In this episode with Dr. Mati Hlatshwayo-Davis, the following has been discussed:

• Exploring Health Equity and Public Health Work in St. Louis
• How can we define health equity, especially when it comes to public health work?
• Could you share some of the strengths and challenges that the City of St. Louis Department of Health is currently facing?
• What have been the most rewarding and challenging aspects of your role?
• You've managed to establish some impressive partnerships and alliances for St. Louis, which have helped improve public health services. Can you tell us more about these partnerships and how you were able to create them?
• What does public health need from academia, and what kind of support do you require from implementation research?
• In terms of dissemination and implementation (D&I) research, how do equity gaps affect your work, the community's service, and the communities you collaborate with?
• Have there been any community engagement or public health intervention strategies that you have found particularly helpful during your tenure? Is there anything that certain bureaus have implemented that has been successful?
• Lastly, what kind of legacy for health equity do you hope to achieve through your leadership at the City of St. Louis?

Guest Bio:

Dr. Matifadza Hlatshwayo Davis, MD, MPH, is the Director of Health

for the City of St. Louis. Dr. Hlatshwayo Davis received her medical

degree from Cleveland Clinic Lerner College of Medicine and a

Master’s in Public Health Degree from Case Western Reserve

University. She completed her internal medicine residency at

University Hospitals Case Medical Center. She went on to complete

her Infectious Diseases fellowship at the Washington University

School of Medicine (WUSM), also completing a one-year dedicated

non-ACGME HIV fellowship and a two-year dedicated Sexually

Transmitted Infections (STI) fellowship.

She was a Clinical Instructor, Associate Program Director of the

Division of Infectious Diseases fellowship program and in the

leadership of the Office of Inclusion and Diversity at the

Washington University School of Medicine. She was also an Infectious Diseases physician at the John

Cochran VA Medical Center where she was the Lead HIV Clinician, Graduate Medical Education

Coordinator, and Outpatient Parenteral Antibiotic Therapy, supervisor.

Her passion for community engagement, health equity, and patients living with HIV (PLWH),

culminated in her becoming the co-chair of the Fast Track Cities initiative in St. Louis, and later

appointed to the City of St. Louis Board of Health. Dr. Hlatshwayo Davis is now a national and

international medical contributor on COVID-19 with a particular focus on marginalized populations and

has been featured in outlets such as CNN, BBC, Al Jazeera, MSNBC, and Newsweek, among others. She

is also an Associate Editor for Disparities and Competent Care for the Infectious Diseases Society of

America (IDSA).

Dr. Tucker-Seeley is currently the Vice-President of Health Equity at ZERO- Prostate Cancer. In this role, he leads the development and implementation of ZERO’s health equity strategy to reduce racial/ethnic and place-based disparities in prostate cancer. Dr. Tucker-Seeley completed master's and doctoral degrees in public health at the Harvard T.H. Chan School of Public Health (HSPH) and a postdoctoral fellowship in cancer prevention and control at HSPH and the Dana-Farber Cancer Institute (DFCI). His research has focused on social determinants of health across the life course, such as the association between the neighborhood environment and health behavior; and on individual-level socioeconomic determinants of multi-morbidity, mortality, and self-rated physical, mental, and oral health. His research has also investigated the association of financial hardship with health across the cancer continuum from prevention to end-of-life care.

Dr. Tucker-Seeley has a longstanding interest in the impact of health policy and social policy on racial/ethnic minorities and across socioeconomic groups. He has experience working on local and state level health disparities policy, and he has developed and taught courses focused on measuring and reporting health disparities. In 2017-2018, Dr. Tucker-Seeley was a Robert Wood Johnson Health Policy Fellow with a placement in the United States Senate. Prior to joining ZERO, he was the inaugural holder of the Edward L. Schneider chair in gerontology and Assistant Professor in the Leonard Davis School of Gerontology at the University of Southern California (USC). Prior to joining USC, he was an Assistant Professor of Social and Behavioral Sciences at DFCI and HSPH.

The costs for cancer care are expected to increase by more than 30% from 2015 to 2030, with a total cost of approximately $246 billion.

Recent research from the Centers for Disease Control and Prevention, the American Cancer Society, and the National Cancer Institute using data from the 2011-2016 Medical Expenditure Panel Survey showed that material financial hardship was experienced by 25.3% of cancer survivors, and psychological financial hardship was experienced by 34.3% of cancer survivors. Approximately 26% of cancer survivors experienced behavioral financial hardship.

Guest Bio:

Reginald Tucker-Seeley, ScD

Dr. Tucker-Seeley is currently the Vice-President of Health Equity at ZERO-The End of Prostate Cancer. In this role, he leads the development and implementation of ZERO’s health equity strategy to reduce racial/ethnic and place-based disparities in prostate cancer. Dr. Tucker-Seeley completed master and doctoral degrees in public health at the Harvard T.H. Chan School of Public Health (HSPH) and a postdoctoral fellowship in cancer prevention and control at HSPH and the Dana-Farber Cancer Institute (DFCI). His research has focused on social determinants of health across the life course, such as the association between the neighborhood environment and health behavior; and on individual-level socioeconomic determinants of multi-morbidity, mortality, self-rated physical, mental, and oral health. His research has also investigated the association of financial hardship with health across the cancer continuum from prevention to end-of-life care.

LinkedIn: https://www.linkedin.com/in/reginald-tucker-seeley/

Twitter: @regtucksee

This is a mind-blowing episode with Evan Eschliman where Dr. Bradley and Evan discussed:

Cultural adaptation (CA) is a process of modifying evidence-based interventions to be more congruent with the cultural norms, values, and beliefs of a particular community. CA is critical to the successful implementation of evidence-based interventions, as it ensures that interventions are relevant and acceptable to the target population. To add to the discussion on the significance of CA to implementation, it is important to note that CA can also increase the reach and impact of interventions by overcoming cultural barriers that may prevent individuals from engaging in interventions.

Local collaborators play a vital role in the CA process. They possess valuable knowledge and understanding of the cultural context and can help identify areas where modifications are needed. It is important to involve local collaborators in all stages of the CA process to ensure that interventions are adapted in a way that is respectful and appropriate to the community.

Recalling the findings by stage of EPIS can provide valuable insights into the effectiveness of CA. For example, in the Exploration stage, identifying community needs and beliefs can inform the CA process and make interventions more acceptable. In the Preparation stage, involving local collaborators can facilitate the implementation process and increase buy-in from the community.

When considering the common pitfalls and barriers of bringing CA and implementation in closer alignment, it is important to be aware of potential power imbalances and cultural biases. It is also important to recognize that CA is an ongoing process and may require adaptations as the cultural context changes over time. Unique strengths of bringing CA and implementation in closer alignment include increased relevance and acceptability of interventions, increased community engagement and ownership, and increased potential for sustainability.

Overall, cultural adaptation is a critical component of successful implementation and has the potential to increase the reach and impact of evidence-based interventions. By involving local collaborators and being mindful of potential pitfalls and barriers, we can ensure that CA is conducted in a respectful and appropriate manner and that interventions are tailored to the unique needs of the community.

Guest Bio:

Evan L. Eschliman, MS (they/he) is currently a PhD Candidate in the Department of Health, Behavior and Society at the Johns Hopkins School of Public Health. Evan’s research uses multiple methods to uncover and document stigma’s negative health effects, with particular focuses on how structures and systems produce and reproduce stigma and how stigma can be intervened against in culturally and structurally responsive ways.

Twitter: @EvanEschliman

Instagram: @eschclamation