5 Questions for Jen Sacheck about Community Health Advocacy

by Meghan Johnson

Jen Sacheck is an Assistant Professor here at the Friedman School. As a scientist, she hasn’t always been able to connect with the communities she works with, but she is excited to now have the opportunity to do so by leading a new study looking at Vitamin D. During a previous study conducted at Tufts, Jen found that 75% of 4th-8th grade children in Somerville, Massachusetts, were Vitamin D deficient and 97% were Vitamin D insufficient.  These findings prompted Tufts investigators to examine this issue on a broader scale and to do so, partner with more communities in the Boston area. In her upcoming study, Jen will be leading a team of researchers that hope to look at more than 600 children in Everett, Malden, Cambridge, Somerville and Lynn.

Jen has learned quite a bit about working in communities and advocating for healthier living through her work on Vitamin D. She was kind enough to share a few pearls of wisdom with us.

Meghan: How did you become involved in health advocacy work?

Jen: You know it was basically doing work as a scientist and then feeling frustrated that what we do never gets translated out to the public even if it is really relevant. My advocacy started when I realized initially, with the pilot data, that’s there is a big problem and no one really knows about it and no one really cares so even though the science has to go on, what often gets lost is that work to let people know what’s happening. These side projects, like the Vitamin D campaign, really let people know what’s happening; it helps make a difference. That’s really how it all spun out. It was really once I got into the community and dealt with families and kids and sort of understood that there’s a whole bunch of things going on that I really understood that the awareness has to be there.

The parents might read something as a headline and it can be totally misinterpreted. The Vitamin D Guidelines came out in November saying no one is deficient, but in their community, everybody is! It might not be something they even care about and it’s not high on their priority list, but if there’s awareness, I think subtle things about knowledge can lead to change. And the first thing is letting them know what’s going on.

I think as researchers too, there’s an ethical component. If you study someone, they’re people. They’re not fish. You take home something from working with them too. I feel very strongly about that. I feel like in the past, in the clinical setting, I wasn’t able to do that as well. I had to move onto the next project. There’s not time built in, to sort of say “Oh I’ll give you an extra $10,000 to get the word out.” It’s a real bummer. That’s why it’s great working here with people who do communications well and are interested in public health. It’s like having one foot in science and one foot in policy; doing this work is really rewarding.

Meghan: What lessons have you learned so far from the work you’ve done in the community?

Jen: I let 400 kids know that they’re Vitamin D deficient, and even though I said to share it with your pediatrician, I only heard back from one parent asking, “What do I do? My son is going to see his pediatrician in April, is there anything I should think about?” Even though I said to contact their pediatrician, my contact information was on there and I was the lead study investigator. And no one got in touch with me. That made me just understand where vitamin deficiency falls in terms of priority. Or maybe they just took it literally and only contacted their pediatrician. It raises some concern about what other issues might be more important to these poor families. A big issue to me might not be as big to them. I think that was sort of a wake-up call.

And then you just hope that nothing went wrong logistically with getting the letters home. They were mailed with an address that was put on a consent form a year ago but there are misspellings and people move- it’s pretty transient. You figure there are about 10-15% per year that will move. For me, realizing that in order to keep doing this kind of work moving forward (I’m involved with the Tisch Fellows program too), I need to learn how to be a better community advocate. I feel like I’ve failed myself a few times.

Maybe I’ve published a study but did I send it to everybody that helped me out? Maybe I think they didn’t care but there’s multiple ways you can let people know what’s going on. I’m slowly learning about how to be more efficient about how to spread the results. You always hope you can do more.

But you don’t ever want to tell anyone anything prematurely. Like with my Vitamin D work, I wanted them re-measured because I didn’t want to tell 200 people that they’re deficient if they’re really not. But then the data is a year old and you wonder, “Will anyone even care what I measured a year ago and by the time I publish this actual article, it’s two years later. Does anybody even care anymore if I send this out?” You always get this little bit of sensitivity to ‘What took her so long?’ But that’s the process with academia and with publishing.

Meghan: Does that make programs like Friedman’s Nutrition Communication and the School of Medicine’s Health Communication seem all the more important in helping scientists get their findings out into the communities they study? It seems like we shouldn’t rely on scientists to be both the researchers and the communicators.

Jen: Exactly, and we’re not trained in this way. We’ve had huge discussions at the National Institutes of Health about, “Who are those people?” We have like two people who deal with the school but it’s not like they are in our group or know what’s happening all the time. It’s not as natural sometimes. And the media is not necessarily tied in with a community. Finding those people that are the conduits is tough but very important.

Meghan: In your experience what skills are most valuable in doing advocacy work?

Jen: You have to be real and approachable. You have to have a sense of humor because sometimes people won’t listen to you and you have to deflect. Don’t take yourself too seriously but believe in your cause. Be passionate.

You want to relate to who you’re working with. If it takes me going into Somerville yesterday talking to one of the head school nurses at the Department of Public Health so she knows that I lived in Somerville, I worked with them before, I’ve been with the kids. Then I’m much more real to her and I can say, “Yes I’ve worked with Lynn, the school nurse at the Healy School.” That all helps people trust and understand where you’re coming from. Even if you’re not from the community, you have to find that connection about why it is important for me to be in Somerville. And it’s not just because the demographics are exactly what I need for the particular study. But that there’s a reason I’m here.

Meghan: Some students who read this may be interested in getting involved with public health advocacy. Do you have any words of wisdom for students who want to follow in your footsteps?

Jen: I think it’s the same thing for a student. If you can find something you’re passionate about and link up with research that is already going on. Sometimes there are funds in a study and someone says, “Oh yea getting physical fitness in the curriculum can help academic achievement.” But someone needs to actually do a project or a directed study and then they can push the cause that keeping your kids fit is going to help their test scores so we need to keep physical education in schools.

That sort of cause that someone is passionate about will get him or her in the door instead of just knocking on doors and saying, “What are you working on?” You have to find the group or the researcher or the institution that is working on that. You can’t do it on your own. There might be something you’re really passionate about but, I’m finding, the connections are what lead you out to this whole network of individuals that will help you with that. For me it was one person who told me to talk to another person who linked me up with three people. Every person I meet with, I ask, “Who else should I talk to?” So I’m going down different paths, sometimes in circles, but you sometimes have to spread the web a little bit.

Jen’s Vitamin D community intervention will start the Fall of 2011 and occur in two waves – Fall of 2011 and Fall of 2012.  The results will indicate the magnitude of the vitamin D deficiency problem in schoolchildren from the Northeastern US, whether vitamin D supplementation is warranted and effective in these children, and finally how vitamin D status impacts the health of children.  Stay tuned for the results.

Meghan Johnson is a first-year FPAN student with a specialization in Health & Nutrition Communication. She relocated to Boston from Washington DC and is doing her best to acclimate to the lingo, the bitter winds, and clam chowder.

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