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THEARI Educational Blog Series: All of Us Research Program, March 2022

THEARI staff and Board of Directors address public health disparities by keeping diversity, equity, and inclusion at the forefront, see how!

 

Written By: Abigail Irlbeck, Juliet Farnan, and Kathleen McInnis

 

THEARI is proud to educate our communities about the All of Us Research Program and promote participation, as we believe that we are an integral part of delivering precision medicine that will better support the minority communities across the U.S. As a non-profit healthcare education institution, THEARI staff members and Board of Directors are consistently putting energy towards reducing health disparities and ensuring that healthcare education is inclusive. The work done every day is in direct alignment with the All of Us Research Program because we believe diversity and the unique qualities and perceptions of individuals can better inform the work that we do. What better to share with our readers than the daily, active efforts by THEARI staff members, including Susan Garrett, Regional Health Connector, and Mitch Fittro, Education and Workforce Manager, and Board Directors, including Deb Center, Chief Program Officer at the Colorado Center for Nursing Excellence and Erika Kaye, Chief Executive Officer at Reunion Rehabilitation Hospital. We asked:

  1. The cornerstone of the All of Us Research Program is to invite one million or more individuals that reflect the rich diversity of the United States to increase participation in biomedical research, particularly among communities that have been historically underrepresented. In your role, how do you actively address public health disparities?
  2. The All of Us Research Program aims to engage a diverse community of researchers to study and utilize the data provided by its participants. This may impact diversity of thinking, create new and innovative ideas, and improve health outcomes for future generations. How do you keep diversity, equity, and inclusion at the forefront of the work that you do?

 

It is our responsibility.

It is our responsibility to address public health disparities. This work, however, is undoubtedly challenging. It requires systemic changes that need to be made at many levels of the healthcare delivery system.

Working within many aspects of the healthcare delivery system allows us to connect with historically underrepresented populations and get a better understanding of how these diverse groups experience care – the good and the bad. More importantly, it nudges us to think about what we can do in our positions to remove the roadblocks that get in the way of a positive healthcare experience.

 

We have workforce strength in Colorado.

Mitch Fittro, Education and Workforce Manager at THEARI, describes his role as bringing initial awareness to prospective job seekers about the healthcare pathways that are available. Participants in the Health Careers Pre-Apprenticeship Program (HCPA) explore the vast span of health careers. During their class sessions, conversations often arise regarding the variety and quality of healthcare. This program has served over one hundred participants from local workforce centers over the past five years, with representation of racially, ethnically, socio-economically, and age diverse populations. It is no secret that we need a diverse healthcare workforce to support diverse communities not only in Colorado but across the United States. Representation is key.

At the Colorado Center for Nursing Excellence (CNE), Deb Center describes their work in a similar way. As a workforce organization, their goal is to create a nursing and healthcare workforce that best mirrors the populations they serve. The CNE strives to remove barriers and create pathways that ensure underrepresented minorities successfully navigate a meaningful healthcare career. Together with a variety of academic partners, the CNE has integrated holistic admission processes ensuring that elements including lived experience, public health disparities, and equity are also considered in addition to academic scores. And now, the CNE is working with clinical and academic partners to ensure the work environment promotes a sense of belonging, mitigates biases, enhances cultural competency, and removes systemic barriers to ensure the long-term retention of a diverse healthcare workforce.

 

Our communities are unique.

How do we respect the unique needs of our communities and still provide precise care and support? Erika Kaye, Chief Executive Officer at Reunion Rehabilitation Hospital (RRH), observed early in the COVID-19 pandemic that many patients at their facility were from multi-generational families that live together. From a cultural diversity perspective, multi-generational families who value togetherness are also disproportionately impacted by the COVID-19 pandemic.

We recognize that many factors impact health outcomes and that care is not one-size-fits-all. Rural communities are another demographic that are often underserved in healthcare partially due to workforce shortages, economic stagnation, and lack of transportation. Mitch recognizes the need to serve in ways that are representative of those communities through his work with THEARI’s student housing program. The placement of these future healthcare professionals is in rural and underserved areas.

Unique variables also mean that prevention and medical treatments might work well for one person, but not another. Recognizing differences at a community level are critical to impacting individual health. The All of Us Research Program aims to provide diverse medical data to scientists so that they may deliver precision medicine, an approach to improving health, treating disease, and identifying cures. It acknowledges that each person is unique. Precision medicine aims to deliver the right treatment to the right person at the right time, ultimately keeping people healthy for longer.

As we collaborate with various community partners to improve the health of our communities, Susan Garrett, Regional Health Connector at THEARI says the most important question to ask is, “Who is not at the table?” We must seek to safeguard that everyone has a voice and that the strongest voice belongs to the community members most impacted by the health issue being addressed.

 

We work to ensure safe spaces where everyone is seen, heard, and affirmed.

We are all doing our best to ensure underrepresented communities have a safe space to use their voice. Susan highlights her project that focuses on helping LGBTQ+ youth find safe and affirming behavioral health providers. In a recent survey by Envision:YOU found that: 20% of those surveyed reported a behavioral health provider had invalidated their identity, and 11% reported a behavioral health provider had tried to change their identity. The ability to identify a safe and affirming behavioral health care provider may be life saving for LGBTQ+ youth, as the suicide rate for this community is far higher than for the cis hetero community.

Erika approaches her work with the same focus. At RRH, anyone who shows up at their door receives care. There are excellent case managers who do everything they can to make sure patients have a safe discharge plan. They set up follow up appointments and provide transportation and shelter. They also address public health disparities on a systematic level, such as structural barriers to transportation, regular communication with patients, and how the hospital serves as a support system for patients. Every patient has different needs, and the staff at RRH makes sure to address each one of them.

One of Susan’s current projects focuses on healthcare resiliency. This project involves bringing resiliency resources to healthcare workers, with an emphasis on unlicensed healthcare workers (nursing assistants, dietary aids, housekeeping, etc.). Unlicensed healthcare workers have disproportionately low income and are often racial and/or ethnic minorities. Few resources are available for this population. Simple measures such as incorporating mindfulness into handwashing, can increase well-being without requiring additional time and effort.

 

Commitment, trust, and celebration.

One of the ways the CNE is committed to regular diversity, equity, and inclusion efforts is through JEDI, a strategic pillar for their organization, standing for Justice, Equity, Diversity, and Inclusion. To accomplish this, the CNE started with their internal team first. Team members receive education surrounding these topics and together, they spend time focusing on how current policies in place reflect JEDI. CNE also has ten team members that are diversity training experts from all levels of the organization. The CNE diversity team teaches both the internal and external groups about JEDI and creates opportunities for learning and developing new perspectives.

The entire team at THEARI and our Board of Directors is committed to making a difference in our communities by continually shining a light on diversity, equity, and inclusion and building trust. We encourage everyone to continue to view our work through an equity lens. We believe this work will support the elimination of public health disparities.

 

For more information about the All of Us Research Program, visit JoinAllofUs.org/togetherDenver

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