Cultural Ambassadors: Collaborating with the Community

Involving the New Haven community in Yale’s clinical and translational research is critical to improving health outcomes and was the impetus for YCCI’s Cultural Ambassadors program. A joint undertaking with Junta for Progressive Action and the African Methodist Episcopal (AME) Zion Church, the program is designed to ensure that clinical Cultural Ambassadors are committed to increasing awareness within in clinical trials; the ambassadors serve as expert resources to Yale investigators regarding the best ways to engage these populations.

Established in early 2011, the program has been beneficial for both patients and investigators. Initially, representatives from Junta and AME Zion underwent intensive education on all aspects of clinical research theory and practice on such topics as patient protections, regulatory requirements, and research in specific disease areas. This training has continued in the form of monthly Community Grand Rounds, a bi-directional forum between Yale faculty and Cultural Ambassadors in which the faculty members present their research or seek input about the design of clinical studies and advice about recruitment. For example, Marsha Guess, M.Sc., M.D., assistant professor of obstetrics, gynecology, and reproductive services, met with the Cultural Ambassadors to discuss her research on uterine prolapse—a subject some women find distressing to discuss. Guess sought the group’s advice on how best to approach this topic in their communities. Similarly, Rafael Perez-Escamilla, Ph.D., professor of epidemiology and associate director of YCCI’s T3 Translational Research Core, sought the group’s input on a study that involves breastfeeding and obesity, as well as a health disparities center that he is seeking to establish.

Cultural ambassadors have provided valuable input in creating such culturally sensitive recruitment materials as brochures and posters, and have appeared in recruitment advertising with messages aimed at their respective populations. For example, AME Zion and Junta representatives provided advice regarding relevant topics to include in YCCI’s “Help Us Discover” brochure about clinical trials; and gave testimonials about the importance of volunteering for clinical research. “Our collaboration with Yale has been a terrific opportunity to educate people about opportunities that have the potential to greatly benefit all of us,” said Sandra Trevino, Junta’s Executive Director. Junta representatives also translated the brochure, as well as standard sections of the informed consent form, into Spanish. They are available to translate study materials and provide interpreter service on an as-needed basis at a reasonable cost (visit http://YCCI.yale.edu/researchers/ors/translation.aspx for details).

In addition to participation in these activities, there have been further opportunities to collaborate with Junta and AME Zion that have been facilitated through the structure created by the program. YCCI representatives have staffed tables at church health fairs and Yale faculty members have made presentations about clinical research at AME Zion conferences and meetings. Cultural Ambassadors have also asked YCCI for assistance in addressing specific health topics that are of concern to their populations, which has led to several faculty presentations at various events. For example, AME Zion pastors expressed concern about high cancer rates in the African American and Hispanic communities, which led to presentations by Thomas J. Lynch, M.D., director of the Yale Cancer Center and Howard Hochster, M.D., associate director for clinical research at the Cancer Center. Both Lynch and Hochster had already met with the group as part of the intensive training in clinical research that took place when the program was established, but welcomed the chance to lead a more focused discussion. “It was a wonderful opportunity for the Cancer Center and YCCI to interact with leaders of the community to address important health issues that directly affect these groups,” said Lynch.

At the same time, Cultural Ambassadors periodically join Yale faculty at community events. On January 26, they were on hand to raise awareness of clinical trials at the Annual Dr. Martin Luther King Jr. Conference at the Wexler-Grant Community School. Tesheia Johnson, YCCI’s chief operating officer, conducted several presentations on what clinical trials involve and why it’s important for people to volunteer. Anees Chagpar, M.D., assistant director of diversity and health equity at the Yale Cancer Center and director of The Yale Breast Center at Smilow Cancer Hospital, conducted several sessions on research related to cancer and the latest findings in the field. Also on hand were research coordinators for studies in the fields of diabetes, mental health, and the Yale Child Study Center, as well as studies recruiting healthy volunteers. 

“As a 10-year survivor of prostate cancer, I welcome the opportunity to educate our community about clinical research in general and the opportunities to participate in research at Yale,” said the Rev. Timothy Howard, Presiding Elder, Western District, AME Zion Church, who participates in the program. 

The Cultural Ambassadors program has fostered a level of trust and mutual respect regarding Yale as an institution while at the same time benefiting the population it serves. Facilitating communication involving respected members of New Haven’s minority communities has created an avenue to lower the barriers to research participation in a meaningful way and engage the community in research that has the potential to benefit everyone.