Dr. Nancy Schoenberg is Marion Pearsall Professor of Behavioral Science (College of Medicine) and Associate Dean for Research (College of Public Health) at the University of Kentucky. Dr. Schoenberg, a medical anthropologist, focuses on health decision-making in underserved populations, with a specific emphasis on the prevention and control of chronic conditions. In partnership with community members, this research involves developing, administering, and evaluating community-engaged health promotion and disease prevention interventions among health disparity population.
Dr. Schoenberg founded the Faith Moves Mountain (FMM) community-based research organization in 2004 and has worked with rural residents to undertake rigorous, innovative randomized controlled trials. She has served as PI or co-PI on the following NIH grants: “An Intergenerational CBPR Intervention to Reduce Appalachian Health Disparities” (R01 DK081324, N=1200); ”Appalachians Together Restoring the Eating Environment (Appal-TREE)” (R24MD008018, N=500); the first known Appalachian faith-based RCT for cancer screening (“An Appalachian Cervical Cancer Prevention Project”, R01CA108696, N=460); ”Faith Moves Mountains: A CBPR Appalachian Wellness & Cancer Prevention Program” (R24MD002757, N=2400); and Patient Navigation for Cervical Cancer in Appalachia (R01 CA120606, N=350). She currently leads several research projects including R01 ES024771 NIEHS/NIH “Community-engaged research & action to reduce respiratory disease in Appalachia;” “Appalachians Together Restoring the Eating Environment (Appal-TREE): Advancing Sustainable CBPR Interventions to Improve Healthy Diet in Rural Appalachian Children” U01 MD010556-01) and “Grandfamilies in Gardens” (Retirement Research Foundation #2014-211).
She and her colleagues have published over 115 peer reviewed publications in diverse, interdisciplinary journals including medicine, public health, healthy policy, health disparities, and social and behavioral science. She regularly mentors junior colleagues, serves on NIH study section, and served as the Associate Editor of The Gerontologist for six years.
Questions & Answers
The lay health advisors (LHA) will work anywhere if they are strategically hired, authentically local, and well trained.
Also, partnering with a wide array of faith (or many other civic and local organizations) would be a very solid strategy that would work well in diverse locations. Finally, that one-on-one approach, where materials and discussions are tailored to individuals’ particular barriers and circumstances was very helpful and would be a desirable approach in most populations.
We would speculate that this program could be well adapted to any population, but most particularly one that tends to be underserved by formal medical care (and thus might do better with a trustworthy local person who is similar to them) and populations that have a strong faith tradition.
The program might not work as well with populations that are geographically very remote, as the face to face time with LHA was critical.
Facilitators include a very committed group of community members who know local norms and values. We found it essential, however, to pay them for their time, as everyone is so busy and the competing demands are almost impossible without compensation.
Our training and retraining really facilitated progress; we met on a fairly regular basis with our lay health advisors and interviewers and overall staff to make sure that the information being conveyed was consistent and that the protocols that we were following was standard.
Challenges range from unavoidable issues like poor weather making it hard for us to hold events or face to face sessions; multiple and competing demands that continue to result in people not being able to prioritize preventive health procedures; and ensuring fidelity among the many staff people working on the project.
We cannot overemphasize the need for everyone to be on the same page with the materials, processes, and information that they provide. Drift from the core materials, processes, and information will result in very uneven outcomes.
We developed a fidelity checklist to help, and even though our materials and newsletters were individualized, we made sure that they were based on a template.