When Ivana and Irmina Clarke enrolled at the Colorado School of Public Health (ColoradoSPH) in 2022, both were driven by a shared goal of making a meaningful impact on the health of Black and other underserved communities in the state.
After completing their Public Health Science certificate in 2023, they started pursuing their Master of Public Health (MPH) degrees with custom concentrations in community and behavioral health and epidemiology with a global focus. They are eager to apply what they have learned to real-world challenges.
"We've been passionate about community health since we were kids," Ivana says. "Our mother is from Benin, West Africa, and our father is African American. Growing up bicultural, we witnessed firsthand the health disparities affecting our communities."
The Clarke sisters attended a community event focused on diabetes in the Black community, where they met Cynthia Hazel, DrPH '19, MSc, an accomplished alumna and co-founder of the Gyedi Project (pronounced 'jee-di'), a community-led non-profit organization focused on improving health equity in Black communities, including Black immigrant and refugee groups in the Denver Metro area.
Gyedi (pronounced 'jee-di'), is an Akan word that means trust or belief. Community trust is a fundamental value of the Gyedi Project.
"Meeting Dr. Hazel is like finding a mentor we didn't know we were searching for," Irmina says. "Her dedication to health equity and community engagement resonates deeply with us."
Originally from Ghana, Hazel has committed her career to improving health literacy and promoting equity among underserved Black populations, focusing on African immigrants and refugees (in Aurora, Colorado). During her studies at ColoradoSPH, she discovered that the core competencies of public health are developed best outside the classroom. She teamed up with her husband and co-founder of the Gyedi Project, Kweku Hazel, MD, an assistant professor in the Division of GI, Trauma, and Endocrine Surgery at the University of Colorado Department of Surgery. Kweku Hazel is a metabolic surgeon at the University of Colorado Hospital, whose community-engaged research focuses on surgical equity, obesity disparities, and metabolic disease prevention and treatment.
"Being out in the community taught me lessons I could never learn from a textbook," Hazel says, reflecting on her time at ColoradoSPH. "It showed me the power of connecting with people where they are."
While immersed in community settings, she realized that these learning opportunities are essential for understanding complex issues such as health disparities. This realization ignited her passion for practice-based learning and for working with students.
NIH-Funded Research Addressing Health Inequities
United by a shared interest, the Clarke sisters joined the Gyedi Project's newest initiative, an NIH-funded research study dubbed “MOVE: (Motivating Ongoing Vital Exercise) Exercise Adherence and Cognitive Decline: Engaging with the Black Community to Develop and Test a Goal-setting and Exercise Intensity Intervention.” The MOVE study, in which Hazel and her husband are co-investigators, collaborates with the Department of Psychology and Neuroscience at CU Boulder and Angela Bryan, PhD, professor of Psychology and Neuroscience, as the principal investigator. The study aims to increase exercise maintenance among Black adults aged 45 to 65 by offering a culturally tailored exercise program. Recognizing that traditional exercise initiatives often lack cultural relevance, the study researchers seek to understand and address the unique barriers that Black adults face in maintaining regular physical activity that could reduce the disproportionate risk of cognitive decline.
"Many exercise studies fail to connect with Black adults because they don't consider cultural contexts," Hazel explains. "There's a significant gap in research regarding understanding how cultural factors influence exercise habits in Black communities."
Despite the well-documented benefits of physical activity, Black adults are less likely to start and maintain exercise routines compared to other populations. Historical underrepresentation in clinical studies, systemic barriers, and cultural differences have left a void in understanding what truly motivates sustained physical activity among Black adults.
"We realized that a one-size-fits-all approach doesn't work," Hazel says. "Without considering the unique cultural experiences of Black adults, including immigrant and refugee populations, it's challenging to develop physical activity programs that are both effective and engaging."
The MOVE study incorporates goal-setting strategies and community engagement methods, allowing participants to set exercise goals within a supportive cultural environment. This personalized approach addresses barriers such as access to facilities, the need for initial support during exercise initiation, cultural perceptions of exercise, and historical mistrust of medical institutions.
"Understanding and integrating cultural nuances is crucial for behavior adoption and maintenance," Hazel adds. "It's about meeting people where they are and providing the support they need to succeed independently."
Community-Centered Approach
As part of their practicum and capstone experience, Ivana and Irmina are involved in various aspects of the project, including participant recruitment, community outreach and engagement, exercise supervision, and data collection and analysis. Their community engagement includes connecting with more than 200 organizations, such as churches, community-based organizations, and cultural groups, primarily targeting those that serve Black adults. This focus emphasizes health education and addressing barriers to physical activity among these communities to build trust and encourage participation in the MOVE study.
Recruiting participants who may be skeptical of academic researchers requires care and specific outreach strategies. "We understand the historical context," Hazel notes. "Transparency, supporting health literacy, and cultural responsiveness are essential to our approach."
"Building relationships within the community is essential," Irmina emphasizes. "We want participants to feel supported and empowered to take control of their health. Trust is everything. We can't just drop into communities and expect people to believe what we say or join us. We have to understand and validate their concerns and show that we're in this together. Ongoing engagement is important for building trust."
Participants in the study already show increased motivation and commitment to an active lifestyle. One participant expressed eagerness to continue exercising independently after the supervised sessions. "Seeing participants gain confidence in regular exercise is incredibly rewarding," Ivana says.
As the MOVE study advances, the team is committed to refining strategies based on participant feedback and measurable outcomes. With plans to scale the study, they aim to amplify its impact on health equity through targeted education campaigns, broader community engagement, and strategic community partnerships. By tailoring their approach to the unique needs of Black communities, they strive to deepen trust and equip individuals with actionable knowledge and resources needed to initiate and achieve sustained physical activity.
"This experience is shaping our careers, and we look forward to seeing where this journey leads," Irmina says.
Bridging the Gap Between Academia and Community
The MOVE team worked with a community advisory board of Black adults, including leaders of nonprofits, health professionals, faith leaders, and community members, to culturally tailor the intervention. They plan to share their study findings through community presentations, social media, newsletters, and academic publications to increase awareness of the importance of cultural tailoring in behavioral health interventions and encourage more people to engage in physical activity. The findings will be shared using evidence-informed dissemination and implementation framework, targeting the unique cultural experiences and barriers and acknowledging the systemic inequities that have historically limited access to health-promoting resources and behaviors.
To guide this effort, the MOVE program incorporates a culturally responsive approach rooted in behavioral change theories, emphasizing intrinsic motivation, exercise identity, self-efficacy, and intention. By working closely with the community advisory board, the team ensures its methods and messaging resonate deeply with the focused population, Black adults. This collaborative framework facilitates meaningful engagement and helps bridge the gap between academic research and the communities, making sustainable health improvements achievable for historically underserved communities.
"Knowledge is power," Ivana stresses. "We want to empower people with information that can improve their lives."
The Clarke sisters’ collaboration with the Gyedi Project demonstrates ColoradoSPH's commitment to practice-based learning and diversifying the public health workforce. By working closely with an alumna like Hazel, the Clarke sisters gain practical skills while contributing to meaningful change. Hazel emphasizes the importance of experiential learning in public health education and encourages increased support for students across ColoradoSPH’s three campuses to engage in community-based work.
The MOVE program demonstrates how experiential learning can bridge academic research and community impact. The program emphasizes addressing systemic inequities in public health education and research through culturally tailored frameworks, including goal-setting strategies and insights from community advisory boards. By involving the Clarke sisters in all aspects of the study, from participant engagement to data analysis, their experience will develop important skills and provide a hands-on education while enhancing their experiences in addressing health inequity.
"Transitioning from classroom knowledge to community practice can be quite different," Hazel notes. "Experiential learning provides opportunities for students to experience that before they graduate as professionals."
Mary K. Dinger, PhD, FACSM, clinical professor of community and behavioral health and faculty director of practice-based learning at ColoradoSPH, highlights the significance of such experiences.
"Experiential learning with programs like MOVE provides students with invaluable real-world experience. They not only fulfill academic requirements but also foster the development of skills and empathy students will need as public health professionals,” Dinger said.
The Clarke sisters are not only gaining invaluable real-world experience as they pursue their MPH, but they are also taking significant steps in their mission to tackle the historical health inequities experienced by Black Coloradans, including their own families.
The Clarke sisters' collaboration with Hazel highlights the positive effects of proactive, intentional, and dedicated efforts on career development. By working together, they strengthen the connections within the ColoradoSPH community and take meaningful steps toward advancing health equity.
