WEBVTT 00:00:00.000 --> 00:00:02.500 Hey y 'all, welcome to Questions You Didn't Ask. 00:00:02.839 --> 00:00:07.179 Did you know that this very spot could be showcasing 00:00:07.179 --> 00:00:10.320 your business or event? Whether it's an audio 00:00:10.320 --> 00:00:14.460 ad on our podcast, or a visual ad on our new 00:00:14.460 --> 00:00:18.100 YouTube station, or even both, we've got the 00:00:18.100 --> 00:00:21.620 space for you. Nyesha Frey Consulting is reaching 00:00:21.620 --> 00:00:24.420 a growing audience of over a thousand leaders 00:00:24.420 --> 00:00:27.839 who are passionate about health equity, social 00:00:27.839 --> 00:00:32.070 justice, and civil rights activism. These are 00:00:32.070 --> 00:00:35.329 professionals just like you working across higher 00:00:35.329 --> 00:00:40.409 education, research, healthcare, nonprofit, government, 00:00:40.590 --> 00:00:44.030 and even public health sectors. If you're ready 00:00:44.030 --> 00:00:46.630 to get your message in front of a dedicated and 00:00:46.630 --> 00:00:52.469 engaged audience, send me an email at naishafrayconsultingllc 00:00:52.469 --> 00:00:57.149 at gmail .com. Let's talk about how we can help 00:00:57.149 --> 00:00:59.710 you connect with the people who need to hear 00:00:59.710 --> 00:01:02.810 about your services and products that advance 00:01:02.810 --> 00:01:06.969 health equity and wellness. Don't miss out. Get 00:01:06.969 --> 00:01:09.269 in the mix and let's make an impact together. 00:01:25.390 --> 00:01:28.219 Welcome back to Questions You Didn't Ask. I'm 00:01:28.219 --> 00:01:31.480 Nyisha Frey. Today, I'm joined by Dr. Shanita 00:01:31.480 --> 00:01:34.719 Randolph and Dr. Reagan Johnson from Duke University 00:01:34.719 --> 00:01:37.879 School of Nursing. Together, we're diving into 00:01:37.879 --> 00:01:40.879 how stylists and community spaces are changing 00:01:40.879 --> 00:01:44.700 the story of HIV prevention. This is Doing It 00:01:44.700 --> 00:01:47.420 For Ourselves. Let's get into it. One thing that 00:01:47.420 --> 00:01:50.159 I have appreciated, you know, watching and listening 00:01:50.159 --> 00:01:56.579 to you, Reagan, is how you will point out the 00:01:56.579 --> 00:02:00.920 reality of what it's like to actually be a practitioner, 00:02:01.099 --> 00:02:03.739 right? Whether that has to do with time, whether 00:02:03.739 --> 00:02:06.180 it has to do with policy, whether that has to 00:02:06.180 --> 00:02:08.840 do with patient engagement, right? In terms of 00:02:08.840 --> 00:02:11.400 conversations and communication, like what's 00:02:11.400 --> 00:02:15.319 realistically going to happen when this thing 00:02:15.319 --> 00:02:18.199 gets implemented, right? And so, and research. 00:02:18.919 --> 00:02:20.500 You know, one of the things that I love about 00:02:20.500 --> 00:02:23.000 it is that it's so creative. You can be so creative. 00:02:23.099 --> 00:02:27.099 Right. And sometimes we have, you know, research 00:02:27.099 --> 00:02:30.539 that is so creative and so innovative and so, 00:02:30.539 --> 00:02:35.719 you know, unique that it doesn't fit. It doesn't 00:02:35.719 --> 00:02:40.419 fit in real life. It's a great idea. And if you 00:02:40.419 --> 00:02:43.400 were able to replicate those conditions in every 00:02:43.400 --> 00:02:45.419 community, then that would be awesome. But that 00:02:45.419 --> 00:02:48.879 might not actually be our live reality. And I 00:02:48.879 --> 00:02:51.659 see you pulling that into the conversation oftentimes. 00:02:52.840 --> 00:02:55.099 Exactly. Because you have to think about, can 00:02:55.099 --> 00:02:58.080 it be realistically done? And then also, can 00:02:58.080 --> 00:03:01.180 it be realistically sustained? Because anybody 00:03:01.180 --> 00:03:04.639 will take your $25 gift card or your $50 gift 00:03:04.639 --> 00:03:07.379 card and do it for the six weeks or the six months 00:03:07.379 --> 00:03:11.219 of a program or a project. But can it become 00:03:11.219 --> 00:03:15.020 a part of your daily practice? That's the question. 00:03:15.240 --> 00:03:18.599 And so you have to design these things that It 00:03:18.599 --> 00:03:21.460 translates to the provider. Are they willing 00:03:21.460 --> 00:03:24.280 to do it? Is this something that, forget time, 00:03:24.599 --> 00:03:28.419 will they even do it, period? And then for the 00:03:28.419 --> 00:03:30.900 end user, the patient, does the patient want 00:03:30.900 --> 00:03:35.460 it? That part. And how do they want it? And how 00:03:35.460 --> 00:03:39.460 does that align with the research that these 00:03:39.460 --> 00:03:42.699 great innovations and interventions, is this 00:03:42.699 --> 00:03:44.300 something that the patient wants in this way? 00:03:44.840 --> 00:03:47.919 Yeah. And I do think that that's an important 00:03:47.919 --> 00:03:51.659 point to make in regard to what makes this dynamic 00:03:51.659 --> 00:03:55.300 duo so special and what makes this heat lab so 00:03:55.300 --> 00:03:57.919 effective. We've talked a lot about research. 00:03:58.000 --> 00:04:00.699 We've talked a lot about practice. And Shanita, 00:04:00.699 --> 00:04:05.960 you picked up on one of the limitations of research, 00:04:06.080 --> 00:04:08.819 which is that it oftentimes takes so long to 00:04:08.819 --> 00:04:11.419 translate, right? You said 17 years. I mean, 00:04:11.439 --> 00:04:13.439 there's some marriages that don't last that long, 00:04:13.500 --> 00:04:17.339 right? So, you know, you want to talk about commitment. 00:04:22.730 --> 00:04:25.209 Even with the power of research, the creativity 00:04:25.209 --> 00:04:28.050 of research, what are some of the other limitations 00:04:28.050 --> 00:04:31.250 of academic approaches to advancing health equity 00:04:31.250 --> 00:04:40.230 that you have seen in your work? So many. The 00:04:40.230 --> 00:04:42.649 community, particularly, and I'm speaking from 00:04:42.649 --> 00:04:45.410 the lens of community engaged research, because 00:04:45.410 --> 00:04:47.870 that's what we do in the HEAT Lab, right? We 00:04:47.870 --> 00:04:50.110 want to address these issues through equity, 00:04:50.250 --> 00:04:54.199 engagement, advocacy, and trust. If there is 00:04:54.199 --> 00:04:56.720 a problem, I'll give example on gun violence. 00:04:57.339 --> 00:05:01.420 The community, their thought is boots on the 00:05:01.420 --> 00:05:04.600 ground. Let's fix this problem. Like let's address 00:05:04.600 --> 00:05:09.060 it. They're mobilizing grassroots efforts, making 00:05:09.060 --> 00:05:13.899 things happen, right? And being creative, being 00:05:13.899 --> 00:05:17.959 innovative in that space right now. It doesn't 00:05:17.959 --> 00:05:23.050 align with academia. Right. And so we got to 00:05:23.050 --> 00:05:26.329 write papers about it. We got to prove that we 00:05:26.329 --> 00:05:29.009 we're worthy of it. We got to go to conferences, 00:05:29.170 --> 00:05:32.610 national and international. Again, the pilot 00:05:32.610 --> 00:05:35.889 of the pilot. So I think that is a limitation 00:05:35.889 --> 00:05:39.269 in some of our structures and our systems, even 00:05:39.269 --> 00:05:42.470 from our regulatory, from our institutional review 00:05:42.470 --> 00:05:46.089 boards. You know, we have to make sure that things 00:05:46.089 --> 00:05:49.850 are done ethically. morally right. And although 00:05:49.850 --> 00:05:53.910 that is good, I think what we have done is created 00:05:53.910 --> 00:05:57.790 systems, though, that are making it more challenging. 00:05:58.529 --> 00:06:03.110 We made our good be evil spoken of, you know, 00:06:03.149 --> 00:06:06.410 even when it comes to engaging, you know, the 00:06:06.410 --> 00:06:09.850 community. And maybe if we're giving compensations, 00:06:09.850 --> 00:06:12.569 like we need their social security number, right? 00:06:13.899 --> 00:06:16.220 You're asking immigrants or you're asking communities 00:06:16.220 --> 00:06:18.920 of color to give their social security number 00:06:18.920 --> 00:06:23.300 for participating in the research project. I'll 00:06:23.300 --> 00:06:27.139 pause. There's already a trust issue, right? 00:06:27.220 --> 00:06:30.319 I give my social security number to no one. So 00:06:30.319 --> 00:06:32.839 one thing we do in the heat lab is there are 00:06:32.839 --> 00:06:35.540 opportunities to waive that for certain amounts. 00:06:35.939 --> 00:06:39.819 And so we have. found some ways to bypass that. 00:06:39.959 --> 00:06:42.339 But it's things like that I think that are in 00:06:42.339 --> 00:06:45.860 our systems and in the structure on the academic 00:06:45.860 --> 00:06:49.579 side that we have good intentions on regulatory, 00:06:50.079 --> 00:06:53.199 but our good intentions have also caused a lot 00:06:53.199 --> 00:06:57.519 of barriers and limitations. I think the other 00:06:57.519 --> 00:07:01.540 limitation is how we disseminate that information 00:07:01.540 --> 00:07:05.660 back to the community. And, you know, community 00:07:05.660 --> 00:07:07.819 saying that, you know, I've been a part of this 00:07:07.819 --> 00:07:11.579 research, but I never heard what happened. Like, 00:07:11.600 --> 00:07:15.620 so how do you close that loop and make sure that 00:07:15.620 --> 00:07:18.079 the research that people are participating, that 00:07:18.079 --> 00:07:21.240 they know what's next? And we are very intentional 00:07:21.240 --> 00:07:23.740 about doing that in the heat lab. But that becomes 00:07:23.740 --> 00:07:26.519 a limitation because the next study, the person 00:07:26.519 --> 00:07:29.240 doesn't really they don't see what are you doing? 00:07:30.839 --> 00:07:33.959 How is this really impacting my day to day? And 00:07:33.959 --> 00:07:37.379 I think that there are more strategies that we 00:07:37.379 --> 00:07:40.139 need to have to stop some of those limitations. 00:07:40.819 --> 00:07:44.680 Funding sources bring limits. You know, like 00:07:44.680 --> 00:07:46.819 you can pay for this, but you can't do that. 00:07:47.339 --> 00:07:51.199 Yeah, it's even for community engagement. Like 00:07:51.199 --> 00:07:53.839 if you get federally funded, you can't use any 00:07:53.839 --> 00:07:56.920 of that money on like a venue space. You can't 00:07:56.920 --> 00:08:00.899 use it on food. For the community, you need to 00:08:00.899 --> 00:08:05.040 feed them. Yeah. So the limitations go on and 00:08:05.040 --> 00:08:09.360 on and on and on and on. I've had quite a few, 00:08:09.620 --> 00:08:15.379 but we are working around them. But yeah, a lot 00:08:15.379 --> 00:08:18.379 can be done. Right. And Reagan, you know, from 00:08:18.379 --> 00:08:21.120 your perspective, you know, looking at it as 00:08:21.120 --> 00:08:24.519 a doctor of nursing practice, how would you say 00:08:24.519 --> 00:08:27.980 these limitations affect practice and health 00:08:27.980 --> 00:08:31.879 outcomes? Like with academic research. Yeah, 00:08:31.939 --> 00:08:34.440 because like you said, it's a 17 -year gap, right? 00:08:34.519 --> 00:08:37.419 At least a 17 -year gap. Well, medicine changes 00:08:37.419 --> 00:08:42.299 like almost weekly. So in 17 years, whatever 00:08:42.299 --> 00:08:44.960 you came up with then, no matter, no more, because 00:08:44.960 --> 00:08:47.899 we're doing something different now, it's outdated. 00:08:48.220 --> 00:08:50.860 A lot of it never even gets there. By the time 00:08:50.860 --> 00:08:53.419 it gets there, it's outdated, right? And so that 00:08:53.419 --> 00:08:56.720 has huge implications for health outcomes because 00:08:56.720 --> 00:09:00.559 patients are dealing with outdated ideas. Look 00:09:00.559 --> 00:09:05.539 at AI, for instance. We're seeing a huge shift 00:09:05.539 --> 00:09:07.759 to AI. And as Shanita said, the community is 00:09:07.759 --> 00:09:11.120 already using AI, looking up their own, diagnosing 00:09:11.120 --> 00:09:15.519 themselves with AI. And healthcare is behind 00:09:15.519 --> 00:09:18.940 the game on it. 50 % of the people are resistant 00:09:18.940 --> 00:09:22.000 to using it. The other 50 % don't know how to 00:09:22.000 --> 00:09:25.059 use it, even if they wanted to. So this stopgap. 00:09:25.370 --> 00:09:28.309 between what we think, even what we think we 00:09:28.309 --> 00:09:31.549 need or what could be created and the time it 00:09:31.549 --> 00:09:34.409 takes to get there. So I think what we're doing 00:09:34.409 --> 00:09:39.190 helps that because we're shortening that time 00:09:39.190 --> 00:09:42.549 tremendously. So if we write a paper for an academic 00:09:42.549 --> 00:09:44.730 journal, we're also trying to write one for a 00:09:44.730 --> 00:09:47.889 practice journal so that practice folks can see 00:09:47.889 --> 00:09:49.889 it in real time because their practice people 00:09:49.889 --> 00:09:52.509 aren't reading as much research journals. You 00:09:52.509 --> 00:09:53.950 know, they're going to read stuff about practice. 00:09:54.539 --> 00:09:56.419 If we put out something, we want to put it out 00:09:56.419 --> 00:10:00.460 for research, practice and the community. So 00:10:00.460 --> 00:10:03.980 this three pronged approach. Right. And so you're 00:10:03.980 --> 00:10:06.580 turning yourselves into little octopi, if I'm 00:10:06.580 --> 00:10:09.840 saying that correctly. But, you know, the point 00:10:09.840 --> 00:10:11.419 is, is that that's one of the reasons why you 00:10:11.419 --> 00:10:14.379 have a lab. Right. You have multiple people working 00:10:14.379 --> 00:10:18.620 collectively with shared values and unique expertise 00:10:18.620 --> 00:10:22.139 to help drive that work forward in an effective 00:10:22.139 --> 00:10:25.480 fashion. And so when we think about that, you 00:10:25.480 --> 00:10:27.899 know, we kind of talked around health equity. 00:10:28.059 --> 00:10:30.580 Like, I think my audience knows what health equity 00:10:30.580 --> 00:10:33.639 is because, you know, I talk about it in every 00:10:33.639 --> 00:10:37.559 single episode. But if you could share with my 00:10:37.559 --> 00:10:40.179 audience a little bit more about, you know, how 00:10:40.179 --> 00:10:43.179 does it show up in your day -to -day work? What 00:10:43.179 --> 00:10:45.559 is health equity to you and how does it show 00:10:45.559 --> 00:10:48.379 up in your work, you know, when you're doing 00:10:48.379 --> 00:10:53.529 research or teaching even? So health equity for 00:10:53.529 --> 00:10:57.590 me is the basis from which I operate. Right. 00:10:57.690 --> 00:11:00.450 So if I'm going to be delivering health care, 00:11:00.549 --> 00:11:02.610 then I need to do it in a way that that is true 00:11:02.610 --> 00:11:06.370 to myself and my moral compass. So I say I am 00:11:06.370 --> 00:11:08.470 a North Star and that's health equity and that's 00:11:08.470 --> 00:11:11.090 to treat everybody in the way that they need. 00:11:11.659 --> 00:11:14.639 Right. Oftentimes we think equity means equality, 00:11:15.019 --> 00:11:17.519 that everybody gets the same treatment and that's 00:11:17.519 --> 00:11:20.960 not equitable. And some people move forward into 00:11:20.960 --> 00:11:23.860 health justice. Right. Ensuring that everybody 00:11:23.860 --> 00:11:26.379 gets the very specific thing that they need in 00:11:26.379 --> 00:11:28.740 order to reach the place that they need to be. 00:11:28.820 --> 00:11:31.059 And I think that's where we should be moving. 00:11:31.299 --> 00:11:34.340 I think that requires a lot of, like Shanita 00:11:34.340 --> 00:11:38.620 said, policy and audit. We may not be there yet, 00:11:38.679 --> 00:11:42.580 but what we can do individually. is ensure that 00:11:42.580 --> 00:11:47.039 we're operating from this idea that we use this 00:11:47.039 --> 00:11:50.440 framework, five W's of health equity and research 00:11:50.440 --> 00:11:54.080 of these principles that ask these questions 00:11:54.080 --> 00:11:56.899 of what does this mean for the community? Who's 00:11:56.899 --> 00:11:59.820 involved? Where are you doing this research? 00:12:00.320 --> 00:12:02.899 I can't think of the other W's right now, but 00:12:02.899 --> 00:12:05.360 there's this foundation that we operate from 00:12:05.360 --> 00:12:10.169 to say we can check ourselves, really. To say, 00:12:10.309 --> 00:12:13.450 okay, what are we missing? Who's not at the table? 00:12:14.169 --> 00:12:18.649 And how do we correct it in real time? And just 00:12:18.649 --> 00:12:21.210 to help our audience and fill in the gaps before 00:12:21.210 --> 00:12:25.330 I move over to Shanita is, you know, exactly 00:12:25.330 --> 00:12:27.409 what you're saying. Just kind of checking ourselves, 00:12:27.990 --> 00:12:30.990 right? Checking in with ourselves from our values, 00:12:31.389 --> 00:12:34.649 right? And being consistent in terms of looking 00:12:34.649 --> 00:12:38.529 at the patient that you serve and thinking about. 00:12:39.049 --> 00:12:42.289 If I'm making a decision or I'm having a practice, 00:12:42.549 --> 00:12:44.789 I got to think about who is impacted by these 00:12:44.789 --> 00:12:48.549 decisions, what values and resources are prioritized, 00:12:48.649 --> 00:12:52.210 what are activities, where are activities, and 00:12:52.210 --> 00:12:55.110 why are they being conducted? And so those kind 00:12:55.110 --> 00:12:57.389 of, I just did a quick search and was able to 00:12:57.389 --> 00:13:00.870 fill in that gap of what the five W's of health 00:13:00.870 --> 00:13:04.309 equity are. And I just encourage everybody to 00:13:04.309 --> 00:13:07.029 look that up and get some more information about. 00:13:07.419 --> 00:13:10.460 Who benefits? Who is at the table? Who experiences 00:13:10.460 --> 00:13:13.360 the negative impacts of inequities? And what 00:13:13.360 --> 00:13:16.460 values or resources or access opportunities are 00:13:16.460 --> 00:13:20.019 being prioritized or neglected? When are research 00:13:20.019 --> 00:13:22.080 activities held? And does this create barriers 00:13:22.080 --> 00:13:24.600 for certain groups? When do the issues being 00:13:24.600 --> 00:13:26.820 addressed by the research occur in a person's 00:13:26.820 --> 00:13:30.100 life? Where are activities taking place? And 00:13:30.100 --> 00:13:32.399 the list goes on. So I'm not going to read them 00:13:32.399 --> 00:13:35.659 all. I encourage everyone else to lean in. But 00:13:35.659 --> 00:13:38.870 I do want to turn to... to Shanita and ask a 00:13:38.870 --> 00:13:42.610 similar question of how does health equity show 00:13:42.610 --> 00:13:44.490 up in your day -to -day efforts? And I thank 00:13:44.490 --> 00:13:47.610 you, Reagan, for bringing up the five W's. Yeah. 00:13:48.129 --> 00:13:50.629 You know, touching back on what Reagan said, 00:13:50.830 --> 00:13:54.210 right? Like I have this leadership framework 00:13:54.210 --> 00:13:57.509 of leading from the inside out, right? You're 00:13:57.509 --> 00:14:01.220 going to lead based on your values. When you 00:14:01.220 --> 00:14:04.519 think about health equity, what is it? It's giving 00:14:04.519 --> 00:14:08.600 people what they need to live healthy and to 00:14:08.600 --> 00:14:12.740 reach their full potential. Health equity isn't 00:14:12.740 --> 00:14:17.100 what I do. Health equity is who I am. As a leader, 00:14:17.379 --> 00:14:22.379 that's my belief, even in leading students or 00:14:22.379 --> 00:14:26.639 being a leader for a research project, is giving 00:14:26.639 --> 00:14:29.879 people the full potential. You know, given what 00:14:29.879 --> 00:14:32.879 they need to have that full potential to be healthy. 00:14:33.080 --> 00:14:37.059 And I think that one thing that we can do in 00:14:37.059 --> 00:14:39.120 this space is when we think about health equity 00:14:39.120 --> 00:14:43.139 is taking an opportunity to reflect inwardly 00:14:43.139 --> 00:14:46.440 and to add five W's, which, you know, we contribute 00:14:46.440 --> 00:14:49.320 that to Keisha Bentley Edwards and Nadine Barrett. 00:14:49.519 --> 00:14:53.659 They were two creators of the five W's and they 00:14:53.659 --> 00:14:56.259 co -authored that manuscript that your audience 00:14:56.259 --> 00:14:59.879 may take a look at. But how do we do that? And 00:14:59.879 --> 00:15:04.320 what is our why? Right. Because if you can truly 00:15:04.320 --> 00:15:09.379 reflect on that in times like these that we are 00:15:09.379 --> 00:15:12.980 experiencing and have been experiencing since 00:15:12.980 --> 00:15:17.320 January of this year, you're not easily shaken. 00:15:18.879 --> 00:15:22.259 You know, and I think that is a call to action 00:15:22.259 --> 00:15:25.460 for anyone that's doing health equity work. ask 00:15:25.460 --> 00:15:27.559 ourselves this question that you're asking us, 00:15:27.639 --> 00:15:30.620 like, how does this show up in our day -to -day 00:15:30.620 --> 00:15:34.919 efforts? And it shows up internally in everything 00:15:34.919 --> 00:15:38.700 that, that I aim to do. And so therefore it's 00:15:38.700 --> 00:15:41.200 easy for it to show up when we're doing a research 00:15:41.200 --> 00:15:45.820 project to ask the community, what do you think 00:15:45.820 --> 00:15:47.679 about this and how do we need to shift this? 00:15:48.299 --> 00:15:51.480 And then actually do what they say, right? And 00:15:51.480 --> 00:15:54.720 actually do it. You know, there are pieces. Our 00:15:54.720 --> 00:15:58.679 project that has shifted, have changed in the 00:15:58.679 --> 00:16:01.580 middle of things because the community, our advisory 00:16:01.580 --> 00:16:06.840 council members, women have told us, no, that's 00:16:06.840 --> 00:16:08.539 not going to work out here in these streets. 00:16:09.980 --> 00:16:14.559 Literally. Scientific rigor was strong. There 00:16:14.559 --> 00:16:17.779 you go. It didn't translate. If you're enjoying 00:16:17.779 --> 00:16:20.940 the show as much as we love creating it, consider 00:16:20.940 --> 00:16:24.370 showing your support. By buying us a cup of coffee, 00:16:24.490 --> 00:16:30.250 visit buymeacoffee .com slash Nyesha Frey O. 00:16:30.690 --> 00:16:37.690 That's buymeacoffee .com forward slash Nyesha 00:16:37.690 --> 00:16:43.029 Frey O. All one word. Each cup is just $5 and 00:16:43.029 --> 00:16:46.230 every single one helps us continue to produce, 00:16:46.549 --> 00:16:49.830 develop, and sustain the high quality content. 00:16:50.240 --> 00:16:52.840 you've come to expect from questions you didn't 00:16:52.840 --> 00:16:56.360 ask. Thank you for your continued support. And 00:16:56.360 --> 00:17:00.000 let's keep the conversation going. Right. So, 00:17:00.100 --> 00:17:02.159 you know, I'm going to, you know, we talked about, 00:17:02.200 --> 00:17:04.799 you know, academia, the limitations and things 00:17:04.799 --> 00:17:07.000 like that. And we also talked about, you know, 00:17:07.019 --> 00:17:09.720 translating to community. And one thing that 00:17:09.720 --> 00:17:12.279 we know is that, you know, it takes money to 00:17:12.279 --> 00:17:14.960 do research and it takes money to create systems 00:17:14.960 --> 00:17:19.519 change. Right. So. We know the times that we're 00:17:19.519 --> 00:17:22.779 in right now, it's, you know, health equity, 00:17:22.960 --> 00:17:25.440 diversity, equity, inclusion have turned into 00:17:25.440 --> 00:17:30.500 target words, right? Words that have been targeted 00:17:30.500 --> 00:17:33.980 by our current 47th Executive Federal Administration 00:17:33.980 --> 00:17:38.200 to dissuade people from going down this path, 00:17:38.440 --> 00:17:45.230 right? It's also, though, this conundrum of health 00:17:45.230 --> 00:17:47.950 equity is, at least for my audience, is seen 00:17:47.950 --> 00:17:50.170 as a moral thing. You know, you guys have talked 00:17:50.170 --> 00:17:53.349 about how it's a moral issue, but it's also economic. 00:17:53.509 --> 00:17:55.809 And you mentioned Dr. Keisha Bentley Edwards. 00:17:55.950 --> 00:17:58.650 She is talking about the connection between health 00:17:58.650 --> 00:18:01.329 equity and economic justice on one of my previous 00:18:01.329 --> 00:18:04.809 series. And so how do you communicate the value 00:18:04.809 --> 00:18:09.819 of equity to funders and institutions? Or does 00:18:09.819 --> 00:18:15.519 it shape who you go to for funding and institutions? 00:18:18.240 --> 00:18:21.359 Yeah, I think it's both. You know, in moving 00:18:21.359 --> 00:18:23.160 forward, I think that's one of the things that 00:18:23.160 --> 00:18:25.400 I've been thinking about personally and professionally 00:18:25.400 --> 00:18:30.619 with the Heat Lab is bringing on a business collaborator. 00:18:30.759 --> 00:18:34.480 I think a lot of what we do in this space. has 00:18:34.480 --> 00:18:36.940 lots of limits because of the lenses in which 00:18:36.940 --> 00:18:40.980 we have been educated on how to address these 00:18:40.980 --> 00:18:44.019 issues, right? And so partnering and collaborating 00:18:44.019 --> 00:18:46.960 with business and entrepreneurs, I think, is 00:18:46.960 --> 00:18:50.759 key. You know, understanding the communicating, 00:18:50.759 --> 00:18:54.079 I think, with funders. Like, for example, you 00:18:54.079 --> 00:18:58.339 know, where we are now, and even in this project, 00:18:58.359 --> 00:19:00.140 we've had people to ask us, why are you just 00:19:00.140 --> 00:19:03.579 focusing on Black women? Not only Black women. 00:19:04.619 --> 00:19:07.740 There's an economic piece to that, right? So 00:19:07.740 --> 00:19:11.039 if we can fix some of the barriers and the gaps 00:19:11.039 --> 00:19:15.359 for what is known and has been known for populations 00:19:15.359 --> 00:19:18.500 who have the worst outcomes, what we are doing 00:19:18.500 --> 00:19:22.200 is that is a standard that we're fixing. But 00:19:22.200 --> 00:19:24.299 we're also, by fixing that, we're fixing it for 00:19:24.299 --> 00:19:28.480 everybody. Right? And so we're saving money. 00:19:29.799 --> 00:19:33.359 So if you can address the people and populations 00:19:33.359 --> 00:19:36.299 within a system that have the worst outcomes, 00:19:36.680 --> 00:19:40.980 you are fixing the worst things about that organization 00:19:40.980 --> 00:19:43.859 or about that system. And whenever you do that, 00:19:43.900 --> 00:19:46.779 you're saving that system money. You're creating 00:19:46.779 --> 00:19:49.059 better outcomes for everyone who comes across 00:19:49.059 --> 00:19:52.299 that system. So I know for me, I'm wanting to 00:19:52.299 --> 00:19:56.799 increase and show the dynamics of what that looks 00:19:56.799 --> 00:20:00.829 like from a financial perspective. Yeah. Reagan, 00:20:00.910 --> 00:20:03.009 do you have any thoughts on that in terms of 00:20:03.009 --> 00:20:06.809 the economic translation of health equity research 00:20:06.809 --> 00:20:10.750 and how it plays into funding and things like 00:20:10.750 --> 00:20:14.349 that? Yeah, I think for this, you've already 00:20:14.349 --> 00:20:16.289 mentioned this current administration and the 00:20:16.289 --> 00:20:19.130 cuts that have been made to government funding 00:20:19.130 --> 00:20:23.950 for health equity research or the buzzwords of 00:20:23.950 --> 00:20:27.089 DEI and all of that. I think what's interesting 00:20:27.089 --> 00:20:31.700 is. academia itself prioritized this government 00:20:31.700 --> 00:20:36.599 funding, right? You weren't really, you were 00:20:36.599 --> 00:20:39.539 a better researcher if you get these high -level 00:20:39.539 --> 00:20:42.539 grants from the government, right? But now that 00:20:42.539 --> 00:20:45.680 everybody's scrambling to get funding, economic 00:20:45.680 --> 00:20:50.559 equity, and we're looking outside of those, and 00:20:50.559 --> 00:20:52.519 there's always been foundation grants and that 00:20:52.519 --> 00:20:56.289 kind of thing. typically aligned. I think now's 00:20:56.289 --> 00:20:59.890 an opportunity for us to look to organizations, 00:21:00.390 --> 00:21:04.049 large organizations and places who've not traditionally 00:21:04.049 --> 00:21:08.609 been stewards in that way. And how can they take 00:21:08.609 --> 00:21:11.329 some of their philanthropy dollars and open up 00:21:11.329 --> 00:21:16.630 grant funding? So the NBA, the NBA, how can they 00:21:16.630 --> 00:21:22.759 get into funding grants for Really, their base. 00:21:23.220 --> 00:21:27.279 These are predominantly black leagues. We have 00:21:27.279 --> 00:21:29.599 to prioritize health and maybe they have a specific 00:21:29.599 --> 00:21:32.980 way that they want to fund certain health projects. 00:21:33.200 --> 00:21:35.720 But can we be looking at all of these other businesses, 00:21:35.839 --> 00:21:39.039 like Shanita said, these large organizations 00:21:39.039 --> 00:21:41.940 that could be given money and really funding 00:21:41.940 --> 00:21:46.900 this work? And I'll just add, you know, the heat 00:21:46.900 --> 00:21:51.900 lab, we have industry. private, public, and foundation 00:21:51.900 --> 00:21:55.460 funding, and also through philanthropy, through 00:21:55.460 --> 00:21:59.420 our work with the PhD nurse scientist program. 00:21:59.740 --> 00:22:02.279 But the other piece, too, just sort of to add 00:22:02.279 --> 00:22:05.200 to that is this is an opportunity for us also 00:22:05.200 --> 00:22:08.339 to redefine in higher education what impact looks 00:22:08.339 --> 00:22:12.380 like and how we create that impact, because we 00:22:12.380 --> 00:22:15.500 have created a structure that says to us as scientists 00:22:15.500 --> 00:22:20.059 in higher institutions, That to be successful, 00:22:20.359 --> 00:22:23.119 you have to have federal funding from the NIH. 00:22:23.279 --> 00:22:27.140 That's what we've said. Right. Or NSF. Right. 00:22:27.640 --> 00:22:31.359 Right. And I think what it does is it puts limitations 00:22:31.359 --> 00:22:35.960 on our creativity and our innovation as scientists, 00:22:36.059 --> 00:22:39.519 because at some point what you are doing then, 00:22:39.559 --> 00:22:44.839 if you're not careful, is you start chasing the 00:22:44.839 --> 00:22:51.359 academic promotion tenure. Yes. You're not careful 00:22:51.359 --> 00:22:55.740 and forget about why you actually went into this 00:22:55.740 --> 00:22:57.660 space in the first place. And so I think it's 00:22:57.660 --> 00:23:00.140 an opportunity to challenge higher education 00:23:00.140 --> 00:23:05.299 to rethink what impact looks like and how people 00:23:05.299 --> 00:23:10.599 are measured by success and promotion. Making 00:23:10.599 --> 00:23:14.859 sure that what that criteria is, that it truly 00:23:14.859 --> 00:23:22.160 aligns with what your mission is. I definitely 00:23:22.160 --> 00:23:24.859 get that. And I think that it's really important 00:23:24.859 --> 00:23:29.240 to say that, you know, out loud, especially in 00:23:29.240 --> 00:23:32.599 the positions that you both hold as faculty at 00:23:32.599 --> 00:23:36.500 a top tier research, you know, institution that, 00:23:36.619 --> 00:23:40.220 you know, the way in which academia is structured, 00:23:40.259 --> 00:23:46.269 that it can create a system. that it incentivizes 00:23:46.269 --> 00:23:48.470 people to chase the money as opposed to chase 00:23:48.470 --> 00:23:52.130 the mission. Yes. And so we have an opportunity 00:23:52.130 --> 00:23:56.549 to shift that. And we've talked a lot about the 00:23:56.549 --> 00:23:59.230 Heat Lab, but now I want to lean into it a little 00:23:59.230 --> 00:24:01.730 bit more. Shanita, I want you to tell us, what 00:24:01.730 --> 00:24:06.430 does HEAT stand for? And what are some of the 00:24:06.430 --> 00:24:10.410 standout projects that you all have innovated 00:24:10.410 --> 00:24:15.539 in through the Heat Lab? Yes. And so HEAT is 00:24:15.539 --> 00:24:17.839 addressing health disparities through engagement, 00:24:18.059 --> 00:24:21.299 equity, advocacy, and trust. You might want to 00:24:21.299 --> 00:24:24.339 take this out, but AI has caused me to think 00:24:24.339 --> 00:24:28.440 that there are other ways. There are other ways 00:24:28.440 --> 00:24:31.220 that we can actually make HEAT sound a little 00:24:31.220 --> 00:24:35.660 better. I'm thinking about how we can revise 00:24:35.660 --> 00:24:39.500 HEAT. But I like it. I like it the way it is. 00:24:39.640 --> 00:24:41.920 So let's say it again for the audience with our 00:24:41.920 --> 00:24:45.079 full chest. Addressing health disparities through 00:24:45.079 --> 00:24:49.920 engagement, equity, advocacy and trust. And a 00:24:49.920 --> 00:24:51.960 lot of our work, again, has been partnering with 00:24:51.960 --> 00:24:55.180 the beauty industry, barbershops and beauty salons 00:24:55.180 --> 00:24:59.299 as trusted spaces in the community. One of the 00:24:59.299 --> 00:25:02.359 things that we have done in our beginning days 00:25:02.359 --> 00:25:05.960 was addressing sexual health among adolescent 00:25:05.960 --> 00:25:10.069 males. and the engagement of their fathers. Partnered 00:25:10.069 --> 00:25:14.789 with two barbershops and two barber owners to 00:25:14.789 --> 00:25:18.529 co -create The Talk, which is an intervention 00:25:18.529 --> 00:25:21.190 that focuses on parent -adolescent sexual health 00:25:21.190 --> 00:25:25.529 communications. We have created podcasts, talk 00:25:25.529 --> 00:25:28.690 conversation cards, which we are excited about 00:25:28.690 --> 00:25:31.789 those and moving forward with those. People are 00:25:31.789 --> 00:25:33.910 actually using them now. So these are conversation 00:25:33.910 --> 00:25:37.180 cards that... give the opportunity for parents, 00:25:37.220 --> 00:25:40.240 adolescents, or for peers of adolescents to just 00:25:40.240 --> 00:25:43.859 have conversations around sexual health. And 00:25:43.859 --> 00:25:46.140 then our work also focuses on Black women in 00:25:46.140 --> 00:25:49.319 HIV. We have co -created with the community using 00:25:49.319 --> 00:25:51.759 PrEP, doing it for ourselves, protective styles, 00:25:51.960 --> 00:25:55.380 which is updos, which is a three -part intervention 00:25:55.380 --> 00:25:58.380 that focuses on bringing awareness and increasing 00:25:58.380 --> 00:26:02.079 the uptake of pre -exposure prophylaxis among 00:26:02.079 --> 00:26:06.269 Black women who currently are only like 1 % to 00:26:06.269 --> 00:26:08.950 2 % of the population who actually use PrEP. 00:26:09.430 --> 00:26:12.410 So that's what we've been doing in that space. 00:26:12.630 --> 00:26:15.710 We've done a couple of projects focused around 00:26:15.710 --> 00:26:21.250 COVID and preferences, barriers, and facilitators 00:26:21.250 --> 00:26:25.970 to testing in the Black community. And if we 00:26:25.970 --> 00:26:29.210 were to have another major pandemic, how best 00:26:29.210 --> 00:26:32.210 do we partner with the Black community to address 00:26:32.210 --> 00:26:37.019 those? those things as well. So there's a number 00:26:37.019 --> 00:26:39.859 of different topics and partners that you all 00:26:39.859 --> 00:26:42.619 have covered through the Heat Lab. I'll turn 00:26:42.619 --> 00:26:45.740 to you, Reagan. How do you decide what problems 00:26:45.740 --> 00:26:48.059 to tackle? I mean, when I think about the Black 00:26:48.059 --> 00:26:51.000 community or health equity, there's so many things 00:26:51.000 --> 00:26:54.940 that could be, you know, benefit from this type 00:26:54.940 --> 00:26:58.119 of collaborative research lab. But how do you 00:26:58.119 --> 00:27:01.700 all decide what problems to tackle? Yeah, that's 00:27:01.700 --> 00:27:04.579 a really, really good question. I think for me 00:27:04.579 --> 00:27:07.019 and I'll say Shanita as well, we both had very 00:27:07.019 --> 00:27:10.539 personal experiences with people living with 00:27:10.539 --> 00:27:13.579 HIV that we either knew or were close to in some 00:27:13.579 --> 00:27:17.759 type of way. And that kind of guided or gave 00:27:17.759 --> 00:27:21.319 me a direction that I initially wanted to go 00:27:21.319 --> 00:27:23.559 in. And then you go out into practice or you 00:27:23.559 --> 00:27:26.700 go out into the community and you see that. there's 00:27:26.700 --> 00:27:30.079 this gap that people don't necessarily understand 00:27:30.079 --> 00:27:32.400 that it's an issue or an issue for their community. 00:27:32.720 --> 00:27:37.880 And so I think that's been one of the kind of 00:27:37.880 --> 00:27:41.079 lampposts that we've used to choose a topic. 00:27:41.240 --> 00:27:44.299 I know that Shanita says this all the time that 00:27:44.299 --> 00:27:47.500 HIV is where we are right now, but we have an 00:27:47.500 --> 00:27:51.720 opportunity to expand that. And once you find 00:27:51.720 --> 00:27:56.220 that your method works. Right. Then you can expand 00:27:56.220 --> 00:27:59.380 that to other topics that people need. I'll give 00:27:59.380 --> 00:28:02.000 you an example. Some of our earlier work, we 00:28:02.000 --> 00:28:04.839 asked women, you know, I think that's another 00:28:04.839 --> 00:28:07.019 major way, like thinking about what position 00:28:07.019 --> 00:28:08.759 you want to make in the world and then asking 00:28:08.759 --> 00:28:11.240 the community that you're interested, what they 00:28:11.240 --> 00:28:14.220 want. And some of that came back up. Hey, yeah, 00:28:14.319 --> 00:28:16.599 we're interested in HIV prevention and sexual 00:28:16.599 --> 00:28:19.900 health promotion, but we'd also like that couched. 00:28:20.140 --> 00:28:23.400 you know, within other health topics. So we want 00:28:23.400 --> 00:28:25.119 to know more about heart disease and we want 00:28:25.119 --> 00:28:27.160 to know more about this. And so we've been able 00:28:27.160 --> 00:28:31.980 to kind of fortify the project with this other 00:28:31.980 --> 00:28:36.339 information. So we're not just solely giving 00:28:36.339 --> 00:28:39.160 what we want them to have, but what they're asking 00:28:39.160 --> 00:28:43.559 for too. Yeah. And I left out community and firearm 00:28:43.559 --> 00:28:47.460 violence. Definitely not one of our priority 00:28:47.460 --> 00:28:51.230 things, but. What our theme is, is addressing 00:28:51.230 --> 00:28:53.009 health disparities through engagement, equity, 00:28:53.089 --> 00:28:55.029 advocacy, and trust, right? And so we did have 00:28:55.029 --> 00:28:58.710 a community partner who was a barber and a barbershop 00:28:58.710 --> 00:29:02.549 owner who helped to co -develop the talk. And 00:29:02.549 --> 00:29:06.490 so he circled back around as the founder of Establishing 00:29:06.490 --> 00:29:09.210 Safe Cultures and reached out to the Heat Lab 00:29:09.210 --> 00:29:12.890 to partner with them in their efforts to address 00:29:12.890 --> 00:29:16.750 gun violence in the community. And so through 00:29:16.750 --> 00:29:20.130 Rita and Alex Hillman Foundation, we were funded 00:29:20.130 --> 00:29:23.369 to partner with Establishing Safe Cultures to 00:29:23.369 --> 00:29:25.450 address some of these issues. And so we've been 00:29:25.450 --> 00:29:27.630 working with Establishing Safe Cultures as a 00:29:27.630 --> 00:29:30.609 partner for the last year to address firearm 00:29:30.609 --> 00:29:33.609 violence. And what that has looked like is really 00:29:33.609 --> 00:29:37.369 positioning ESC and partnering with them in such 00:29:37.369 --> 00:29:40.750 a way that they can build their infrastructure. 00:29:41.710 --> 00:29:45.109 be in positions to be ready for funding to support 00:29:45.109 --> 00:29:49.670 the sustainability and helping to inform their 00:29:49.670 --> 00:29:53.049 program in terms of some of the gaps in programming 00:29:53.049 --> 00:29:56.529 to prove that programming for the community throughout. 00:29:56.829 --> 00:30:00.049 And so, again, I think when you ask the question, 00:30:00.150 --> 00:30:03.609 how do we, you know, how do we approach this? 00:30:03.670 --> 00:30:06.829 That was a great example. I think that it was 00:30:06.829 --> 00:30:09.410 definitely through community partnership and 00:30:09.410 --> 00:30:12.859 them reaching out. to us for partnership. That 00:30:12.859 --> 00:30:15.619 was Questions You Didn't Ask, hosted by Nyesha 00:30:15.619 --> 00:30:18.460 Frey with Dr. Shanita Randolph and Dr. Regan 00:30:18.460 --> 00:30:21.579 Johnson. If you enjoyed this conversation, tap 00:30:21.579 --> 00:30:24.299 follow and leave a rating wherever you listen. 00:30:24.579 --> 00:30:29.140 Spotify, Apple Podcasts, YouTube Podcasts, Audible, 00:30:29.339 --> 00:30:34.279 Amazon Music, or nyeshafrey .com slash podcast. 00:30:34.759 --> 00:30:37.119 Share it with a friend who cares about health 00:30:37.119 --> 00:30:38.900 equity and community change.