Prakash Chandran, Host: This is Healthy with VCU Health and I'm Prakash Chandran. Join us today for the fourth episode in a series of conversations with Dr. Marcelle Davis, Vice President and Chief Diversity Officer at VCU Health and team members throughout our healthcare system on their commitment to diversity, equity, and inclusion, and its impact on health.

Today, we are sitting down with Dr. Vanessa Sheppard. She's the Interim Founding Dean for the School of Population Health to discuss how the School of Population Health's commitment to this work has a positive influence on our patients, workforce, and community. Dr. Davis and Dr. Sheppard, thank you so much for joining us today. I truly appreciate your time. 

Dr. Davis, welcome back to Healthy with VCU Health. I'd love for us to start by you telling us why you chose Dr. Sheppard as a guest today.

Marcelle Davis, DSL: Oh, my goodness. Thank you so much, Prakash. I appreciate your time and being here with you today. So, I chose Dr. Sheppard to be our guest today for several reasons. First, she is an absolute powerhouse, in every sense of the word. In 2022, Dr. Sheppard won the Researcher of the Year Award for her incredible advances in cancer research.

And this speaks personally to me, because my father died many, many years ago of cancer. So, I am always interested in the research. Then in 2023, Dr. Sheppard was named as the Founding Interim Dean of the School of Population Health, right here at VCU. And who better to lead this new school than Dr. Sheppard, who has literally dedicated her career to understanding and addressing all of the social, cultural, and environmental factors that contribute to cancer disparities among diverse populations.

Host: Well, that is absolutely amazing. And Dr. Sheppard, wow, what an incredible resume and what an honor it is to have you here. You know, I want to first and foremost welcome you to this episode of the DEI series and just start by asking you, can you maybe share a little bit more about the new School of Population Health and your role as Interim Dean? 

Vanessa Sheppard, PhD: Thank you so much for being here today. I appreciate the opportunity and Dr. Davis, you did more than make me blush, you really did. And I think at the core because it's the passion of what we do. And so that's what's so exciting about our new school of population health. Last year, the state council for higher education approved VCU's application to start a school. And so, it was actually last March and we're excited. And still excited about what we're doing at our school. We have four founding departments. And so those departments include biostatistics, and in the biostatistics department, we actually do health data science. It includes social behavioral science, health policy and epidemiology. And so, these departments were, they existed in a different format. So, there were two departments and one division. That division became elevated to a department and then another department split into two. And so, we have these four foundational departments, outstanding faculty and within the last year we've actually grown our student population in our master's in public health program.

We have a new program that will be online in the biostatistics department in August, our first online master’s level program. And so, we're excited about that. And last week, we learned that the Accreditation Agency for Public Health approved what's called your initial application submission. And so, what that means is that the courses that we offer, the faculty that we have, the ratio of faculty to students, so all of that infrastructure work that we've been doing for the last year was approved to meet qualifications as a school.

And they've given us permission that we can change our name to Public Health. So, we are so excited about that. Now you can't call us Public Health yet. Because we're going through institutional processes and then back to the State Council of Higher Education of Virginia, back to CHEV to have permission for that change.

But the fact that the accreditation agency says that this work that we've been doing, and that just speaks to the commitment of our health system. We couldn't do this work without a health system that supports us. And obviously the faculty, the staff and the great students that we have.

So. So that's a commercial for our school and we're here and we're not just here, we've grown our portfolio of research funding since July 1, over 40%. So, there is a lot of energy around this initiative, and we've felt the love across the university as well.

Host: Yeah, absolutely. It's very clear. I mean, congratulations for all those accomplishments. And it's kind of crazy to just hear about how much you have accomplished in such a short amount of time. I just wanted to expand a little bit. What exactly do you do as interim Dean? 

Vanessa Sheppard, PhD: Let's see. Well, for a good while, it was just me in the new school. So, I remember the day that the announcement came out and it went from congratulations, so exciting. And then right after that, it's like, oh, well, what about graduation in May? What is it? Well, hold on. It's just me. Um, and so that initial infrastructure was, you know, working with CHEV in terms of the proposal.

That helped us lay out the groundwork. And then it was getting people on board. So, if you think about it VCU hadn't started a new school in a number of years. People tell me about 15 years or so. So really there's a lot to learn and to do. And we made a plan to relocate from the School of Medicine, those units and departments.

And so that's what we put in place. And so that's the work that I did working with the Dean of Medicine and their team to really move our, all of our programs over and create the infrastructure that they could be housed in. That also involved identifying a team to work with me. And so, I have quite a few people that are now doing double, triple duty because they have interim in their title.

So interim associate deans, interim director for finance and administration, so that we could form the infrastructure, right? So, there was no infrastructure to make things happen. If you think about one quick example, sort of faculty promotion. So, we had to create the infrastructure, the processes and things for that nature.

So, that's what I've been doing and leading a fantastic team who's been willing to lean in while we're building the infrastructure. Then we also had to recognize we have new students coming. We created a new concentration, so we have to make sure to work that is as seamless as possible for them, if you would.

And so, so that's the work I've been doing. We're in the process now, we are hiring new faculty. So, everything from if you had to, I would say, if you moved into a house, we actually had to help build the house, right? And then once we got in there, we had to think about the electricity. So, some of the processes were, how are we going to pay people, right?

How, all of these things. So that's what we've been doing. That may not sound as fun. But so, we get to do that, but then we also get to think about creating new programs, new concentrations, building new partnerships with agencies such as Department of Social Services. So, we've been doing all of this work, meeting perspective donors and people that want to invest. So, I'm pretty busy. 

Host: Yeah, that very, very clear. And you know, just the fact that they hadn't started a new school in 15 years, there's no template for you to really build on, right? You had to do everything from scratch. And so, it cannot be understated just the amount that was required to get this up and running. So, kind of my hats off to you there. Dr. Davis, I had a question, just what would a collaboration with Dr. Sheppard in the School of Population Health exactly look like? 

Marcelle Davis, DSL: Great question. So now do you understand what I mean when I say a powerhouse in every sense of the word?

Prakash Chandran Host): I totally understand. Yes.

Marcelle Davis, DSL: I mean, you want to talk about moving mountains like Dr. Sheppard is doing it. So, for me, Dr. Sheppard's research in disparities is critical and her work ties directly to the work that I do in the health system that's related to equity and inclusion.

And I have a vision for creating a DEI certification program that I had an opportunity to speak with Dr. Sheppard about last year. And her team gathers the data that can help inform the courses that would fall under that DEI certification program. So that's one way that I imagine and envision that we would be able to work with.

And I think the courses that she puts together, the different learning opportunities and degree programming, all of that ties directly back to the healthcare work that we do. And I'm just so excited to have a partner in Dr. Sheppard.

Host: Yeah. I mean, it is so clear. And I, love just, I mentioned this before we started recording, but the energy and the enthusiasm and really the passion that both of you bring, to have people with such conviction working on such an important problem is critical and important. Dr. Sheppard, speaking of powerhouse, you're also the Associate Director of Community Outreach Engagement and Disparities Research at Massey Comprehensive Cancer Center. Tell us, how do both roles interplay and relate with one another? 

Vanessa Sheppard, PhD: Cancer is a major public health problem, and I've been working with the Massey Cancer Center, prior to having a school, and I was working with them very closely as a chair of a department, and part of the work that we do is helping folks to reduce their risk of diseases, chronic diseases in particular and a lot of those risk reduction strategies relate to cancer.

It relates to really the tenets of public health, right? Diet, exercise, your environment. All these types of things. And so, I think the work that I've done over the last several years with community outreach and engagement really helps to frame the perspective that we're bringing into the School of Population Health.

And that is, how do we infuse the community in what we do? You know, how do we prioritize our focus and our efforts? And that's what we did with the role with, I call it COE, at the Cancer Center. So, we focused on the cancers that were of the highest burden in what we call our catchment, our service area.

The patients that we serve, what are they coming into our health system for that's related to cancer, whether the cancer diagnosis or those risk factors. So rather than just doing something because it's important or the hottest thing, we really took a look and saw, took a look to consider, what are folks dying from? The people that we serve and their families. And we have to prioritize that. And then understanding the community perspective in terms of what it's like to get access to care or breaking down those barriers. So, the role of COE, what I developed in that role as AD was this opportunity with great support from the Cancer Center Director and our health system, to hire a team that includes navigators and health educators that are in the community, right? Bringing people to us, but also meeting people where they are, and creating data sources. So, Dr. Davis mentioned the data. So, we can interrogate it from different perspectives to understand what's really happening in communities, what subpopulations within communities.

And so, you know, I think these roles go hand in hand because we focus so much on cancer, but when we are focused on cancer, we saw that people also had other indicators, right? Other social drivers of health. And so now, with Population Health sort of working together, thinking about cancer and our experiences, what we've learned, we are addressing the whole person, right?

And that's what this allows us to do with the school, from our education, what we teach, the courses we develop where we teach them, how we teach them, the research that we do, and then the service.

Host: Yeah, I think one thing just to note is just how you've really approached this from a first principles basis and you're trying to be as objective as possible because when you approach it through that lens, then you can look at the nuance of exactly what needs to be done. Dr. Davis mentioned at the top of the episode that you won the American Cancer Society's 2022 Researcher of the Year Award for advances in cancer research. And I imagine you kind of had that same approach. I'd love for you to give us a summary of the research and one disparity you discovered and how you've addressed it or plan to address that disparity. 

Vanessa Sheppard, PhD: So, when I started my career in cancer, I was at Georgetown University, and knew I wanted to focus on issues of minority health because that always had been my perspective and what I saw in the nation's capital were so many disparities. And so, I was intrigued by the fact that Black women in D.C. have some of the highest rates of cancer mortality in the nation, despite rates of high insurance, despite the presence of several hospitals, health systems, and cancer centers, and high rates of actually being screened. So, it's like, what's the problem here? And it's such a big problem because it's not just one thing.

And when you think about disparities, there's so many factors. And so, I ended up focusing on what happens after a woman was diagnosed, because that's where I saw, well, if you get to care and then we still see these disparities, like what can explain it. And I ended up honing in on the treatment experience.

Because if you think treatment is that intervention, you're diagnosed, you need to get treatment. And so, we interrogated everything from the timeliness of the treatment, and then treatment adherence, meaning completing your treatment. And then to try to understand what are some of those factors? So we saw differences between, I'll just say, Black and white women in terms of the receipt of treatment, right?

So they got in the system, but it didn't start on time. When it did start, they didn't complete it at the same rates. And so by treatment, meaning chemotherapy or adjuvant endocrine therapy, and also there were delays to surgery. And so we looked at this sort of continuum of care. So, every delay, then it has an impact on your likelihood of survival because it impacts disease progression.

And so, you know, we set out doing prospective studies where we know recruit women after diagnosis and then collect a lot of data and then follow them. That takes years to do that. So, we did a five-year cohort study and then another to try to observe what's going on and then develop interventions to address them.

And so where we are now is we're testing an intervention to, to try to improve uptake of systemic therapy. So chemotherapy, adjuvant endocrine therapy, and then completion. Because we know that that's a factor that contributes to positive outcomes. So, that's really the work that we've been doing and everything from collecting the saliva samples to understand the pharmacogenomics.

How is it, how are different drugs metabolized that may potentially impact. But what we really have learned is that it really is these basics of how do we get people into care and that therapeutic relationship that women have with their clinician, that's really critical right, in ensuring that they get X, Y, and Z.

So, so that's sort of been the years of work. And sometimes, we also are looking at symptoms and we see difference in treatment of symptoms and by, you know, from the medication. So, I'm really interested in anything that can inhibit a woman being able to complete her treatment.

Host: Again, I'll mention again, it's just so phenomenal to have someone that is looking at this big picture and understanding the dynamics of what are the small things that we can do. Let's get down to the heart of the problems to not delay the treatment of care that is so sorely needed and the disparities that exist.

Dr. Davis, I'd love for you to speak on the long-term impact the opportunities the School of Population Health will have on VCU Health, its patients and the community really as a whole. 

Marcelle Davis, DSL: Sure. And Prakash, recently, Dr. Sheppard said that population and public health is everyone's health.

Host: Yes.

Marcelle Davis, DSL: And the School of Population Health, they are focusing on addressing the public health workforce, right? And that shortage that the COVID pandemic sort of brought to light and almost caused, dare I say. And so, by creating and increasing the number of healthcare professionals, we are then better able and better positioned to meet the needs of our patients in the various communities that we serve.

And that really does give us an opportunity to create and advance communities that are healthier, stronger, more educated, and more informed.

Host: Yeah, absolutely. But before we close, Dr. Sheppard, it is very clear that there is so much that is being done with regards to the School of Population Health. If you had to pick one thing that really excites you the most, what might that be? 

Vanessa Sheppard, PhD: Wow. I guess the one thing would be, with this school, we have the opportunity to amplify the voices of the people that we serve. And by amplifying their voices, it will enhance our ability to make an impact in the community to ultimately save lives. So, I feel like that's what the school has an opportunity to do, and that's what's exciting to me, is that we can do it differently.

We're not going to be in our offices coming up with courses and coming up with research. We're going to work together as a school across these departments now that haven't necessarily worked together before. And then we can focus on amplifying the experiences and the voices of the community that we serve.

Host: I think that is an amazing answer and the perfect place to end. Dr. Davis and Dr. Sheppard, thank you so much for your time today. 

Vanessa Sheppard, PhD: Thank you. 

Host: To learn more about VCU Health and its commitment to diversity, equity, and inclusion, you can go to vcuhealth.org/DEI. Thank you so much for tuning in. I'm Prakash Chandran, and this has been another episode of Healthy with VCU Health. Thanks.