Minority Affairs Committee Saturday Workshop – Saturday, September 23, 2017
“Meeting of the Minds: Why Haven’t Compelling Epidemiologic Data Eliminated Health Disparities”
Society is an emergent phenomenon that arises from the actions of billions of people, each of whom is an assemblage of billions of neurons and other cells, including many more microorganisms than human cells. The thinking and behavior of individuals and groups reflects this biology and the environmental influences, as these have developed through evolutionary time. Organisms compete and cooperate, as they seek to survive, reproduce, and grow. People have developed abilities to reason, strategize, forecast, theorize, simulate, deceive, etc. and in the process gained enormous power to understand and alter the environment and ourselves. But the world is so complex that even as we gain deep understanding we are also always oversimplifying.
We generally seek to advance our own interests, and existing health disparities reflect the resulting competition, amplified by accumulated differences in resources and power, but because of complexity, inequities can also be fostered unintentionally. After all, every action has multiple effects that may vary across time (immediate, intermediate-term, long-term, eventual), affected individuals (ourselves, our families, our friends, our associates, neighbors, other people in our vicinity, other people at a distance), and arenas (home, school, work, community, professional associations, etc.). Our ability to identify the best action is therefore limited by lack of knowledge and information and myriad influences. We adopt various rubrics (laws, moral principles, religious prescriptions and proscriptions, common sense, what our parents taught us, what our peers do, habit, etc.) and heuristics in order to function. We can probably identify actions that are clearly suboptimal (e.g, they have immediately visible negative consequences with no evident offsetting benefits), but otherwise we rely on diversity of perspectives, the “marketplace of ideas”, and the forces of evolution to shape our individual and institutional practices. Nevertheless, we can apply the practices that have increased our abilities to understand and alter the environment in our attempt to improve the functioning of society.
The aims of the workshop are for participants to explore the following questions:
How can epidemiology help us to understand societal dynamics better and to improve their functioning, so that we can eliminate health disparities and promote better public health in the near term and longer term? As a species, humans have enormous wealth and capabilities. Yet, we waste large fractions of these on conflict and distractions while at the same time promoting environmental degradation and suffering for many. What leads people, particularly those with wealth and power, to follow a narrow interpretation of their self interest, taking actions that harm others when other choices can be made? What leads them to willfully disregard harm and to promote disinformation when that is not necessary for their own survival and reproduction? Can such behavior be precisely characterized and measured? Can its determinants be identified? Can we modify those determinants through disseminating and implementing epidemiologic findings?
Workshop 1- Dissemination and Implementation Research in Health (morning) Sunday, September 24, 2017
Co-chairs: Gila Neta, MD, National Cancer Institute, and Ross Brownson, PhD, Washington University
Dissemination and implementation (D&I) research seeks to bridge the gap between health sciences research, everyday practice and population health by building a knowledge base about how health information, interventions, and new clinical practices and policies are communicated and implemented in public health and health care settings. It is focused on understanding and accelerating the integration of research findings and research-based innovations into everyday practice settings in order to improve health. This workshop is targeted towards epidemiologists at all stages in their careers, from graduate students to mid-career professionals, interested in increasing the impact of their research. Participants will learn what the field of D&I is (and is not), why it is important, what it is trying to achieve, and how it is relevant to epidemiologists. They will learn about the major components of a D&I study, as well as how to design and conduct a D&I study. Moreover, participants will learn how to tailor their own epidemiological research to better enhance its value for dissemination and implementation and how the unique methods and approaches from epidemiology can be applied to D&I questions to advance D&I science. Finally, participants will work on developing a specific aims page they can use to apply for funding opportunities in D&I research at major funders such as the NIH, CDC, PCORI, and VA, as well as the key components of a successful grant application. Didactic presentations, small-group work, and expert consultations will facilitate the learning process.
Workshop 2- In the News: Communicating Research Findings to the Media and Public (morning), Sunday, September 24, 2017
Chair: Jennifer Loukissas, MPP, National Cancer Institute
Saloni Nayar, MPH, Mayo Clinic
This workshop will help epidemiologists effectively communicate their research findings to the media and public. Workshop participants will learn how reporters think and develop skills for successful interviews with journalists. Participants will gain tips for engaging with institutional media relations staff and strategies for showcasing the importance of their research. As time allows, participants will have the opportunity to practice their skills in mock interviews. This workshop is designed to be of interest to epidemiologists at all stages in their career, though may be particularly relevant to those with less experience with the media.
Workshop 3: The Medium is the Message: Crafting your Results to Impact Policy and the Public (afternoon) Sunday, September 24, 2017
Chair: Stephen Deppen, MA, MS, PhD, Vanderbilt University
This workshop will help epidemiologists tailor and communicate their results to inform differing constituencies including public audiences, policy makers, advocates and stakeholders. We will specifically describe partnering with local PR experts, policy advocates and the media to enhance public communication. We’ll also examine differences in methods of communicating results and how an epidemiological message influenced relevant policies.
Workshop 4: QGIS Basics (afternoon) Sunday, September 24, 2017
Chair: Amber Dismer, MPH, Centers for Diseases Control and Prevention
This QGIS basics workshop is designed for public health professionals with no prior GIS experience. By the end of the work shop, you will have experience creating your first maps in QGIS to prepare for a survey. You will also learn how to join existing data that has been collected by a surveillance system to shapefiles to create and analyze results. These hands-on sessions will move quickly, be practice-oriented, and provide you with step-by-step exercises and resources to continue learning. All software used is open source and should be downloaded and installed before the workshop. Data will be provided in the workshop for use.
Workshop 5: Extreme Personal Exposure Biomarker Levels: Guidance for Investigators (Full-Day) Sunday, September 24, 2017
Chair: Susan Pinney, PhD, University of Cincinnati Department of Environmental Health
Since the late 1990s, advances in technology have permitted measuring the low levels of environmental chemicals and metals in whole blood, serum and urine of the general population. Environmental epidemiology studies have embraced this technique for estimating internal exposure, and over 650 studies have been published in the last decade. More recently, many investigators have engaged in the practice of reporting back the personal biomarker measurements to study participants, and the pros and cons of this practice have been thoroughly examined through national workshops and in scientific journal articles. An issue that has not been addressed, and for which there is no established guidance, is how to respond to an incidental finding of a very high level of a chemical or metal in a single study participant. Should those findings be reported to the research participant’s personal physician? Do community physicians want to receive that information? Are they prepared to counsel their patients? The objective of the proposed working group is to explore the medical, ethical and legal issues presented with the incidental finding of a very high level of an exposure biomarker, and ultimately to propose some guidance for researchers and community physicians.