental (PSE) change initiatives and social marketing strategies to address food insecurity and obesity prevention in low-resource communities across the state. Week of March 15, 2021 General-Covid-19 related news story Michele Polacsek, PhD, MPH and Jennifer Gunderman, MPH were interviewed for a news story about eating at restaurants during the COVID-19 pandemic. Herald: https://www.centralmaine.com/2021/03/15/ask-me-is- dining-in-an-outdoor-structure-safer-than-inside-a-restaurant/ Week of April 5, 2021 Supplemental Nutrition Assistance Program-Education Maine SNAP-Ed’s Program Manager, Lori Kaley, MS, LD, RDN, MSB, and Obesity Prevention Coordinator, Hannah Ruhl, MPH, presented Maine SNAP-Ed – Pivoting Resources and Expertise to Support Maine Communities during a Pandemic at the Maine Nutrition Council 2021 Virtual Conference on April 7, 2021. Hannah Ruhl coordinated with Maine SNAP-Ed’s local Nutrition Educators, Sam McClean, Samantha Cottone, Lindsey Williams and Division Manager Andrea Sockabasin for their presentation Maine SNAP-Ed’s Response to Nutrition Education and Food Security during a Pandemic through Three Local Stories at the Maine Nutrition Council 2021 Virtual Conference on April 7, 2021. Page 15

Center for Excellence in Public Health Week of May 29, 2021 Substance Use Prevention Program In April 2021, following six months of preparation, Laurie Jevons from the Center for Excellence in Public Health obtained her Project Management Professional (PMP) Certification from the Project Management Institute (https://www.pmi.org/). This certification is held by more than two million project managers globally and is the top project management certification in North America. The PMP proves project leadership experience and supercharges careers for project leaders, helping organizations work smarter and perform better. The Project Management Professional Certification validates skill in three domains: people (soft skills to effectively lead a project); process (technical aspects of successful project management); and business environment (highlighting the connection between projects and organizational strategy). The PMP establishes credentialing in three key skill areas, including predictive, agile, and hybrid approaches. Week of May 7, 2021 Substance Use Prevention Program In May 2021, Laurie Jevons was selected as the fellow representing the state of Maine for the New England Prevention Technology Transfer Center (NE PTTC) Fellowship. The Substance Abuse and Mental Health Services Administration (SAMHSA) Region I Fellowship program was awarded to one representative from each state in New England to develop an innovative piece of research and accompanying tool for the benefit of the prevention workforce. The focus for the 2021 fellowship is Diversity, Equity and Inclusion in substance abuse prevention. Jevons was selected for her proposal to create culturally competent and translated resources for New Mainers and international students regarding cannabis use, which is legal for retail sale in Maine but remains a Schedule 1 drug nationally. Research Week of June 7, 2021 Michele Polacsek, Ph.D., M.H.S., professor of public health and director of the Center for Excellence in Public Health at the University of New England, is the co-author on three journal articles published this week. The first, published in the American Journal of Preventive Medicine, evaluates the changes in the calorie content of prepared foods at two large U.S. supermarket chains following the April 2017 implementation of calorie labels. The study found that prepared bakery items decreased by 7.7 calories per item after calorie labels were implemented and that supply-side changes could lead to reductions in caloric intake. Published in the Journal of Nutrition, Education and Behavior, Polacsek’s second article describes the grocery shopping patterns of people who shopped both online and in store. When shopping online, participants spent more per transaction and purchased more items. Compared with in-store shopping, shopping online was associated with reduced spending per transaction on candy, cold or frozen desserts, and grain-based desserts. Online shopping was associated with lower spending on certain unhealthy, impulse-sensitive foods. The researchers concluded that grocery based healthy eating initiatives might leverage online ordering platforms to increase their reach and effectiveness. The third article, published in Public Health Nutrition, describes shopper characteristics of online and in-store shoppers in one Maine community. Being female, having a greater number of children, and a higher income were significantly associated with the likelihood of shopping online. Reducing barriers to increase availability of online shopping for low-income families is paramount, Polacsek said. Page 16

Center for Excellence in Public Health Workforce Development Week of June 19, 2021 Jennifer Gunderman, MPH delivered a presentation on public health surveillance to an array of approximately seventy public health and health care professionals on May 21. Her talk “Infectious Disease Surveillance” was a part of a series hosted by the Maine Public Health Association. The Maine AHEC Network received CARES ACT funding to address COVID 19. The funding will focus on providing COVID 19 related training to health care professionals and students as well as conduct assessments on the impact of COVID 19 on minority and rural communities. Jennifer Gunderman, Elizabeth Mann, and Micaela Maynard completed the Project ECHO Immersion training in May. By completing the training, the Center for Excellence in Public Health will be able to coordinate and host Project ECHO sessions. Planning is underway for ECHO sessions focused on COVID 19 and upstream contributors to health. Week of June 26, 2021 Supplemental Nutrition Assistance Program-Education Two success stories written by a UNE MPH graduate student working with the Center for Excellence in Public Health (CEPH) were published to the USDA’s SNAP-Ed website. One story focused on the addition of fresh produce, recipes, and other resources to Commodity Supplemental Food Program (CSFP) for food insecure seniors in western Maine. The other story featured the successful partnership between Maine SNAP-Ed and Good Shepherd Food Bank in Androscoggin County, which resulted in the screening of about 5,000 patients for food insecurity and the subsequent connection to resources to reduce hunger. These success stories, in addition to two others, were completed by Gabrielle Lanich, during her practicum with CEPH in the spring of 2019 and were published on the SNAP-Ed Connection in May 2020. After graduating, Lanich was hired as a SNAP-Ed nutrition educator with Cornell Cooperative Extension. Pamela Bruno, Senior Research Associate with the SNAP-Ed program, oversaw Gabrielle’s work as her preceptor. Week of July 12, 2021 Substance Use Prevention Program Faculty and Staff from CEPH and COM present poster on stigma at the Governor’s 3rd Annual Opioid Response Summit. Thanks to the PCSS-U grant, UNE is leading the way in training students on OUD issues. Training health professions students on issues around stigma early in their careers can create less stigmatizing health care environments in the future. Senior Research Associate Toho Soma, MPH, MS ’20 (Evaluator), COM Clinical Faculty and Interprofessional Education Coordinator Jenifer Van Deusen, MEd (Principal Investigator), COM Assistant Clinical Professor Selma Holden, MD, MPH, MS (Clinical Director), and COM Project Coordinator Cameron Samuelson (Project Coordinator) were authors. COM and PA students received training on how stigma towards people with OUD negatively affects access to care, and then they rated their level of agreement with stigmatizing statements. Results show that the level of agreement with stigmatizing statements was significantly reduced after most trainings (i.e., they feel less stigma toward people with OUD after the training). This is part of the larger 3- Page 17

Center for Excellence in Public Health year Providers Clinical Support System – University (PCSS-U) grant that COM received in October 2019 through the federal Substance Abuse and Mental Health Services Administration, entitled “Maine PCSS-U.” (https://sites.une.edu/mainepcssu/) Workforce Development The Maine Area Health Education Center (AHEC) Network housed within the Center for Excellence in Public Health (CEPH) represented UNE at the 2021 National AHEC Organization’s (NAO) Annual Meeting Biennial Conference held virtually from June 29th through July 2nd. AHEC is a federally funded program that focuses on health profession workforce development with a focus on rural and underserved populations. The Maine AHEC Network includes the Program Office at CEPH and three regional centers located in eastern (Northern Light), western (Franklin Healthcare), and northern (Northern Maine Community College). A presentation and virtual Q&A session on Maine AHEC’s Rural Health Immersions, a program where UNE graduate health professions students are hosted in rural and underserved communities throughout Maine, was well attended. CEPH staff also presented on cross-state collaborative data collection efforts to spotlight the impact AHECs make nationally. More detail on the panel presentations presented by UNE staff at the conference can be found below: Ian Imbert, AHEC CUP Scholar Program Manager, led a team of AHEC Program and Center staff in a presentation and discussion titled “Creating Immersive Rural Health Experiences for Future Health Providers. Maine AHEC Network Director Jennifer Gunderman, AHEC Evaluator Kira Rodriguez, and Northern Maine AHEC Center Director Leah Buck also shared their experiences planning, implementing and evaluating these unique immersive, rural experiences for health professions students. To address the unique healthcare workforce needs of Maine, University of New England (UNE) faculty and staff developed the Rural Health Immersion (RHI) in 2016. The program was first piloted in Spring of 2016 in Aroostook County, Maine’s northernmost County. The RHI was created to increase student interest in rural health and expand clinical learning opportunities in rural communities with healthcare provider shortages. Since inception, over 200 students from UNE’s Colleges of Osteopathic Medicine, Pharmacy, Dental Medicine, and other Health Professions have participated in the RHI program, including over 100 AHEC Scholars. This presentation provided an opportunity for Maine AHEC Staff to share more about this unique program, how it is implemented, and what students have told us about how their experiences will influence future practice. Additionally, adaptations made during the COVID-19 pandemic were shared. Page 18

Center for Excellence in Public Health Kira Rodriguez, Senior Research Associate at CEPH, led a presentation and panel discussion titled “Showing our Impact with One Voice: NAO CORE Annual Data Collection & Reporting” with colleagues from Colorado, Wisconsin, Michigan and Massachusetts AHECs. This presentation was a collaborative effort from members of the NAO Committee on Outcome, Research and Evaluation (CORE). Committee members presented information on the background, content and methodology used to create the 2020 NAO National Data Flyer and used interactive technology to gather participant feedback on the Flyer. Examples of how Programs and Centers around the country have used the NAO data flyer template to create their own flyers will be shared, as well as suggestions for sharing your Center/Program/State’s Scholars evaluation tool results and reporting to HRSA. This session will provide information relevant for your evaluation report due to HRSA on Aug. 31, 2021 and will illustrate the importance of local, regional and national data collection efforts. Week of July 30, 2021 Substance Use Prevention Services Rebecca (Becky) Ireland, UNE MPH ’20, Certified Prevention Specialist and Senior Program Coordinator, Maine Substance Use Prevention Services Center for Excellence in Public Health, was invited as a guest on Maine Public Broadcasting’s Maine Calling radio show to discuss the topic of Stimulant Misuse in Maine. Maine Public Broadcasting’s Maine Calling radio show wanted to highlight stimulant misuse as an important public health issue negatively impacting Maine and something that can be prevented and intervened with to save lives. Rebecca Ireland joined the Maine Calling staff and fellow guests to educate the audience about the issue and what can be done around prevention, treatment, and recovery of substance misuse disorders. Rebecca brought her 20 years of substance use prevention experience to the show to highlight some risk and protective factors for stimulant misuse, things every Mainer can do to be a partner in preventing stimulant misuse, and some web resources available to help people learn more about preventing and intervening with stimulant misuse on July 26, 2021. Stimulant misuse and overdose is on the rise in Maine and across the country impacting the health and well-being of individuals, families, and communities; stimulant misuse has received far less public attention than opioid misuse, but has been tied to many deaths, injuries, and negative situations in the lives of Mainers. Stimulant misuse is something that individuals, families, organizations, healthcare, and community partners can work together to prevent or intervene with before loss of life or other harms occur. Increasing Mainers’ awareness of the issue and what they can do to protect their loved ones and communities is essential to tackling this issue. Page 19



Michele Polacsek, Ph.D., M.H.S. Professor, Public Health Director, Center for Excellence in Public Health [email protected] The Center for Excellence in Public Health (CEPH) works to create a world where everyone has fair and just opportunities for health. Our mission is to improve the health of the public and advance health equity by engaging UNE faculty, professional staff, students, and community partners to generate new knowledge, contribute to best practice, grow local capacity, and create opportunities for learning. Center for Excellence in Public Health (207) 221-4671 1075 Forest Avenue, Suite 123 Portland, ME 04103