Five projects aimed at advancing health equity have been awarded grants by the University of Colorado Department of Medicine as part of its Diversity, Equity, Inclusion, and Justice (DEIJ) grant program.
From addressing language barriers in clinical trials to investigating methods of increasing resilience to climate change, the projects — proposed by CU faculty and trainees — will promote more diverse, inclusive, and equity-focused approaches to treating patients. This is the second round of grant awardees, following last year’s inaugural awards to five projects.
“In the Department of Medicine, we recognize that diversity and inclusion create a climate where everybody feels seen and heard. These projects are a testament to this commitment,” says Sonia Flores, PhD, the department’s vice chair for diversity and justice. “These projects will and have already improved the climate, and more importantly, it shows that we are willing to put department resources into their completion.”
The award recipients are as follows:
- Maria Amaya, MD, PhD, and Jorge Monge, MD, for the project: “Improving Clinical Trial Awareness and Accrual of Underrepresented in Medicine Populations by Addressing Language Barriers.”
- Reem Hanna, MD, for the project: "Empowering Internal Medicine Residents to Work Effectively with Medical Interpreters: A Strategy to Improve Care for Refugee and Immigrant Populations."
- Sarah Young, MD, and Sherri Cook, PhD, for the project: "Building Resilience to Climate Change in the Dialysis Population: Using Life Cycle and Systems Thinking to Identify the Least Vulnerable Dialysis Option."
- Enrique Soto Pérez de Celis, MD, PhD, and Francis Gisselle Garay, MD, for the project: “Promoting Inclusion of Ethnically and Linguistically Diverse Populations in Cancer Clinical Trials: Exploring the Role of Clinical Research Coordinators.”
- Prashanth Francis, MD, PhD, and Elena Lebduska, MD, for the project: “Equidad por Todos: A Community-Focused Approach to Tackle Spanish-Language Disparities in Colorectal Cancer Screening.”
Agents of change
As a doctor from Honduras who is applying for medical residency in the United States, the department’s DEIJ grant offers the perfect opportunity for Garay, a senior research professional for the CU Cancer Center, to gain research experience and help people from underrepresented communities.
“When Dr. Soto told me about this grant, we sat down, talked, and put together an idea based on our experiences in the U.S. academic and health care system. As someone from an underrepresented background, I feel a strong responsibility to identify problems we commonly face and find solutions,” Garay says. “Cultural differences and/or language barriers play a significant role in the quality of medical care patients receive.”
“The representation of ethnically and linguistically diverse patients in cancer care and research is very low across the U.S., and Colorado has a large proportion of patients from diverse backgrounds experiencing this health disparity,” she adds.
Garay and Soto, the CU Cancer Center’s associate director for global oncology and a visiting associate professor of medical oncology, ultimately decided to have their project focus on increasing the representation of patients in cancer clinical trials and research staff involved in recruitment. To do this, they aim to first gain a better understanding of the barriers that clinical research coordinators and other research staff face when trying to recruit patients from ethnically and linguistically diverse communities into cancer clinical trials.
“The news that our grant proposal was selected for funding felt inspiring. It meant to me that we were being heard and that our project had a strong likelihood of positively impacting the lives of ethnically and linguistically diverse cancer patients in Colorado,” Garay says. “Having the opportunity to serve as an agent of change is very fulfilling.”
The project’s purpose goes beyond understanding the problem, Garay explains, as she hopes to also uncover solutions to help CU with the recruitment process of patients from these traditionally underrepresented communities into cancer clinical trials.
Renewed grant, steadfast dedication
For Amaya, an assistant professor of hematology, being named an awardee was particularly special because this is the second time that her team has received a DEIJ grant. With the renewed funding, her team will be able to continue creating high-quality videos in English and Spanish for patients that explain a certain disease, how it is treated, and how a clinical trial works.
“We know that underrepresented minorities have lower enrollment rates in clinical trials, and we are committed to finding ways to improve this,” Amaya says. “We believe that increasing resources for patients may improve their understanding of their disease and clinical trials available that may be beneficial for them.”
Thus far, the team has produced videos about lymphoma and leukemia, and the next video will be about multiple myeloma. These videos have been published on the CU Division of Hematology website, and they have also been shared with community partners and other institutions. Flores says one of the reasons the grant was awarded to Amaya and her team was because of the work’s dissemination.
“They showed the sustainability of their project, and more importantly, their work has now been disseminated to other institutions, which is one of our review criteria,” Flores says. “I would like all projects to be scalable and expanded to other divisions, departments, or even the entire school, which illustrates their sustainability and impact.”
Amaya explains the renewed grant will allow her team to produce more videos and survey patients to assess whether the videos impacted their understanding of their disease and thoughts about clinical trials. The team is also partnering with other institutions to create a larger source of information for patients by creating interactive websites in multiple languages.
Fostering hope
The DEIJ grant will allow Young, a nephrologist and associate professor of clinical practice in the Division of Renal Diseases and Hypertension, and her colleagues Cook, an environmental engineer at CU Boulder, and Amy Li, MD, a CU research nephrology fellow, to further investigate a unique relationship between kidney dialysis and climate change.
“Patients on dialysis are reliant on public infrastructure, water, energy, and transportation, which are very vulnerable to extreme weather events from climate change such as flooding and drought,” Young says. “Black, Hispanic, and Native American individuals on dialysis are more likely to be struggling with poverty, employment, live in crowded rental units, and have no transportation of their own, making them the most vulnerable to extreme weather events from climate.”
“We want to understand how best to provide dialysis to this patient population as the planet warms and we have more disruptions to the public and medical infrastructure upon which they rely,” she adds.
Cook’s research expertise in quantitative sustainable design will allow the team to study the climate resilience of each type of dialysis treatment, such as hemodialysis, peritoneal dialysis, and home dialysis, Young explains. Through this research, they hope to learn which dialysis modality will best serve patients who are going through an extreme weather event, such as a hurricane or heat wave.
“Using scenario analysis to evaluate the impact of climate change on dialysis reliability is novel,” Young says. “The goal of our research is to identify vulnerabilities of each dialysis modality in order to increase the sustainability and resilience for the end-stage renal disease population, who are disproportionately poor, people of color, and socially and economically marginalized.”
Overall, the department’s DEIJ grant represents hope, Young says.
“I am a non-traditional academic with an idea, a very motivated fellow, and a CU Boulder colleague,” Young says. “This grant program is needed to support people with well thought-out research ideas who are trying to get a project from an idea to a publication. It gives us hope that we can do this important work.”
