Graduate Student Internship Program

2008 Catalog of Internship Opportunities

This internship has been filled.

Secondary Data Analyses of Maternal and Child Health Datasets in Hawaii

Program: Family Health Services Division
Department of Health, Honolulu, HI
Skill Area: Data Analysis and Monitoring

Agency Information

The Family Health Services Division (FHSD) is located in the Hawaii State Department of Health. The Division is responsible for several important data sets related to maternal and child health in Hawaii including the Pregnancy Risk Assessment and Monitoring System (PRAMS), Women, infant, and Children (WIC), Birth defects registry, newborn metabolic and hearing screening, and interacts with the Office of Health Status and Monitoring to analyze vital statistics data related to issues important to maternal and child health (MCH) population.

Purpose, goals, and objectives of internship

FHSD is seeking a student to work directly with the FHSD epidemiologist on secondary data analyses and translation of data to action while participating as a team member in the state agency. The intern would gain skill in conducting data analyses around important MCH issues using any of many potential data sets and will learn about MCH activities conducted at a small state agency through participation in meetings and presentations within the Department of Health. The intern may choose from one of the following projects:

1) A growing trend across the nation involves the increase use of c-section and accounts for approximately a quarter of all live births in Hawaii. Various studies demonstrate increased risk in adverse neonatal and maternal outcomes. Other outcomes including maternal morbidity, hospital costs, and long term infant outcomes are unclear and represent additional areas of concerns in Hawaii. To better evaluate this issue in Hawaii, we are seeking a student to better inform various maternal and child health stakeholders and the Hawaii Department of Health. The student will conduct an analysis using PRAMS data to evaluate the type of delivery as an outcome (primary c-section, repeat csection, vaginal birth after c-section, and spontaneous vaginal delivery) to assess for disparities in Hawaii's unique population. The project will also include discussion with clinicians, the Hawaii Medical Association, and other stakeholders with input into the development of a future survey to discuss the use of c-sections in Hawaii. Products anticipated from this practicum include the development of a fact sheet, abstract, and possible manuscript.

2) In Hawaii as across the nation, mothers are increasingly delaying child birth to later years and this has been reflected by the increases in mean age of births. Concurrently there has been a substantial increase in risk factors for as well as the development of chronic disease such as obesity, hypertension, diabetes, and cancer. This increase in disease can influence maternal and child health outcomes. Further, about half of all pregnancies are unintended so it is important to emphasize clinical and public health programs to promote healthy pregnancies in those contemplating a pregnancy as well as those not currently anticipating one. Studies are needed to determine relationships between chronic disease, medication use, advancing maternal age, pregnancy intendedness, family planning, and receipt of appropriate clinical care. This highlights the increasing importance of preconception and inter-conception care for women of reproductive age. The Hawaii Department of Health is seeking a graduate student to evaluate the PRAMS Hawaii data set for relations between several of these indicators and how they relate to preconception and inter-conception care. This practicum will occur in a broader context to utilize current data and drive the development of and use of various data sets to inform the Department of Health and Maternal and Child Health stakeholders in Hawaii. This may include meeting with various clinical providers, medical training programs, and the Hawaii Medical Association. Products anticipated from this practicum include the development of a fact sheet, abstract, and a manuscript.

3) Hawaii is a very unique population. Some of this uniqueness is reflected in that the majority of all births in Hawaii can be considered multi-ethnic. The impact of this heterogeneity on outcomes is not known. The Department of Health seeks a graduate student to evaluate the birth certificate file for birth outcomes of Preterm delivery and Low birth-weight with a particular interest in changes depending on classification based on reported child's race, compared to mother's race, father's race, and both the father's and mother's race. This work will help inform the department on the use of ethnicity data for program purposes. Products anticipated from this practicum include the development of a fact sheet, abstract, and a manuscript.

Data or analytic tasks and activities

Development of a topic prior to the start of the internship is strongly recommended and can be done over telephone and email discussion between intern and preceptor.

Data or analytic skills required

Knowledge of SAS is required, and experience with SUDAAN is recommended for analysis using data from PRAMS.

Supervisors

Don Hayes, MD, MPH will be the primary supervisor and is a CDC assigned epidemiologist to the state of Hawaii FHSD.

Internship begins

Start time is flexible.

Housing

There may be some difficulty in obtaining inexpensive housing for a 3-month period for those coming from out of state, but will attempt to provide some information. Prospective interns should be aware of the high cost of living in Hawaii and the stipend provided by this program may not cover all expenses for the duration of the assignment.

Transportation

The office is accessible by the city bus line.

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