Heidi Lee Pottinger

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Courses

Scholarly Contributions

Chapters

• Duncan, B. R., Andrews, J. G., Pottinger, H. L., & Meaney, F. J. (2017). Developmental Disabilities. In Nutrition and Health in a Developing World(pp 526-558). Switzerland: Springer Nature. doi:10.1007/978-3-319-43739-2

Journals/Publications

• Pottinger, H. L., Rahlin, M., Voigt, J., Walsh, M. E., Fregosi, C. M., & Duncan, B. R. (2020). Feasibility of an intensive outpatient Perception-Action Approach intervention for children with cerebral palsy: a pilot study. PHYSIOTHERAPY THEORY AND PRACTICE, 36(9), 973-988.
• Rahlin, M., Duncan, B. R., Howe, C. L., & Pottinger, H. L. (2020). How does the intensity of physical therapy affect the Gross Motor Function Measure (GMFM-66) total score in children with cerebral palsy? A systematic review protocol.. BMJ, 10, e036630. doi:10.1136/ bmjopen-2019-036630
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  https://bmjopen.bmj.com/content/10/7/e036630
• Yoo, W., Koskan, A., Scotch, M., Pottinger, H., Huh, W. K., & Helitzer, D. (2020). Patterns and Disparities in Human Papillomavirus (HPV) Vaccine Uptake for Young Female Adolescents among US States: NIS-Teen (2008-2016). CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 29(7), 1458-1467.
• Pottinger, H. L., Jacobs, E. T., Haenchen, S. D., & Ernst, K. C. (2018). Parental attitudes and perceptions associated with childhood vaccine exemptions in high-exemption schools. PLOS ONE, 13(6).
• Pottinger, H. L., Rahlin, M., Voigt, J., Walsh, M. E., Fregosi, C., & Duncan, B. R. (2018). Feasibility of an intensive outpatient PerceptionAction Approach intervention for children with cerebral palsy: a pilot study. Physiotherapy Theory and Practice: An International Journal of Physical Therapy. doi:https://doi.org/10.1080/09593985.2018.1517847
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  Purpose: The purpose of this pilot study was (1) to evaluate feasibility of attendance and parent satisfaction with an intensive outpatient physical and occupational therapy program for young children with spastic cerebral palsy (CP) and (2) to examine changes in motor function. Methods: Sixteen children with CP, age range 18–36 months (mean 24.3 ± 6.3 months), received physical and occupational therapy sessions (30 minutes each) 5 days per week for 12 weeks. Attendance rates and parent satisfaction were assessed. Change in motor function using a one-group pre-post design was evaluated using the Gross Motor Function Measure-66 (GMFM-66), Quality of Upper Extremity Skills Test, and Pediatric Evaluation of Disability Inventory. GMFM-66 outcomes were also compared with expected outcomes using previously published normative developmental trajectories of children receiving standard therapies. Results: An average of 82% of scheduled outpatient physical and occupational therapies for 16 children were completed and the 11 parents who completed the Hills and Kitchen’s Physiotherapy Outpatient Satisfaction Questionnaire were satisfied with the therapies and with their child’s progress. Participants showed notable, statistically significant improvement across all activity-related measures. Conclusion: An intensive protocol of outpatient therapies utilizing Perception-Action Approach was feasible for most families of young children with spastic CP to attend at the outpatient clinic location. As this was not an experimental study, no reliable conclusions related to efficacy can be made, but the promising results suggest that further research into the effectiveness of intensive protocols is worthwhileKEYWORDS: Cerebral palsy, children, intensive therapy, neuroplasticity, Perception-Action Approach, pilot
• Valdez, E. S., Pottinger, H. L., Duncan, B. R., & Urbon-Bonine, A. (2018). Feasibility of engaging college students in a 10-day plant-based diet. Health Education Journal. doi:https://doi.org/10.1177/0017896918785933
• Valdez, E. S., Pottinger, H., Urbon-Bonine, A., & Duncan, B. (2018). Feasibility of engaging college students in a 10-day plant-based diet. HEALTH EDUCATION JOURNAL, 77(8), 952-963.
• Haenchen, S. D., Jacobs, E. T., Bratton, K. N., Carman, A. S., Oren, E., Pottinger, H. L., Regan, J. A., & Ernst, K. C. (2014). Perceptions of personal belief vaccine exemption policy: A survey of Arizona vaccine providers. VACCINE, 32(29), 3630-3635.
• Haenchen, S. D., Jacobs, E. T., Bratton, K. N., Carman, A. S., Oren, E., Pottinger, H. L., Regan, J. A., & Ernst, K. C. (2014). Perceptions of personal belief vaccine exemption policy: a survey of Arizona vaccine providers. Vaccine, 32(29), 3630-5.
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  As exemptions to school-entry requirements rise, vaccination rates in Arizona school children are approaching levels that may threaten public health. Understanding the interactions physicians have with vaccine-hesitant parents, as well as the opinions physicians hold regarding vaccination, exemption, and exemption policies, are critical to our understanding of, and ability to affect, vaccination exemption rates among children.
• Alvarez, M. L., Pinyerd, H. L., Topal, E., & Cardineau, G. A. (2008). P19-dependent and P19-independent reversion of F1-V gene silencing in tomato. Plant molecular biology, 68(1-2), 61-79.
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  As a part of a project to develop a plant-made plague vaccine, we expressed the Yersinia pestis F1-V antigen fusion protein in tomato. We discovered that in some of these plants the expression of the f1-v gene was undetectable in leaves and fruit by ELISA, even though they had multiple copies of f1-v according to Southern-blot analysis. A likely explanation of these results is the phenomenon of RNA silencing, a group of RNA-based processes that produces sequence-specific inhibition of gene expression and may result in transgene silencing in plants. Here we report the reversion of the f1-v gene silencing in transgenic tomato plants through two different mechanisms. In the P19-dependent Reversion or Type I, the viral suppressor of gene silencing, P19, induces the reversion of gene silencing. In the P19-independent Reversion or Type II, the f1-v gene expression is restored after the substantial loss of gene copies as a consequence of transgene segregation in the progeny. The transient and stable expression of the p19 gene driven by a constitutive promoter as well as an ethanol inducible promoter induced a P19-dependent reversion of f1-v gene silencing. In particular, the second generation plant 3D1.6 had the highest P19 protein levels and correlated with the highest F1-V protein accumulation, almost a three-fold increase of F1-V protein levels in fruit than that previously reported for the non-silenced F1-V elite tomato lines. These results confirm the potential exploitation of P19 to substantially increase the expression of value-added proteins in plants.
• Alvarez, M. L., Pinyerd, H. L., Crisantes, J. D., Rigano, M. M., Pinkhasov, J., Walmsley, A. M., Mason, H. S., & Cardineau, G. A. (2006). Plant-made subunit vaccine against pneumonic and bubonic plague is orally immunogenic in mice. Vaccine, 24(14), 2477-90.
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  Yersinia pestis, the causative agent of plague, is an extremely virulent bacterium but there are no approved vaccines for protection against it. Our goal was to produce a vaccine that would address: ease of delivery, mucosal efficacy, safety, rapid scalability, and cost. We developed a novel production and delivery system for a plague vaccine of a Y. pestis F1-V antigen fusion protein expressed in tomato. Immunogenicity of the F1-V transgenic tomatoes was confirmed in mice that were primed subcutaneously with bacterially-produced F1-V and boosted orally with transgenic tomato fruit. Expression of the plague antigens in fruit allowed producing an oral vaccine candidate without protein purification and with minimal processing technology.

Presentations

• Koch, B., Leih, R., Pottinger, H. L., Trejo, M., Tucker, K., Romero-Cardenas, K., & Ruedas, P. (2019, April). Public Health Immigration Advocacy in Action. Social Justice Symposium. Tucson, AZ: Mel & Enid Zuckerman College of Public Health.
• Lewis, S., Pottinger, H. L., & Talavera, N. S. (2019, September). "A Sandy Hook Mother's Mission to Create Safer Schools & Communities from the Inside Out". DuVal Auditorium Presentation. DuVal Auditorium, University of Arizona Medical Center: University of Arizona Department of Health Promotion Sciences and Child Health & Resilience Mastery (CHARM).
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  A presentation by Ms. Scarlett Lewis, Founder & Chief Movement Officer of the Jesse Lewis Choose Love Movement -- a no-cost infant, toddler, and pre-K through 12th grade social and emotional learning program that teaches children and adults how to choose love in any circumstance, helping them to become connected, resilient, and empowered.Introduction by Dr. Heidi Pottinger of the University of Arizona Mel & Enid Zuckerman College of Public Health Department of Health Promotion Sciences and Executive Director of Child Health & Resilience Mastery (CHARM), the not-for-profit Arizona Ambassador of the Choose Love Movement.Following this dynamic presentation is a Q&A with Choose Love Movement Founder Ms. Lewis and CHARM co-founders, Dr. Pottinger and Ms. Nisa Stover Talavera.
• Pottinger, H. L., Beider, S., Frazee, K., & Pacheco, R. (2019, April). Integrative Wellness Sessions in a Children’s Hospital Setting: Evaluation of the Integrative Touch Hospital Program at Banner’s Diamond Children’s Hospital.. Resilience Conference (ResCon). Nashville, TN.
• Pottinger, H. L., Beider, S., Duncan, B. R., Schwartz, G. E., Frazee, K., Angulo, B., Cramton, R., & Ehiri, J. E. (2017, November). Integrative Wellness Sessions in a Children’s Hospital Setting: A Feasibility Study to Assess the Hospital Heroes Program at Banner’s Diamond Children’s Hospital. American Public Health Association (APHA). Atlanta, GA.
• Valdez, E. S., Pottinger, H. L., Urbon-Bonine, A., & Duncan, B. R. (2017, November). Experiential Learning to Engage College Students in 10-Day ‘Jumpstart’ Plant-Based Diet to Combat Chronic Disease. American Public Health Association. Atlanta, GA.
• Duncan, B. R., Pottinger, H. L., & Trujillo, F. (2014, November). Engaging bi-national communities to support a social business manufacturing medical devices: training, employment, and leadership opportunities for individuals with disabilities. Association of University Centers on Disabilities (AUCD). Washington, DC.
• Pottinger, H. L. (2013, October). Muscular Dystrophy Association: Myotonic Muscular Dystrophy. Ninth International Myotonic Dystrophy Consortium Meeting (IDMC-9). Donostia, San Sebastian, Spain: Muscular Dystrophy Association.

Poster Presentations

• Aubert-Vasquez, M., Duncan, B. R., Packard, S., Pottinger, H. L., Niebla, L., K, R., & Trujillo, F. (2017, November). An innovative program in Nogales, Mexico that enables individuals with a disability to re- integrate back into society. American Public Health Association. Atlanta, GA.
• Pottinger, H. L., Dodds, S., Ehiri, J. E., & Duncan, B. R. (2015, April). Intense physiotherapy and cognitively- based compassion training to improve health outcomes and communication for families of children with cerebral palsy. 2015 Public Health Research Poster Forum. Tucson, AZ: Mel & Enid Zuckerman College of Public Health.
• Pottinger, H. L., Packard, S., Trujillo, F., Gutierrez, A., Zepeda, G., Roark, G., Hedayati, L. L., Dean, J., & Duncan, B. R. (2015, April). Cross-border project offers training and assisted devices to individuals with disabilities. 2015 Public Health Research Poster Forum. Tucson, AZ: Mel & Enid Zuckerman College of Public Health.
• Haenchen, S. D., Pottinger, H. L., Jacobs, E. T., Gast, P. B., & Ernst, K. C. (2013, March). Opinions of Arizona Physicians Regarding Childhood Immunizations. 2013 Public Health Research Poster Forum. Tucson, AZ: Mel & Enid Zuckerman College of Public Health.
• Pottinger, H. L., Steven, H. D., Jacobs, E. T., & Ernst, K. C. (2013, March). Parental attitudes toward childhood immunization(s) in Arizona elementary schools. 2013 Public Health Research Poster Forum. Tucson, AZ: Mel & Enid Zuckerman College of Public Health.
• Pottinger, H. L., Haenchen, S. D., Jacobs, E. T., Gast, P. B., & Ernst, K. C. (2012, November). Parental attitudes toward childhood immunization(s) in Arizona elementary schools. 2012 Frontiers in Biomedical Research Poster Forum. Tucson, AZ: The University of Arizona College of Medicine.

Others

• Goodrum Sterling, F. D., Pottinger, H. L., Pottinger, H. L., & Goodrum Sterling, F. D. (2019, February). Everyone Has a Part to Play in Ending Vaccine Hesitancy. The Health Care Blog. https://thehealthcareblog.com/blog/2019/02/12/everyone-has-a-part-to-play-in-ending-vaccine-hesitancy/
• Pottinger, H. L. (2019, April). Grief Can Awaken Moments of Profound Joy. Thrive Global. https://thriveglobal.com/stories/grief-can-awaken-moments-of-profound-joy/
• Pottinger, H. L. (2019, March). How Border Communities Support One Another. Latino Rebels. https://www.latinorebels.com/2019/03/20/bordercommunities/
• Pottinger, H. L., & Ernst, K. C. (2019, March). Why Some Parents Seek Vaccine Exemptions. Arizona Public Media. https://www.azpm.org/p/azillhome/2019/3/8/147544-why-some-parents-seek-vaccine-exemptions/
• Pottinger, H. L., & Goodrum Sterling, F. D. (2019, March). Vaccine exemptions create problems for states. The Hill. https://thehill.com/opinion/healthcare/435211-vaccine-exemptions-create-problems-for-states
• Pottinger, H. L. (2018, December). Spirituality as a Clinical Target. Thrive Global. https://thriveglobal.com/stories/spirituality-as-a-clinical-target/
• Pottinger, H. L. (2018, November). Attitude of Gratitude. Medium. https://medium.com/@heidi.pottinger/attitude-of-gratitude-faf445f206c0
• Pottinger, H. L. (2018, November). Thanks to active-shooter drills at school, my 4-year-old thought fireworks were gunshots. Enough already. The Washington Post. https://www.washingtonpost.com/education/2018/11/01/mom-thanks-active-shooter-drills-school-my-year-old-thought-fireworks-were-gunshots-enough-already/?fbclid=IwAR18fSidUwUfptIaiVyqlpKj_utlnlT_O12kOMRMr7gN0RRPuH1RGpb1O0c
• Pottinger, H. L. (2017, August). Integrative Wellness Sessions In A Pediatric Hospital Setting: A Feasibility Study to Assess Evaluation of the Hospital Heroes Program at Banner's Diamond Children's Hospital. The University of Arizona. https://repository.arizona.edu/handle/10150/625669
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  AbstractBACKGROUND: Evidence suggests complementary and alternative medicine (CAM) therapies can be effective in treating certain chronic, recurrent, and incurable conditions. Use of CAM in pediatric populations is increasing considerably and uptake is especially evident among hospitalized children. Further, burnout among healthcare providers is increasing, affecting both their wellbeing and patient outcomes. At Banner Children's Diamond Children's Hospital, patients, families, and staff can receive CAM through the Integrative Touch for Kids™ (ITK) Hospital Heroes (HH) program. SIGNIFICANCE: Further study to evaluate HH is vital to understanding the quality of care delivered and recommendations for improvement. OBJECTIVES: Assess feasibility of evaluation of HH by Aim 1: Describing the vision and programmatic structure of the HH program. Aim 2: Achieving therapist consensus on referral, care coordination, and debriefing processes; Aim 3: Evaluating session impact on pain, fear/distress/anxiety, global/overall well-being, and satisfaction. Describe retrospective case studies to highlight valuable outcomes otherwise not represented. FRAMEWORKS & METHODS: The Centers for Disease Control & Prevention Framework for Program Evaluation in Public Health, elements from the Ethnographic Assessment of Evaluation Systems, and elements from Donabedian's Quality Framework were used to create a novel, theory-based, whole practice, program evaluation framework to evaluate HH via the following aims. Aim 1: Structure- Key- informant ethnographic interviews with ITK management (N=2) and self-completed questionnaires by HH therapists (N=4) were used to describe the program vision and structural elements. Interviews were transcribed and all data was de-identified, described, and summarized. Transcripts were converted into culturally-appropriate word clouds validated by participants. Univariate and descriptive statistics were used to assess questionnaire items related to human resources and quality rankings were assigned based on ITK standards. Aim 2: Process- The Delphi method was used by administering self-administered ethnographic questionnaires (N=3) to all HH therapists (N=4) to generate consensus on referrals, care coordination, and debriefing processes. Concept Maps were created for each element and validated by participants. Aim 3: Outcomes- Evaluation instruments were developed and piloted in collaboration with ITK stakeholders and data was collected over a two-month period representing nearly 50% of sessions administered by the HH therapists, from Aims 1 and 2, for 2017. Session and recipient characteristics for all sessions (N=95), regardless of recipient ability to report, were summarized. Pre/post changes were calculated using validated scales for pain, fear/distress/anxiety, global/ overall well-being, and likelihood to recommend the hospital. Session satisfaction rankings were collected post-session. Wilcoxon matched-pair signed-rank tests were done to calculate significant differences between median changes pre/post session for recipients able to respond and stratified by recipient type. Retrospective case studies (N=4) were described from data in the electronic health record and/or ITK records, as well as interviews with HH therapists. RESULTS: The program structure was described and quality of human resources met or exceeded criteria for most indicators of quality. Expert consensus on therapist interactions related to referrals, care-coordination, and debriefing was achieved. Evaluation of the HH program was determined feasible and in alignment with the program model and short-term vision. Strong evidence to support decreases in pain and fear/distress/anxiety, as well as increases in global overall well-being were observed in recipients able to report. High levels of satisfaction (mean≥9.0) and top-box rankings for likelihood to recommend the hospital overall, were reported. Retrospective case studies (N=4) highlighted additional outcomes from multiple perspectives. CONCLUSION: These results help to support ethnographic evaluation of the HH program, a holistic and integrative model of care, as ITK continues expanding and replicating the HH program within and beyond the current setting. Knowledge reported provides a new theory-based, whole practice, program evaluation model and expands existing evidence on CAM use in hospitalized pediatric patients.