Cheryl Martin (Host): This is Healthy with VCU Health. Coming up the second episode in a series of conversations with the Vice President and Chief Diversity Officer at VCU Health, Dr. Marcelle Davis, and team members throughout our health care system on their commitment to diversity, equity, and inclusion, and its impact on health.

Today, along with Dr. Davis, we're sitting down with Dr. Robert Winn, Director of the VCU Massey Comprehensive Cancer Center. The focus, how VCU Massey Comprehensive Cancer Center's commitment to this work has a positive influence on our patients, workforce, and community. This is Healthy with VCU Health.

I'm Cheryl Martin. Delighted to have both of you on and looking forward to our discussion. So, Dr. Davis, let me begin with you. Tell us a bit about your background and why you chose Dr. Winn as your second guest.

Dr. Marcelle Davis: Cheryl, thank you so much. As the Vice President of Diversity, Equity and Inclusion here at VCU Health, my role focuses on ensuring that everything we do at the health system is grounded in equity and inclusion, and that means different things to different people, right? But here at VCU Health, my team creates and executes initiatives that really equip our workforce that's made up of more than 13,000 team members to be culturally responsive to the needs of our diverse patient population.

And I chose Dr. Winn as our second guest because he is a dynamic, brilliant, and engaging individual who really works tirelessly to do several things, like diversifying the pathways that lead to being a healthcare professional, or teaching cultural humility, or engaging with the community. And finally, he works to increase awareness around diagnosing and treating cancer.

Cheryl Martin (Host): Dr. Winn, welcome to this episode of the DEI series. So, tell us a little bit about your background.

Dr. Robert Winn: Thank you for the invitation for being here and for the work that you all do. In short, I always say that my dream has always been to stay connected with the community. So I grew up in New York, to a teen mom. I, did not have this interest in the science or those passion for medicine.

In fact, my passion was driven towards being the youngest foreman at GM. I look back and thankfully that didn't work out. But what I am an example of is when people see something in you before you see it in yourself. So that when people see me as a now a cancer center director of a comprehensive cancer center in 2019, the only African American cancer center director in the country at that point of a designated center; what most people see is that, he's, you know, accomplished doctor, accomplished in the laboratory, et cetera, et cetera. But what they don't see is that all of those things were really catalyzed not by me but by other people who saw something in me. By the time I got to Notre Dame, again I was grateful to be there, but wanted a job at GM at the end of it all, cause the athletic stuff doesn't usually tend to work out.

And it was two priests, a Father Walter and a Father Auster, who saw something in me that says, son, you're not really an engineer. Although I was passing my classes just for the records though. But I think you'd be a better fit would be medicine. Now at that time, I didn't even think I could do it because I hadn't seen any black doctors. So for me, it was one of these things of an example of why we always have to pay it forward.

And that our job really as doctors, as administrators, as health professionals and scientists is to see things in those young people that they may not see in themselves. So I got here on the shoulders and with the prayers and the ability of others to see things in me that I couldn't see in myself at the time.

Cheryl Martin (Host): And you are definitely paying it forward, especially in this position here, because the VCU Massey Comprehensive Cancer Center has achieved NCI designated Comprehensive Cancer Center status. So tell us what this is and its importance, particularly for diverse communities.

Dr. Robert Winn: Yeah, thank you for asking that question because most of the time when we tend to do things on an academic institution, it tends to be very insular, like the comprehensive status only matters for us, right? It's our bragging rights. And that certainly is true. Certainly getting comprehensive after almost trying for almost 50 years feels good.

I stand on the shoulders of people like Gordon Ginder, I say he is like a ketchup bottle who did all the right things that made it easier for me to actually bring the comprehensive home. But I actually wanted to let people know that it's not just about the bragging rights or the ability of us to recruit better people or to recruit high impact trials here.

Literally getting comprehensive, most people in the street, in the barbershops, in the beauty salons, and out in a restaurant or shopping, have no idea that getting the comprehensive also will equal to saving more lives. And people say, well, how does that work? Well, as a result of being comprehensive, we're now in a network where we're going to have access to many, many more high impact clinical trials.

We're going to have impact on the ability to bring some of the best and brightest that will impact the way that they carry out either the research or the way they carry out seeing patients. And so the comprehensive is a nice gold seal, I give you that. But for me, the comprehensive has always been driven by the indication that by obtaining it, we're much more organized.

By the way, we've had the greatest number of opportunities to be on clinical trials than we've had ever. And there are many more markers. Our science has actually picked up. We're publishing now three times more, than we had previously in high impact scientific journals. So we're doing a lot of those things.

And so from an academic perspective, you say, aha, that's great. But what that translates into that we don't always do a good job into, is that that translates directly into the ability of being more organized and being more impactful and therefore saving more lives.

Cheryl Martin (Host): And this is the highest recognition from the National Cancer Institute.

Dr. Robert Winn: Yeah, it's all the way to the top.

Cheryl Martin (Host): Now, Dr. Winn, you also created and lead the Robert A. Winn Diversity in Clinical Trials Career Development Award Program. So please explain what this is and why you decided to develop this program.

Dr. Robert Winn: Yeah, this had been a few years in the making. And so let me first of all, just tell you that when I talk about clinical trials, I tell everybody the following, when the standard of cancer care ends and there is no extra road, in the 21st century, the standard of care is the opportunity to actually be having access to clinical trials. In fact, back in the day, what happens with us is that clinical trials seemed to be experimentation. That was true back in the day that's why out of the pain and the sorrow of things like, the Tuskegee, and there were many, many others in that, but the Tuskegee experiments and stuff, out of that pain came some good in the context of making sure that all of our experiments and anything we do with trials now are overseen. By the way, when people usually come on clinical trials, it doesn't mean that you give up the standard of care for cancer anyways. It means you have the standard of care plus this additional agent to make sure that you're taken care of.

So, I say all that to say that the new program that I have tried to bridge two things that I love very much that were like two ships passing in the night. One was that we oftentimes think of outreach and engagement as being this sort of soft thing and not related to science. Well, I wanted to refute that and say that it is very much rooted in the science of outreach and engagement, and we've developed a body of literature and approaches over the last 50 years.

By the way, those folks while they were good at outreach and engagement and the science of that were very bad at understanding the difficult road it took to get somebody who came up with a molecule that became a medicine that became accessible to people for clinical trials. On the other hand, you had people who could write a high impact trial. They knew how to write it. They knew how to implement it, but they had no idea how to reach populations, rural populations, urban underserved populations, and then would complain that no black and brown, tan people, no rural people ever got on their trials.

Well, I learned from middle school two things, and this is how the program came up, that the reason why I didn't dance as much as I probably should have is because I never asked anyone. And that's our profession. We blame people from rural and urban underserved areas because they don't join our trials, but we make no attempt in figuring out how to make that more accessible.

This program really does attempt to sort of come all Charlie Wilson, like, you know what I mean? The other thing is, even if I asked somebody to dance, I would sound all crazy because, you know, I didn't have my Charlie Wilson game on, back then. So I didn't know how to step to people the right way.

And in fact, that's what I would say about the academic medical centers. Even when we ask, it's so crazy and it's not geared towards effective communication that we tend to have people say no. So this was merger of the first class and I now have three cohorts throughout the country where they are learning now not only how to design and implement the best trials, but they're learning how to use asset maps. Community asset maps. They're learning how to use the strategies and skills within the communities to before they even design their trials. The hope is that by doing this approach, we're going to get more people from urban underserved areas and rural areas onto these, I think in some cases, life changing trials.

Cheryl Martin (Host): Now, you mentioned strategy. Is one of your strategies a program that you initiated? A Facts and Faith Fridays program? Tell us about it and why it was important to get involved with the community in this way.

Dr. Robert Winn: Well, turns out that over the years, and I think COVID has taught us this, that you can have all the high-tech stuff that you want to in the world, but if its lacking high touch, people don't usually use it. So, we, not only are we now developing a program in which we are developing the concept of high tech and high touch among our trainees to develop trials, but we also had to figure out how we can bring that down to the community.

During the period of COVID, people look, the big C, cancer didn't go away. It existed before COVID, and as COVID starts dwindling down, the cancer will still be there. But at that very moment, what was needed was the information of how does one safely get through a church service back then. And so with Dr. F Todd Gray and with Rudeen Mercer Haynes, who's just an outstanding lawyer and just community activists, the three of us, I know it sounds like a joke, what happens when a lawyer, a preacher, and a doctor get in the same room, but that's actually what happened. And out of that came this concept that facts are not war with your faith.

And then what came out of that was how we could establish then a regular cadence to faith-based leaders and their communities, not just their congregation, but their communities of how to stay safe through COVID. That's now transitioned into things in which we are now having services, understanding the amount of rigor in the burnout within the faith-based community, particularly with the preachers and the reverends.

So we're doing a mental behavioral workshops and things like that with them at least once a month. We are actually extending beyond just COVID and talking about cancer or talking about social issues, education. And so it's been wonderful to connect with the community in a high touch because once you connect and you build trust, they're much more willing then to believe that some of the high-tech stuff that we have to offer can benefit them.

Cheryl Martin (Host): What would you say is the most significant outcome of this program?

Dr. Robert Winn: First of all, I think the most significant outcome of Facts, Faith, and Fridays is that according to Norm Oliver who is the Commissioner of Health for the Virginia Department of Health, we actually can point directly that these men and women who are part of the Facts, Faith, and Fridays save lives.

The second thing is the next benefit that has come out of it. We have things like, something called the multi cancer early detection. This is again, I'm writing a paper right now that says that every new technology we come up with, every new drug we come up with tends to inadvertently introduce disparities.

This multi cancer early detection device, which is really just a blood draw. Think about this. You can draw blood and potentially have someone says you really should go get screened or you really should go get tested because you may have breast cancer. In fact, we just had a cancer of a woman who was feeling great, who just came along with a friend who had some blood tested and the blood had two markers.

It was a hit for colorectal and breast. And she was like, what is this? Turns out that when we actually followed up and followed through, it was breast cancer that she had. Early, early-stage breast cancer, which is then curable. So, I do this because the Facts, Faith, Friday crew wouldn't have no idea that this new technology is there, nor will we have the time in most communities to break it down to say, is it safe? Will it help? The Facts, Faith, and Friday is a way in which we can convene people to have those discussions and how it's helped. We, I don't know if you all heard, but a couple weeks ago we had a couple of the faith-based leaders from Facts, Faith, and Fridays bring together a group of African American churches to launch this multi cancer early detection sort of trial and be part of it. So, I think there's a lot of good stuff that's happening.

Cheryl Martin (Host): We hear all the time that we need to be advocates. So, going back to the blood markers, in those cases, do you encourage people to specifically say to a doctor, I want the blood tests that will reveal the markers, or just wait for the doctor to order those blood tests?

Dr. Robert Winn: Those days of waiting for somebody to ask you are over. So, here's what I'm saying. And that when I'm trying to get my community, my doctors, but let's focus on folks in the community is to, whenever you meet one of your doctors, and even if you're beginning your cancer therapy to say, if this fails, what are the clinical trials that are appropriate and available for me? Upfront, so we can get to think about it and the second thing is what you just sort of said, are there other trials, like for example, or are there other ways in which you can help me detect my cancer early by screening? And so I think that, again, as I've been telling many African American families and many families just throughout the commonwealth, that when you, keep your family secrets about so and so had this kind of cancer and they don't know, family secrets kill.

And it's now time that people within our rural and at risk communities and underserved communities, et cetera, et cetera, and just any community starts being more open and transparent about not only our family history, but the importance of screening for various cancers. And so I'm a big proponent of this new approach. But I'm also a proponent of whatever screening you can get, that's the best screening.

Cheryl Martin (Host): Okay, Dr. Davis, I want to continue with you with the subject on the community. So what's the impact of these key initiatives that Dr. Winn and VCU Massey Comprehensive Cancer Center are leading? And how do they support the community and develop talent for future workforce?

Dr. Marcelle Davis: You know, Cheryl, when I listen to Dr. Winn share all of the incredible work and the initiatives that he is working on to really drive that impact across the community; he touched on Facts and Faith Fridays. And I remember I was fairly new here at VCU Health, and I found myself on a work group with Dr. Winn, because at the time we were working to figure out how to get more shots in arms. And being on this work group, I really got to see Dr. Winn and understand his modus operandi, so to speak. And what he doesn't share is he's had guests like Dr. Jill Biden, Dr. Fauci, Mayor Stoney, and Senator McClellan, just to name a few.

I mean, Facts and Faith Fridays is one of those things that not just shared information, but it taught cultural humility and I believe that that helps both us as a healthcare provider and it helps our community because it helps us to build trust and not only gather information but push that out as well.

And the result was tremendous because we really were able to get more shots in arms across the community and have open dialogue about how we could really provide better care to our patients. And this program among so many others that Dr. Winn drives, not only supports the community, but it helps to develop talent for the future workforce in a variety of ways.

Cheryl Martin (Host): Well, both of you have covered a lot on this episode, Dr. Winn and Dr. Davis. Anything else either of you would like to add?

Dr. Robert Winn: Yes, Dr. Davis is the bomb and the work that she's doing in the context of DEI should be commended and elevated and I have nothing but great things to say about her and we're so lucky to have her here at VCU.

Dr. Marcelle Davis: Oh, Dr. Winn, thank you so much. I really, really appreciate that. And interestingly enough, I'd like to reciprocate that. A special note of thanks to you for taking time out of your busy schedule to be here on the podcast today. You're making such an incredible difference, not just here in VCU Health or healthcare in general, but across the community and truly, I chuckle about this, but almost every time I turn my radio on, I hear you talking about all of the great work that you're doing in the community.

And I, one thing that really stands out is just how you have that knack to connect and share information. And you're like a big brother to so many people that I talk to. So thank you. Because really for us to advance diversity, equity and inclusion, it takes intentionality, and more importantly, it takes all of us to have the courage to identify our own biases and then take steps to mitigate against them.

Cheryl Martin (Host): Very well said. A lot of great information coming out today, and I just want to say as we close our podcast, I want to reiterate VCU Health's mission. It is, quote, "to preserve and restore health for all people of Virginia and beyond through innovation in service, research, and education." Thank you to our guests, this episode, Dr. Marcelle Davis and Dr. Robert Winn for putting that mission at the center of what you do. Thank you so much.

Dr. Robert Winn: Thank you.

Dr. Marcelle Davis: Thank you.

Cheryl Martin (Host): To learn more about VCU Health and its commitment to diversity, equity, and inclusion, go to vcuhealth.org/DEI. That's vcuhealth.org/DEI. To listen to other podcasts from VCU Health, visit vcuhealth.org/podcast. This is Healthy with VCU Health. I'm Cheryl Martin.