Advancing Prostate Cancer Research in Black Men

Mar 11 11:20am | Kanaaz Pereira, Connect Moderator | @kanaazpereira

Gladys Asiedu, Ph.D., always knew she wanted to make a difference in people's lives. A steady focus on that altruistic goal would ultimately lead her to Mayo Clinic.

She received her undergraduate degree in English and religious studies from the University of Cape Coast in Ghana. In 2004, she and her family landed in Manhattan, Kansas, where she pursued graduate education at Kansas State University, receiving a master's in family studies and human services, a Ph.D. in family studies, and a graduate certificate in women's studies.

A passion for equity in the pursuit of health and wellness

Dr. Asiedu's experience in international and community health programs before coming to the U.S. gave her firsthand knowledge of the devastating effects of such a diagnosis on underprivileged and underserved populations.

In both her master's thesis and Ph.D. dissertation, Dr. Asiedu argued that HIV/AIDS-related stigma and discrimination are not something that affects just one person or one family. It is a systemic issue that affects the health and well-being of a whole community, healthcare providers and care systems.

Dr. Asiedu observed that this stigma was fueled by misinformation and a limited understanding of science, and she proposed that education was the first step to averting fears related to the disease.

Her dissertation expanded on this finding and illustrated that community-based, participatory research — a newly emerging concept at the time — was an effective way to identify potential interventions.

A continuing focus on community

In 2010, Dr. Asiedu moved to Rochester, where she hoped to help build a world where people would have equitable experiences and opportunities to live their healthiest and happiest lives.

Today, Dr. Asiedu is a leading researcher in the new Diversity Science Program of the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.

Program Director Renaldo Blocker, Ph.D., Dr. Asiedu and other colleagues defined diversity science at Mayo. They started by thinking about the biases and inequities in the U.S.

"We were initially moved by our own experiences and the experiences of our colleagues, and were passionate about effecting change in our workplace and community," says Dr. Asiedu. "We became passionate about addressing this for our own institution and wanted to do good in the workforce space.  But after the murder of George Floyd, it grew beyond the initial vision."

Mayo Clinic pledged $100 million to eliminate racism, advance equity and inclusion within Mayo Clinic, and improve health equity for people everywhere.

"We created the Diversity Science Program to be a hub for scientists and practitioners who wanted to work in this space but needed the guidance, consults and strategies that could potentially accelerate progress toward inclusivity through research," Dr. Asiedu says.

The team knew their work had to be more than just internal to Mayo. They needed to address the needs of the workforce, patients and community. They had to investigate and build interventions for sustainable transformation inside Mayo and across the global community.

"The fact that this program came into existence signifies our recognition of inequities and inequalities in our world, oppressions and disparities that come from systems of power," Dr. Asiedu says. "Systemic structures and cultural norms that have allowed dominant groups to undermine the value and dignity of members of minority groups.

"Launching the Diversity Science Program showed a renewed commitment by Mayo to conduct the rigorous research that underlies transformation and to share the knowledge gained through investigation and implementation of interventions," says Dr. Asiedu. "It's about time we change the science of characterizing inequities and disparities and move toward impactful science that implements interventions and programs resulting in equity and meaningful outcomes for all groups of people."

Seeking a new perspective on clinical trial participation among underrepresented minority patients

Together with Katharine Price, M.D.Rahma Warsame, M.D., and others, Dr. Asiedu explored the experiences, motivations, and decision-making of underrepresented minority patients successfully treated in a cancer clinical trial. After reviewing existing literature, they deliberately chose a mixed-methods approach, considering the question from an entirely new angle.

The team used surveys and the photo-elicitation interview technique — a visual research method — to explore and understand the motivations and facilitators of trial participation.

The authors found that altruism appears to be a significant motivator to enroll in a cancer clinical trial. This message could be incorporated into recruitment strategies to improve the recruitment of diverse patients.

To gain a more comprehensive picture, the study included perspectives from physicians, study coordinators, clinical trial investigators, recruitment personnel and other staff involved in clinical trials to provide important insight into the complex issue of inclusive accrual.

Ultimately, Dr. Asiedu and the team's most critical observation was that clinical trial participation requires a relational approach. It is more than a simple two-party contractual agreement.

"It's not just you, the patient, making the decision. It is a decision for you and your family and friends and together with doctors," she says.

Improving care for men with prostate cancer who are also immigrants from sub-Saharan Africa

Most recently, Dr. Asiedu has been working with colleagues at Mayo Clinic Comprehensive Cancer Center to customize another framework — one for understanding the social determinants of migrant health. They hope their work leads to improved care and survivorship experiences for Black men with prostate cancer.

The current investigation is a pilot study among sub-Saharan African immigrants, identifying factors contributing to health-seeking behavior. Their findings advance knowledge in the iCCaRE Consortium, a shortened name for the Inclusive Cancer Care Research Equity for Black Men Consortium.

The team expects to expand the pilot to phase 2 in early 2024, involving other African and Caribbean immigrant communities and expanding collaborations to the University of Texas MD Anderson Cancer Center.

Read more about this collaboration in Cancer Epidemiology, Biomarkers & Prevention.

Excerpted from Mayo Clinic News Network

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