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Topics: Community Engagement, Five Questions, Health Disparities

Weaving a New Narrative Around Health Equity

Five Questions with Nancy B. Smith on engaging communities in research.

Nancy B. Smith considers herself a weaver of sorts. In concert with her colleagues on our Community Coalition for Equity in Research, Smith helps thread the loom that interweaves community members with research teams. It’s part of a new push across Harvard University and around the world to engage and include historically underrepresented communities in clinical and translational research.

Smith’s personal experiences supporting loved ones with vision impairment and hearing loss also drove her to join a Community Engagement Studio. The event linked community members to researchers who received pilot funding in our 2022 Five Senses opportunity to help improve the inclusivity and community relevance of the research projects.

A member of the coalition since 2021, Smith works for the Mayor’s Office of Emergency Management in the City of Boston, where she manages the Community Emergency Response Team (CERT) and its volunteers. She is currently working on special programming to examine climate change adaptation for the City of Boston. Formerly, she was program manager for community resilience and engagement at the Boston Public Health Commission (BPHC).

What makes you want to be part of this coalition?

There’s so much that the coalition brings forth, beginning with the amazing two-way highway between researchers and coalition members. They value us and we value them.

Most of all, I’ve enjoyed seeing that most or all of the research that’s being presented to us has everyday purposes. I don’t see money being wasted. That has been one of the most important things for me in looking at the topics researchers are coming in with. And I genuinely want to know which gaps need to be filled.

We typically hold our coalition meetings during lunchtime, and as we review the research that is current or possibly coming, you feel like you’re sitting down to enjoy a meal with family members, with all these plates before you – which in this case, are the research studies.

We have subject matter experts who are sharp; I mean they’re on it. My intersection with the Coalition draws upon my years in public health, first working in five different departments at the Boston Public Health Commission and now with my new position at the city of Boston, where I’m part of the lead team for the upcoming relaunch of CERT.

So we each bring our particular strengths and life experience to the table. That’s the good thing about the coalition: We are all working together like one body with different moving parts.

“We each bring our particular strengths and life experience to the table. That’s the good thing about the coalition: We are all working together like one body with different moving parts.”

From your perspective, can this kind of effort move the needle on systemic issues such as underrepresentation in clinical research and healthcare inequities?

Yes, I do believe it can move the needle.

I think of everyone on this coalition as being weavers. We bring in individuals with links within the community, people who have credibility there. Not all of us can say: “I am that credible source,” but we can usually get you to that credible source.

The weaving may materialize as making sure we let a community leader know about a particular piece of research relevant to their work, or by connecting a researcher to someone in the community. That allows opportunities for people to change the story, to change the narrative about health inequity.

I think we’re at a stage where we can look at research very differently, and probably clinical trials as well. As you bring in individuals such as myself and my colleagues on the coalition, there’s a growing balance of respect. When we review a researcher’s study as the coalition and offer feedback to the research team, they trust that we’re giving them good advice.

At the end of the day, they want to be successful for the community’s sake. They want to change outcomes for people. I’ve never gotten the feeling that anyone is there just because they received money to do something, that they’re not going to try to help the community. Instead, I’ve had the feeling that we’re all in it together, that what we’re doing is everybody’s business.

What’s one thing you’d like to see the coalition focus on moving forward?

“I think we’re at a stage where we can look at research very differently, and probably clinical trials as well.”

I’m a “Shark Tank” fan; that’s my guilty pleasure. I love it because it’s one of the best narratives for taking your dream and going for it, and you’re cheering for these contestants. What I love most is when the contestants come back a year later and give an update on their project. We see how people have progressed, how their lives have changed as a result of being on the show.

I’d love to see an update a year later on the research we as a group have reviewed. What have they been doing? What happened with the guidance offered? How successful was the effort? For researchers to share with us their successes, but also the ones that weren’t successful, because then we can look a little bit deeper to ask why or why not. Were they able to use any of the suggestions and solutions that we offered? Or maybe we missed the ball on something.

It would be great to examine a year later some of the studies we advised and see what transpired.

Of all the studies you’ve reviewed as part of the coalition, what stands out?

I have a couple favorites. My most favorite was research aimed at improving children’s oral health that we reviewed as a smaller group. I’ll tell you why it’s my favorite: I’m just gonna’ smile. I’m doing that because my mom grew up in the deep south where oral care and dentistry were not the norm. When she became more financially stable, keeping our teeth healthy was something she strongly instilled upon us. I’m talking, if the dentist said you had a cavity, you were in trouble. Because she valued having healthy teeth. So for me, the opportunity to have a research program that goes into the community to give individuals information about oral health was just great.

The other project involved prostate health, and that was of interest because it has affected my family personally, not just one time, but four.

Outside of binging on “Shark Tank,” what do you do for fun?

Gardening is my therapy. Once the weather allows, we’re outside gardening. I have a community garden and a garden at my home.

My other fun thing  is TikTok dancing. I especially like when they do the dance challenges. You’ll be in your house, and some of that music comes on, and you’ve just got to move around. There was a challenge a while back to dance all the way to your car as you leave your house. My neighbors are still laughing because they’d see me dancing my way down the street. I’d just wave.

I feel like it’s a phenomenon that’s similar to why musicals with dancing were so popular after World War II; maybe people wouldn’t get so depressed. It’s hard to be depressed when you’re dancing.

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