“I’ve noticed too often that patients are not taking medications as they should,” Trivedi said. “I used to always wonder, “what good is my research? I’m here trying to develop new drugs--and if the patients don’t take the ones that are effective as we know from large clinical trials and are saving patients’ lives, coming up with newer drugs isn’t going to solve the problem.”
Trivedi is currently spearheading the Pilot Grant Research initiative, “Interventions to Improve Adherence to Oral Endocrine Therapies for Prevention of New or Recurrent Breast Cancer in African American Women of Low Socioeconomic Status.” The project was awarded $50,000 from NIHMD and HEALTH-RCMI (PI: Dr. Ezemenari Obasi). The key MPI’s on the team science initiative include Dr. Trivedi, Dr. Onyebuchi Ononogbu, Dr. Susan Abughosh, and UH’s Director of the School of Theatre & Dance, Rob Shimko.
Through a collaboration with Harris Health and Houston Methodist, Trivedi and her team are working with African American breast cancer survivors to improve medication adherence to oral endocrine therapies which must be taken 5-10 years after the initial cancer treatment to prevent recurrence of cancer. A patient-centered approach is implemented in this pilot grant project through motivational interviewing and the development of an educational film.
“In talking with patients, I felt the message of how important it was to take these medications was not getting across,” Trivedi said. “The medication could really reduce the chance of cancer coming back by 50 percent. That’s huge. Somehow, they’re not getting the message. I wanted to have this message come across very loud and clear.”
During the launch of this research initiative, Trivedi specifically focused on exploring medication adherence among African American women to help improve health outcomes. According to the American Cancer Society, Black American women are 41% more likely to die from breast cancer than white women, despite lower incidence of the disease.
“There is a big cancer health disparity in Houston,” Trivedi said. “In Harris Health population which serves the underserved community of Houston, the medication adherence is very low compared to what we have seen at the Houston Methodist. We wanted to focus our efforts on African Americans because the adherence was lowest.”
Bridging the cancer health disparity gap is the most promising aspect of the research initiative, according to UH College of Pharmacy researcher, Dr. Ononogbu.
“This research initiative is just the beginning of what is to come,” Ononogbu said. “Right now, we are investigating the barriers to medication adherence in African American women taking oral endocrine therapy, however the bigger picture is the lack of research in minorities.”
Trivedi collaborated with UH Professor of Pharmaceutical Health Outcomes and Policy, Dr. Susan Abughosh on the research initiative, primarily because of Abughosh’s dedicated research in motivational interviewing and medication adherence. For Abughosh, this project resonated with her passion for creating interventions that will truly help improve health outcomes for people.
“What we would love to do is develop a highly customized intervention and implement this on a larger scale in several sites to improve the health outcomes of African American women,” Abughosh said.
The innovative idea of using “cinema” to address the problem of medication adherence emerged when Trivedi reached out to UH Director of Theatre and Dance, Rob Shimko. In essence, the project thoughtfully blended team science with the humanities.
“In terms of team science, this was a way to bring the expertise of different people focusing on health and humanities and their unique thoughts on the problem that you’re dealing with,” Trivedi said. “This is a very unique research project with an arts component that I’ve never had.”
When Shimko was approached to collaborate on the project, he was intrigued and enthusiastic about the prospect of helping Trivedi on the project. Trivedi asked for Shimko’s help to create a short 5-minute educational film that spotlighted a human conversation that resonated with people and spoke to the issue of the importance of medication adherence.
It was after a series of table readings of the script and discussions that the short educational film, “Worth the Fight” was created. The video features two African American sisters in an informative, engaging conversation about taking medication that will directly help with the prevention of breast cancer.
“It’s incredibly meaningful work,” Shimko said. “There is entertaining your audience and informing your audience. This project is a good example of where art and scientific research meet.”
Shimko added that during the edit of “Worth the Fight,” the informational video had transformed into a compelling short film featuring the talents of Houston professional playwright, Patrina Randolph.
“From the film crew to the actors—all the UH students and guest artists involved were paid out of this grant. Patrina’s dialogue has a lot of realism to it. The video itself looks like you’re watching 5 minutes of network TV,” Shimko added.
Through this innovative pilot project, three African American PharmD students are being mentored, including Camille Johnson, Ann Adigwe, and Nicole Ekezie. The overarching hope is that the educational film, “Worth the Fight” in addition to motivational interviewing will help improve the lives and health outcomes of African American women..
“Just telling people what to do does not translate into behavior change,” Abughosh said. “Behavior change has to come from within. As a patient, you have to understand what works for you. Our ultimate goal in the end is to improve the health outcomes.”
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