Authors

  1. Reid Ponte, Patricia DNSc, RN, FAAN, NEA-BC

Abstract

This month's column is an interview with Dr Janeane N. Anderson, assistant professor, College of Nursing, at the University of Tennessee Health Science Center (UTHSC) in Memphis who is a health communication scholar with a focus on patient-provider communication and healthcare disparities.

 

Article Content

Dr Reid Ponte: I attended the virtual fall conference of the National Organization of Nurse Practitioner Faculties this past November and heard you speak on a panel entitled "Building an Equitable Environment for Nurse Practitioner Education." This is crucial information at a time in the nation when structural racism and health disparities are more acknowledged than ever as well as whiteness within the nursing profession. Could you talk a bit about what brought you to your current college of nursing faculty position, particularly given that you aren't a nurse?

  
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Dr Anderson: I have had an unusual career in that I started at the age of 14 with my press credentials as a high school student in Dallas working with a teacher who saw something in me. I had an inherent interest in the theoretical underpinnings of how people communicate. I knew that I wanted to help underprivileged and underserved groups. I did not quite know how, but I knew change was needed. After completing an undergraduate and master's degree in journalism and working as a journalist for about a decade, I knew I needed to attain a PhD to really effect change in my community. I completed my PhD in communication at the University of Southern California. During that time, I worked in collaboration with several Los Angeles (LA)-area community organizations to develop HIV prevention and risk-reduction interventions. I had a full-circle moment when I began working with Black and Latinx adolescents in South and East LA to improve their sexual health and overall wellness. For my dissertation, I designed and tested a peer-led, social media-based intervention to increase student use of a school-based health center and reduce risky behaviors, like unprotected sexual intercourse, alcohol and illicit drug consumption, tobacco use, and other common teenage health concerns. I became a principled community-based researcher; however, my dissertation experience piqued my interest in the role of technology and web-based interventions to improve health service delivery and health outcomes among patients of color and those from other marginalized communities. When I had the opportunity to gain postdoctoral-level training in health service delivery and web-based interventions with Dr Ilana Graetz, whose program of research focused on this with women with breast cancer, I relocated from LA to Memphis.

 

Dr Reid Ponte: I see that you are a principal investigator of an RO1 supplement grant to study patient-provider communication about sexual health among Black women with breast cancer and coinvestigator on another federal grant supplement, exploring patient-provider communication, symptom management, and medication adherence among lesbian, bisexual, and queer women with breast cancer. Could you tell us what you have learned so far about the health experiences and outcomes of the women in your study?

 

Dr Anderson: It is apparent that providers are challenged to initiate open, candid conversations with breast cancer patients about their sexuality and sexual health concerns during active treatment and survivorship phases. Women in our studies have been prescribed adjuvant endocrine therapy medications and experience a range of adverse effects that disrupt their quality of life. Unfortunately, patients and their providers are more likely to discuss symptoms like joint pain, nausea, and insomnia during visits than sensitive subjects like sexual and mental health. For some women I interviewed, sexual dysfunction not only had a negative impact on their body image and self-esteem that triggered concerns about romantic partner infidelity but also led them to medication nonadherence. I am currently collaborating with a community advisory council of breast cancer survivors to develop communication protocols and a clinical intervention to improve patient-clinician communication about sexual health concerns in oncology care.

 

Dr Reid Ponte: So, when NONPF leaders reached out to you to participate in this important panel regarding what institutional policies and practices are needed to better educate nurse practitioners (NPs), what drew you to wanting to do this?

 

Dr Anderson: I am in awe of the work that nurses and NPs do. I work with nurse faculty at the school of nursing at UTHSC. I have been so moved by the collective awakening about oppression: police brutality against people of color, organizational structural racism, health disparities of people of color with COVID-19, economic and wealth disparities, and social determinants of health based on race, class, sex, ability, age, and more. Given my expertise and scholarship in journalism and communication and given that I am a woman of color, there's no question that I need to lead in a variety of ways at this crucial time in our organizations and society.

 

Dr Reid Ponte: I agree! I would say that it must be a privilege for the faculty in UTHSC's college of nursing to be able to engage and have access to such a scholar. What would you advise nurses, nurse educators, NPs, nurse scientists and nurse leaders to do relative to racism, other forms of discrimination and health disparities?

 

Dr Anderson: NPs and educators must do more than give lip service to diversity, equity, and inclusion. Nurse leaders must be willing to share the intellectual space with students, community members, other colleagues, and individuals who have alternative viewpoints. I think the 1st step to address racism and other "-isms" is to create inclusive environments in which voices that were silenced, marginalized, or tokenized are elevated. Nurse leaders who model inclusion have an opportunity to positively impact US healthcare. Nurses who model sharing intellectual space, engaging with dissenting voices, seeking cultural humility and responsiveness, and valuing diversity create new norms and future healthcare clinicians to improve patient outcomes that reduce persistent health disparities. We need to be on a journey toward antiracism. We need to be different, together while confident and humble. This means speaking boldly and authentically about personal experiences with race, racism, anti-Blackness, and White supremacy being mindful of the unconscious biases we have. Learning and unlearning need to happen within the nursing discipline and our society. We need to enlighten ourselves about the realities of race in America. I challenge each reader to become an antiracist and to ensure that healthcare organizations and community institutions do not continue to oppress marginalized individual and groups. We need change agents.

 

Reference

 

1. Anderson JN, Graff C, Krukowski RA, et al. "Nobody will tell you. You've got to ask!": race-based differences in patient-provider communication between Black and White women with early-stage breast cancer. Health Commun. 2021;36(11):1331-1342. doi:.