• Dr. Whitney Irie describes the purpose and joy discovered in implementation research with Black women advancing their sexual and reproductive health.
    1 hr and 10 mins
  • What does it take to realize health equity in population health through the work of local public health entities with Dr. Mati Hlatshwayo-Davis
    Jun 26 2023

    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).

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    55 mins
  • Financial Toxicity as a barrier to equitable implementation & equitable implementation of prostate cancer screening for Black men with Dr. Reggie Tucker-Seeley
    Jun 26 2023

    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

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    1 hr and 8 mins
  • Cultural Adaptation Across Implementation Stages with Evan Eschliman
    Jun 19 2023

    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


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    1 hr
  • Understanding mistrust, distrust, and trustworthiness in medical care and medical research to advance health equity with Dr. Derek Griffith
    Jun 12 2023

    In this episode, Dr. Derek Griffith shared his work around trust, distrust, and mistrust. He provided a walk-through of those distinctions he described in his paper.


    It's true that the terms "medical mistrust" and "medical distrust" are often used interchangeably without a clear distinction between them. This can sometimes lead to confusion and misunderstanding when discussing issues such as radicalized health disparities and the impact of historical events like the Tuskegee study.


    Regarding the use of "medical mistrust" in addressing health disparities, some argue that it may not be the most effective way to approach justice efforts. By focusing solely on mistrust, we may miss the opportunity to build trusting relationships and address the root causes of distrust.


    As for your question on the link between trust and health equity/justice, it's important to recognize that trust is a critical component in healthcare delivery and outcomes. Patients who trust their healthcare providers are more likely to adhere to treatment plans and experience better health outcomes. Additionally, trust is essential in addressing health disparities and promoting health equity. Without trust, marginalized communities may be hesitant to engage with healthcare systems or may not receive the care they need.


    Finally, in regard to intervention research and implementation, building trusting relationships among stakeholders is key to successful implementation and sustained positive outcomes. As the theoretical model proposed by Allison Metz et al highlights, trusting relationships can increase motivation, capability, and opportunity for supporting implementation. This ultimately leads to greater commitment and resilience, which are essential for achieving positive implementation outcomes.


    Guest Bio:


    Dr. Derek M. Griffith is a Founding Co-Director of the Racial Justice Institute, Founder and Director of the Center for Men’s Health Equity, Member of the Lombardi Comprehensive Cancer Center, and Professor of Health Management & Policy and Oncology. He recently was elected Chair of Global Action on Men's Health and appointed to be on the Board of Directors of the Men's Health Network.


    Trained in psychology and public health, Dr. Griffith’s program of research focuses on developing strategies to achieve racial, ethnic and gender equity in health. He specializes in interventions to promote Black men's health and well-being and interventions to address racism in organizations and to mitigate the effects of structural racism on health. Dr. Griffith is a contributor to and editor of three books – Men’s Health Equity: A Handbook (Routledge, 2019), Racism: Science and Tools for the Public Health Professional (APHA Press, 2019), and Health Promotion with Adolescent Boys and Young Men of Colour: Global Strategies for Advancing Research, Policy, and Practice in Context (Springer, 2023).


    He is the author of over 150 peer-reviewed manuscripts, and he has been the principal investigator of research grants from the American Cancer Society, the Robert Wood Johnson Foundation, and several institutes within the National Institutes of Health. Dr. Griffith serves on the editorial boards of several public health and men's health journals, and he has been a guest editor of journal special issues or supplements on African American men's health, men's health equity, qualitative approaches to health equity research, and other topics.


    He has received three noteworthy honors: (a) Tom Bruce Award from the Community-Based Public Health Caucus of the American Public Health Association in recognition of his research on “eliminating health disparities that vary by race, ethnicity and gender”, (b) he was named a Fellow of the American Academy of Health Behavior for his significant contributions to the field of health behavior research, and (c) he was named one of 1,000 Inspiring Black Scientists in America by the Cell Mentor’s Community of Scholars.

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    1 hr and 5 mins
  • Implementing social needs screening and response in primary care as an approach to health equity with Dr. Connor Drake
    Jun 5 2023

    Exploring the Link Between Social Needs Screening, Health Equity, and Implementation Science.

    
Join Dr. Connor Drake and Dr. Cory Bradley in a thought-provoking episode where they discuss the research on "Implementation of social needs screening in primary care: a qualitative study using the health equity implementation framework." The conversation delves into how awareness of social care needs assessed in screening can be integrated into care practices to improve implementation of tools and interventions. Gain insights into the overall research program and how it intersects with implementation science and health equity.


    Guest Bio:


    Connor Drake is a health services researcher and implementation scientist. His research interests are at the intersection of primary care, population health management, social determinants of health, chronic illness care redesign, and health equity. He has experience with policy analysis, electronic health record data, mixed and multi-methods, community-engaged research, and implementation and dissemination methods. Dr. Drake's current research focuses on developing and implementing behavioral interventions and 'whole-person' care models for patients with cardiovascular disease and metabolic disorders; and studying social care interventions to respond to social risk factors including food insecurity, housing instability, and social isolation to improve health outcomes and equity.


    LinkedIn: https://www.linkedin.com/in/cddrake/

    Twitter: https://twitter.com/cddrake_HPM

    Google Scholar: https://scholar.google.com/citations?hl=en&user=OxX3eigAAAAJ



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    1 hr and 13 mins
  • Advancing justice-making in implementation research in global health settings with Dr. Nadia A. Sam-Agudu
    May 29 2023

    Scientists in countries in Africa have taken a leadership role. In this episode, Dr. Bradley and his friend and colleague, Dr. Nadia A. Sam-Agudu discussed the growing momentum in global health research to support the creation of a research ecosystem free of residual colonial practices and thinking.


    The issue of coloniality and injustice in global health is multifaceted and complex. The knowledge system in global health is often built on the foundations of white supremacy and colonialism. As such, there is a need for changes in both the content and the terms of the content in order to address these practices. The impacts of inequity in the enterprise of scientific research are far-reaching, affecting both the communities receiving interventions and care as well as the researchers themselves.


    Some of the effects of this inequity include:

    • Limited access to resources and funding for research initiatives in marginalized communities
    • Structural barriers that prevent marginalized communities from participating in research
    • The perpetuation of harmful stereotypes and biases that negatively impact the health outcomes of marginalized communities


    Implementation research and practice can contribute significantly to global health priorities in service to health justice, social justice, and equity. Participation approaches can also be effective in remedying inequalities and addressing the influence and effects of colonial, imperialist, and neoliberal regimes. These approaches can empower marginalized communities and promote their active participation in research and decision-making processes.


    As for building capacity and power among African scientists to advance the enterprise of research and implementation research among African nations, there are various activities that can be undertaken.


    These include:

    • Providing funding and resources for research initiatives

    • Promoting collaboration and partnerships between African and non-African researchers

    • Offering training and mentorship programs for African researchers


    While progress has been made in advancing global public health and implementation efforts in these settings, there is still much work to be done. Bold and radical solutions are needed to enable liberated global health. This may involve challenging existing power structures and promoting the active participation of marginalized communities in decision-making processes. It may also involve reimagining the ways in which we approach research and implementation in order to promote health justice, social justice, and equity.


    Guest Bio:

    Dr. Nadia Sam-Agudu is an Associate Professor of Pediatrics at the Institute of Human Virology in the University of Maryland School of Medicine, Baltimore. She has a BA in Interdisciplinary African Studies, which helped to root and frame her subsequent medical and research career. Her clinical and research specialty is pediatric infectious diseases. Since 2010, she has worked full-time in Nigeria at the Institute of Human Virology Nigeria in Abuja.


    Dr. Sam-Agudu’s research focuses on the use of implementation science methods to develop and deliver interventions for the prevention and treatment of HIV and other major infectious diseases among children and adolescents in Nigeria and other African countries. Over time, she has woven the principles of health equity, justice and decolonization into her career development, her research, and her collaborations.


    She is an active member of the Nigeria Implementation Science Alliance (known as NISA) and the NIH Adolescent HIV Implementation Science Alliance (AHISA). She also leads the Central and West Africa Implementation Science Alliance (CAWISA).


    Social Media Handles:

    • Twitter: @NASAdoc

    • Facebook: https://web.facebook.com/garifoto

    • LinkedIn: https://www.linkedin.com/in/nasamagudu/

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    1 hr and 4 mins
  • Implementing the Demands of Justice: Considering Power in Implementation Processes with Megan Stanton, PhD, MSW
    Jan 9 2023

    We are making huge strides in preventing and managing HIV and AIDS over the last two decades. According to UNAIDS, new HIV infections decreased by over 50% since their peak in 1996.

    In spite of the breakthroughs, these conditions continue to impact over a million people in the United States alone. Over 10 percent are not even aware of their status.

    Further, these diseases still disproportionately affect certain populations. According to the CDC, in 2019, nearly 500,000 black or African American adults and teens were diagnosed with HIV, accounting for the highest prevalence rate among races or ethnicities. About 13% of them were undiagnosed before the pandemic.

    Playing a huge role in the discrepancy is health inequality. For example, blacks and Latinos are still more likely to be uninsured than whites despite the Affordable Care Act (ACT).

    The government, from the federal to the local, implements many policies and programs to bridge or even close the gap. But not all succeed because it lacks an essential component: an implementation process grounded on collaboration and a unified goal of breaking down barriers that support health inequality, such as structural racism.

    To help us understand this point, I sat down with Dr. Megan Stanton, a social work assistant professor at Eastern Connecticut State University. She is also the director of research and evaluation at the Sustained Compass Coordinating Center.

    Finally, she helped founded the Collective for Community Action, which champions implementation science in their work toward systemic transformation to eliminate health disparities.

    To say that this conversation is deep and aspirational is an understatement. I strongly encourage you to sit down with us and listen.

    In This Episode:
    • Know the definition of the normalization process
    • Learn how being white benefits from the status quo, making it one of the biggest obstacles to change, and how race can turn everything around
    • Unpack how addressing the power structure can spearhead and sustain intervention implementation
    • Hear implementation "in action" through the work of the advocacy group
    Guest Bio:

    Megan Stanton, MSW, PhD (she/her) is the Director of Research and Evaluation at the SUSTAIN COMPASS Coordinating Center and an Assistant Professor of Social Work at Eastern Connecticut State University. She is a founding member of the Collective for Community Action which is a collective of healing-centered scholars, activists, and community members working in the field of HIV. Her research interests include equity centered implementation science, health justice and inequity, community-led and multilevel health interventions, and the implementation of trauma informed care and harm reduction approaches in HIV service organizations. She completed a PhD in Social Welfare at the University of Pennsylvania School of Social Policy and Practice and a Master of Social Work at the University of Connecticut. Dr. Stanton’s work is grounded in the ethics of community-based participatory research.

    Social media for the Collective for Community Action:

    Instagram: @collectiveforcommunityaction

    https://www.instagram.com/collectiveforcommunityaction/

    Facebook: @CollectiveforCommunityAction

    ​​https://www.facebook.com/CollectiveforCommunityAction/

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    1 hr and 11 mins