Improving Health Disparities through Nursing Research - Podcast Transcript

Alicia: Welcome to the research podcast. I’m Alicia Gregory, director of Research Communications at the University of Kentucky. Jenna Hatcher is an associate professor in the UK College of Nursing. She is the director of the college’s Dream Center. DREAM stands for Disparities Researchers Equalizing Access for Minorities. Jenna shared her passion for community outreach in her explanation of how she ended up in research.

Jenna Hatcher Well, what inspired me to pick this area of research is that, for the twenty years that I was a nurse before I went into research, a staff nurse, I found that different people had different healthcare outcomes. And it didn’t matter what area I was working in; the operating room, the intensive care unit, a psychiatric place. Anywhere you go, people have different health outcomes based on who they are rather than the care that we know is available to people.

I decided that I needed to not only know more about why that was the case, but help be a part of the solution for that because I’ve lived all over the country. I lived in Massachusetts, California, Louisiana, Kentucky, Alabama, and in each of those places there were segments of the population that didn’t get the same kind of healthcare outcomes that other people got and it made me want to fix that.

Alicia: Do you remember your first research project? Tell me a little bit about it.

Jenna Hatcher: My first research project was my dissertation research. And my dissertation focused on African American women and their mental health. So the thing that stands out the most about my first research project, was that I talked about self-esteem with African American women and I thought I knew what their self-esteem would be like, but I didn’t. And these were single mothers, African American single moms. And so I thought, “I’m a single mom, I know all about this. I got this. I know what they’re going to say” but I had no idea what they were going to say. And it was my first experience with understanding that research is really to find out something that you don’t know the answer. When you go in, you find out the answer. So it really impressed on me that even if you’re one of the population, you don’t know what’s going on within the population.

Alicia: Let’s talk about your focus on health disparities and, in particular, the S.E.E.D.S. project.

Jenna Hatcher: What I’m doing now and what I’ve kind of always done, starting with my dissertation, is look at differences in health for different populations. That’s what I call health disparities. So I’ve…I’ve moved through different disease processes because health disparities researchers concentrate on populations verses diseases. So in my dissertation, I concentrated on mental health, but after I finished my Ph.D. I began to concentrate on cancer disparities. One of the most stunning disparities for African Americans that there are, because African Americans die from all cancers more than any other racial ethnic group in the country. And so I began to just concentrate on cancer. And so, the S.E.E.D.S. project, which is Sisters Educated in Emergency Departments, was my first solo project that I was in charge of. Nothing’s solo because there’s a team of us, but I was actually in charge of it.

And so we went into emergency departments and educated African American women about breast cancer and mammography, and also tried to understand why they wouldn’t be getting mammograms. We did a whole bunch of individual interviews with the women, and I went to their homes and did in-depth interviews with them. But also, as we contacted them in the emergency department when they were waiting for non-urgent care, we were able to use a lay-person to sit down with them and talk about mammograms and talk through the barriers and issues that they had obtaining mammograms. So that was the first research project that I did, and that concentrated on breast cancer.

And then I did a project on colorectal cancer in rural Appalachians. Which I’m currently still doing a project with rural Appalachians and colorectal cancer, where we went into the emergency department again, because it’s a place where people were finding their medical home, and they often don’t have a primary care physician, which is the reason people get screened. So if I go to doctor and the doctor says, “You should get a mammogram,” I get a mammogram. If I don’t go and they don’t say it, I might wait years to get that mammogram. So we’re hoping to catch the people that have fallen through the safety net of having primary care physicians or providers that they go to, and in… their sitting in emergency rooms waiting for… they have a headache, but they might be willing to talk to us while they have that headache, or they’re waiting for someone else in the emergency room. Their average wait time; six hours. So we’ve got a lot of time and we’ve got an audience that has a heightened sense of awareness about their health because they’re in a healthcare facility for six hours, just waiting. So we use that opportunity to go in and talk to people about screening for cancers.

Alicia: If you were talking to a person on the street, how would you explain what you and your team are trying to better understand through research?

Jenna Hatcher: “We’re trying to understand what keeps you from getting the healthcare that you think you deserve and that we know that you deserve. Healthcare is a right. You should be as healthy as anyone else walking around. Is there anything that stops you from being that healthy? Is the healthcare system a barrier or does it help you? Is your race a barrier? When you go in the door, do you feel like you don’t get the care you deserve because of how you look or who you are? This can be because you’re transgender, because you’re black, because you have an accent. Because of anything about you, are you not getting the healthcare and the healthcare outcomes that you deserve?” Well, I already know they’re not, but if I were talking to a person on the street, I’d say, “Tell me, help me understand why you’re not.” And what we’re trying to do is understand that, but we’re moving beyond just understanding it to intervening because we’ve had years to know that this is the case. That people don’t get the same healthcare outcomes. So I would say to a person on the street, “What we’re trying to do is fix this. We know there’s a problem. We know that certain people in our country don’t have the same health outcomes as other people. And what I try to do every day, me and my team, is fix this. Find out what the problem is, there’s various problems at different levels, find a level that we can intervene on and try to fix it.”

Alicia: What are you most excited about in terms of your research in the near future?

Jenna Hatcher: I’m most excited in the near future about the use of social media to effect peoples’ health. I think that I found a little bit of a niche in social media. I used… I’ve recently done a study texting and social media for African Americans over 50 to help with their cardiovascular outcomes and their cancer outcomes. There’s two things that excite me about that. One is the combination of cancer and cardiovascular disease, because the risk factors are largely the same. Obesity, physical inactivity, some of the modifiable risk factors are the same for the chronic diseases. So I’m excited that we can maybe help in a wide range of areas… chronic diseases. And I’m also excited because we’re using technology to do that. I’m excited that I can see people over the age of 50 use their phones and Facebook and all of that to understand more about their health and to access things about their health, and they really love it. We did a small study with 40 African Americans. They loved it. They shared it with their friends, they went on the Facebook page, they were happy to get recipes and exercises, and the text messages from us every day. So I’m just excited that we’re able to be in the present time with technology and to help people with chronic diseases.

Alicia: What is your favorite aspect of being a researcher?

Jenna Hatcher: My ultimate favorite aspect is that the people that I work with in the community know me and they kind of own me. If… it’s like the legacy of being an African American where you’ve come behind people who’ve marched on Selma and done all the things to give me these opportunities, and now it’s like they own me. They say, “This is Dr. Hatcher and she’s in our community. Look what she’s doing for us.” So that is my favorite thing when I go to a church or in the street, that they’re happy and proud that I’m helping with our community to help our health outcomes.

Alicia: How does your experience as a researcher help you in your leadership roles, like the National Black Nurses Association?

Jenna Hatcher: So all of my leadership roles are tied to my health disparities research. I have a few leadership roles. I’m the president of the local National Black Nurses Association, which means I can work with students, pre-nursing students, current nursing students, and nurses that are in staff positions to help them develop. And I can do that somewhat because I understand health disparities, I understand blockages to success, and I understand what they need to succeed, and kind of because I’ve walked that road myself. So those two are certainly married.

My role as the director of the DREAM Center is certainly paired with my research, because it’s about equalizing access for minorities and that’s what I do in my research, and that’s what the Center is about. It’s about educational opportunities, it’s about research with disparate populations, and it allows me to help mentor another generation of people to do the same kind of research, young researchers, even people who’ve been around for a while but are switching into health disparities research. So my research helps me to mentor those people to understand what’s necessary to be a scientist in this field.

Alicia: What inspires you about being a part of the University of Kentucky?

Jenna Hatcher: It’s a land-grant institution. People really own the institution in the community and everywhere. If you say you’re from the University of Kentucky, you have a certain pride with that. And so, I’m happy to be a part of a University that has that kind of strong history and strong presence in the community for the people that we serve.

Alicia: What keeps you coming to work every day? What keeps you motivated?

Jenna Hatcher: The people that I’m working for motivate me for sure, the community that I serve. I do research that’s very closely tied to the community. I get to meet the people that I’m helping. And so, unlike maybe if were behind the doors in a lab, I do some things behind the doors in a lab because I have to design the research study, I have to analyze the data, I have to do those things. But the thing that keeps me coming back is the appreciation of the people that I’m helping, and I think we’re able to disseminate the findings quickly. They can understand how this helped them. Like the texting study. Right away, people knew that this helped them. They lost weight. They changed their eating habits. In the S.E.E.D. study, people went and got mammograms and even eight or ten years later they’ll say to me, “I’m getting mammograms now.” So what keeps me coming back is the fact that those people keep coming to me and saying you’re helping me, and so as long as I keep helping people I’ll just keep doing it.

Alicia: Thanks, Jenna and thank you for listening to the Research Podcast. Join us next time to find out more about research at the University of Kentucky and visit site our site: reveal.uky.edu.