WEBVTT 00:00:13.630 --> 00:00:16.429 Hello, and welcome to Listen Up People, a podcast 00:00:16.429 --> 00:00:19.309 of the USC Suzanne Dworak -Peck School of Social 00:00:19.309 --> 00:00:22.250 Work. I'm Dr. Eric Rice, professor and associate 00:00:22.250 --> 00:00:24.649 dean for research. Today, we are going to be 00:00:24.649 --> 00:00:27.210 talking about social work and health interventions. 00:00:27.850 --> 00:00:30.050 When people think about social work and health, 00:00:30.410 --> 00:00:32.829 I think many of us think about hospital -based 00:00:32.829 --> 00:00:35.990 social workers. But my colleagues today are here 00:00:35.990 --> 00:00:38.490 to share about the health interventions that 00:00:38.490 --> 00:00:40.990 they work on that go beyond hospitals and medical 00:00:40.990 --> 00:00:44.280 facilities. to shine a light on how social determinants 00:00:44.280 --> 00:00:46.979 can impact health and how interventions can be 00:00:46.979 --> 00:00:49.759 developed to better reflect the context and cultures 00:00:49.759 --> 00:00:51.880 of people in need. So I have the pleasure of 00:00:51.880 --> 00:00:53.759 introducing two of my colleagues who are leading 00:00:53.759 --> 00:00:56.960 experts in this field. First, I'd like to introduce 00:00:56.960 --> 00:00:59.380 Dr. Jane Lee, who is an associate professor here 00:00:59.380 --> 00:01:02.719 at this school. and her colleague and my colleague, 00:01:02.820 --> 00:01:05.640 Dr. Shinhyi Wu, associate professor of social work 00:01:05.640 --> 00:01:08.340 and industrial systems engineering, and a senior 00:01:08.340 --> 00:01:11.780 scientist at the USC Edward R. Roybal Institute 00:01:11.780 --> 00:01:14.219 on Aging. It's wonderful to have you both here 00:01:14.219 --> 00:01:17.260 today. Welcome. Thank you. Thanks for having 00:01:17.260 --> 00:01:21.319 us. So I want to start off with a question that 00:01:21.319 --> 00:01:24.040 I ask most of my guests at the beginning of the 00:01:24.040 --> 00:01:27.480 episodes, which is, How did you get interested 00:01:27.480 --> 00:01:29.579 in doing this kind of work? So maybe I'll turn 00:01:29.579 --> 00:01:32.280 first to Shinyi and then to you, Jane. So Shinyi, 00:01:32.379 --> 00:01:35.420 how did you get interested in doing health intervention 00:01:35.420 --> 00:01:40.379 work? So this went back a long history. So I'm 00:01:40.379 --> 00:01:44.000 very interested in understanding how people do 00:01:44.000 --> 00:01:47.319 things differently, which has an impact in life 00:01:47.319 --> 00:01:50.439 and health happen to be the things I'm most interested 00:01:50.439 --> 00:01:53.439 in. In the early part of my career, I got to 00:01:53.439 --> 00:01:56.980 evaluate a model called chronic illness care 00:01:56.980 --> 00:02:00.700 model, which are implemented in healthcare system 00:02:00.700 --> 00:02:03.319 to help patients better manage their chronic 00:02:03.319 --> 00:02:07.319 illnesses. And we saw quite a bit of differences 00:02:07.319 --> 00:02:11.229 in how the clinics are implementing the model 00:02:11.229 --> 00:02:14.169 and how patients are benefiting from this new 00:02:14.169 --> 00:02:16.389 type of programs to better manage their health. 00:02:16.849 --> 00:02:20.430 So that got me into thinking about what are the 00:02:20.430 --> 00:02:23.569 variations. And I see clinics with less resources 00:02:23.569 --> 00:02:26.810 such as safety net clinics suffer them. They 00:02:26.810 --> 00:02:31.830 didn't benefit as much. So I wanted to do something 00:02:31.830 --> 00:02:35.710 to change that. So I began to develop some models 00:02:35.710 --> 00:02:38.590 to help clinics to do it. And that wasn't enough. 00:02:38.780 --> 00:02:40.979 So I want to do some intervention to help patients 00:02:40.979 --> 00:02:43.620 directly. So that gets me into this type of work. 00:02:44.020 --> 00:02:46.699 Very cool. Very cool. Jane, what led you to health 00:02:46.699 --> 00:02:49.680 interventions? Yeah, so interesting, Shinyi. For 00:02:49.680 --> 00:02:53.879 me, it really started when I was in my MSW program. 00:02:54.020 --> 00:02:57.659 And I was interning at a domestic violence agency. 00:02:57.699 --> 00:03:00.960 And I was working primarily with immigrant women. 00:03:02.159 --> 00:03:05.419 I began to see firsthand that many of the tools 00:03:05.419 --> 00:03:08.539 and approaches that I was learning about really 00:03:08.539 --> 00:03:11.099 didn't fully account for what these women were 00:03:11.099 --> 00:03:13.680 actually experiencing. So factors like language 00:03:13.680 --> 00:03:17.280 barriers, lack of health insurance, barriers 00:03:17.280 --> 00:03:20.370 related to their immigration status or... difficulty 00:03:20.370 --> 00:03:22.789 finding, you know, work or employment and all 00:03:22.789 --> 00:03:26.310 of those factors affected not just their safety, 00:03:26.650 --> 00:03:29.689 but their overall health and well -being. And 00:03:29.689 --> 00:03:32.150 I think that experience really opened my eyes 00:03:32.150 --> 00:03:35.990 to how social determinants of health show up 00:03:35.990 --> 00:03:38.090 in people's everyday lives and how interventions 00:03:38.439 --> 00:03:42.360 have to be responsive to those realities and 00:03:42.360 --> 00:03:45.560 so it pushed me towards community -based research 00:03:45.560 --> 00:03:49.539 and towards understanding cultural and social 00:03:49.879 --> 00:03:52.400 context, especially within immigrant communities 00:03:52.400 --> 00:03:55.639 and to focus on developing health interventions 00:03:55.639 --> 00:03:58.699 that are really grounded in people's lived experiences 00:03:58.699 --> 00:04:01.520 and their communities. That's amazing. You know, 00:04:01.620 --> 00:04:04.759 you said a phrase that I know we use a lot in 00:04:04.759 --> 00:04:08.460 social work and and some other related health 00:04:08.460 --> 00:04:11.580 disciplines. But you said the phrase social determinants 00:04:11.580 --> 00:04:17.029 of health. And I'd love to take a beat. and give 00:04:17.029 --> 00:04:19.230 our audience a little bit of a definition. What 00:04:19.230 --> 00:04:21.250 is this phrase, social determinants of health? 00:04:21.310 --> 00:04:23.149 What does this mean? Can you unpack it a little 00:04:23.149 --> 00:04:26.370 bit for us? Of course. So I think we're talking 00:04:26.370 --> 00:04:30.250 about the idea that people's health and well 00:04:30.250 --> 00:04:33.670 -being isn't just shaped by their individual 00:04:33.670 --> 00:04:37.459 choices or biology. It's actually shaped by the 00:04:37.459 --> 00:04:40.220 conditions and characteristics in which they 00:04:40.220 --> 00:04:43.839 live and work and connect with other people and 00:04:43.839 --> 00:04:46.560 so as I mentioned in my work with immigrant communities 00:04:46.560 --> 00:04:49.160 we know factors like whether or not someone has 00:04:49.160 --> 00:04:52.399 health insurance or language barriers or you 00:04:52.399 --> 00:04:55.420 know what language they speak that has implications 00:04:55.420 --> 00:04:58.560 for being able to access health services which 00:04:58.560 --> 00:05:01.319 can you know influence whether someone can stay 00:05:01.319 --> 00:05:05.300 healthy or get the care that they need. So when 00:05:05.300 --> 00:05:08.060 we think about improving health, it's not just 00:05:08.060 --> 00:05:10.699 about, you know, providing the medical services 00:05:10.699 --> 00:05:12.680 or as you mentioned, you know, like care in a 00:05:12.680 --> 00:05:16.019 hospital, but it's also about addressing those 00:05:16.019 --> 00:05:19.259 social and structural conditions. It's so interesting 00:05:19.259 --> 00:05:21.399 that you basically just made the causal connection 00:05:21.399 --> 00:05:24.540 between what language you speak and your health. 00:05:25.019 --> 00:05:28.819 I don't think most people outside of perhaps 00:05:28.819 --> 00:05:31.899 social work and public health and maybe sort 00:05:31.899 --> 00:05:34.959 of medical fields in general ever think about 00:05:34.959 --> 00:05:37.720 what language you speak could impact your health. 00:05:37.800 --> 00:05:41.699 I mean, that is such a fascinating and important. 00:05:42.740 --> 00:05:45.459 concept just to deal with. And I think, you know, 00:05:45.459 --> 00:05:48.939 another phrase that gets thrown around a lot 00:05:48.939 --> 00:05:52.060 in the context of this work, which neither of 00:05:52.060 --> 00:05:54.800 you have used quite yet, but I'll throw it out 00:05:54.800 --> 00:05:58.300 there. I'll be the jargon laden one is behavioral 00:05:58.300 --> 00:06:01.240 health, right? So this idea that we oftentimes, 00:06:01.519 --> 00:06:04.120 you know, social determinants of health impact 00:06:04.120 --> 00:06:06.279 our wellbeing, but it's through this concept 00:06:06.279 --> 00:06:08.600 of behavioral health. And so I know Shinyi, I 00:06:08.600 --> 00:06:10.459 know you have done a lot of work around behavioral 00:06:10.459 --> 00:06:11.920 health. I mean, do you maybe want to give our 00:06:11.850 --> 00:06:13.290 audience a little bit of an understanding of 00:06:13.290 --> 00:06:15.189 like, what is behavioral health? Like, what does 00:06:15.189 --> 00:06:18.209 that even mean? Yeah. So I think that comes from 00:06:18.209 --> 00:06:21.329 my background of a systems engineer. So I'm very 00:06:21.329 --> 00:06:24.149 interested in what are those processes and the 00:06:24.149 --> 00:06:26.889 steps that gets to the outcomes. So the structural 00:06:26.889 --> 00:06:29.709 components that Jane mentioned are very important, 00:06:30.250 --> 00:06:35.069 but health is a process. So how we eat, how we... 00:06:35.079 --> 00:06:39.199 physical activities, our sleep, how we manage 00:06:39.199 --> 00:06:44.100 stress, our choice of taking medications or adherence 00:06:44.100 --> 00:06:47.019 to the medications or choose other substance 00:06:47.019 --> 00:06:51.240 to manage stress. These are all behaviors that 00:06:51.240 --> 00:06:54.100 could impact on outcomes. So my research and 00:06:54.100 --> 00:06:57.300 my intervention are targeting on these behavioral 00:06:57.300 --> 00:07:01.920 processes that we can either improve or make 00:07:01.920 --> 00:07:04.740 this decision differently that can improve patients' 00:07:05.040 --> 00:07:07.839 outcomes. Thank you for sharing that. It's so 00:07:07.839 --> 00:07:09.800 important, I think, for people to understand 00:07:09.800 --> 00:07:11.980 this idea of social determinants and what it 00:07:11.980 --> 00:07:13.420 is that we're talking about with this behavioral 00:07:13.420 --> 00:07:16.540 health because so much of our health is impacted, 00:07:16.620 --> 00:07:20.730 as you said, Jane, by things out. that one might 00:07:20.730 --> 00:07:22.610 not think about like language or the neighborhood 00:07:22.610 --> 00:07:25.910 that we live in. And the causal linkages are 00:07:25.910 --> 00:07:28.149 oftentimes through the things that we make decisions 00:07:28.149 --> 00:07:30.610 about that impact our health. So thank you for 00:07:30.610 --> 00:07:33.389 clarifying that for us as well, Shinyi. I wanna 00:07:33.389 --> 00:07:36.569 get into the weeds a little bit with both of 00:07:36.569 --> 00:07:38.110 you on the work that you're actually doing in 00:07:38.110 --> 00:07:41.209 this space. So I know, Jane, you alluded to at 00:07:41.209 --> 00:07:43.750 the beginning that you're really interested in. 00:07:44.079 --> 00:07:46.959 immigrant health and sort of the context. I mean, 00:07:47.339 --> 00:07:49.600 what are some of the health -related interventions 00:07:49.600 --> 00:07:52.079 that you are working on now that you're most 00:07:52.079 --> 00:07:54.699 excited about? Yeah, so there's a lot there, 00:07:54.759 --> 00:07:58.959 but a lot of my work is focused on HIV prevention 00:07:58.959 --> 00:08:03.199 and care as one of the primary outcomes. And 00:08:03.199 --> 00:08:06.620 what I've always been drawn to is interdisciplinary 00:08:06.620 --> 00:08:08.420 research and collaboration, which, you know, 00:08:08.519 --> 00:08:10.740 she needs a great example of that given her background 00:08:10.740 --> 00:08:13.839 in engineering. But the reasons I love social 00:08:13.839 --> 00:08:16.160 work and looking at health outcomes like HIV 00:08:16.160 --> 00:08:19.120 prevention through a social work lens is it really 00:08:19.120 --> 00:08:21.699 brings together insights from so many different 00:08:21.699 --> 00:08:26.860 fields. And with my work in HIV prevention, one 00:08:26.860 --> 00:08:29.779 of the kind of frameworks I use come from health 00:08:29.779 --> 00:08:32.399 communication. And I'm doing some work on this 00:08:32.399 --> 00:08:36.649 idea of key storytellers. which comes from communication 00:08:36.649 --> 00:08:38.809 infrastructure theory, which is really just looking 00:08:38.809 --> 00:08:41.610 at how information flows within communities. 00:08:41.610 --> 00:08:43.929 You mentioned a lot of the different factors 00:08:43.929 --> 00:08:46.889 that go into different health outcomes. And in 00:08:46.889 --> 00:08:49.549 any community at the individual level, there 00:08:49.549 --> 00:08:52.669 are certain people, whether they're kind of have 00:08:52.669 --> 00:08:55.830 formal roles or informal roles. And these people 00:08:55.830 --> 00:08:59.309 are individuals that folks might turn to for 00:08:59.309 --> 00:09:02.759 guidance or support. for trusted information. 00:09:03.460 --> 00:09:05.580 And so these are kind of the key storytellers 00:09:05.580 --> 00:09:08.100 that in my research with Latino men who have 00:09:08.100 --> 00:09:11.059 sex with men for HIV prevention, I really wanted 00:09:11.059 --> 00:09:14.700 to understand who those key storytellers are 00:09:14.700 --> 00:09:17.799 and how they share information about HIV prevention, 00:09:18.100 --> 00:09:21.320 especially considering differences in language, 00:09:21.480 --> 00:09:25.940 geography, access to resources, including health 00:09:25.940 --> 00:09:29.240 and HIV prevention resources. So the goal is 00:09:29.240 --> 00:09:32.539 to really build interventions that amplify those 00:09:32.539 --> 00:09:34.960 voices, those trusted voices that are already 00:09:34.960 --> 00:09:37.879 doing a lot of this important work within their 00:09:37.879 --> 00:09:40.759 own communities. So whether it's HIV prevention 00:09:40.759 --> 00:09:44.200 or mental health or oral health, I really think 00:09:44.200 --> 00:09:48.090 about it with with attention to social determinants 00:09:48.090 --> 00:09:50.909 and thinking critically about the resources and 00:09:50.909 --> 00:09:52.929 strengths that are already within the community. 00:09:53.549 --> 00:09:56.990 I love that. I love that. I often spend time 00:09:56.990 --> 00:10:00.230 thinking about the context is almost always the 00:10:00.230 --> 00:10:03.070 most important part of the problem. And both 00:10:03.070 --> 00:10:05.470 of your work hones in on the importance of that. 00:10:06.469 --> 00:10:08.289 Shinyi, you know, you and I have known for one 00:10:08.289 --> 00:10:10.009 another for quite some time, and I know about 00:10:10.009 --> 00:10:11.990 a lot of your health related work, but there's 00:10:11.990 --> 00:10:13.570 a project that you've been working on recently 00:10:13.570 --> 00:10:16.590 that I really want to nudge you to talk about, 00:10:16.909 --> 00:10:20.269 which is around, if I remember the context exactly 00:10:20.269 --> 00:10:22.590 correctly, it's about Chinese Americans and whether 00:10:22.590 --> 00:10:25.090 or not they're going to uptake a particular kind 00:10:25.090 --> 00:10:27.450 of surgery. Can you maybe tell us a little bit 00:10:27.450 --> 00:10:31.529 more about this and again, how context and language 00:10:31.529 --> 00:10:33.629 and all of this matters in the work that you're 00:10:33.629 --> 00:10:36.580 doing? Before that, may I respond to Jane's work? 00:10:36.919 --> 00:10:39.179 Oh, of course. Go for it. You and I actually 00:10:39.179 --> 00:10:41.679 went back a long time when we both work on HIV 00:10:41.679 --> 00:10:45.220 -related work. And part of my work was actually 00:10:45.220 --> 00:10:48.539 evaluating cost effectiveness of different interventions 00:10:48.539 --> 00:10:52.389 treating HIV. But the type of intervention you're 00:10:52.389 --> 00:10:55.090 doing, Jen, is new. So maybe at some point I 00:10:55.090 --> 00:10:57.409 could update my analysis to include your type 00:10:57.409 --> 00:11:02.610 of intervention. I think all three of us have 00:11:02.610 --> 00:11:06.190 worked on HIV -related interventions in the course 00:11:06.190 --> 00:11:08.409 of our careers. We probably just have done a 00:11:08.409 --> 00:11:10.929 whole episode on HIV -related interventions, 00:11:11.090 --> 00:11:13.649 not health interventions. I know, Shinyi, your 00:11:13.649 --> 00:11:15.950 most recent one is not in the space of HIV, and 00:11:15.950 --> 00:11:17.269 so maybe you can tell us a little bit about that 00:11:17.269 --> 00:11:20.830 one, too. Yes. So the work I did with HIV and 00:11:20.830 --> 00:11:23.250 the work I'm actually doing right now have some 00:11:23.250 --> 00:11:26.429 common theme, which is how do we deliver care 00:11:26.429 --> 00:11:29.850 more effectively and efficiently as well as more 00:11:29.850 --> 00:11:33.279 affordable? So when I evaluate HIV interventions, 00:11:33.600 --> 00:11:36.259 I look at the cost effectiveness. In the specific 00:11:36.259 --> 00:11:38.320 project I'm currently doing right now is that 00:11:38.320 --> 00:11:40.320 we know there's intervention that's effective 00:11:40.320 --> 00:11:43.580 and that benefit patients of different cultural 00:11:43.580 --> 00:11:46.539 backgrounds or different languages. But certain 00:11:46.539 --> 00:11:49.940 groups of patients, like Chinese, Americans, 00:11:50.500 --> 00:11:53.840 are less likely to accept that type of interventions. 00:11:54.539 --> 00:11:57.019 So that type of decision making make me wondered 00:11:57.019 --> 00:12:00.960 why and how we could help them. So I think really 00:12:00.960 --> 00:12:04.539 social work helped me to have this concept of 00:12:04.539 --> 00:12:08.460 getting into listen to people's story. So I first 00:12:08.460 --> 00:12:11.240 begin this project with interviews with patients 00:12:11.240 --> 00:12:14.480 to understand the experiences. And part of that, 00:12:14.639 --> 00:12:18.480 I get to understand why they make decision this 00:12:18.480 --> 00:12:22.419 way could be they are lacking the information 00:12:22.419 --> 00:12:26.120 from providers because patients don't speak English 00:12:26.120 --> 00:12:28.360 as fluently and the information they were given 00:12:28.360 --> 00:12:30.480 were in English. So that's the language part 00:12:30.480 --> 00:12:34.320 that could affect health. The other issue is 00:12:34.320 --> 00:12:37.679 patients' assessment of their conditions are 00:12:37.679 --> 00:12:40.480 different, grounding their cultural background. 00:12:41.139 --> 00:12:44.559 Like in Chinese culture, people feel that they 00:12:44.559 --> 00:12:47.840 should sustain discomfort, part of the reason. 00:12:48.039 --> 00:12:49.980 believe it or not, so they don't want to bother 00:12:49.980 --> 00:12:53.899 other people, including their providers. So those 00:12:53.899 --> 00:12:56.759 stories and those information needs are the reason 00:12:56.759 --> 00:12:59.299 that I began to develop these interventions, 00:12:59.740 --> 00:13:02.639 which is intended to support patients to make 00:13:02.639 --> 00:13:06.120 more patient -centered decision making. The context 00:13:06.120 --> 00:13:08.980 is, as I said before, it's just so important. 00:13:09.320 --> 00:13:13.200 And I know, Jane, your work with HIV, you take 00:13:13.200 --> 00:13:15.659 context. Very, very, very, very seriously. Can 00:13:15.659 --> 00:13:17.940 you maybe tell us a little bit more about some 00:13:17.940 --> 00:13:20.860 of your work, you know, relates to this sort 00:13:20.860 --> 00:13:23.700 of idea that Shinny was sharing with us as well? 00:13:23.850 --> 00:13:26.029 Yeah, I mean, I resonate a lot with what Shinyi 00:13:26.029 --> 00:13:28.090 was saying, because we're talking a lot about, 00:13:28.090 --> 00:13:30.289 you know, implementation issues. Just because 00:13:30.289 --> 00:13:32.570 an intervention is, quote unquote, effective 00:13:32.570 --> 00:13:35.370 doesn't mean it's necessarily going to work for 00:13:35.370 --> 00:13:37.990 all communities, right? We have to look at what's 00:13:37.990 --> 00:13:40.549 feasible, what's acceptable in different populations 00:13:40.549 --> 00:13:43.309 and groups. So really asking these questions 00:13:43.309 --> 00:13:46.509 about, you know, implementation science and what 00:13:46.509 --> 00:13:50.169 can be really sustainable outside of the research 00:13:50.169 --> 00:13:53.049 study or a specific kind of clinical trial that 00:13:53.049 --> 00:13:54.870 we might be doing. So really thinking about the 00:13:54.870 --> 00:13:58.429 sustainability of such efforts. And I think one 00:13:58.429 --> 00:14:01.730 important way to really ensure that is to involve 00:14:01.730 --> 00:14:04.629 communities in research and in our studies, and 00:14:04.629 --> 00:14:07.450 even in the questions that we ask, because they 00:14:07.450 --> 00:14:09.549 understand the context. They understand their 00:14:09.549 --> 00:14:12.830 priorities. We might have a particular interest 00:14:12.830 --> 00:14:16.409 of an area. Even my work, as I mentioned when 00:14:16.409 --> 00:14:19.370 I was doing kind of DV work, I realized we're 00:14:19.580 --> 00:14:21.700 we're talking about issues related to domestic 00:14:21.700 --> 00:14:25.799 violence, but some of my clients' priorities 00:14:25.799 --> 00:14:30.120 were kind of beyond that. They need a safe place 00:14:30.120 --> 00:14:33.259 to stay. They need to find a job. And so all 00:14:33.259 --> 00:14:35.299 of these other factors come in. So I think it 00:14:35.299 --> 00:14:38.320 is really important to center communities in 00:14:38.320 --> 00:14:40.639 our work and make sure that they are bringing 00:14:40.639 --> 00:14:43.019 in their perspective so that, at the end of the 00:14:43.019 --> 00:14:46.279 day, the interventions really work for them and 00:14:46.279 --> 00:14:51.289 address their priorities. I think that in social 00:14:51.289 --> 00:14:55.009 work we almost take for granted that people should 00:14:55.009 --> 00:14:57.929 talk to people in communities, but I don't think 00:14:57.929 --> 00:15:00.950 that it's necessarily something that a lot of 00:15:00.950 --> 00:15:05.559 other fields do, but I know having seen presentations 00:15:05.559 --> 00:15:08.179 by both of you over the last year that both of 00:15:08.179 --> 00:15:11.179 you take very seriously the communities that 00:15:11.179 --> 00:15:13.500 you work with and part you partner with them 00:15:13.500 --> 00:15:15.740 you know it's not just that you're studying them 00:15:15.740 --> 00:15:17.720 but you're actually partnering with them you're 00:15:17.720 --> 00:15:21.990 actually involving them legitimately and earnestly 00:15:21.990 --> 00:15:24.490 in the process of helping you understand what's 00:15:24.490 --> 00:15:27.009 happening and to create solutions. I think it's 00:15:27.009 --> 00:15:29.269 a really beautiful thing that I've seen in both 00:15:29.269 --> 00:15:32.929 of your work. Shinyi, you alluded to this project 00:15:32.929 --> 00:15:35.429 where you were interviewing a lot of people around 00:15:35.429 --> 00:15:38.289 some of the cultural barriers to believe it. 00:15:38.389 --> 00:15:41.690 What's the condition that you're addressing in 00:15:41.690 --> 00:15:43.509 this particular intervention? It was like a type 00:15:43.509 --> 00:15:46.250 of surgery, right? Yeah, it's a condition related 00:15:46.250 --> 00:15:49.009 to congestive nose. It's called the chronic... 00:15:49.620 --> 00:15:53.179 Okay, it's a surgical procedure and that some 00:15:53.179 --> 00:15:55.799 people, and you found this, as you were saying 00:15:55.799 --> 00:15:58.759 before, that there are folks who are not wanting 00:15:58.759 --> 00:16:02.000 to take up this surgery, which has been shown 00:16:02.000 --> 00:16:04.860 to be effective. After you found out from the 00:16:04.860 --> 00:16:07.059 community what some of the barriers were, what 00:16:07.059 --> 00:16:09.139 were some of the ideas that you then brought 00:16:09.139 --> 00:16:12.200 as possible solutions? So the surgery is called 00:16:12.200 --> 00:16:15.620 endoscopic surgery, which is the non -invasive 00:16:15.620 --> 00:16:22.419 surgery. the term sounds to some patients is 00:16:22.419 --> 00:16:26.340 not an option they will take. This is the last 00:16:26.340 --> 00:16:30.559 resort. Despite our study shows patients have 00:16:30.559 --> 00:16:32.899 significantly improved their quality of life. 00:16:33.000 --> 00:16:35.700 This is a disease. It's not life or death disease. 00:16:35.840 --> 00:16:38.440 This is a quality of life disease. But the improvement 00:16:38.440 --> 00:16:41.700 in quality of life is dramatic. It's even greater 00:16:41.700 --> 00:16:44.919 than treating your heart disease or diabetes. 00:16:45.580 --> 00:16:48.820 but patients are still concerned about it. So 00:16:48.820 --> 00:16:51.840 utilizing the community concept, through the 00:16:51.840 --> 00:16:54.899 interviews, we try to bring people in the community 00:16:54.899 --> 00:16:58.179 to share their experiences and convert that into 00:16:58.179 --> 00:17:01.899 a story in our intervention. So we use storytelling 00:17:01.899 --> 00:17:05.980 in our intervention. So we provide a website, 00:17:06.400 --> 00:17:09.299 one of the interventions component I often use 00:17:09.299 --> 00:17:12.160 to make information more accessible, available, 00:17:12.480 --> 00:17:15.190 and more standardized. as part of the communication. 00:17:15.829 --> 00:17:18.430 And so we provide information about the conditions 00:17:18.430 --> 00:17:21.990 in the language that patients are familiar with 00:17:21.990 --> 00:17:25.230 so we can address the language barriers. We use 00:17:25.230 --> 00:17:29.430 visuals to help improve the understanding. So 00:17:29.430 --> 00:17:31.849 those are standard communication tools we use. 00:17:32.869 --> 00:17:35.470 We ask patients what they frequently ask questions 00:17:35.470 --> 00:17:38.150 so we can make the information more succinct 00:17:38.150 --> 00:17:40.970 to answer patients, especially patients with 00:17:40.990 --> 00:17:44.109 cultural or different language background, they 00:17:44.109 --> 00:17:46.390 have different type of questions. So we try to 00:17:46.390 --> 00:17:49.390 make this process very clear to understand the 00:17:49.390 --> 00:17:52.769 information. But more innovative is that patient 00:17:52.769 --> 00:17:56.170 story part. So we ask patients if we can convert 00:17:56.170 --> 00:17:59.049 their interviews into story to share with others. 00:17:59.369 --> 00:18:02.569 And we found very interesting the patients. When 00:18:02.569 --> 00:18:04.750 they first see the website, they go to the patient 00:18:04.750 --> 00:18:07.630 stories and looking for people most similar to 00:18:07.630 --> 00:18:12.700 them. Race, language, gender. I love that because 00:18:12.700 --> 00:18:15.619 a lot of my work right now is also kind of involving 00:18:15.619 --> 00:18:18.759 peers, right? Because it's this idea that it's 00:18:18.759 --> 00:18:20.940 not just about the information that you get, 00:18:21.059 --> 00:18:23.180 but who's delivering it, who's kind of sharing 00:18:23.180 --> 00:18:25.500 their experiences and can you relate with them? 00:18:25.539 --> 00:18:28.000 And do you kind of see yourself in them? And 00:18:28.000 --> 00:18:30.240 oftentimes when that's the case, you're more 00:18:30.240 --> 00:18:33.380 likely to, you know, want and trust that information 00:18:33.380 --> 00:18:35.940 or utilize that information. So I think that's 00:18:35.940 --> 00:18:39.460 so that's so important because it isn't the case 00:18:39.460 --> 00:18:42.119 that, you know, if the interventions exist, people 00:18:42.119 --> 00:18:44.420 will use them or, you know, there will be uptake 00:18:44.420 --> 00:18:47.160 of them. You need to understand how to best engage 00:18:47.160 --> 00:18:50.039 folks and make sure that it's acceptable and 00:18:50.039 --> 00:18:53.799 think about norms as well. So so many parallels, 00:18:53.859 --> 00:18:56.920 which I love. Yeah. Yeah, I see those parallels 00:18:56.920 --> 00:18:58.519 as well, too. And I'm glad that you highlighted 00:18:58.519 --> 00:19:00.440 some of them. Another parallel that I was going 00:19:00.440 --> 00:19:02.819 to try to prompt you about, though, is also the 00:19:02.819 --> 00:19:04.920 use of technology. Right. I know that you've 00:19:04.920 --> 00:19:08.660 also thought, Jane, a lot about how you can take 00:19:08.660 --> 00:19:11.440 advantage of of particular social media. You 00:19:11.440 --> 00:19:13.599 want to talk a little bit about that too? Yeah, 00:19:13.759 --> 00:19:16.500 so you know the idea of using social media too 00:19:16.500 --> 00:19:19.640 really came from the community itself when you 00:19:19.640 --> 00:19:22.599 know social media platforms were becoming more 00:19:22.599 --> 00:19:25.119 popular. It was actually community partners who 00:19:25.119 --> 00:19:27.559 were like you know how can we use this as a tool 00:19:27.559 --> 00:19:32.019 for HIV prevention, especially for Latino immigrant 00:19:32.019 --> 00:19:34.980 communities. And so they were interested in it 00:19:34.980 --> 00:19:36.759 because it was something that was developing. 00:19:36.960 --> 00:19:39.339 And a big question for me was also, you know, 00:19:40.319 --> 00:19:42.960 there might be a digital divide, right? did the 00:19:42.960 --> 00:19:45.799 people we want to reach even have access to social 00:19:45.799 --> 00:19:49.420 media or reliable technology? So similar to Shinyi, 00:19:49.799 --> 00:19:51.960 our early work was really focused on understanding 00:19:51.960 --> 00:19:54.920 people's experiences with these platforms, asking 00:19:54.920 --> 00:19:57.579 whether they wanted to even receive HIV prevention 00:19:57.579 --> 00:20:00.980 information that way. And so we also wanted to 00:20:00.980 --> 00:20:03.960 think about how we can make any content that's 00:20:03.960 --> 00:20:06.559 delivered on social media platforms meaningful 00:20:06.559 --> 00:20:11.140 and culturally relevant. So it wasn't just information 00:20:11.140 --> 00:20:14.200 being pushed out. the communication that actually 00:20:14.200 --> 00:20:17.480 resonated and I think what's exciting is that 00:20:17.480 --> 00:20:21.279 you know social media and technology are constantly 00:20:21.279 --> 00:20:24.359 evolving and new tools are being developed so 00:20:24.359 --> 00:20:27.400 that means we have to keep listening to the community 00:20:27.400 --> 00:20:30.380 and adapting how we use these tools because the 00:20:30.380 --> 00:20:33.339 ways that we're connecting and sharing information 00:20:33.339 --> 00:20:36.700 and engaging with each other are rapidly changing. 00:20:37.460 --> 00:20:39.900 Indeed, indeed. I mean, I could riff with you, 00:20:39.960 --> 00:20:41.819 the two of you about that aspect of this work 00:20:41.819 --> 00:20:44.720 for hours. I mean, having done HIV prevention 00:20:44.720 --> 00:20:47.839 related work around social networks and social 00:20:47.839 --> 00:20:50.430 media and all this stuff. I mean, I, I love it. 00:20:50.450 --> 00:20:52.730 I think it's also kind of cool that this episode 00:20:52.730 --> 00:20:56.950 is going to be airing during National HIV AIDS 00:20:56.950 --> 00:20:59.029 Awareness Month in December. And so I think it's 00:20:59.029 --> 00:21:01.450 nice that we've had a, you know, Jane, your work 00:21:01.450 --> 00:21:03.509 explicitly, but also Shanee for you to remind 00:21:03.509 --> 00:21:08.309 me about your origins in HIV prevention and care 00:21:08.309 --> 00:21:11.150 work. And also then reminding me, oh yeah, right, 00:21:11.150 --> 00:21:13.769 Eric, you do a lot of HIV oriented work as well 00:21:13.769 --> 00:21:16.710 too. And you also like to center the voices of 00:21:16.710 --> 00:21:19.349 the communities and all this. It's really... 00:21:19.109 --> 00:21:22.630 fun to share this time with you, thinking about 00:21:22.630 --> 00:21:25.910 these important issues. You know, we're kind 00:21:25.910 --> 00:21:28.009 of running toward the end of the time that we 00:21:28.009 --> 00:21:29.730 have together, but I always want to make sure 00:21:29.730 --> 00:21:33.990 that I leave my guests time to leave something 00:21:33.990 --> 00:21:36.950 of a parting thought for our listeners, because 00:21:36.950 --> 00:21:40.029 I think my intention here is to introduce people 00:21:40.029 --> 00:21:42.349 to topics, knowing that there's so much more 00:21:42.349 --> 00:21:45.099 to be said about both of your lines of research 00:21:45.099 --> 00:21:47.180 about health interventions. We could have a whole 00:21:47.180 --> 00:21:49.660 series just on health interventions. But since 00:21:49.660 --> 00:21:52.000 you're here with us today, I'd like to give you 00:21:52.000 --> 00:21:54.519 an opportunity to leave our audience with some 00:21:54.519 --> 00:21:56.000 parting thoughts, perhaps something that you 00:21:56.000 --> 00:21:59.529 think they might. misunderstand about health 00:21:59.529 --> 00:22:02.309 interventions or something that you think that 00:22:02.309 --> 00:22:04.509 from your own work, working with the communities 00:22:04.509 --> 00:22:06.589 that you work with, you really want to elevate 00:22:06.589 --> 00:22:09.869 for our audience to think about. So maybe I'll 00:22:09.869 --> 00:22:12.950 turn to Shinyi first and then to Jane. 00:22:13.009 --> 00:22:15.269 Shinyi, what would you like to leave our listeners with? 00:22:15.450 --> 00:22:18.829 studying health interventions for a long time, 00:22:19.150 --> 00:22:23.450 I began to think about the intervention fit with 00:22:23.450 --> 00:22:26.109 individuals. We have talked about people with 00:22:26.109 --> 00:22:28.509 different languages, different social determinants 00:22:28.509 --> 00:22:32.319 of health, so the intervention is not. one size 00:22:32.319 --> 00:22:35.400 fits all. I think researchers will use intervention 00:22:35.400 --> 00:22:38.339 based on evidence, based on the data we know 00:22:38.339 --> 00:22:41.299 the best, based on the community needs. And I'm 00:22:41.299 --> 00:22:44.119 hoping with the technology, we will be able to 00:22:44.119 --> 00:22:48.220 deliver more patient -centered fit of the type 00:22:48.220 --> 00:22:51.180 of intervention. with individuals' needs and 00:22:51.180 --> 00:22:53.720 their different experiences and the sort of determinants 00:22:53.720 --> 00:22:56.920 surrounding them. So the type of work I begin 00:22:56.920 --> 00:23:01.119 to do is to also look into more patient -centered, 00:23:01.500 --> 00:23:04.960 as well as understanding different type of patients, 00:23:05.220 --> 00:23:07.039 like different type of decision -making, different 00:23:07.039 --> 00:23:11.640 type of health behaviors, so we can do more intervention 00:23:11.640 --> 00:23:14.500 that's based on patients' person strengths. That's 00:23:14.500 --> 00:23:17.519 wonderful. Jane, what would you like to leave our listeners with? 00:23:17.519 --> 00:23:21.019 Yeah, I reflect. I'm reflecting on some 00:23:21.019 --> 00:23:22.839 of what she needs that I agree, you know, one 00:23:22.839 --> 00:23:25.900 size doesn't fit all. And to a point you mentioned 00:23:25.900 --> 00:23:29.140 earlier about, you know, is research taking place 00:23:29.140 --> 00:23:31.660 on communities or really with communities? And 00:23:31.660 --> 00:23:34.079 that's a question I really, you know, ask my 00:23:34.079 --> 00:23:36.339 students to think about in our in classes that 00:23:36.339 --> 00:23:39.220 I teach, like how was the research done and were 00:23:39.220 --> 00:23:42.420 community perspectives integrated? And I think 00:23:42.420 --> 00:23:46.079 that's really key because, you know, health doesn't 00:23:46.079 --> 00:23:49.700 happen in isolation. So we really need to understand 00:23:49.700 --> 00:23:52.740 the broader environments that people live in, 00:23:52.920 --> 00:23:54.900 their relationships and all of the different. 00:23:55.079 --> 00:23:57.839 structural factors that shape their experiences. 00:23:57.940 --> 00:24:00.759 So I think it is really understanding community 00:24:00.759 --> 00:24:03.180 perspectives. And I hope it's not just social 00:24:03.180 --> 00:24:05.740 work, but that all research kind of works more 00:24:05.740 --> 00:24:09.160 towards that approach, like really engaging community 00:24:09.160 --> 00:24:13.380 perspectives, recognizing also the diversity 00:24:13.380 --> 00:24:16.480 within communities, taking an intersectional 00:24:16.480 --> 00:24:18.920 approach as well, recognizing the multiple identities 00:24:18.920 --> 00:24:22.150 that people have. And also, You know, really 00:24:22.150 --> 00:24:25.009 asking when we design health interventions, like 00:24:25.009 --> 00:24:27.630 what are community or cultural strengths that 00:24:27.630 --> 00:24:31.410 we can build on? And I think that can really 00:24:31.410 --> 00:24:34.509 help ensure that interventions are not just evidence 00:24:34.509 --> 00:24:37.349 based, but also, you know, culturally informed 00:24:37.349 --> 00:24:41.089 and really responsive to the realities of the 00:24:41.089 --> 00:24:43.579 communities that. they're meant to serve. Well, 00:24:43.599 --> 00:24:45.660 thank you so much for that. It's beautifully 00:24:45.660 --> 00:24:48.700 put by both of you. And I think with that mission 00:24:48.700 --> 00:24:51.740 in mind, I have every confidence that both of 00:24:51.740 --> 00:24:55.319 you are going to continue to develop yet more 00:24:55.319 --> 00:24:58.519 interventions that really hit people in the places 00:24:58.519 --> 00:25:01.519 where they are. And it's great to have colleagues 00:25:01.519 --> 00:25:05.680 like you that are so committed to really listening 00:25:05.680 --> 00:25:09.309 to community and really developing programs with 00:25:09.309 --> 00:25:11.650 those communities that serve those communities 00:25:11.650 --> 00:25:15.190 and the nuance and the heterogeneity and the 00:25:15.190 --> 00:25:17.069 individuality and the strength that those people 00:25:17.069 --> 00:25:20.230 bring, which I'm left with a lot of warm fuzzy 00:25:20.230 --> 00:25:22.630 feelings today after having this conversation 00:25:22.630 --> 00:25:24.450 with you, which is nice because health interventions 00:25:24.450 --> 00:25:26.769 are oftentimes when we're seeing people at not 00:25:26.769 --> 00:25:29.190 such great points, you know, HIV is a very serious 00:25:29.190 --> 00:25:31.329 disease, sinus conditions that you're talking 00:25:31.329 --> 00:25:33.109 about, you know, shinny, I mean, these are serious 00:25:33.109 --> 00:25:36.470 things and it's great to have, you know, a moment 00:25:36.470 --> 00:25:38.960 of hope and inspiration. that we're going to 00:25:38.960 --> 00:25:41.970 be... working with communities to build interventions 00:25:41.970 --> 00:25:45.369 that work for those communities. Well, if you, 00:25:45.430 --> 00:25:47.470 the audience want to learn more about the research 00:25:47.470 --> 00:25:50.150 here at the USC Suzanne Dworak-Peck School of 00:25:50.150 --> 00:25:52.509 Social Work, you can visit our school's website 00:25:52.509 --> 00:25:56.529 at dworakpeck.usc .edu. And if you have any 00:25:56.529 --> 00:25:58.710 questions for the guests on our show or you want 00:25:58.710 --> 00:26:01.609 to support our transformative research and programs 00:26:01.609 --> 00:26:05.450 here at the school, you can contact us at listenuppeople@usc.edu. 00:26:05.450 --> 00:26:09.769 And Jane, Shinyi, thank you both. 00:26:09.990 --> 00:26:12.190 Once again, it was wonderful to have you. 00:26:12.190 --> 00:26:13.170 Thank you, Eric. Pleasure.