Researcher Uses Health Literacy, Culture to Improve Communications

SPECIAL SERIES: WOMEN IN ONCOLOGY

Women faculty at Moffitt Cancer Center come from different backgrounds and cultures around the globe. Their areas of research and clinical care span the entire cancer continuum, including clinical science and trials, basic science, epidemiology, health outcomes, integrated mathematical oncology, biostatistics and more. Community involvement, mentorship and inclusion among faculty are foundational, and we celebrate the essential roles women play in making a difference at the cancer center and in society.

Describe your interest in health literacy and culture and why this focus is important to Moffitt’s mission?

Even before I came to Moffitt, I was interested in health literacy. As a nurse, I would see patients discard pamphlets and I wondered why. Figuring out how to make information digestible and visually interesting was intriguing. Besides health literacy, culture plays a role too in our communications. For example, taking time to appreciate peoples’ life experiences, considering the role that beliefs have on health and illness, and being alert to language and the meaning of words used. Together, culture and literacy are factors, which are important to the design of cancer communications and research interventions.

Do you see a translational research component to your area of work?

Yes, a translational component is part and parcel of my community-engaged work. A great deal of our team’s work is geared toward finding ways to increase colorectal cancer screening in community centers. Our work in community clinics has shown improvements in screening through education plus access to a simple fecal immunochemical test. Our current work, CARES REACH (Colorectal Cancer Awareness, Research, and Education and Screening-Rural Expansion, Access, and Capacity for Health) focuses on implementing a set of evidence-based features to hasten the adoption of colorectal cancer screening into practice in rural and urban clinics.

What drove you to your career path?

I have numerous nurses in my family and began my career in cardiac nursing. I was introduced to patient education when asked to teach cardiac classes. This led me to a medical center in Milwaukee where I developed the institution’s patient education program and first Heath Education Center. It was there that I first got a taste of team science by collaborating with physicians on smoking cessation and prostate/colorectal cancer screening intervention studies. I also had the unique opportunity to host a cable TV health show, which sparked my interest in how we could use the media as a health education communication tool. This interest has carried over my research at Moffitt today.

What is one of the biggest challenges in what you do today?

Disentangling the many factors that impact health disparities brings challenges, but also opportunities. We know that there are different things that influence health and behavior (like access, education, where people live, support networks and so on). To uncover and understand these factors, be co-learners with community members. When I reflect on the development of TBCCN, the first five years was mostly about building relationships and creating trustworthy partnerships. The foundation to tackle health disparities takes time.

How would you describe mentoring?

Mentoring is a ‘trusted’ learning relationship — it’s a highly supportive process. It involves guiding someone’s personal growth and career development through candid conversations and sharing of professional/life experiences. A mentoring relationship can be beneficial to both the mentor/mentee. I think of a mentor as a good listener, sounding board, encourager and motivator.

How would you encourage mentoring?

Mentoring can be encouraged in many ways and in many settings. It might be structured and formal with scheduled time blocks. Or it might emerge naturally and informally based on short-term needs and interests. Our lab works to create an environment where team members can learn from each other, making mentoring a shared responsibility among faculty, research staff and trainees at different career points. I see ‘mentoring at its best’ when team members collectively share ideas to help others grow.

How important is mentoring?

Very important. We all need mentors and we all should be mentors. We may think that the most important aspects of mentoring are imparting new knowledge and building research skills. Yet, what I hear and know is that one-on-one mentor time is the most valuable aspect. It could be a 45-minute discussion on a particular scientific problem, a 10-minute drop-in office conversation about a training opportunity, a phone/zoom chat to discuss a recent (happy or sad) life experience or a meet-up at a conference just to catch up. Making time for moments of conversation, even if brief, makes a difference. 

I believe there are two areas we could improve on. First, more mentor-mentee training so that mentor matches are identified, work well and have good synergy. And second, keeping a sharp eye on more mentoring efforts to increase and retain underrepresented students in science and health careers. This means being willing to be a mentor and role model, reaching out to your communities, schools and organizations to be a mentor. Or getting involved in Moffitt’s many training and education programs.

What mentor encouraged you the most in your career?

My early mentor was a nurse and a well-respected community leader in Milwaukee. We worked only for one year together, but our relationship lasted close to four decades (she died in 2020 of Alzheimer’s disease). I am thankful for all that she was able to teach me.  Her guidance and friendship were steadfast, instructive and nurturing. For some reason, she took me under her wing early on and helped me understand the value of community assets versus deficits. She shared her life experiences with me, took me to meetings and introduced me to leaders and community members so I could understand how community feedback is the glue of effective program development. She encouraged me to think more deeply about persistent factors that get in the way of good health like poverty, racism, discrimination or where you live in the city. She impacted my early understanding of health disparities and pushed me to relook at my own beliefs about the causes of health disparities. Her influence motivated my community-engaged work. Thank you, Jestene — I am forever grateful for knowing you.

What advice would you give to a young, new faculty member?

• Find balance each day, even if it is 10 minutes of quiet time in early morning or late at night.
• Take time to gather your thoughts. I do this a lot when I walk early in the morning. New ideas emerge, and you might just see an alligator, armadillo or falcon!
• Go for teamwork. You don’t need to know everything. You just need to know how to find the answers.
• Let others know the skills and unique knowledge you have. Share it with others.
• Find a trusted mentor, one who is honest, direct and genuine.