Each episode is a dynamic blend of interviews, storytelling, and practical takeaways, showcasing the power of multidisciplinary collaboration to address systemic racism and improve health outcomes. From the methodology behind successful team projects to the nuanced process of engaging communities, we illuminate how shared leadership, restorative practices, and intentional planning can create sustainable, impactful change. Whether you’re seeking inspiration, tools, or evidence to amplify your own efforts, this podcast offers a space to learn, reflect, and act.

What to Expect in Each Episode?

• Engaging conversations with health equity leaders and community partners
• Insightful stories that connect personal experiences with broader data and research
• Practical tools and resources to implement promising practices
• Honest reflections on challenges, lessons learned, and the transformative power of shared leadership

The Power of Shared Leadership in Research

Season 1, Episode 6 | July 3, 2025

• Hosted by:  Krystal Lee and J. Robin Moon
• Guests: Kathleen Call and Ms. Bob-e Simpson Epps

Mandy LeBreche  00:04

This is the promising practices for Health Equity podcast brought to you by the interdisciplinary research Leaders Program, a national leadership program of the Robert Wood Johnson Foundation.

Cody Cotton  00:22

Hello, and welcome to promising practices for health equity. The podcast created by the Interdisciplinary Research Leaders Program, affectionately known as IRL. I’m Cody cotton, sitting in for Krystal today, and my cohost is the illustrious J. Robin Moon. Hey, Robin!

Robin Moon

Hi Cody.

Cody Cotton

In our last episode, we talked with Nancy Fishman, former Program Officer for IRL. If you haven’t already done so, I encourage you to go back and listen to Nancy’s episode. We talk about how IRL came about, the original vision for the program, and some of the lessons learned as the program evolved. Today we will examine the program from a different perspective. Our guests today are Dr. Kathleen Call and Miss Barbara Simpson Epps, also known as Miss Bob-e. Hello, Kathleen. Hello, Miss Bob-e. Thanks for being with us today.

Dr. Kathleen Call  01:19

Great to be here.

Robin Moon 01:21

Kathleen served for over nine years, from the beginning of IRL, as Associate Director for Community Engagement. And Miss Bob-e also has been with us from the very beginning, has been the senior advisor with us, and also led the Community Action Advisory Board, as in CAAB we say, since the since its inception in 2021 is that right, Miss Bob-e?

Barbara Simpson Epps  01:44

yes,

Robin Moon 01:47

We’re so happy to have you both here today. Before we get started, we want to invite you to just check in with us as you know – and we’ve been practicing together – one of our core beliefs is that nurturing personal relationships is key to building the kinds of communities that collaborate effectively in the work towards health equity. So at the beginning of our meetings, all our episodes, we do a quick check in to help us continuously build connections in our team – our beloved community. So here’s our check in for today? What is the one thing that makes you feel hopeful these days? It Feels like a particularly difficult question. At least for me, I will start – I have to think about this. I think about the five year anniversary of the pandemic. Five years ago now, we were in the very, very thick of it, and it feels like yesterday. And at the same time, it feels like 100 years ago. I think about how we actually made, I can’t believe, if I sit and think about it, I can’t believe we actually made it out of that, and this life saving vaccines and all kinds of innovations and as community, that we pulled together and that we’re here recording this podcast. So I am really grateful for that. And when I hit the lowest moment, which I did at the time, there will be there will be a tomorrow. And I think about it these days, every day, since the since about March, that that gives me hope. Can I toss it to you, Cody?

Cody Cotton  03:23

Please do. Please do. I had some time to think about it. I would have to say the youth – and that’s like two sided, right? So I often think about the kids and the students we work with here in Chicago with the youth mentorship. But it’s very easy for me just to look at my kids here at home. I was quick to say my boys, but it’s not my boys anymore. It’s my boys and my baby girl as well. So, the family brings me a lot of joy, a lot of hope. Yeah. So thank you. I’m gonna toss it to you, Kathleen.

Dr. Kathleen Call  03:57

Well, I’m gonna piggyback on your answer, Cody. So for me, when I want to feel hopeful and be reminded that there’s joy and a future that could be amazing for us, it’s really hard for me to get there, but I look at videos of my grandbaby, or I was at the March this past week, and there was this little girl on her dad’s shoulders holding her own sign, saying, “hands off my future”. And I’m thinking, Yes, you know, the next generations are going to save the world, crossing my fingers. So I would say it’s also youth and the joy that they bring and the positivity they bring to the world, before they turn into cynical adults, like us, like me. I can’t speak for y’all, but I guess I pop it to miss Bob-e.

Barbara Simpson Epps  04:53

Well, I’m going to do a culmination of all of your responses. I think about the footprints. And, the footprints that were laid before I came help me, and helped give me the determination, the strength, the resilience, the fight that I have for what I believe in. I see those same footprints being made by myself and each of you and others as we are traversing this new terrain, whether it’s COVID or whether it’s inflation or whether it’s looking at what’s happening with our democracy right now, we are all making footprints, and as I think about the young people in my life, especially my grandchildren. When my and now 10 year old grandson can talk to me about fascism and democracy and truly understand what that means for us, certainly, some footprints have been laid that open up his mind to possibility and reality, and what he wants and hopes for in his future, and I see that in all of our children. So I think about the footprints that we make, and I know that they can step into what I’ve done, what each of you have done, and I know they’ll do even greater things.

Robin Moon 06:17

Beautiful!

Cody Cotton  06:19

Beautiful, beautiful. I love that. I said we have a lot to be hopeful for all of us. Thank you for that. All right, let’s dive right into it. Kathleen, you’ve been a part of the leadership team literally since IRL has began. Tell us what you remember about the original vision for the IRL at the time of development, and also, what were your motivations and hopes for the program?

Dr. Kathleen Call  06:44

Sure. So it’s a bit muddy, but I remember feeling like there were people strategizing. You know, there was this huge call, not just for IRL, but three other programs and people like scrambling to be part of it, and I think for different reasons, right. For the prestige and money, but also the vision. And I was really motivated by the vision. I have been a huge fan of and participant in community engaged research, you know, pretty early in my career, in different aspects of the kind of research I like to do, and I think can be impactful. So the opportunity to, like, do a national program that was really encouraging that community, voice, drive and influence research and the solutions, like, I want to be part of that. So I was motivated from the very beginning to just to be part of that movement. Because there really was, I think, envisioned as a movement. You start with one cohort, they’re scattered all over. There’s another cohort the next year. And so I think just that the value of engagement and the value of doing research that can bring about change was huge. And so yeah, and it’s certainly evolved over the years, but that’s my motivation was very much about doing engaged research, impactful research.

Cody Cotton  08:27

Thank you. What about you? Miss Bob-e, what were your motivations and hopes for the program when you first got involved?

Barbara Simpson Epps  08:33

Well, when I first came into the program, I didn’t come in through the same doorway that Kathleen entered into. I came, I was a part of I was presenting with another group to see too, and I at that time, I met Michael Oakes, Jen Malcolm, Nancy, Fishman, Sarah Gollust. I met Kathleen and a lot of others who had sewed into the creation and beginning of this program, I was motivated and hope to help in guiding the teams around authentic relationship building and the importance of community engagement. I really wanted to influence others about understanding the history of community, particularly those that they had hoped to plan to work with, and I wanted to have them filter some of my questions, like, what has been the experience with community, what has been the community’s experience with researchers? And how do you build on that, and who are the people in the community you want to engage with? So I wanted to to really dig deep into the relationship and the history of community, so that those kind of questions would be answered and asked up front.

Robin Moon 09:51

Question for Kathleen, looking back the IRL, the research side of the IRL, and then community side of the IRL, I feel like we’ve been spending a lot of time integrating the two sides into one interdisciplinary, truly interdisciplinary and community collaborative work. And Kathleen you served in the role of Associate Director of Community Engagement for the entire time. As we said, While both of you and Miss Bob-e represented and fostered the community’s perspective, as in, like the you know, as opposed to the researchers perspective, you’re an academic yourself, we’re very curious to know what you have to say about how you approach your role and the goals initially that you set out to achieve through programs and maybe particularly for our fellows, and whether it panned out the way that you had envisioned, probably not an easy question. Was there, like, what would you say the biggest surprise might be?

Dr. Kathleen Call  10:57

So that was a long question. So I’ve been thinking about this a lot. Like, I feel like there was, there was like, the program as it launched, and then how it evolved, and then there’s like, my responsibility for a particular aspect of that program and how it involved. And they’re both, at first, I was thinking, well, they’re kind of separate things, but they’re really not, they’re really like. I think when the when we started IRL at the very, very beginning, we have the research centric approach. And people were, fellows were pushing back at that from the very beginning, and some members of the larger team were able to accept that critique, and others just tried to present the same material differently. So I think there was kind of these phases of evolution, and I think there was also, you know, a diversity of response among different members of the kind of the leadership team, but I had honestly gone into it like when we were conceptualizing, what are the things that we we need to really train or prepare or provide resources for interdisciplinary research leaders. I think we took a very academic as in one way conversation perspective, like, what do we need to give them? What do we need to give them? Not like, what can they give back to us? So I feel like that was the biggest evolution. So from really focusing on what do we have to offer, how do we want to set up this experience to like, what’s what? You know, are we meeting their needs? What are their needs and actually having conversations around that? So I’ve started in my own component of the program, engaged scholarship, thinking about, what do they need to know about community engaged research, what are its pros and its cons? How has it been received? Like very intellectualized idea of what the program should be, and then we quickly learned it was like, how do we help people build relationships and see the assets of different members of their team and what they bring and what’s their common goal? Like helping them develop a common goal that helped them get beyond some of the conflict that’s inevitable in relationships. So it really switched from this kind of intellectualizing and thinking about, how do I prepare folks, what resources will they need, to actually observing like relationships falling apart and thriving and, you know, going through tremendous conflict and then coming back together as a team to say, No, we have to set this aside. We are here for the community, and we can set aside our differences for the community and what we’re trying to do together. So it went from intellectual to emotional, relational and really listening and co-creating, you know that experience versus thinking, I know what’s best, they know what’s best, and how do I facilitate giving them what they say they need? So that listening component and relational component was huge. And just even like interdisciplinary is like, assumes that there’s an academic like academic disciplines, and that’s how it was looked at. We’re talking cross sectoral like just like variation in so many ways that each member of that three person team brings to what they’re trying to accomplish. And like fully recognizing that, valuing it and naming it, which we weren’t very good at at the beginning. I think we got better, but there’s always room for growth. That was such a long winded answer….

Robin Moon 14:53

You know, if we were to write an abstract of this long paper of IRL’s evolution, that will be it. I think you really said it really well. And I think that you know, step by step, it might, might not, be very easy to see how much we change, but looking back 10 years now, I think it’s just so much obvious and clearer, and it’s just really so humbling. Thank you for sharing what’s in your heart, knowing you that really came from your heart. Miss Bob-e, in our conversation with Nancy Fishman in the last episode, she talked about how important it was for the National Program Center to include someone who was from the community where the research is happening, so that that will be you tell us about how you’ve seen this work throughout your time with IRL and how it might have evolved in your understanding.

Barbara Simpson Epps  15:45

Well, what I’ve appreciated most is, and I’m going to add some of what Kathleen talked about is when I first joined, the term rigorous research was something that was always said, and I didn’t… I said, Please define I asked Michael Oakes, what is rigorous research? And we have many long conversations about it, and it’s still never, it just didn’t land inside of me because of the language that researchers use. It was just something this intersectionality of shared leadership with community leaders and researchers interdisciplinary. It wasn’t lay language. It wasn’t language that community understood and and it was a three legged stool. It set the odds up for there to be tension automatically when you have two researchers who have the same background, somewhat similar experiences and understanding about that, and a community person who may or may not have ever worked with a researcher or with researchers before, I felt that that that just kind of jaded the impact of community voice being heard and being understood. I think that there was a lack of good communication, and communication is the is the legs and heart of how to build relationships. I don’t know that there was real talk about shared values, about what’s important to me from a community perspective, what’s important to you as a researcher, understanding that researchers rely on these grants to to get a check, to be published, all of the things that are inherent to their to them, and this particular project and others never talked about flexibility and being able to pivot community people do that all the time, and always knowing that there is more than one way to accomplish a task and more. So I’ve I’ve seen, I say all that to say that I’ve seen it evolve in numerous ways, and I’ve appreciated most from a curriculum perspective that was so research oriented and intense that now it is more diverse and much more inspiring. The curriculum is. I remember having research 101, and other topics that community people were to cover, and it was a headache. They didn’t want to do it. They were boldly talking about not wanting to do it, and the community partners weren’t getting much out of that curriculum. And quite frankly, I don’t know that the researchers were getting that much out of the curriculum. What I do remember around the evolution is the founding of the EDI Task Force. The EDI Task Force pushed the needs of the community to the forefront in a lot of ways. And I remember having two subcommittees in the EDI Task Force, the accountability committee and the curriculum committee. Kathleen, which one I don’t remember which one you were on, but I think you were on probably curriculum, right? I think you brought curriculum, and Paul and Ifrah and a lot of the rest of us were on the accountability committee, and it was so great that we pushed and pushed and pushed so much so that I believe was in 2019 and the October Minnesota meeting that the roles of community and researchers were began to intertwine. And there were, actually, it was a face to face right before COVID, and there were presentations- Kathleen and I did a session together – I remember Joe Sammen did a session on, I think it was on white supremacy, I believe, or something similar to that. There are a lot of sessions where community people got to work with researchers in a way that it was an equal pairing and equal responsibility, and people stepped up. And there were so many topics that came up that it opened the door for more clarity, shared appreciation and camaraderie. And since that time, of course, you said the CAAB, the CAAB has been started. And since that time, I’ve seen things elevated in ways that had not been elevated before, even the need to take care of yourself, which is really something that is often overlooked, but from a community perspective or research perspective, you cannot do this work day in and day out, and not think about taking care of yourself. And so I think that even I think the CAAB came up with a recipe for leadership that I didn’t, I didn’t see so much being talked about around leadership. Initially, all I saw was research kinds of things, and I just couldn’t understand, how can you have interdisciplinary research leaders and nothing about what it takes to be a leader, either as a researcher or a leader as a partner with a researcher. I think if we talk more about leadership and the evolution and probably the conflict on teams would have been less. I wouldn’t, I won’t say it won’t, wouldn’t go all the way away, but it would have been less because talking about what it means to be a leader means that you have to be able to figure out how you get along. How do you resolve differences, how do you bring information to and from, and how do you do things with… rather you and me? So I just thought the evolution over time has just been really great in terms of what I see today, first on what was initially started, the research is rigorous, but the relationships are better.

Robin Moon 21:48

That’s such a great answer. Yes. Kathleen,

Dr. Kathleen Call  21:52

I was just gonna riff off of Bob-e around, like research rigor was initially like, very like, causal model, kind of focus, like proof, and it really evolved to rigor as relevancy, relevancy for people who can bring about change and like authenticity. And so I completely agree with Miss Bob-e on that and in this like, we, like the early years, we didn’t pay attention. It was like, so focused on interdisciplinary and research that leadership, like what defines leadership, was kind of ignored or invisible. And I really credit some of the work that you did with us in the early days, Miss Bob-e, around, relational leadership that – like to be a good leader. It’s not you dictating what others do. It’s like, you know, shared power “leading with” rather than dictating, you know. So it’s like this idea of power, sharing and recognizing the power of others on your team. So I just thought it was, it became more explicit, and later, in the later versions of the IRL program.

Barbara Simpson Epps  23:10

I also, I’d add, I’d add to Kathleen, I’d just say that too, I think that researchers began to appreciate community partners in a different way, and didn’t see them as somebody that was going to pick up the bucket and do all the cleaning that they didn’t want to do, but rather as a vital part of that three legged stool that if you didn’t have everybody working together, it would topple over. And that changed a lot.

Robin Moon 23:38

Yeah, it’s such a great reminder Miss Bob-e, that it didn’t just happen by osmosis. It took accountability. It took resistance and resilience of the community where we were the we are, the microcosm of the world, and that was well demonstrated in the way that we have evolved. That’s how I see it. So I really appreciate the response.

Barbara Simpson Epps  24:01

I want to add one more thing too, because I feel like not mentioning Dr. Zinzi  Bailey, in my experience, would be awful on my part, because she and I spent so much time together, as we still do, initially, combating and fighting and pushing against this rigorous research. We would sit in meetings for hours, and at the end, I’d call her, or she’d call me, and I’d say, what, what just happened? But what, what was just talked about? And I mean, we would be completely like in a land of not knowing, and it took many walks with some of the leaders who were in place at that time to really help them understand that a foreign language and you’re not valuing or hearing what other people are saying about how to move this process forward and how to have some longevity for people, as they are rolling out this work in their communities, longevity and sustainability, yeah.

Dr. Kathleen Call  25:10

And that accountability, Miss Bob-e like, expecting teams to like, set aside differences, value each other, yet the leadership wasn’t doing that. It was like there was a lot of deferring to loud voices that were holding up their PI-ship And then, you know, as though that leadership changed to people who were actually listening to ideas around how things could evolve for the better. Like, it took it, you know, it was kind of the beliefs about leadership and like, separate from the fellows, versus doing the work with the fellows. I think that was a huge change too. Like, you know, to lead, you have to be willing to do the same work as the folks that you’re working with or leading. And so instead of being observers of the fellows and creating these experiences like it, became much more co-creating and participating in and I think that was a really big shift. And I do, I do attribute to that, like the openness of our evolving leadership of the overall program, from like two epidemiologists, but one who really understands community and relational leadership and personal accountability, to be in a very different way.

Robin Moon 26:42

Oh, and for our listeners, EDI Task Force. It’s Equity, Diversity and Inclusion. I know the world. We know the world says DEI but EDI just rolls better off better, you know, rolls off your tongue better. So we say, EDI task force. Now let’s take the IRL outside of us and into the world. What’s next?

Cody Cotton  27:04

Yes, yes, I want to ask the question. I just want to make a very quick comment. I promise I’m gonna get right to the question. Miss Bob-e just really resonated when you talked about being able to have shared values. That’s very important within leadership. And I think it’s amazing that IRL was listening, because eventually you were able to lead and form the CAAB the Community Action Advisory Board. So a lot of progress there. Shout out to you. All right. Next question, all right, this question would be for both of you all. So how would you each describe the impact the IRL has made in moving us towards health equity.

Barbara Simpson Epps  27:41

Well, I would say that our I think leaders, not just within this program, but I think leaders even when I think about RWJF, and I think about many of the regional conferences I’ve had the pleasure and the joy of attending, I think that leaders are listening more intently to engage in community, and I think their their sessions, their language, really is beginning to focus on community strategy and addressing things that community needs in order to be successful. I also think that it’s highlighted the multiple areas of inequity within systems and institutions and in the community that help everybody focus on what’s important. And I think health equity issues come in many forms. You know, prior to this work, I did some work with other work, other entities here in town that looked at the grass and the green space, and they looked at the air that was being breathed in by traffic routes where certain people live. They’re on busy streets, so they’re getting all the fumes from buses and cars and breathing that in. And looking at the rate of asthma, particularly for young black boys. And so the health equity issues that come in many forms, I think people typically weren’t thinking about that. They tended to think about health equity only in the sense of what’s happening in your physical body. And so I think IRL the impact that it has made for me, and I think for other people, is really looking at the universe, that we were given a perfect planet with everything that we needed, and I’m really disappointed to see how we’ve cared for the earth. I remember my oldest granddaughter talking to me at age seven about waste and plastic and gardening, and she really held me accountable to “Okay, let’s put all of the plastic in the right container. Let’s put all of the the aluminum foil in the right spaces”. And today, she’s 32 and things have not gotten much better. As a matter of fact, I think it’s even worse, but IRL puts you in that space where you have greater awareness, greater sensitivity, and you really want to work on health equity, and I believe that they’ve amassed hundreds of advocates, allies and accomplices to move in that direction across this nation and to get the job done. And I think people are creative. They’re more enlightened. And I just, you know, if I had to find a program, and I’ve been a fellow in two other programs, I think by far, this was probably the most powerful I’ve experienced. Probably because I’m not a fellow and I get to sit on the other side and hear how well people plan, leadership plans for everything, the number of discussions, thinking about every single thing so that when they do come together, they have the kind of experiences that acknowledges what they their contributions, acknowledges them in this field, and rewards them in many ways, that will charge them up and refuel them to keep pushing health equity as as something that we all have to continue to think about and contribute towards.

Dr. Kathleen Call  31:31

I’m glad you went first. Miss Bob-e. This was the question that I really thought of. Like, you know, I can think of a lot of different ways of approaching it. So, like, in the grand scheme of things, you know, we talk about dismantling structural racism and moving towards health equity. It’s like, I don’t think I’m going to see that in my lifetime, but what are the kind of the foundational things that I think IRL has really worked at to gift to each other and gift to the fellows, and that is this kind of intentional intentionality around creating experiences where relationships can be formed. You see somebody as a human being with complexity and values and not just an acquaintance that you run into at the conference every year. So like that, intentionality about building relationships, creating a space for people to go deep, if they are so inclined, but also not require it and make them uncomfortable with with being in the space. So they’re welcome, they’re invited, but it’s not demanded of them. And I think they’ve responded really well to that, and when they I think it like it sparked this kind of interest. “Could I create the space in my future projects?” That’s my hope, that it can really spark that centering of research as relationship and relationships are required to have impactful research and to bring about social change. How did IRL model that for us? How can we do that for our students? Work with students. Work in the community, work amongst our boards as community researchers, and what’s the future of research like? What does that look like in a really positive way that you don’t usually get in academia or a research 101, intended for community members, right? So it really got to the core of the heart of research is like doing work that’s important to you and that you hope you can have an impact on even if it doesn’t happen in your life. But are you creating a foundation of hope and co-creation with people so that they want to keep doing their best work towards this towards that end. Again, I feel like I’m rambling, but it’s like it when I think about answering this question, it really is a question from my heart and not my head, and I think that that’s where we’ve done the most in evolving as a program, moving far away from the head and much more towards the heart of what research is.

Barbara Simpson Epps  34:29

I always think about some of the conflicts that we’ve had at some of our that are inevitable when you bring people together. And always think about the preparation and the thought given to the ‘what ifs’, and in spite of the what ifs, there’s always something. But I always think about a couple of incidents that I won’t mention, but I see how people have moved beyond that conflict, the grace. I think what it is, is the grace that I have been, that I’ve seen. Which is a part of health equity. I think sometimes we like to take the human response out of the work that we do, the tension out of the work that we do, the natural reactions that people may have out of what we do. But I think I initially came in to do a session on ACEs, the Adverse Childhood Experiences Study, which is all about trauma, And trauma is one of those things that lives in all of us. And when I think about health equity, how I’ve seen that show up, and how everybody on this screen right now has shown up and responded to that. It makes me proud to be a part of a team like that. We do it with compassion, we do it with grace. We do it with an amount of sensitivity to everybody that is included in that event. And I think the more we are living on this planet, the more we’re going to be challenged about moving towards a structural and systemic racism in our healthcare system. And the only way to do that is to do it from a with a compassionate lens, so that you everybody together at the end of the day, and I could talk more because I think about the restorative justice work we we’re doing other things that we’re doing that is all a part about moving towards health equity in ways that weren’t an original part of this work.

Dr. Kathleen Call  36:37

I 100% agree, Miss Bob-e, especially like this idea of you know, from the very beginning, we talked about conflict is inherent in relationships. How do you move with the conflict, through the conflict? But we didn’t have the whole harm and healing restorative justice that really completed that picture. So it’s one thing to say, conflict happens, and how do you grow from it, but also having the healing and recognition of harm part of it that we didn’t have that language at the very beginning, and I wish we would have woken up to that sooner, and perhaps people were trying to get the group to wake up to that sooner, but I think it was, it’s it kind of helped fill a hole in how we were approaching the inevitability of conflict.

Barbara Simpson Epps  37:31

That’s a practice. I think, everything that we’ve learned around restorative justice and other practices about being human centered, it’s impactful. It’s been impactful for me. It’s impactful for other people. I’ve seen how people show up and how when they have the time to really think things through and process things that it it leads towards better relationships, more understanding, authenticity, inclusion, grace, all of those things.

Dr. Kathleen Call  38:01

…and health equity on these different levels, right from microcosm, little relationships, to much bigger, the organization of how we’ve been doing our work.

Robin Moon 38:15

All those, all those things, therefore, health equity. I’m just going to note how all the vocabularies we’re using in this conversation, we haven’t said the word ‘method’ once. Health Equity means whatever statistics you know, improved, you know, declined. This is a remarkable open conversation, and we really appreciate this. So we’ve been talking about how your impact on IRL, what you know, what you have contributed to the program and the fellows. This is our last question for you. Both of you tell us about the impact that IRL has had on you. How has IRL changed you?

Dr. Kathleen Call  39:01

I would say it hit me at the like it came at the right moment in my kind of development as a academic and somebody who believes in the power community. I talked to earlier about intellectualizing the program, intellectualizing the problem of certain problems, and until it’s in your heart, I think it’s really hard to do really good work. And I think that was my evolution as a really, as a researcher, like not just learning everything I could about a certain area or subject to really know, like knowing people that were impacted by just like being open to the relationship, being open to feeling the pain of different things are like our health system does to people. Like not just reading about it, observing it, but actually like feeling it, having empathy and compassion. And that’s where I think IRL kind of fast track that for me, because I met so many people that were doing amazing work and so passionate about it in a way that I hadn’t been exposed to in most of the kind of academic circles I had been part of. And certainly the community like it was like this blending of my two worlds, like living in academia, but working in and with community, and then having that all come together, it was just like it was something that was so exciting, and I think I was ready for that, like being able to really see where I had to evolve along with the program, and feeling safe to do that because of all the people I was in relationship with in this program.

Barbara Simpson Epps  41:08

I think for me, I never understood why I was asked to be a part of IRL, but that’s my honest answer. I didn’t have a role, and I used to just, I like walking around and just being present in ways that people may not notice. I like to see how people twitch sometimes, or who walked with who, or who talked with who, or when people sat in a corner, why they sat in a corner. I liked just being in the space with people that I thought were just geniuses. I liked hearing them in small conversations that I wasn’t engaged in. I liked sitting in a lot of the sessions. When I think back on all of the sessions that I sat in all of the learning that I had, all the remarkable people that I’ve met, the relationships that I have with people, and knowing that many of those relationships will continue. Then I look back on how I grew over the program. I grew in all kinds of ways, probably relationships I always thought I was pretty good at, but I’ve had some misses in that, and so that has helped me grow as well. But it’s helped me really look at the human condition in ways that I hadn’t before. Even when people come and they think that they are okay, people are always looking for connection, and I have a greater sensitivity for connecting with people, one on one in those spaces, especially when I see the same people that are continually standing alone, people who are introverts, who don’t speak up. People who I know have so much to contribute, and yet they are silent. So it’s helped me in my walking around in spaces to not only observe, but to step up in ways that I hadn’t before, and I’ll always be grateful for that.

Cody Cotton  43:21

I appreciate you all both for sharing. Well, thank you. And a lot is resonating. We know from just this past experience that working towards health equity can be daunting. It can be challenging, especially a large effort, given what the experience has been these days. Audre Lorde reminds us that caring for ourselves is not self indulgence, it is self preservation, which is an act of political warfare and an act of resistance. So with that being said and keeping that in mind, tell us how you all are taking care of yourselves.

Barbara Simpson Epps  44:00

Well, I have a practice that I’ve always had for a number of years. I like to wake up in the morning early, and I spend time with my God, just in meditation, just being quiet. I spend time thinking about what’s going on inside of me so that I’m prepared to be decent with the world that is out there. I don’t think I have. I never want to take that part of me out into the world that I need to keep at home, especially when I’m not like at myself. Is a term that that African Americans would say that I wouldn’t clothe in my right mind. A lot of people carry a lot of things, and I take time in the morning to get all of those things out of me and to prepare myself to be a decent person in the world. Because just as I know that I have issues, I know I’m going to encounter people whose issues are mountains compared to mine. And so it’s like complaining about a pair of shoes, and then you meet somebody that doesn’t have any feet, or complaining about not being able to do my eyebrows, when you meet somebody whose face has been scarred and burned. So I think about, how can I be the best me when I show up in the world? And that’s a habit that I’ve had most of my life, which centers me. It opens doors for me, because some days I’ll say, Well, you need to go out and take a walk. You might need to go out and have that bowl of ice cream that you’ve not had for a long time, and you might need to call somebody up and say, I was thinking about you, or you might need to call somebody up and say, It’s time for us to talk. It’s those kinds of things that prepare me to meet the world head on and with my best self, and I owe that to me, and I owe that to the people that I encounter.

Dr. Kathleen Call  46:08

I think my self care regimen is somewhat similar to Miss Bob-e in that I wake up early so I can have some time to myself. I wouldn’t say I meditate, but I just like the silence in time to kind of reflect about what the day is going to bring and figure out how to be present for the day. I think, you know, my favorite way of taking care of myself is being with people that I love and and some of those are conflicted relationships, but there’s still people I love and just being able to kind of linger and pause and not react like that’s the way I’m trying really hard to take care of myself and the people I love, not reacting – pausing, lingering and trying to work things through. And honestly, I’m like an ever ready bunny, like I need to expel some energy. So walking and biking is absolutely central to my self care, because I just gotta get the jiggles out. So it’s all those things.

Barbara Simpson Epps  47:24

Pivoting is always important for me, because there’s so many people in my life with six kids and 10 grandkids and three great grandkids, I have to be able to pivot. And so I prepare my day with thinking about how I can step up or step back or step in or step away.

Cody Cotton  47:45

Love that – that resonates. That’s an RJ principle of ours knowing when to step up and want to step back. And Kathleen, I was sure I was going to I was going to have to remind you that walking was one of yours, just in case.

Dr. Kathleen Call  47:59

You thought it was going to be first, right?

Robin Moon 48:04

I was like, “wait. What about walking?”

Dr. Kathleen Call  48:09

Miss Bob-e inspired me to be more self reflective about my response.

Robin Moon 48:16

Thank you so much, Kathleen and Miss Bob-e for being so open, being willing to be vulnerable in this space. You’ve said so much, but I’m thinking about Grace Lee Boggs, a great American activist and scholar who said, transform yourself before you transform the world. And I keep on hearing that as a theme. And that’s also I agree. That’s something IRL, among other things IRL has taught me.

And thank you for our listeners for tuning in, for this wonderful conversation today. We want this to be a two way conversation, so we’d love to hear from you listeners – share your thoughts with us via our LinkedIn page where we will post our show notes and any resources discussed in this episode. And don’t forget to subscribe to Promising Practices for Health Equity so you never miss an episode. You can find us on Apple podcast, Spotify, YouTube or wherever you get your podcasts. Thanks for joining us today, and remember, we’re all on this journey together, and every step we take together brings us closer to a healthier, more just world. Until next time, bye friends!

Mandy LeBreche  49:38

Promising Practices for Health Equity is produced by the interdisciplinary research Leaders Program, a national leadership program of the Robert Wood Johnson Foundation. A special thanks to our guests, our production team at Studio Americana, and to you, our listeners for being a part of this important conversation.

The Evolution of the IRL Program

Season 1, Episode 5 | June 15, 2025

• Hosted by:  Krystal Lee and Mandy LaBreche
• Guests: Zinzi Bailey, Mandy LeBreche, Toben Nelson

Mandy LeBreche  00:04

This is the promising practices for Health Equity podcast brought to you by the Interdisciplinary Research Leaders Program, a national leadership program of the Robert Wood Johnson Foundation.

Krystal Lee  00:20

Hello and welcome to Promising Practices for Health Equity, the podcast created by the interdisciplinary research Leaders Program, affectionately known as IRL. I’m Krystal Lee, and today my co host is the inimitable Mandy LeBrech, hey Mandy.

In previous episodes, we have heard from some of the original program leadership, and today we are thrilled to have current members of the leadership team with us. Today we have IRL co directors, Dr Zinzi Bailey and Cody cotton, as well as senior advisor and former co director, Dr Tobin Nelson. Welcome y’all and thanks for joining us.

Zinzi Bailey  01:02

Hey, hey, it’s great to be here. 

Mandy LeBreche  01:05

Hey, friends, as you know, we like to start our meetings with a check in question, and this podcast is certainly no exception to that. So our check in question for today is, what is one thing that makes you feel hopeful these days. And I can start, I think what’s making me hopeful these days is our younger generation, the youths, as I like to say. I feel like they seem, to me, like the most inclusive generation. They’re more naturally able to embrace differences, and I feel like they have a lot of empathy and a sense of curiosity for the world around them. I think things that are happening that are good and bad, I feel like I see them better able to maybe lift up the good stuff and fight the bad stuff. And I always think back to what a former IRL teammate and friend, Haley Cureton, [Hey, Haley!] shared with me in the early days of IRL, and she would talk about how curiosity helps to develop and nurture empathy, and I think that’s a lot of what I see in our younger generations and kind of the young adult population. I will toss it to Krystal.

Krystal Lee  02:22

Thanks Mandy, the thing that’s making me hopeful today is still like individual acts of kindness. So when I see people helping people, when I see folks taking intentional steps towards cultivating community and just, you know, caring for each other, even in, you know, the unprecedented times that we’re experiencing. I personally would like to experience some “precedented times”, but until we can manage that, I am taking hope – I’m feeling hopeful about individuals caring for each other, and I will toss it to Cody Cotton.

Cody Cotton  03:01

Appreciate that Krystal. I said I was going to change my answer, but I think I mistake with the basics, the origins kind of leaning more towards what Mandy said, the youth. There’s so much hope in the youth. Definitely, if you have an environment where we can teach them how to do better, as well as help them learn from our mistakes that we’ve made. So definitely lean on the youth – they give us a lot of hope for today. Throwing it to you Toben.

Toben Nelson  03:27

Yeah, thanks. I like those answers a lot, but I’m going to go in a different direction. I feel like what is making me hopeful is that people are pissed, that people are really angry and not okay with how things are, are going, and they want to see something different. And there’s, there’s a standard I think, that people are setting for themselves and for their communities and for their broader affiliations nationally, and that I think anger is okay, and it helps keep us accountable, and helps keep us on track. And I always come back to the definition of public health is the constant redefinition of what is unacceptable. And there’s a lot that we address that’s unacceptable, completely unacceptable. And I take hope in, and some amount of pride too, in working with people who are constantly trying to be better, so that, that that’s a weird way of saying, that’s what gives me hope. Zinzi…

Zinzi Bailey  04:34

Well, that’s a hard act to follow, but I think I’m going to steal from all of you being the last person I think that’s my privilege to steal from you all in that, this weekend, I was at a protest, which is a peaceful way of exercising my rights in this democracy, supposedly, right? So being able to be in that space, there were lots of young people, young kids who were seeing what democracy in action meant. Being able to articulate where we currently stand, and being able to say, hey, I don’t really agree with what’s going on at the base level. I don’t have to get involved in all the key components, but I don’t like the way my friends are being treated and being able to be there, be inclusive. And within that space, I was really I had some of my faith restored in human beings, because even in the face of opposition and disagreement, everyone was in such a positive space. And disagreements, just like rolled off of us and we were just together, right? So being in that intergenerational space and exercising rights, I find that hopeful. 

Krystal Lee  05:55

Thanks y’all for checking in. I always appreciate hearing from other folks, what’s making them hopeful? Because, you know, it’s kind of helps me to feel, oh yeah, maybe I missed that, or give me something to feel positively about in in times when I don’t feel so positive. So thank you so much for sharing that. How about we just jump right into the conversation? Zinzi and Tobin, you’ve been with the program for almost as long as Mandy, who is a day one person, tell us what you remember about the original vision for IRL at the time of development, and then what were your like motivations and hopes for the program?

Toben Nelson  06:35

I mean, I think early days when I started as a senior advisor for the program, and really came in with the research team. I really got the impression that, like folks, were really thoughtful about trying to put this all together and also recognizing that there was a “seat of the pants element” to it. I think the thing that a lot of folks talked about in early days was “building the plane while we’re trying to fly it”, which I don’t necessarily love that metaphor, but I understand what it means, at least in the IRL context. And then, I think the nice thing about RWJ is that they’re really willing to let people roll with it. There’s not a lot of barriers or specific ways that they want things to happen. They really trusted us as a team to learn as we were going and make adjustments as we were going, and when I came in as as director the the I did not have an intention of really trying to make big changes, but we were getting a lot of feedback, and there was the demand for it, and it was coming really from the fellows. And I think the best thing that we could do, the best thing we ever have done, is listen carefully to what they’re saying and try and make adjustments. I don’t think we succeeded in every case, but, but I do think we tried to be responsive, and I hope, and I think we’ve gotten some feedback anyway, that some of the changes we made helped improve the program. So I take some satisfaction in that, and I think we’ve also built in some structures so we can open up the channels to better respond, better listen, better give fellows opportunities to share their thoughts with us and taking that criticism, taking that and being accountable to them, I think, has been, has been a good thing for the program.

Zinzi Bailey  08:48

And I joined not too far after Toben. I remember we joined the research team in particular, and I think we were both kind of like figuring out, what is this program? We got some initial information, but there’s a lot of like, “okay, so what do we do?” And I remember that initially we were tasked to build out more of the elements of the research team interactions. And I think for a lot of us, we were still trying to figure out what, what is the direction that we want to be in? And so I think we spent a good amount of time just taking that in. And I think what was very clear was this desire for amplifying and enhancing community engaged research, having these, these relationships that were being built, but there being an attention with how we defined research rigor, especially in traditional disciplines, right? And as we have received them, right? So I think part of our challenge with the research team, and then beyond is balancing what that means, right? What it means to be community engaged, community driven, and producing research that’s worth doing. And that doesn’t have to be at odds, right? And it doesn’t mean that it’s a clinical trial. So I think that has been a lot of IRL navigating what are the things that matter, what are the things that are going to have impact on community in a lasting way, and how do we navigate that through data and research? So I think as we’ve gone along, there’s been a lot of pivots in terms of what we talk about, and I think we would, you know, I think it was purposefully vague what research rigor was and what community was. And I think as we’ve gone along, I think we’ve meandered into more solid conceptualizations of what those things are.

Mandy LeBreche  10:56

Z, so you’ve been involved in IRL for a while now. I think maybe year two, around year two is when you joined so you’re a year two person, and now that you’ve been serving as co director, can you tell us a little bit about how you’ve seen the program evolve over your time on IRL, and how and why have program priorities shifted over the last 10 years, or maybe eight years for you.

Zinzi Bailey  11:25

I think there are a number of things that have changed throughout the program. I think, number one, I think we became a lot more intentional around what community meant, right? I think there were, as Toben said, we were building the plane as we were flying it, which I feel very uncomfortable doing that, but that’s the life that we live, right? But I think people had an intuition, okay? There’s something about community that’s important, right? So how do we define that? Initial ideas of how to create these teams, be more intentional about how communities are included. I know in some of the initial passes, changing some of the questions that we had interviewing potential fellows or potential teams just being, being more probing around connections to communities and … how were teams going to be held accountable to their communities moving forward? And I think that was a very important shift. It wasn’t just about like, Okay, what is the research project that you’re going to be able to create, but how are you going to make the work that you’re going to do- how are you going to be accountable to the communities that you’re a part of.

As it’s moved on, I think we’ve been more intentional about like, what does a community partner get out of this program? What do community partners need? Which has been a kind of evolving story. Again, we haven’t gotten it completely right, but we’re, we’re, if not anything else, responsive to feedback and what people need. I think as we’ve gotten further, yes, there are very specific things that communities or community partners might need. But you know, what are the key differences between a community and research partner? Right? There are some elements that are structural that we can start getting at in terms of exercise of power and money and all of those key components, and being able to navigate those and maybe create ways of dispersing funds that are more aware and and considering of those, those connections, and we developed a group the CAAB so that kind of help advise us in terms of directions and provide ideas and new directions, lead certain things that we see as like assets for community partners, right?

So we’ve figured out different ways to further define this community component. I think we have further to go. If we had another 10 years, we would go even further, but I think we’ve learned so much, right? I think there was an initial idea around this, like community organizing thing being a thing and important. I think we didn’t formalize exactly what we expected or hoped different teams to take away from some of the skill sets or or case studies or people that they’re interacting with, but they were able to connect with this idea of base building and there being power in people, and being able to connect in that way.

And I think as we’ve gone on, we’ve really delved a little bit more into restorative justice, because while we talk about all these things about community and like the definitions and this work and the skill set, really we are all individuals; people trying to connect. Caring about key things that you know, we’re bringing our entire lives with us into an interaction and being able to connect with one another. And sometimes that goes well, sometimes not so well. But all of this is built on relationships, right? So we’ve invested more in what ‘community’ means for our IRL community. So that means getting to know one another, not just our work, but what draws us to this work, what connects us to want to do similar work, and how we can work together moving forward. So we’ve we’ve invested more in that, I think so those are some of the very key investments that we’ve made in this program, pivots and changes.

Krystal Lee  15:46

Such a comprehensive overview of the last eight years! Thank you so much for for highlighting that there’s, there’s so many things that you’ve mentioned you talked about having to make pivots. We’re talking about this concept of building the plane as it flies, which is, like number one, fascinating, but also terrifying to me personally. And I can see how, you know, it becomes necessary as a result of that way of doing, yeah, the way of doing things that it becomes necessary to pivot and change and listen and do all of these things that I’m hearing you all talk about. One of the things that you identified was the development of the CAAB as a way to kind of elevate and try to serve the community and the community partners that are part of IRL in a way that was not necessarily conceptualized at the beginning of the program. So I want to invite Cody to tell us a little bit about the CAAB. Cody, you started as a member of the CAAB, and now you serve as co director of the IRL program with Zinzi. So tell us about that experience. Tell us about the work that you did with the CAAB, how it’s evolved over time, and just how you have experienced that.

Cody Cotton  16:59

Yes, appreciate it. Zinzi, you did an amazing job. I wish I could just cut up and clip most of the things you said when talking about it. But the CAAB, the Community Action Advisory Board. Where do I start? One, I’m just grateful for the rest of our CAAB members who’ve done an unbelievable job since the incubation of it. But our main goal was to advise leadership on possibly more ways to center community – think about community, not just community as a whole, but the community partners. Then it started to expand a little bit more, to being able to be involved more during some of our in person meetings, to being able to get engaged with the fellows, to possibly teaching workshops, to leading more in a restorative way. Zinzi hit on it before. What does it mean to be restorative, and what did it look like to bring this into IRL setting? It looked to – it looked like being more, more than just restorative, sitting down in the circle, listening to what people have to say, but truly understanding who we are. And who we are isn’t just our names, but our values and our principles that we choose to bring to the space together and how we choose to see each other. So there’s been so many different aspects of not just how the CAAB got involved, but eventually how we continue to evolve as a program to ask the important questions like, not just what does it mean to be in community, or what does research mean, but how are we modeling ourselves as leaders? How are we putting being a leader in the forefront of what we do? So so much, so much has been gained in the last few years, especially the last 10 years, but I would like to say it’s been a beautiful progress since we’ve been able to add value and support, not only just as the CAAB, but being grateful to be in the role as co director as well. 

Zinzi Bailey  18:46

And I would be remiss to not call out that this CAAB actually evolved out of the EDI task force. So it was a group of people. It was supposed to be a short term, you know, collection of folks trying to kind of change some of the structures of IRL to reflect the diverse groups of people that were part of it. From making sure that we weren’t just like going with the contractor that did the thing that we said that we wanted to have, but that it was really embedded in who was part of the program and what we wanted to bring out in those people. And knowing that, you know, some folks have had deep experience with, for example, Diversity Equity and Inclusion training or things like that, maybe could have even led things themselves, and being able to show that people are in different places, and being able to speak to that. So out of that initial group of IRL fellows, and then alum, you know, came this idea that actually, yes, there’s the EDI Task Force, but there is an overall need for spelling out more of what community partners needed. And that is kind of the genesis of the CAAB. So from the fellows, in a more directed feedback way through the EDI Task Force, came this CAAB.

Cody Cotton  20:12

I love that Z, i think it even hits on the point of just saying how we evolve. It wasn’t just by being in meetings thinking that we have all the answers. It was easy to take advice, listen to fellows, figure out how we could get engaged. I even think about the community corner, the way we’ve been able to give space to community partners, just to talk amongst themselves, to talk about the wins, to talk about what’s working out for them, to talk about ways things to get better, not just within their own community, but with even within their project. So a lot of improvement. I feel like the IRL journey, if you could explain it in one word, and in my opinion, I would just say growth. And then two, I’ll say intentional growth.

Toben Nelson  20:56

Yeah, I want to speak to that a little bit. I think the initial idea of IRL was a good one. I think there was a recognition that community members can bring a lot more to the table and enhance doing research. But I think it wasn’t not until we got into it, and some of the tensions that exist in doing this kind of work, especially community engaged research, really started to come up. And it’s not just that we were doing it, but we also had to go back and repair or really reorient the whole way of doing work with community partners in community than I think maybe was initially conceptualized, and that push really came from the community partners in early cohorts.

So the feedback we got, and we heard this a lot in early meetings, like they’re tired of being exploited, they’re tired of this sort of colonial parachute in, take data and go out, without really engaging with the community, without really listening to the kinds of questions that they wanted answered. What kinds and what do you do with the research findings when you generate them, anyway? So I think that really was a reorienting, and I would say we’re part way through that reorienting. I don’t think we’ve necessarily nailed it at this point, but the process of doing all this and the process of taking the feedback and hearing some of the anger from folks has prompted us, I think, to try and reorient a little bit to a different way of doing work. And I think the value of engagement with community really does shine through, including our having research that is led by members of the community, having members of the community ask questions that they need answers to. And then what follows is a different kind of structure for doing research. And it also follows that there’s a shift in power and control of money. And I think a lot of what I’ve learned is when I came up, “Oh, you got to go study hard and get your PhD and come in and you’ll be celebrated as this great mind, this great scholar”. And the reality is, unless you actually produce something, no one cares about that. And the process of that doesn’t select for humility, and I think humility is a big lesson, especially for researchers in this process. And I think we’re trying to craft a new way of doing research that we still think is more valuable than the sort of the old ways, the traditional ways of doing research. I think we’re on our way, and I look forward to more progress in that space.

Krystal Lee  24:14

Wow, y’all have said a lot about like, changes and shifts to how things have happened over the last nine years, and even in the past five years, like we’ve been through a global pandemic, we’ve been through lockdowns, and not to mention, like all the current changes in the public health DEI/EDI landscape, and you’ve talked about some of the shifts that you’ve made in response to these changes, and I wonder if there are lessons that you have taken away from the experience that you would be willing to share, for folks who are engaged in work like this, or folks who are having to pivot in this time. What advice from this experience would you share with somebody who is having to deal with a lot of change right now?

Zinzi Bailey  25:03

I can start where I think you have to lean into your team and be able to connect with those who are around you. Be open and curious about what others are experiencing both on the team, and you know for us, it was what the fellows were experiencing. And I think especially during the pandemic, but I think also now, being willing to bypass what is planned and go off script to understand what the needs are and to be able to start to address them. And I think one of the things that’s necessary in order for that to happen is to have a little bit of humility in terms of, like, “Oh, I know what to do, or I don’t know what to do”, being able to because I think especially researchers… Well, I’ll speak for myself as a researcher, what I experience a lot is that we are brought up to get to a point where we say that we are an expert and that we know all the things, and we have a plan, or we have this research that indicates X or Y, and we have a deep knowing of exactly what to do. And I think that’s not necessarily that helpful, and especially in times like these, where there’s continuous pivots, there is no way to know exactly what to do, right? So I think that level of humility is necessary, and people are willing to share more of what they’re going through and what they might actually need, as opposed to trying to be like, “okay, yeah, I’m also a person who knows exactly what I’m doing, and I have no problems. My team has no problems, and everything is fine.” It allows, if you open up that environment so that people can share from where they don’t know where to go, or there are missteps, or there are team tensions or conflicts like then I think we’re better able to navigate the different pivots and be able to move forward in a way that works. So that’s what I would offer.

Cody Cotton  27:25

Love that, Z. Just want to speak on it really quickly. I think I said a lot about this already, but think one of my favorite parts, when I think about IRL and the impact it’s had on its fellows, often after we meet, we talk about what we’ve learned during the conference, but often people talk about how they had opportunity to reset, to have a different narrative, a different perspective on just their lives. We’ve done a great job on leadership, but we do an even better job onwhat does it mean to be human? What does it mean to stand for something? What does it mean to just have faith, right? Just the small things. But I think when we look at the model, what IRL has represented, and definitely in a world we want to see is to truly work on yourself. There’s so much impact that could be done in the community. There’s a lot of impact that could be done in the organization, but it truly starts with ourself. 

Toben Nelson  28:18

I’ll just add, we’re talking a little bit about the pandemic kind of happening right in the middle of IRL, and that’s a really terrible experience. I certainly wish that had not happened. It really laid bare, I think, some of the tensions that we saw within the program, especially the kind of real stark differences between researchers and community members, where researchers were paused and they felt a little handcuffed and well, we can’t do certain things. And on the community side, it was hair on fire working around the clock, [we] just saw really remarkable efforts by folks in those community organizations, our community partners within IRL, how much they were dedicated, how much they cared about community, and how hard they were willing and able to work to meet the needs of their communities. And I think that experience was humbling, from the perspective of researchers and a lot of folks shared that like just watching their community partner go through what they were going through and feeling a little bit helpless. “Oh, we can’t do our focus groups because people are trying to survive, and they’re trying to get their needs met in a whole variety of different ways”, and it just really, for me, emphasized those really different perspectives that researchers and community members are bringing to the table when they work on research projects together. And I think we’re really trying to strive for a reciprocity of understanding for doing community engaged work. So really having that ability to see what someone else is going through, understand what their needs are, understand what their self interests are, and then still be able to work with each other. And I think those are really different for researchers and for community members, and it’s still important for us to be working together on some of these projects and bringing those different perspectives. But foundationally, it is going to require a large dose of humility. It’s going to require a lot of work on relationships. And we’ve certainly seen great relationships. We’ve seen a lot of very tense relationships across teams. And you know, and just being able to strive for that reciprocity of understanding for everybody. I think that is an important key for successful work in this space.

Krystal Lee  31:11

Oh, my goodness, you all have shared so so much, and it’s, I’m not going to try to to summarize it, but I it’s bringing me back to this book called Emergent Strategy by adrienne maree brown, and she there’s so much in in the book, and I highly recommend it to others, but what I’m hearing from you as the program navigated the necessary shift, it brings me back to something that she said, that adrienne maree brown says in her book, where she the quote is, “… we are realizing that we must become the systems we need. No government, political party or corporation is going to care for us, so we have to remember how to care for each other.” And another thing she says in the book, this brings me to my next question for y’all, which is another thing she says in the book, is that “…we must aim to be an organizational model for the change we call for in the world, for the change that we are calling for in the world”. Can you tell us about from your experiences and these lessons that you’ve learned and you’ve shared with us, how have you seen IRL be and become a model for the world that we want to see?

Zinzi Bailey  32:24

I think that’s a big question, right? So I feel like we have put forth a different way of thinking about leadership where we’re I think a lot of times when we talk about, oh, who are the greatest leaders in our history, we think of these like singular figures, who are charismatic leaders, who are great orators and decision makers. And there’s specific biographies of them. And I think what we’re proposing through this program and through how we try to pivot and change, is an idea of shared leadership, where, yes, there may be a leader, a couple leaders, or we are going to share some of the those leadership responsibilities, but being able to call on one another, where it does not become a cult of ego or a cult of personality, it becomes about the mission that we have at hand, about the people who we have, who are at the center of what we do. We are talking about interdisciplinary leaders, right, and how we lead together, and I think as we move forward, I hope that maybe business school, business school model may not be the sole way of moving forward, and it’s not just a team leadership model. It’s that we are in deep relationship with one another, and we are sharing power for a joint future. So I think in that, you know that joint future is what is holding us together, that is having us take on different roles, and not necessarily needing just one person at the top, the PI or that sort of thing, the hero. We’re not going for a hero model of leadership,

Toben Nelson  34:27

The sort of the flip side of humility -and I think the enemy of good leadership is hubris. And I think recognizing that, you know, no one person knows it all, no one person has the right way. This hero model of leadership, it’s fun to write and read about those kinds of leadership models. I don’t think it reflects reality, especially in our communities, and embracing a diversity of perspectives, embracing diversity of ideas and ways forward, and putting things into the marketplace of ideas and that broader set of things, and seeking those out really enriches the experience. If you’ve got a leader who’s more autocratic, more susceptible to hubris, the strict father model of leadership, where everyone’s looking to that one person for all the answers. [I] think that has some very severe limitations. And then if you’re taking that model, you really have to enforce the credibility, the value of the strict father. And I’m saying “father” very specifically in this case, [I] think that’s not a good long term strategy. And I think innovation is best served by that diversity of perspectives and challenging oneself on various ideas and various decision points. At some point you do have to make decisions, but I think we make better decisions with those broader perspectives.

Cody Cotton  36:13

Thisreally resonates. Toen, thank you again for sharing when we talk about the model for the world and what IRL has been, I just think, from the simple example of literally, the fellowship, what we’re asking our fellows to do within leadership, we’re not asking ourselves not to do. We do a lot of figuring out, what can we do better, self assessing, trying to become as self-aware as possible in the areas that we’re looking to grow and ask our fellows to grow in. That’s why we’ve done different storytelling training, restorative practice, training. I mean, you all name it. You’ve been around longer than I have, but we’ve been very intentional about how we move forward, you know? So I just think, just briefly speaking, we’ve literally modeled, what does it look like to be a leader and to show up in places and not know the right answer. Knowing when to step up and when to step back. So that’s been very important. I love to say that IRL has exemplified that in so many different ways.

Toben Nelson  37:12

I just want to add to that too. One of the concerns I had always had, and we certainly had gotten feedback on this point was that it’s IRL, it’s a leadership program. The L is for leader. Where’s the leadership training? And I’ve mostly felt like leadership training is worthless, at least the sort of the standard leadership training, like, Oh, you’re going to come to a seminar or workshop and we’re going to teach you how to be a leader. I don’t think that’s how it works. And I think maybe, I worried a little bit about not bringing content, but I didn’t know what the content was as I’ve gone along, and I think as we’ve added things like the restorative justice practice and and pay more attention to community perspectives. Really felt the leadership training here is more experiential, and it’s part of the reason that a cohort model is valuable. So it’s not that we’re experts and coming in and saying, here’s the way, here’s the cookbook. You get this as a part of your registration for participating in this program. It really is that sort of emergent quality of we’re learning as we go and as we’re trying to be leaders in these spaces and also getting that peer feedback as well. And everybody has to be the kind of – has to be true to themselves as a leader as well being able to navigate that make mistakes, and we can develop a long list of mistakes that were made in this program, but coming through that, I’m hopeful that most folks got an experiential leadership experience, and that they feel more prepared and able and know what the what thematically are some of the components of strong leadership, and then everybody can craft that to their own style and make it their own. 

Mandy LeBreche  39:22

Wow, I’m loving all of this, and the time is flying by. So I’ll bring us to our next question. It is adrienne maree brown also says in her book emergent strategy, that, and I quote, “all that you touch, you change, and all that you change changes you”. Can each of you tell us about the impact that IRL has had on you, individually and personally, and how has your involvement with the program changed you?

Zinzi Bailey  39:55

Mandy, that’s a massive question.

Toben Nelson  39:59

Gonna need one of those Barcelona couches to answer that question.

Zinzi Bailey  40:06

I feel like there’s so much and that I’m not going to be able to articulate it all. So I’ll just point to one very glaring element. I think that IRL has been my testing ground. And I don’t know what the best word is, but like a playground of sorts, if I can make it a little bit more whimsical in thinking about my leadership on a whole. Thinking about positioning, and thinking about those leaders that I saw as, oh, they they published a lot, or they led all these people, and they were able to have these speeches, or they’re able to do these things, and seeing these like very charismatic personalities, and thinking about them being people right? And having faults and having biases and interacting with other groups of people, and being influenced by other folks, and having changes that they made along their journeys. And so I think from that standpoint, entering into the space more tentatively, there was that initial “okay, I can take the lead on something”, but then being able to move on to essentially be like, “okay, can have more decision making”, but then have this shared idea of leadership, sharing power, not being the final decision maker on some things, trusting others, and being able to be curious about directions. So I feel like I have definitely learned so much, and I can tell you, like the people that I have met through this program have been the best people who will continue to be a part of my life moving forward and being able to develop those relationships year after year, month after month, Zoom call after zoom call, I think has been essential to the last almost decade of my life.

Toben Nelson  42:09

I can reflect on that a bit. I think IRL is awesome and really difficult all at the same time. I think there were a lot of places where just exceptionally challenging for me personally. The thing that I’m most pleased about, I guess, was when those challenging times – when you’re facing those challenging times – and I think I learned this from IRL through IRL, leaning hard into your values and staying focused on the mission of what you’re trying to do, provides a really clear guidance. So when things seem challenging, when there’s hopelessness is creeping in, those values, and I think that for me, they existed prior to being involved in IRL, but I really firmly believe that [they] were strengthened through being involved in IRL, leading into those has been enormously helpful for me, personally, and I hope I have been able to uphold those values, exemplify those values, obviously, not always, but as as best I can, so that I feel good about

Cody Cotton  43:39

There’s a lot that can be said on this question, because Z and Tob, you all did an amazing job answering it, but I’m answering a little differently from my perspective. I’m 30 years old, and I’ve been blessed to be around some amazing leadership, a lot of PhDs, a lot of people who’ve had 20 to 30, even 40 to 50 years in the community doing this work. Yeah, I think about the speakers we brought in, like people who were really, just just really profound in their craft and being able to be around this. I think my number one goal is always seeing what way I could bring this back to my community, what ways I could help other small business, or community based organizations, to be able to have this advantage. Again, some people never even knew about a fellowship [at] my age, let alone had the opportunity to be a co director of one. So this impact has had on me. It allows me to show up more, not just show up more as a leader, but a leader of leaders. So I’m really thankful for this impact IRL has had on me.

Krystal Lee  44:44

Thank you all. I’m so grateful for the time that we spend together. We usually do a checkout question as we wrap up, so we check in with each other, and then we check out. So, as you all know, and we’ve, we’ve talked about over time, you know this work, the work towards health equity, the work against systems of oppression, it takes its toll, right? And Shawn Ginwright, in his book The Four Pivots, says that “… changing things that are broken in our society requires us to heal, both individually and collectively”. And so as a final thought, I want to invite you all to share with our listeners. How do you engage in self care as you engage in this work?

Cody Cotton  45:27

I listen first. I just try to listen to my body and listen to my heart… You know, it’s four seasons for a reason. Depending on the season we’re in, we may feel different. We may move different. We may receive things differently. So depending on the season I’m in, I’m trying to listen to my body. Sometimes I may need to lay in bed, stretched out, playing chess on my phone, but more times than not, I need to do something about it, get active and find out. Maybe it’s rest being in the community, and sometimes it’s just rest being with family. So more than anything, just try to listen to my body and find out what ways I could reset so I could keep this work going.

Zinzi Bailey  46:05

And I think I make sure that I have a lot of downtime. I try to rest, but I oftentimes, for me, that means going somewhere else, where I’m out of cell signal or Wi Fi signal, being able to reflect and take time and like actually being out. Yeah, Krystal being out. So I think that is helpful to reflect and actually know where I stand and how to come back refreshed and be able to, like, tap in and tap out. And I think that’s going to be essential for sustainability. So that’s kind of what I do. And I spend a lot of time with my family, being near or in water as much as possible.

Toben Nelson  47:01

For me, I’m not so sure I’m all that great at taking care of myself. I think a lot of folks may also feel similarly. I certainly can do better. I do appreciate the priority and the premium that that we as a collective have placed on self care in trying to do this work, I talked to my students about doing policy work in public health is a lot like banging your head against the wall, and you do need some rest and perspective and the ability to persist in doing that. And I think some self care is crucial to that. For me during IRL, I took a lot of walks in the woods with my dog, and I think some of that can bring some moments of peace and clarity, which are elusive sometimes. But the other thing I’ll say about this leadership team and also fellows in the program really value the mutual support that folks bring. I don’t feel like I would have made it through this, and I don’t think I would be here today without that. It’s enormously valuable to me, and when I reflect on my IRL experience, [I] think that mutual support has been absolutely critical, and I think that’s a theme for doing this work more broadly as well. I think that the extent to which we can continue to provide that for each other, treat each other as human beings with as much empathy as you can bring. I think those are recipes for success for all of us collectively.

Mandy LeBreche  48:48

Wow, that’s so good. Think we’re at a wrap here. So I just wanted to say thank you to you three, Cody Toben, Zinzi, for joining and talking to us today. We’re so grateful for hearing all your stories and experiences and perspectives with the IRL program over the last several years, and just a special thank you to each of you three. I think, individually and collectively, you three have poured so much just care and intentionality and love into the program, and you know, that’s why we’re here today. So thank you for joining us, and yeah, can’t wait for what’s to come next.

Krystal Lee  49:30

I echo what Mandy said. Thank you all so much for being with us, for sharing your experiences with shepherding the IRL program you know through the last several years. So thank you for being with us, and thank you to our listeners for being with us throughout this episode.

We want this to be a two way conversation, and so we would love to hear from you. Share your thoughts with us via our LinkedIn page, where we’ll post our show notes and any resources that we mentioned in this episode. And don’t forget to subscribe to Promising Practices for Health Equity so you never miss an episode. You can find us on Apple podcasts, Spotify, YouTube or wherever you get your podcasts. Thanks for joining us today, and remember, we’re all on this journey together, and every step we take together brings us closer to a healthier, more just world. Until next time. 

Mandy LeBreche  50:24

Promising Practices for Health Equity is produced by the Interdisciplinary Research Leaders Program, a national leadership program of the Robert Wood Johnson Foundation. A special thanks to our guests, our production team at Studio Americana, and to you our listeners for being a part of this important conversation.

A Conversation with Nancy Fishman

Season 1, Episode 4 | June 5, 2025

• Hosted by:  Krystal Lee and Mandy LaBreche
• Guest: Nancy Fishman

Mandy LeBreche  00:04

This is the Promising Practices for Health Equity Podcast brought to you by the interdisciplinary Research Leaders Program, a national leadership program of the Robert Wood Johnson Foundation. 

Krystal Lee  00:21

Hello and welcome to Promising Practices for Health Equity, the podcast created by the Interdisciplinary Research Leaders Program, affectionately known as IRL. I’m your host, Krystal Lee, and I am so pleased that my co host today is Mandy LaBreche, Associate Director of Operations for IRL. Hey Mandy.

Mandy LaBreche

Hey Krystal.

Krystal Lee

Mandy. In our last episode, we talked with Luis Ortega of Storytellers for Change, about storytelling as a promising practice and as the foundation of this podcast. If you haven’t already done so, I encourage you to go back and listen to Luis’s episode. We talk about the connection between stories and systems and how storytelling can be used as a tool for health equity. Today, we have the enormous privilege of talking with Nancy Fishman, former Program Officer at the Robert Wood Johnson Foundation (RWJF). Hello, Nancy, and thank you for being here with us.

Nancy Fishman

Hi there. Happy to be here.

Krystal Lee

Nancy. We’re so grateful to have you with us. Before we get started and jump into our conversation. We just want to invite you to check in with us. So one of our core beliefs in IRL is that nurturing personal relationships is one key to building the kinds of communities that can collaborate effectively in the work towards health equity. So at the beginning of our meetings, what we usually do is a quick check in to help us to continuously build connections in our team and what we call our beloved community. So here’s our check in question for today. How are you feeling? Physically, emotionally, intellectually and spiritually? I can start so we can so I can model for you. So physically, I am feeling well. I’m feeling rested. I got some good sleep last night, which is kind of unusual for me. Intellectually, I am feeling super engaged, because I’m really looking forward to this conversation. And emotionally, I’m also feeling pretty engaged. And then spiritually. Just okay. Just okay. How about you? Mandy, how are you feeling today?

Mandy LeBreche  02:27

Yeah, I think across the PI, the E and the S, I’m feeling pretty good. I’m always like, striving for balance in my life. And I feel like, when I’m balanced, I don’t know, I just feel better in each of these elements. So, yeah, I’m always on this quest to, like, learn lifelong activities, particularly like sporting activities. So as Krystal, as you know, I learned how to swim. I took private swim lessons last fall, and just last week, I joined this, like beginners running club with a group of people from the Twin City. So yeah, I find that when I’m I don’t know, just like I’m an active, even hyperactive, type of person. So I find that physically, when I’m engaged and learning new things, honing new things, it helps the intellectual, the emotional and the spiritual kind of fall into place. So Nancy, how about you?

Nancy Fishman  03:26

I’m good physically. I’ve been using some of my retirement time to keep healthy and physical. I am about to embark on a large trip tomorrow, so I’m pretty excited about learning lots of new things about a new culture, and I’m happy, but I’m a little nervous. I’m having that feeling. I’m also intellectually excited to have this conversation, because – this is good time to have a caveat. Some of the stuff we’re going to talk about today is 10 years, more than 10 years ago. So I have been getting it back in gear, and I’m excited to talk about that. And spiritually. You know, it’s always, it’s a journey, always, life. And so I’m on my way in more ways than one.

Mandy LeBreche  04:23

All right, Nancy, so you worked at the Robert Wood Johnson Foundation or RWJF in the Research Evaluation and Learning unit for 24 years. Can you tell us a little bit about your work with the foundation and about your role in creating the Interdisciplinary Research Leaders Program.

Nancy Fishman  04:42

Sure. When you work in the foundation, you do work on a variety of different topics. So I worked a lot in community health for the elderly and nursing workforce issues, which sort of led me more towards leadership issues. I worked, as you said, in the research and evaluation so we tried to learn either about a topic or about a program. We did research on topics that were important to the foundation, or we did evaluations of our existing programs. So I did both those things, and I spent many years in what we called our leadership group, thinking about ways to do leadership programs. And that brings me to IRL in around 2014 so right, as I said, we’re going back a ways. The foundation was embarking on our whole kind of new, not new, but articulating better what our mission was around a culture of health. And we, during that process, took a hard look at many of our leadership programs, because we had many. Individual leaders, whether it’s in research or clinical or community, and we decided to transform many of them and some that had been around for 40 years. So it was interesting and hard sometimes to make… change is hard. Change is hard on everyone. So it was kind of a hard time, but we did, after a lot of soul searching, getting input from a lot of people, we did come up with four different programs that we were going to concentrate on. They were going to be bigger than our other programs, and they were going to try to incorporate a bunch of different things. They were also going to be, and we’ll talk about this later, I think, too interdisciplinary in the sense that we had programs that were only for doctors or only for nurses, and we were not going to have any more of those programs. We were going to try to make sure, because we felt like the idea of intermingling all professions in health was going to be more helpful. So these programs, these four new programs, were designed and Interdisciplinary Research Leaders was one of them. It was really meant we had a bunch of different research programs going on, and this was the only research program in the bundle. The other ones were clinical, Clinical Scholars, and then a program for young scholars of diverse backgrounds, and then one for community leaders, and then this one for researchers and community leaders. And so that’s why we decided we needed to develop an IRL.

Mandy LeBreche  07:33

I love that. Can you share a little bit more about what the original vision for IRL was at the time this was all being developed, and if you don’t mind sharing a little bit about what your motivation and hopes for the program were at the time when it was just getting started or developed.

Nancy Fishman  07:53

So I knew we knew we wanted a research program. We wanted to support researchers, but we wanted to do it in a slightly different way. We had in the past, researchers who were in Research one institutions and pretty much ivory tower kind of feel they were doing the research, and they did excellent work, but it was kind of classic social science research, very various types, but still. So one of the things we knew we wanted to do is have things more community oriented. Then we started thinking, Well, of course, we want something sort of community, participatory research. And I then and again, this is an apologies, because it was 10 years ago, but we had, I spoke with you guys about this. We had somebody come and talk to us who was really a pioneer in community participatory research. And I left that meeting realizing, I said, Wow, we don’t want just to fund researchers. What we want to do is make sure that the people in the community are part of the program, so they get the leadership, they get the stipend, they’re really part of the team, and they’re not kind of a traditional where we give researchers money and they go out to the community, and that doesn’t always go so well. They don’t have the right insight, and I think we’ve learned so much over time in IRL about making that work.

So it was just an original thought that we wanted the community person on the team. We decided we definitely wanted a team of people again so we wouldn’t be stuck in an ivory tower. We would be, even if we were in an ivory tower, let me just say, we would be in a number of them, and that interplay would benefit everybody that there would be more give and take. And that’s not how we talk. We talk this way. And. Everybody has their own terms. So that’s really where we were. We knew we wanted a research program, and we knew we wanted something that was more community driven and that was leading more towards our thinking about the value, social value and culture of health. And of course, social determinants of health had become in 2014 all the rage as it should be. People were really understanding what you had to study. So we wanted to incorporate all those things. I will say we had, giving credit where credit is due. We had design firms come in. We funded, I don’t know how many design firms, and we gave them ideas. Oh, we want a research program. We want. We talked to them about what we wanted, and then they all came back with ideas. Some of them really outside the box. Oh, I wish I could remember one of them. It was really wild. It wasn’t for the research program. It was for one of the other programs had to do with, I think, making a TV show, it didn’t, in the end, work with what we wanted to do, but I just wanted to give an idea that we were kind of tried to incorporate new things and new ways of thinking. And so I did pull things from the design I got, mostly you guys will relate to this. The idea that we have a planning period so that we can really, I don’t know, six months. Is that what we use six month planning period, or whatever it is, and then it gets kind of shaped and approved and and moves on. And that was part of the design people, the idea and the also the idea of it, of course, being interdisciplinary, they agreed with that.

So, you know, we were trying to reach all sorts of people and get all sorts of ideas. And we had an advisory committee too. And then we wrote up our document calling for people to run these programs. Again, there were four programs. We sent it out, and you actually could, if you wanted to apply to all four. Not too many places did that, but some places applied to more than one, and went through the process. And then, of course, once we gave the grant, it was then we almost started the design over again, because there’s so many little things, every particular little question suddenly brings up a great big issue. For instance, what do we call the people, the community people? That guys are shaking your head, but they’re not community researchers. We didn’t want to put a researcher in that place. We wanted somebody who was head of a nonprofit, or whatever they were doing. I know when we wrote, I looked back at that piece of paper and it says community mentors. But I remember talking with Michael and Jan and just trying to figure out what other word we can use. You know, we just, I think, ended up with Team participants, and some of them are researchers, and some of them were community members. But even a little thing like that makes you step back and think, “Well, what is their role? And is it different? And you know, how do you value it?” And it made a difference. So anyway, of course, when we gave the grant to University of Minnesota, we almost, you don’t start again, but you start over, in a way.

Krystal Lee  13:31

Thanks for that context, Nancy, and I really appreciate the point that you made about like the what we call the people who are involved in this program because words matter. Words matter, and yeah, and so it’s, I think that’s an important lesson to take away for future efforts like this, you know, to be intentional about how we describe what we’re asking for, and who we want to participate, because we want people to be able to see themselves as part of the group that they’re being invited to be a part of, right? So let’s dig a little deeper into the into words. So what words mean? Interdisciplinary Research Leaders like, what were the intentions that you alluded to this earlier? But what were the intentions behind using the concepts of interdisciplinarity, research and leadership in creating this new program for the foundation. 

Nancy Fishman  14:28

Okay, we’ll start with leaders, because it was in this package of programs where we wanted to create cohort, a large cohort, of leaders who really understood health from the point of the community and social determinants of health and how to work with the community. And so that framework sat over all four programs, and so leaders that was part of what we want. We wanted people who could drive change, and most of the people we knew people – we weren’t inventing this, but we wanted to give people, still tools that they would be able to use in order to make change in their community and nation. And so that leadership, it was, was the big umbrella.

And research, as I mentioned, we wanted to have a bunch of different spokes on this wheel. One of them were community leaders. One of them was research leaders, student leaders. We wanted to get more now. That was our the student program. And then what’s Oh, clinical, our clinical, clinical leaders that were very similar in attitude, because they were also always interdisciplinary, but we wanted them to, of course, their what their research was was going to be a little different than what our research was in IRL. They didn’t always have to have a research program, but many of them did.

But anyway, so entered and then interdisciplinary for us, for like I said, just to compare to Clinical Scholars, that was mostly all clinicians, nurses, dietitians, pharmacists, doctors, of course, and all sorts of people joined that program, and that was the intent. And for ours, our past programs had very much been Social Sciences, which we still were, of course, very strong on. But the idea that we could expand that – we also wanted some people with medical, medical or nursing backgrounds in that would be fine. And we got them, I know we did, and our regular more social science and, of course, public health. Those are, like I said, social science, public health, those are the people we always funded. But we wanted to be able to make sure that we could tug on their experiences. And again, you know, just to expand everybody’s mind by throwing in a geography, a geographer, anthropologist, of course, I think we funded many anthropologists, actually, but a variety of other things for the tug and the pull of having those conversations, which always broadens your view. And so that’s what interdisciplinary it was very broad. 

We did require that they be a researcher, have research experience. This was not a program for brand new post doc researchers. This was people who had experience, but we wanted to somehow possibly change their frame a little bit to make it a little more community oriented, or just the experience. Maybe they were fabulous community researchers who had done lots of participatory, you know, community research, but maybe they hadn’t done it on the topics that we might choose, or maybe they hadn’t done it with, I’ll just say, a nurse. I do a lot of a nurse involved before, and they’re, you know, political science researchers, and so we wanted to make that kind of the thing. The thing I always would say about IRL, when we when it was hard, because it was always, you know, getting the teams to work together, and was hard. That was the work of IRL, that that was the whole point. The whole point was to get through that struggle.

Krystal Lee  18:19

Thanks for sharing. Nancy, I want to go back a little bit to something you mentioned earlier about a guest that you had at the foundation that really influenced the decision to incorporate the community in a different way than you had in the past. Could you talk a little bit about how, in thinking about IRL, how the community was a part of the conceptualization of the program, and what you hoped to come from that.

Nancy Fishman  18:48

I think we were aware, and I think possibly from this talk, but others of community based participatory research was out there and had been going on for years and years, but didn’t always go smoothly. Didn’t always end up answering the question the community really wanted. It often answered the question the researchers wanted to answer for the community. And so I think when we started to think about it. We thought, well, we there’s lots of experience with CBPR, but how is there a way to tweak it? And so I think that after hearing from people, particularly, you know, one talk, we were talking to somebody who had a lot of experience with this, it’s I thought, Well, part of the problem, I think, is that they have to be part of that the group from the beginning to to have the same agency as the researchers. Because, of course, all community based research, they came into the community and sat with people and they talked with people. I believe that, you know. Oh, that, of course, that happened, but then they went away, and they didn’t bring a community person with them to keep bugging them. And I kind of was thinking maybe, you know, you get that the community people have are, are going to be in every meeting and have the same kind of training. And one of the things I definitely brought from my work was actually my work in the nursing workforce, and that was to be able to have people who weren’t researchers. And it first dawned on me when I was working with a bunch of bedside nurses. But true for community nonprofit leaders also they have to be able to understand research well enough to use it like if they really, really understand it. So we did want an IRL. And I know, like I said, I in my past programs, I saw that as a nurse myself, I kind of understood that if you don’t have the agency or the knowledge to speak about data. You know, this person collects this data, but then you don’t use the right term, or you get mixed up, you know, you’re just not as impactful. So that was also it wasn’t just that we were going to use the community members because to answer the correct questions, we wanted to leave them with the ability to use the research.

Mandy LeBreche  21:23

I just have a quick follow up, Nancy, I liked how you talked about in one of your earlier answers, just the push and pull, the struggle and the joy of three people coming together to do this community engaged project and work together throughout three years of this fellowship program, and I feel like we’ve heard throughout the whole program, just why is there two researchers and only one community partner? So I was just wondering if you could speak a little bit more in terms of the development of of IRL and how, yeah, all you all arrived at three people, two researchers, one community partner, because I feel like that has been an ongoing thing… strategic, I guess, is just that the imbalance and and researchers and and community leaders.

Nancy Fishman  22:17

Yeah, totally, that’s a good question. And that is a question that we, I recall, and Mandy, you might have been part of those conversations early on, that when, as I said, after Minnesota got the grant, there was still another whole design from and we could have been free to do it that way, but it’s, I mean, I say this, but it is a money thing. We would have to have decreased the number of teams greatly to balance it. And I want, and I think we felt, the foundation felt pretty strongly that there had to be at least two researchers, because can’t be interdisciplinary if you only have one. And remember, in this umbrella of programs, this was the research program. We had a whole ‘nother program that had teams of community leaders, and they came together as a team to do a community project. And so yes, there’s that push and pull, and I know it was difficult, and there was definitely some power struggle there, and I know as time went on, an interesting part was who got the grant? And that’s the whole and I have to say, this is all stuff we were learning too, right? We were all learning this together. Who got the grant made a big difference. The amount of care that a community person needs is different than a researcher. The amount of care a community person needs working at a small nonprofit, I should say, is different than the amount of care a researcher needs working at a great, big, giant institution, although I don’t mean they don’t need care. They just need different things, and it comes to and and the power tug too. So ideally, I suppose it would have been fun to have four people on every team too, and that would have been nice. And I think that would have decreased the teams a lot. I have to say. It just comes back to our umbrella, thinking of this as a research program and money, because we only have so much money. We had a lot of money, but we didn’t have enough money to do everything. Do you think if, as you talked to teams over the years, that would have been a better choice overall to do maybe two and two. You hear it enough in the last three or four cohorts that I wasn’t involved in.

Mandy LeBreche  24:47

Yeah, that’s such a good question. I think I do probably think overall, having two and two could have been better, but I’m sure it also would present itself with different challenges than the two in one approach. There’s no perfect solution there. When I think back, like the tension that we saw in the relationships of all these three person teams, it’s not always between community and researchers. I feel like we see a good amount of tension among the two researchers. So I don’t know, yeah, it’s hard to say. I think maybe would have been a little better. But then, as you said, it would have been, it would have meant funding fewer teams, and, you know, fewer individuals overall.

Nancy Fishman  25:35

We learned so, so much in this program, I think, and about this very specific thing that you know about how teams work, and that’s it’s all learning. But some of it was, we didn’t anticipate a lot of it. We really didn’t. We didn’t understand how much of that of the struggle, as I said before, as we went on, in the first couple years, they started to think IRL that the team building is the work of the program, meaning it’s you’re learning that people are growing, probably more from that than certainly their research skills, because other researchers already had those skills, and the community members can learn research skills. That’s not that hard. What’s hard is learning how to work together in that group.

26:25

Yeah, absolutely.

Krystal Lee  26:26

So you mentioned, like, this is a it was a continuous process of learning, and you learned so much, and there were things that you didn’t think about in the beginning that emerged over time. And I just wonder, in terms of thinking about the evolution of the program while you were with the foundation, and while you were working with IRL with the benefit of hindsight, like, what does that evolution look like, and what would you describe as the impact that IRL has had in moving us towards health equity?

Nancy Fishman  26:55

Well, the thing that came to my mind first is totally about equity, and that is understanding that a community participant in this research team needed different things and in order to do and you know, isn’t that really equity in order to be at the team in the same way that people who are supported from different organizations needed, needed different things. In the end, I know I’ve checked with talking with you too, just recently, I did check that that continued, but we did not think about, I have to, I’m just going to say we didn’t think about the fact that when you pull community person from their nonprofit, which is what a lot of the community people came from, that leaves a big hole, and that organization suffers. And I think we just didn’t think about that hard enough. And isn’t that what really equity is all about, like, understanding what every person needs to be at the same level. And so I think the foundation learned that was a great that’s great for all of us, that lesson. So I think that that’s probably one of the big lessons. I mean, I think the other big lesson is the work of getting the question right, the research question right, the project question right, whatever you want to call it. So that it met the needs of the community in a real way. And that was very difficult because, of course, when we funded these teams they came up with their project, their research, and they had done some digging, the three of them together, but not a lot. And so it could be that when they talked with the community, and I kind of remember one in particular, the community had a whole different set of needs. They really didn’t even care about this project. So isn’t that also equity? Because that’s if this is about a community broad, about helping building a culture of health in a place, isn’t it about getting that correct too. So you serve the needs of the community in a way that you when that they need, and not the way you think they need. So that was the second big way that I feel that we learned more. We knew that was going to be I mean, I think anybody who’s done community knew that would be an issue, but I you know, we just didn’t always know how much of a we were able to build that in, which is why I think some teams were more successful than others, but even those who weren’t as successful getting their program off the ground were successful in building and learning from that experience.

Mandy LeBreche  29:59

So I guess now that you shared some of your bigger lessons learned from your time as program officer for IRL Nancy, if you had to do it all over again, what would you do differently? Or is there anything you would do differently?

Nancy Fishman  30:17

Well, if I knew all that I know now, I would still have the same National Program Office, that’s for sure. You guys did such a phenomenal job in bending and learning and implementing all the changes. I constantly commend you for doing that, and all the many changes like life happens as we go through too and so that was great. But I think that I would, I would know so much more about what the community members of the team needed, but I would also, I think we started out, everybody was so excited our first couple cohorts, people were so excited to be part of it, and it was a real joy to have them, but we didn’t really know, even the researchers, what level of research acumen they would have, and it varied quite a bit over the years. And I know Krystal’s shaking her head like she knows, so I don’t know that you could prevent that, but I think we could definitely have anticipated that. Anticipated the wide variety of professional experience, along with personal experience everybody brought in. And of course, as we said, The thing about supporting, the nonprofits that the community people were being pulled from; that totally could have been done right up front, and we just didn’t realize so I think those are the kind of – you learn every time you do a big meeting, too. Mandy, you wouldn’t know that, and I didn’t well know me. I just showed up. I was lucky enough to have this great team, but we always debriefed and knew what worked and what didn’t. So of course, anytime you go into a meeting now, your meetings are probably different than they were when we started. So that’s hard to say. I would do differently, because you don’t really, you don’t really know what you’re going to get. But I think that it would be around our community members and more flexibility for the researchers and expanding or building on what they already – their expertise in research and expanding it without rehashing things they already were well aware of. You know, it was very hard to know, so it’d almost have to be an Individual Learning Plan, because I recall the first couple meetings, we were trying to go over things, and some people were fascinated, and some people were like, I could teach this. I’m sure you run into that to this day. Knowing that in advance, but thinking that through we were – we, meaning University of Minnesota and and people at the Foundation who are supporting me, as we always say, we’re creating the plane as we flew it, because the foundation was very devoted to getting these programs going. Because we had stopped so many of our leadership programs; I believe we closed 10 of them. It was life altering for all of us to have to go through that process. So we were just like, we have to let the field know and the world know we are not walking away from these kind of programs. We were just changing them. So we put a lot of pressure on our new programs to make it move fast. And of course, I would say, if we didn’t have to do that, that would have been grand, but we didn’t do it that way, so we put a lot of pressure to keep them moving, which then caused us to have a rough start. Yeah, I don’t know the rest of like I said, everybody, the participants, were all so happy to be there, and I think they had good, good experiences. Our first cohort, particularly, they loved being Guinea kid pigs, but I think that they would have been nice if we’d had a little more time to develop and test a few things.

Krystal Lee  34:11

All of that makes so much sense to me, especially from a curriculum standpoint. One of the first things that you would do as far as, like, learn about your learner. Yeah, see what they’re already bringing with them and what they need, and then make that plan moving forward, make the plan for them, for what you will teach them, or what you will have them do to build upon that. So in that, that makes sense to me as a lesson learned. I think that’s good. Thanks for highlighting that. I wonder, Nancy, if you could tell us about what’s, what do you think IRL legacy will be when you think about the growth of the program, like, are there things that you are … What are some of the things that you are most proud of about the program?

Nancy Fishman  34:52

Well, I am enormously proud that this program had all those cohorts, and there are all those people out there. What is the final number, Mandy?

Mandy LaBreche  35:02

I think it’s 297 fellows.

Nancy Fishman  35:04

Wow, so isn’t that you should you should all feel really proud about that, that they’re out there, that have, they’ve had this experience, and all the things that we just talked about, so that they have skills that they didn’t have. They come and they can continue to apply them and continue to speak for health equity in their institutions. I know one of the we didn’t talk about this, but I’ll turn to this right now. I do recall that the researchers themselves spent time talking about bringing this kind of knowledge into the ivory tower, as we were, I keep pointing over here as if I have an ivory tower in the corner of my room, and it was hard sometimes because it wasn’t valued in the same way. Let’s not ignore the fact that we’re going through tough times as a nation. And so I think they are going to have skills that will be very necessary. Of course, our community members will also and as I said, hopefully have skills in working with researchers and just using information and knowing what real science is. So I think that those things are important. And I do believe that the lessons we learned as a foundation, we continue to have research programs that aren’t called leadership programs. They’re more on the research side. And I can’t really speak to many of them because I’m no longer at the foundation. However, I do know that they’re very much more engaged with community in different ways, but and I think the legacy and the hard work of IRL is getting those three people together and having them work, and it was unique, but I think it’s really valuable in some of the lessons we learned were valuable for that too.

Mandy LeBreche  36:58

All right. Nancy, one, last question before we wrap up. It’s kind of a biggie, but I think it’s important for our current time. What do you think is the role of the private sector and philanthropists like RWJF and driving health equity in the current political climate?

Nancy Fishman  37:21

Well, again, and maybe I should have said this earlier, because I don’t work at the foundation anymore, so I don’t speak for the foundation. However, having been there for 24 years, I feel like it’s in my blood. And I do know you can see by the work and what they’ve put out there that they’re moving forward, and I think moving forward with the work that needs to be done to improve the health of the nation, and that includes addressing disparities and improving health equity and promoting science that as real science that we know. And so I think the role of those people, particularly foundations, who aren’t do not get money from federal government or state is to keep on, keeping on, as they say, and I believe that is what the Robert Wood Johnson Foundation is doing, is to continue to promote the needs of the people in this country, and as many, hopefully as many private other private sectors, I’m quite sure you all would feel this way too, that the nonprofit world out there, although they will be impacted if there’s pullbacks on money from various points, will continue the work to address the needs in their communities and and help lift up the stories of those in need and the what health equity really means. And I think that their struggle is going to be much bigger. And so the role of foundations will be, of course, to continue to help that. As you both know, the purse of a foundation is nowhere, nowhere near what the federal government is. So it’s not as though all the foundations out there can step up and replace it. So there has to be other ways. But I think that the Robert Wood Johnson Foundation is holding its own, and going forward with the work that it’s already said is important.

Mandy LeBreche  39:28

Thanks for that. All right, I lied. There’s technically one more question, but it’s like our checkout question, okay, we know that working towards equity, and again, systems of oppression can take its toll. And in her book emergent strategy, adrienne maree brown encourages us to and I quote her, “…grow our capacity to embody the just and liberated worlds we long for”. So as a final thought, can you share with our listeners how you engage in self care as you continue to do this work,

Nancy Fishman  40:05

That’s really hard. It’s really hard right now, self care is really hard, and I wake up in the morning and read too much bad news before I get going. But I, since I retired, what I’m mostly doing outside of the house is volunteer work. So it I think that’s what we all have to do, is to do more. So my self care is action. I think that that makes me feel better. I’m not very good at meditating, which I should do after I do my readings in the morning of various people and newsletters. I should meditate then it would help my whole day, but I don’t. But I do go out and do a couple different things in our community, and that helps me feel better and keep moving. And so I think action helps me with self care more than you might think. And I’m sure meditation would help too, but I don’t do it. I do exercise, though, that helps.

Mandy LeBreche  41:01

Yep, you’re checking off the boxes there. Yeah, into meditation at some point. I’m not a big meditator either, even though I do know it would benefit me beautifully. Yeah, Nancy we were so glad that you could spend the time with us today. It was great, great, to see you. It’s been so many years, and yeah, you felt like it was just back to five years ago when I joined the Zoom meeting and saw you.

Nancy Fishman  41:29

I know! I don’t know you guys, I hope that I articulated something I don’t know or didn’t. So it was fun. It’s fun to revisit this. I’m really proud of this program, and it feels really, really good to be able to put a little cap on it.

Krystal Lee  41:44

Thank you Nancy, and thank you to our listeners, as always, we want this to be a two way conversation, so we would love to hear from you, what promising practices are you using in your work to achieve health equity. Share your thoughts with us via our LinkedIn page, where we will also share our show notes and some of the resources discussed in this episode. And don’t forget to subscribe to Promising Practices for Health Equity so you never miss an episode. You can find us on Apple podcasts, Spotify, YouTube or wherever you get your podcasts. Thanks for joining us today, and remember, where all of this journey together and every step we take together brings us closer to a healthier, more just world, until next time…

Mandy LeBreche  42:32

Promising Practices for health equity is produced by the interdisciplinary Research Leaders Program, a national leadership program of the Robert Wood Johnson Foundation. A special thanks to our guests, our production team at Studio Americana, and to you, our listeners, for being a part of this important conversation.

A Conversation Between IRL’s Original Co-Directors: Jan Malcolm and Michael Oakes

Season 1, Episode 3 | May 22, 2025

• Hosted by:  Krystal Lee
• Guests: Jan Malcolm and Michale Oakes

Krystal Lee  00:00

Hello and welcome to Promising Practices for Health Equity, the podcast created by the interdisciplinary research Leaders Program, affectionately known as IRL. I am your host. Krystal Lee. In our first two episodes, we introduced the Interdisciplinary Research Leaders Program (IRL) and talk about the reason for doing this podcast, our primary goal is to share lessons learned from our IRL experiences, which we conceptualize as promising practices for health equity. Promising practices are activities, procedures, approaches, policies or techniques that have shown positive results in our work with IRL. Episode Two delves into the practice of storytelling as a promising practice for health equity and introduces some of the frameworks that we will use to share our lessons learned through the stories of people who have been involved in IRL over the past 10 years. My co-hosts and I are your guides throughout this journey. Today’s episode, though, is a little different than usual. We’re sharing a podcast recording from 2020 prior to the COVID 19 pandemic. It’s a conversation between the two original co directors of the IRL program, Dr Michael Oakes and Jan Malcolm. In their conversation, they talk about their intentions for IRL, how IRL connects research evidence with community activism and their hopes for the impacts that IRL could make. Have a listen.

Jan Malcolm  01:36

So, was at Alina, and Ira Moskovice, whom I’ve  known over the years, called me one day and said, I want you to come to lunch. There’s this great opportunity that the Robert Wood Johnson Foundation is launching. And I really, I really think you need to know about it, and you should be talking with us about it. So I never turned down an invitation to lunch, especially with people I admire. So we met, as I recall, as a hot summer day sitting outside on the patio at the campus club, and we had never met. And Ira just said, the two of you need to do this. You need to write the RFP and get us this opportunity to stand up a new, very different kind of leadership development program. And I think neither one of us quite knew what we were getting into, but…

Michael Oakes  02:29

…or each other, but I right. Look, I’ll share from my side, I was working as a Professor of Public Health on Social Determinants of Health from an epidemiology perspective, what drives health outcomes from a almost a social science perspective, and spent, you know, a couple decades doing that and a little bit of success, but also began be frustrated. I can show all the differences, the disparities and the problems. What’s the solution? And over time, I wanted more and more solution orientation, and I was working on a grant for the Robert Wood Johnson Foundation, a typical professor’s Sunday afternoon, and Ira called me. Professor Moscovice called me and said, Let’s have lunch. I want to talk to you about a grant opportunity. And I said, Great, assuming he was talking about the one I was working on. So he and I and a couple others were chit chatting at lunch, and I said, “Whoa, I think we’re talking about different things”. And in fact, we were. he had known about this forthcoming request for applications for a major shift from the red boy Johnson foundation to build this thing that we now call Interdisciplinary Research Leaders, and we were talking, a small group of us to lead the application in. And I said, “This looks great. It’s right up my alley. Who should lead it?” And he said, “You should”. And I, of course, I had a surge of anxiety. And then he said, Let’s talk with my friend Jan. We had lunch, and I we’ve been off the races since.

Jan Malcolm  03:59

Yeah, it was such a great, a great opportunity, and being a part of that team to write the application, and when the site visit team came, you know, and we were able to show we are really serious about a partnership between academia and the community. I think the genuineness of that commitment on the university’s part to to really partner with community leaders was very evident. And I think I know how shocked you were and I was that we actually won the award. I remember you calling me. I think you were on, you’re on a canoe trip  and you got the call, yep, and you’re, you know, I thought you’re calling to say, you know, because it was hot, we competed. We knew that. Thought you’re going to say, you know, “thanks for the effort. Didn’t get it was still great. Good work. Thanks. Bye”, instead, you know, very kind of low key tone of voice. I thought, you know, for the first 10 seconds of the call, I thought, “Oh, for sure, he’s just calling to let me down easy”. And then you just said, “Yeah, well, we got it”.

Michael Oakes  05:01

now. What now? Careful what you wish for, right? And so that was the beginning of the IRL program about five years ago, the moment of this recording. And so share with the group. Share with me what your initial thoughts of what our mission was, from your perspective back then, of course.

Jan Malcolm  05:18

Yeah, well it just was so right on in my mind, the and you said it too, the abundance of evidence that we have been accumulating about the fact of health inequities, the fact of poor outcomes at individual and community levels, about how to move the needle. You know, what were really the levers, and how were we going to make more change? And the idea of partnering rigorous research with community activism and training the researchers to be activists, and training the activists to understand and use research, just seemed to me to be so right on, because that’s, that’s what’s missing, is that is that bridge between you know, the academics, who you know, if, if they’re not engaged, and rewarded for what actually is done with their research, but it’s just research for its own sake, research for the next grant. Then, you know, there we’re missing their power in helping to be change agents and community activists. Can have all the passion in the world, but if they don’t have the evidence, it’s certainly hard to make things happen in the real world climate where everybody doesn’t agree on what the problem is or what the solutions are. So this idea of activism plus evidence just seems right on. Seems so then, and it’s certainly born out.

Michael Oakes  06:46

Yeah, no, I agree, obviously, completely. And I think there’s even more to this story that I’ve learned in the ensuing five years, one while many academics, and certainly not all, need to be but those interested in doing this engaged, action oriented work, want to do it. Want to pursue it. Institutions, big research universities, especially, don’t give a lot of incentive, in fact, to actually poo poo this kind of work for the more junior faculty, which makes it all the more problems. So not only try and change systems, you know, in the sort of real world, as you might say, helping people live more healthy lives, but also the nature of the industry of modern scientific, public health oriented research, that has to change as well. It’s been one of the more interesting, challenging and exciting aspects for me, is, how do we change incentive structures? Lift up the people doing the good work in the community, instead of only those, and this isn’t to say it’s all that matters, but instead of only those doing the research of more basic science, which is obviously critically important, but I would like to have a bigger tent, so more people can be engaged in this stuff and be supported the universities, so that the authentic engagement, which we’ll talk about takes a lot of time. It’s relationship building and trust building. And Lord knows, there’s been reasons to not trust. How do you support faculty and faculty like persons in that work, and simultaneously lift up their community leaders to appreciate the research, as you say, to gather the evidence, and frankly, going back to some of your roots, which is so fascinating to me, to appreciate the ethical areas of that from informed consent to what? Why are you asking this research question of the community and all kinds of things like that? So we’re trying to change systems, I think, as much as anything else.

Jan Malcolm  08:38

Yeah. that’s really well said, Michael, and your last point there, you know what? What is ethical research, and how do you engage the community? But also, the power of IRL, to me, was elevating community voice and defining what even is the question because we think we know what the question is, but if it’s not relevant to the community, we’re gonna we’re gonna miss it. And so much of our traditional public health work has not been truly community engaged and it still isn’t, to this day. It’s because it’s darn hard. You mentioned the time it takes to do genuine community engagement, and it’s true, and you often don’t have funding for that, and don’t have time for that, and the legislature gives you six months to stand up a program and six more months to produce data out of it, and it’s really hard to do really community engaged work under those traditional constraints.

Michael Oakes  09:32

Say a little bit about the engaged work, the efforts, and frankly, the barriers to engaged work that you see in the Minnesota Department of Health. What are you seeing as the lead of that group?

Jan Malcolm  09:41

Well, it certainly is time pressure. But you also mentioned the very valid gap, the chasm of lack of trust between the communities and the public health system that’s trying to serve those communities and work with the communities. And partly it’s that, that notion that we’re the experts, we know, you know, we know, clearly, look at the data, we know what the issue is here. You know. We may not know why or what the solution is, but by gosh, we know what’s the problem. And we, that’s been our tendency to come out of our, you know, our well intentioned we want the right outcomes. But we, we think we we know all that we need to know about what what the issues are, and the fact that community engagement can be translated to mean, well, we just pull together an advisory group and we ask for some input, and we say, thank you very much, and we go away and we design the program and roll it out and think that we’ve gotten community input in that that’s so much more than that in genuine community engagement means you’re actually gonna involve the community in making the decision about, what did that data mean, and what should we do with it, and that too. I mean that will not only takes time, but the ability to kind of share the power of making the decision, whether it’s about how the grant gets distributed or what the evaluation measures are, is hard in any case, but particularly when you’ve got, you know, the legislature literally looking over your shoulder saying, How are you spending that money? And why did you do it this way instead of that way? Because the legislature also thinks they know what the answer is, right.

Michael Oakes  11:25

And I imagine there’s a tension you see as commissioner, what we might call deep prevention, working with communities on foundational issues such as housing and education and other aspects of social life, versus more nurses, more N-95 masks in pandemic regions, things like this. How do you navigate that with respect to the policy makers, the decision makers, and frankly, the community members who put them in office or not?

Jan Malcolm  11:55

Yeah, well, I do, I think I said at the very outset, I think I’m optimistic, because the conversation is opening up among policy makers and among sectors of the community to understand the power of the social determinants framework and the, you know, kind of the common sense once you get past the you know, high falutin rhetoric that, of course, transportation matters to to health outcomes, economic development is, you know, probably one of the most powerful tools we Have to go way, way upstream to give people the access and the resources to to make healthier decisions and getting out of this, you said it before, getting out of this narrow frame of individuals just need to make healthier choices. Yes, they do, but we collectively have a job to do to make sure that, though, that they have real access to better choices that they have, you know, access to opportunity and beginning to sort of get more more quantifiable evidence of the difference that, for instance, housing makes to health outcomes or educational outcomes in health. I mean, some of that data has been growing for years, but that’s what I’m really eager to see more of out of these Robert Wood Johnson programs, is, what do we know about those cross sector effects? And is there a multiplier effect? You know, when you get multiple determinants working, you know, working together at once.

Michael Oakes  13:23

What are the barriers you’re encountering as a leader in this area to getting more of this done? Is it understanding? Is it pure politics? I’m just curious.

Jan Malcolm  13:32

I think the understanding is dawning, because it really there is a common sense to it when you start to explain and we what we’re doing, a lot of work at the health department with community partners on narrative, you know, how do we even describe the relationship between housing and health, or education and health, in giving people just ways to describe it and talk about it, that that helped to broaden that perspective. So the understanding is growing what what is now challenging is okay, now you’ve painted a picture that all of this stuff is connected to everything else. Where do we start? Because we can’t do it all. And how do you do it? And how do you do it? So where do you start? How do you start to build some momentum? Because, you know, that’s a frustration for I think us true believers in social determinants, when we’re told, pick the one thing we say, you can’t it’s all related. We have to do all of it, but we can’t do all of it.

Michael Oakes  14:26

No, there’s scarcity, right? Yeah. And so I imagine you might want to improve, let’s just say early child education or housing, right for the citizens of Minnesota. And I know you think beyond that, but your current job is focused there. You don’t have unlimited budget, and you have many competing demands. How does a leader such as you decide and what’s the role of evidence in that decision making process?

Jan Malcolm  14:47

Oh, I wish, I so wish that there was more evidence that could actually guide prioritization, because that is really, really where we’re hurting, I think, because everything we do has a constituency, and it came from somewhere and somebody’s passionate about it. So we can’t afford to say we can’t ever do anything new until we get new money, because that is not going to be the answer. So we have to be able to reallocate resources and decide, what can we do that is more powerful or further upstream, more aimed at closing the equity gaps? And the evidence is not yet powerful enough to help us say, Well, clearly this is more powerful than that, so it does become a more of a struggle of what is the constituency that is able to help push for that?

Michael Oakes  15:42

Yeah, it’s interesting. I’ll say, from my perspective, as limited as it is, I think it’s a failure of the research side. I’ve been involved in research my whole career. I, you know, review and sometimes get NIH grants and other things. I’m always struck when colleagues and even myself write things like. This Research will be beneficial for policy decisions, but there’s hardly ever evidence that that’s true. Like, which commissioners of health Did you talk to, which CEOs, which governors, which community leaders did you talk to who said we need this evidence to move the ball forward? In my experience, inside the academy, in the research world, that’s very rarely done instead, generally, ideas are picked up and pushed forward from what someone else did, or some interesting idea one might have in the shower in the morning, and that’s a cool research project I’ll apply to get money and push it forward, and then my outcome will be a peer reviewed publication which is clearly important, but not usually sufficient for driving the evidence base for people like you making decisions about how to allocate government resources to improve the public health, I so wish, and one of the, as you know, the missions of IRL, is to help researchers. There’s many missions, of course, but one of them is to help researchers think about, oh, I have an interesting idea. I wonder if Commissioner of Health in Alabama would like to have that information to change her or his decision making. Doing that, I would hope my my hope is that would change the research questions asked, the methods to collect and analyze the data, and, of course, the dissemination of the same that’s sort of the research vision side. There’s more to it for the IRL program that we’re trying to cultivate.

Jan Malcolm  17:37

I think that’s that. It’s just critically important. And I think again, there’s a moment here that, certainly in Minnesota, and I know other states as well are really trying to work on more evidence based policy making. There’s this Results First Initiative going on around the country that I believe the Pew Foundation has been pretty instrumental in. We’re working on that here in Minnesota, there’s a whole team at the Management and Budget Office agency, and they are tasked and funded by the legislature to do these sort of meta analyses of what do we know about the impact of a whole bunch of programs? And they’ve they’ve tended to work in corrections and social services and and they’re dipping their toe into public health, and it’s great, and it makes us nervous, because what is the kind of, what’s the mental model of how you how you evaluate stuff, you know, where are you looking for the effects? Are you only looking for the effects of the public health interventions in, you know, clinical measures in six months or a year or two years, that the time frame and the ability to look at effects, you know, secondary effects, or whatever they call them, that don’t count in the traditional way of of evaluation. So if researchers who care about this subject matter can help, you know, can help inform the folks who the legislature is now looking to to help, you know, advise their decisions. There’s a real opportunity there, because this conversation about how do we measure results is really picking up steam in a lot of legislators around the country.

Michael Oakes  19:22

It’s fascinating to me. I know a history of some of this. I studied with the great program evaluator, Peter Rossi and in the 1960s and 70s, the country was working on major social programs coming out of the Johnson administration and so forth, and evaluators were working on, does this work or this not work? And this continues today. What I see today is thinking about evaluation in a more, smaller way. That is not only the huge multi million dollar programs, but the smaller ones. So the evidence base is richer. Does my community organization work with children in school? Is that effective? Or should I use my scarce resources elsewhere? That is, there’s a whole range now of things, and you’re so right. I mean, this is where, I think, hopefully, the professional researchers can help. What are we measuring? How are we measuring it? Who’s involved? And, you know, obviously, what are the ethics there? Becomes super slippery, and it just takes experience to know where the land mines are.

Jan Malcolm  20:27

Right. And to your earlier example of looking for who, who might really use the work that we’re trying to do in that intersection between research and and community change agents, who are the people that we’re trying to help or influence with that work, and to really get their perspective on what the questions are right, right up front there, I’ll just tell you quick, powerful, I think, really powerful story. So we’re doing this, all this results, first work in Minnesota, and when it comes to, you know, a point that I tried to hammer a lot with the legislature last year. And now is being picked up, I think, really seriously, by MMB. Is, is this very notion of, well, okay, so some of our traditional research framework just doesn’t even fit some of the populations experiencing the greatest disparities, because there is no evidence that’s specific to them. And sometimes the evaluation framework itself just is way off point, and we’re the Walz-Flanagan administration of Minnesota is putting a huge priority on working differently and better and more collaboratively with the sovereign Native nations in our state. And so there’s a whole effort now to say this results first framework that we care so much about in Minnesota does not fit the native nations’ experience, their wisdom, their way of evaluating. So rather than just have a caveat, you know, does not apply, or should be, you know, should be tweaked this way or that way, the results first team is working with the Native nations to build an entirely different framework that’s based on indigenous ways of evaluating. And it’s, I just want to stand up and applaud. It’s like, Yay, you know, rather than Well, let’s see how we can fit you into our box. What’s, you know, what’s, what’s a better box?

Michael Oakes  22:17

Or let’s go in and study you, extract what we want, take out what we need, and then leave you to fend for yourself. That’s the cartoon, but sometimes all too real evaluation or research model that we’ve seen. Let’s stick with this conversation for a minute about Native Americans and sovereign tribes, and talk a little bit about equity, diversity, inclusion. How are you understanding this in your role and obviously your career? I know you’re deeply dedicated to the area, but share a few thoughts, if you would, about EDI issues and challenges to improve lives for people who’ve been marginalized, people who haven’t had all the advantages that some of us had.

Jan Malcolm  22:58

Yeah, boy, it’s such a multi-layered question and conversation. But, you know, I think the conversation really continues to evolve. We used to say, Well, we, you know, our top job is to measure disparities, you know, and to and to say that demonstrates our, our, you know, awareness of diversity and equity, by saying, well, here’s, here’s the gap. What though that didn’t do never, never has done is probed deeply enough into what really produces those differences. It’s not just documenting the differences, it’s understanding why does that happen, and the good public health thinking, you know, keep going upstream, upstream, upstream for what are some of those causes? What? What we’ve really adopted at the Minnesota Department of Health is a view that what causes health inequities are gaps in opportunity, inequitable distribution of opportunity. Yeah, and, and that, that really, you know, again, takes us right back into the realm of social determinants and economic development in specific that I think has more to do with understanding the roots of inequity and what it will take to create equitable opportunity, rather than just, you know, concerning ourselves with differential access to care or differential quality outcomes within that narrow clinical slice. Again, as you said earlier, necessary but not sufficient.

Michael Oakes  24:29

Yeah, it’s interesting. I see this on the research side, where many really brilliant, insightful researchers will study, historically, the causes of inequity, redlining, obviously near genocide for Native Americans and so forth. Really important work. But in our framework that we are talking about that’s important to know, understand the history, but what can we do today? I think people need real solutions to have more opportunities to live healthier lives today and going forward. And I think that’s an area that the IRL research community, we’re trying to get to. Scholarship can be so easily focused on what happened in the past, important, but we’re trying to offer solutions to health commissioners and governors. We need things about what can we do and in a feasible policy space in our divided America.

Jan Malcolm  25:17

And it’s a great example, I think so. Understanding the truth of intergenerational trauma, historical oppression, how that translates today into different exposures to ACES and other things, and then the solutions are more community tailored approaches to resilience, or to to work in a trauma informed way, or to try to build resilience in ways that are more culturally based and that are designed by the communities themselves.

Michael Oakes  25:48

Yeah, I think that’s right. I’ll just say from my more research side, it’s not just about doing research differently. It’s about different researchers in the conversation, bringing people from sovereign nations and African Americans and so forth into the discussion of the cutting edge of research. That’s also what we’re trying to do here.

Jan Malcolm  26:08

Which goes, I think, to the importance of inclusion. Inclusion, as you said, it’s understanding. What does equity even mean? You know, diversity, so that’s, we’ve been focused there, like, well, let’s make the workforce more diverse, good idea, but also not sufficient, unless you can retain and grow that workforce through inclusion. You know, we can, we can attract a more diverse community of public health workers, but are they going to grow into the public health leaders that are going to be the ones making the decisions in the future? Which goes right to, you know, the the inclusion part of it, it’s like, what does it take to build a culture in an organization or community that really, truly values a broad range of experiences, and it gets as wonky and nerdy as your hiring criteria, the way you write minimum job specs, and all of us work in different institutions with different rules. But so we have to have a really challenging conversation about challenging the way we, you know, write minimum job qualifications in order to make sure that we’re we’re valuing different kinds of experience, and not just, you know, the the traditional way of saying I need x years of this and this kind of a degree. Yes, you need that technical skill. But how are you going to develop and and really grow an inclusive group of future leaders if you’re, if your pipeline is not more open earlier on?

Michael Oakes  27:46

Yeah, I agree. Obviously the rubber hits the road at some point, often in the hiring decisions, in the promotion decisions that leaders in your organizations and mine making every day. Let’s talk for a few minutes about leadership. You’re a very prominent leader. I know you’ll blush when I say that, but you’ve done tremendous things. Tell me about your leadership training and your views on what makes a good leader?

Jan Malcolm  28:08

Wow. Well, it’s actually a topic quite near and dear to my heart, because I have had the privilege of being in leadership roles for much of my career, but I’ve always wondered, you know, am I taking full advantage of the opportunity, and what does it take to really be a good leader? So Sure you can, to some degree, you are declared a leader by the position that you’re in, but whether you really are viewed as a leader is a different question. I think we, we all have examples of that in our personal and professional and civic lives, that we see people who are in these positions of leadership who really are not leading in the sense of helping their organization, their community, whatever, make progress toward, you know, something compelling. And to me, that leadership is about supporting, you know, the capacity of a group of people to do something big, something big that they care about. And it’s supporting, but it’s also kind of a combination of push and pull and and, as I said at the outset, cheerlead and critique, but to try to really motivate, enable, harness the energies of a group of people to achieve something big that that they couldn’t do just by themselves. So at the health department, we are blessed, and I’m sure this is true of many health departments across the country, but such passionate people in public health, I mean, motivated to, you know, literally protect the health of the public, and driven by a desire to do as well as we possibly can. But the things we’ve been talking about at this hour, you know, the limits to what we traditionally have done and known. And we’ve been working on health equity, for example, at Minnesota Department of Health for decades. And it’s sobering, you know, when we see the relatively little progress we’ve made on really closing the gaps in health opportunity and health outcomes that we know are there. So challenging ourselves to think differently is just an example of what I mean by leadership. So you could just sort of celebrate the fact that we’ve got technically excellent people and programs and where, you know, we get a lot of rewards for doing what we do today, but are we making as much difference as we can, you know, for the future is the, is the leadership question and opportunity. So, I do think you know, and sort of back to your, your question about, what is the leadership development journey first, I think it’s, it’s just so wonderful that we’re developing, you know, more scholarship too, around leadership. What, what is it? And how does one get better at it? Because it isn’t just conferred upon you. You know, my own, you know, my own journey has been one more of just trial and error and trying to figure out, well, that worked and that didn’t, and why. And so I really applaud the commitment of people who are interested in this question of, how do you be a better leader and invest the time in studying it? Because there is a body of work emerging that we can draw on. Plug your book. Well, you know, it’s, I wrote a book with Jim Begun, another great guy from the University of Minnesota, and someday, maybe I’ll I don’t know if I can persuade Jim to rewrite it, because he might. I know he’s moved on to many other topics, but it needs some refreshing for sure. But we, we really did kind of developed this, this notion, you know, that it’s useful to break down the concepts, you know, because leadership’s an easy term to throw around, but it’s like, what are the what are the values, the the beliefs, the values, the traits, but then the the actual hardcore knowledge and the behaviors and the in the skills that that come together to really equip one to handle the kind of the kinds of challenges that you can predict a leader will have, we know. How do you help to set a vision? How do you mobilize people? How do you engage partners? How do you prepare for you might not know what the challenge is going to be, but managing change and managing challenges, or in public health, managing crises, is a big part of the job. And then how do you really push an organization to not rest on its laurels and to just continuously improve. I mean, for Jim and I, that we kind of bucketed leadership challenges in some of those ways and tried to break down, what are the what are the values that guide that? What are the what are the behavioral traits? What’s the knowledge? What are the skills and just just the very notion of trying to unpack the term leadership a little bit and figure out what you know, what does that mean, and what, what do you want it to mean, and then having, you know, a program like IRL that lets you experiment with with it, lets you figure out, where do I think I need some more work and to be part of a community that’s interested in the question of leadership, as well as the question of, how do we build better evidence? Because that’s, that’s really how we how we, we learn. I do think, you know, yes, the pedagogy is useful, but the experience of actually trying to apply the principles and the humility to want to want to keep getting better is really important.

Michael Oakes  33:51

You know, when I as we think about the curriculum of IRL, and I think about it in other spaces I work in, one of the interesting things about the leadership literature, if you will. I mean, there’s a gazillion books from the business side about what makes a good leader, military as well, appropriately so. And one of the interesting things that I think is, in general, particularly in the business side, the leadership books tend to find a current, viewed, excellent leader and say, what made him or her great, and it’s sort of backward looking, which is important, give some clues. What’s not clear to me, as we think about building curriculum like an IRL, and I know you think about it in your organization as well, is the other way. Let’s take a person, Jim or Sally or whoever, what training and experiences do we need to offer them to make them a leader if they’re so interested? So that direction, and what’s the evidence for what works and doesn’t work that is really lacking, and it’s a really fascinating observation that I’ve come to in my work here. We don’t really know. And so in some sense, IRL is one big experiment. And I the fellows sometimes joke, are we guinea pigs? And they’re not, but we’re all trying to get better. And so that resonates with you?

Jan Malcolm  35:07

Oh very much. Yep. And I, you know, you’re right. There are a ton of leadership books, many of them good and helpful and good for prompting self reflection. But most of them, it seems like either are very, very focused on personality attributes or specific behavioral techniques, but a little light on what you know? What is the knowledge that’s helpful to have about change processes or community engagement, or how to use yourself or self knowledge you know? And what is the kind of what is the developmental path of how people can not only develop those that that book learning or the basic skills, but as the world becomes more complicated, and as you rise in in leadership, into more and more complex roles, it’s how do you apply those earlier learnings and lessons to a to increasingly complex situations, which is why I think it’s really good for people who are in leadership positions to keep to keep trying to learn. You know, not just assume, well, hey, I’ve been a leader for 20 years, so what’s to learn? I mean, I think there’s always something to learn about what worked and what didn’t.

Michael Oakes  36:22

That humility, I think, is super important. Just never thinking that you’ve got it figured out. Let me ask a question of you that I have asked for myself as I struggle in my own leadership roles, it can be lonely at times, and we have to make some tough decisions. I know you do. How do you make sense of that? How do you go home and rest well on your pillow when you’re making tough decisions? And frankly, sometimes there’s some, there’s some challenging, lonely moments. Yeah, that is what in these books that we’re talking about. It seems that leadership is always so amazing. We get, you know, typically, higher pay, and we’re having these great decisions and impact, and we’re, we’re sharing our vision with the world cool. But then there’s constraints, and there’s pushback, and at least for me, there’s, Am I doing it right? Thoughts on that?

Jan Malcolm  37:11

Oh, right. And, I mean, I do think just give especially we’re talking about Health Policy and Public Health, and the reality of literally unending series of needs and legitimate requests for attention and help and the time and the resources are don’t allow us to do everything that can or should be done, or to try to figure out some logical order in which to tackle things. Does mean setting priorities, and it means managing disappointment and and and helping the folks whose issue is not number one today, not not stop working. Not stop developing, you know, the case and developing the coalition that’s going to help push that issue higher up the radar screen. Because we need to develop the ability to keep refreshing the agenda and reprioritizing rather than being stuck on, you know, only one thing for forever, especially, especially if, as we gather more evidence that the way we’re doing it may not be working, yeah, but that change management process of helping people figure out how to reprioritize and and not discouraging the people whose issue isn’t yet ripe, is a it’s, I didn’t answer your question at all about loneliness, but I do think that’s where community comes in, you know? And And again, what? What I think we’re hearing from the first cohorts of IRL. The magic is in the in the group, and having people that you that you then can call to say whether, in whatever the context is, whatever the issue area, or the type of role you know, finding, finding peers that you can, that you can be candid with and vulnerable with to say, Geez, I’m really struggling with this, or I don’t know what to do, or I’m worried about X, and that is not something I’m going to stay say, standing in front of, you know, a room full of health department people is, I don’t feel like I know, but I need to have somebody that I can say, we all need somebody like that. Yeah, that I’m I feel, I feel unsure, I feel vulnerable about this, and sometimes all you’ll get is support. Like, yeah, I feel that too. And then at least you don’t feel alone right in your journey.

Michael Oakes  39:41

Have there been official mentors, or have you sort of connected with people in more informal ways that have helped you?

Jan Malcolm  39:51

Yeah, well, you know, here, here we go again, with a shout out to Robert Wood Johnson Foundation. But when I, when I was first appointed health commissioner, they had just started a program called the State Health Leadership Initiative, which was specifically aimed at newly appointed state health officers, because what they knew is that it’s a high failure rate job, that the average tenure at that time was less than two years. And that’s a problem for a lot of reasons. It creates lots of instability and turnover in public health agencies. So they were setting out to try to tackle this question about what do you what predicts success for these politically appointed, high visibility jobs, and so I was in the first cohort of that program, and both the learning was superb, and we got access to faculty for this program who’d worked in politics, who’d you know, supported governors, who’d been health commissioners before. So we got to talk to the experts. But it was the group, you know, it was that, you know, that we could just call each other and say, oh boy, this blew up in my face. Or, what did you do about that? So yes, I had some sort. Some access.

Michael Oakes  41:08

Now we know it’s that secret sauce from so many years ago, right?

Jan Malcolm  41:12

I had access, access to expertise, but I also had access to peers.

Michael Oakes  41:17

What is your view on setting up mentoring programs in your organization or elsewhere?

Jan Malcolm  41:23

Yeah, I think it’s really important again. You know, back to the earlier conversation about diversity and inclusion. We have to be really intentional about developing our future leaders and not expecting it to just happen. You know, don’t just absorb it by osmosis, but so we are. We’re trying to develop mentorship and leadership development programs, really, at all levels, both within the health department and across the larger enterprise of state government.

Michael Oakes  41:53

Let’s shift now to, I guess, the last part of our conversation. Let’s talk about the future. Let’s talk about the future of what I’ll call community engaged, action oriented research. From your perspective as a public health leader, what do you see? What’s necessary we’ve talked a lot about. Maybe we can just summarize a few things for the listener.

Jan Malcolm  42:14

Yeah, well, I think we have covered a lot of the key topics. I think you know, really, and I know iRL is working hard to do this really understanding the difference between real community engagement and rhetorical community engagement, because I do believe that there’s a lot of wisdom in communities about what is possible and what’s going to be, what’s going to be effective and what’s not. And I think we waste a lot of time, a lot of resources, misdiagnosing, or, you know, proposing solutions that aren’t community based solutions. So I think that genuine community engagement is huge. And we’ve talked about the challenge of evidence, of, you know, making it rigorous, especially when, when we’re asking, you know, complicated questions. And what you said earlier intrigues me. I think is worth thinking more about. Is like, Maybe we should get better at evaluating smaller pieces along the way, rather than looking for like the massively complex evaluation that can, you know, answer all questions at once, which is, of course, what the political folks wants to tell me the answer, tell me the thing to do…

Michael Oakes  43:29

… and it would be so easy, right? Yeah, you know, if it matters, I talk about this with my students and friends. I talk about it in a baseball metaphor. I think you should, not entirely, but maybe more so focus on hitting some singles instead of trying to swing for the Grand Slam. Grand Slam is necessary. It’s beautiful. People cheer, but you can usually win more games to follow the metaphor with some singles. And obviously that’s one thing we try to do in the IRL program. The amount of resources we can offer our Fellows is not nothing, but it’s not tremendous. And so the scale of their research proposals and projects can’t be huge. And so the hope is that when you’re doing more of those and more of those very well, collectively, sort of the synthesis that you described earlier, can be more useful for decision makers such as yourself. It’s the hope.

Jan Malcolm  44:19

Yep, oh, well, I think we have a moment when people are open to the conversation about different approaches and our the broader we frame the problem, the more important it is to figure out a logical way to start and a logical way to build and to have that be based on, you know, as much evidence as we can gather about what seems to be most useful, or under what set of conditions is one thing useful or another, because it’s, I’m just really, I’m worried that, you know, it’d be easy to squander this opportunity if we, if we can’t get pretty, pretty practical, pretty fast about…

Michael Oakes  44:58

Some of the news media today, all kinds, all corners, talks about evidence, but evidence from a political perspective, evidence from the right or the left, whatever we want to talk about, and therefore invalid overall. And it really depends where you sit politically, to what you care about with respect to research evidence you have thoughts on that going forward. I mean, you’re working with an interesting legislature right now. What is the role of evidence in a divided country?

Jan Malcolm  45:27

Well, you’re right. I mean, not, unfortunately, we, we can. We can create cases. We can find evidence that appears to support whatever point of view we already have. So what do we call it? What do we draw? And I mean, we, I think continuing to search for common values is something, you know, we, we talk about that, but we kind of leapt past that part pretty fast. Yeah, and I think we need to do a lot more of that to try, you know, the whole culture of health idea and is trying to get multiple sectors and multiple points of view to find those points of common values. But then, you know, to build evidence that can be believed by multiple sectors, I think, goes, goes right back – and maybe this is Pollyannaish – but you’d like to think that that if the evidence is is of high quality, and the way it’s done is is rigorous and can’t be just dismissed as, you know, superficial or partisan. You know, I’d like to take the folks at their word, and I do take the people in the Minnesota Senate and the Minnesota House, both of different parties, both saying the same thing about, oh, we have a hard job. We have to prioritize better. We need evidence and and we need to figure out what kind of evidence we’re collectively going to be willing to use.

Michael Oakes  46:48

Yeah, for me, that’s the key element of our program research leadership, where the research is non partisan, the research is as close to the truth as human beings can get to working with, of course, community members who have deep knowledge and respecting them, obviously. But I think the goal, for me, is more evidence that is less questioned from a political perspective. And to me, that’s really the driver of solid research leadership that I think can improve the public’s health and build a culture of health.

Jan Malcolm  47:22

It’s the right quest…

Michael Oakes  47:24

It’s the right quest. With that, Jan Malcolm, let’s end the hour. It’s such a privilege to have you here, such a privilege to know you as a friend and my mentor.

Jan Malcolm  47:33

Thank you, Michael, yeah, this is just a shout out to all all the IRL family, our first cohorts and the cohorts to come. This is, this is special. This is big, big work, and awfully glad you’re where you are doing what you’re doing. Thanks you too. Thank you. Talk soon.

Krystal Lee  47:55

Thanks for joining us for today’s walk down memory lane with Dr Michael Oakes and Jan Malcolm, the original co directors of the IRL program. As always, we want this to be a two way conversation, so we’d love to hear from you. Share your thoughts with us via our IRL LinkedIn page, and don’t forget to subscribe to Promising Practices for Health Equity so you never miss an episode. You can find us on Apple podcasts, Spotify, YouTube or wherever you get your podcasts, thanks for joining us today, and remember we are all on this journey together, and every step we take together brings us closer to a healthier, more just world. Until next time…

Storytelling for Health Equity

Season 1, Episode 2 | May 17, 2025

• Hosted by:  Krystal Lee and J. Robin Moon
• Guest: Luis Ortega

Mandy LaBreche  00:04

This is the Promising Practices for Health Equity podcast brought to you by the Interdisciplinary Research Leaders Program, a national leadership program of the Robert Wood Johnson Foundation. You

Krystal Lee  00:23

Hello and welcome to Promising Practices for Health Equity, the podcast created by the Interdisciplinary Research Leaders Program, affectionately known as IRL. I’m your host, Krystal Lee, and my co-host today is J. Robin Moon, associate director of research for IRL. Hey Robin! 

In our last episode, we talked about the Interdisciplinary Research Leaders program IRL, we talked about how this podcast came about, and our goal of amplifying what we are calling promising practices. Promising practices are activities, procedures or approaches that have shown positive results for us in the context of IRL, and that we think are worth understanding what makes them promising so that you, our listeners, can replicate, adapt, or adopt them in your efforts to achieve health and other kinds of equity. One of these promising practices is storytelling, and today, we are fortunate to have the storytelling guru himself, Luis Ortega as our guest. Luis is a multidisciplinary storyteller, educator, facilitator, Narrative Strategist, and the founder and director at Storytellers for Change. Hi Luis, thanks for joining us.

Luis Ortega  01:50

Hi Krystal. Hi Robin, thank you for inviting me.

Robin Moon  01:54

Luis, we’re so happy to have you with us. Before we ask you to tell us about yourself and your work. Briefly, we invite you to engage with us in one of our IRL promising practices, that is, to check in with each other. One of our core beliefs is that nurturing personal relationships is a key to building the kinds of communities that collaborate effectively in work, in the work towards health equity. So at the beginning of most of our meetings at IRL, we do a quick check-in to help us continuously build connections in a personal way, within our team and our beloved community. So here’s our check-in for today, which is something that we’ve done with you. How are you? Physically, intellectually, emotionally, and spiritually, also known as “PIES.” It’s a nice acronym, P, I, E, S, I will start. Physically, I am actually in New Mexico this week, driving hours to reach national parks, the land that used to be coexisting with the Native Americans. So I’m a little tired. Physically, intellectually, I am very stimulated, especially with this podcast recording. Emotionally, I’m exhausted with non-stop hammering of all the stuff that’s going on in our country. But spiritually, I am full of hope, and that’s something that I would really like to attribute to our storytelling training and practice that Luis you have helped us with. I’m going to toss it to Krystal.

Krystal Lee  03:36

Thanks, Robin. Physically, I am feeling fine. I’m feeling rested, which is unusual for me, so I’m very grateful for that. Intellectually, I am also feeling stimulated. Part of it is because of my work with IRL. But also, spring is approaching, and I’m planning my garden, yes, planting some things that I’ve never planted before, to include asparagus. I got some asparagus roots yesterday, so I’ve never seen that they look like aliens or like like an octopus or something. So I’m doing my research on how best to promote the growth of the asparagus. Emotionally, I’m a little bit tired. My parents are having some health issues, and, you know, dealing with aging parents can be exhausting, and that’s where I am with that. And spiritually, I just feel calm, which is unusual for me. Usually, I’m an anxious person, but I’ve had to lean into some of the promising practices that I’ve learned in IRL, paying attention to myself, and, you know, taking care of myself, doing some reflection, focusing on the moment instead of trying to fix what’s going to happen tomorrow. So that’s where I stand, and I’m going to toss it to you. Luis,

Luis Ortega  04:47

Thank you, Krystal, and thank you, Robin, for checking in. And I physically feeling strong, but also my body. He is telling me that I should be outside running right now, because usually around this time is when I go for a run. So my body knows. Somatically, it just knows. So after this podcast, I’m gonna go for a run, and I’m looking forward to that. Intellectually as well as emotionally, I am meditating a lot on I just reread a Parable of the Sower and Parable of the Talents by Octavia Butler, and I’m spending a lot of time just thinking around how change is the great constant, and that proverbial quote from, from, from those books that everything that you touch changes you, and everything that you know it’s in relationship with you is continuously in flow and change. And I’m emotionally embracing that for more than than a few reasons, including that tomorrow is my birthday, so I’m just thinking about change in that particular way, but also just about our greater social, political landscape, and what it means to engage with that. And spiritually, I would say that I feel very rooted, and I’m feeling very connected to my partner, to my family, to my friends, to the work that I do, and that’s a practice that I’ve been cultivating for some time now, and I’m just grateful to be in that space right now. 

Robin Moon  06:29

Thank you so much, Luis, and happy birthday, early birthday! Let’s get into it! Okay, I want to tell, I want us to tell the story to our audience, how we met. So we met you. Luis, there are always two sides to the story. We will tell our side first. We met you last year as Krystal and I, as co chairs of the IRL annual leadership meeting in october 2024, and we were in search of a storytelling and narrative change workshop leader, we made storytelling the main theme of the entire meeting, as the path to reimagine our world with health equity, the details of which we’re hoping that you will talk about today, and I’m grateful that you mentioned the Octavia Butler, because I’ve also been reading, we’ve been reading emergent strategies by adrianne marie brown and then Grace Lee Boggs quote that I’m thinking in that book, we need to transform ourselves before we transform our community. So we were looking for an expert who could provide a skills-building workshop that is about storytelling, but as a means, not the end goal, to build our beloved community. It turns out that the task was not very easy, and we spoke to many potential organizations, including the big names that we all know. No names mentioned. But it was just not the right fit. And we were like, what was it they were looking for? We knew one thing that we were we were looking for Marshall Ganz, model of a story of self, story of us, story of now, and really it had to be a tool for community building. So when we finally met with you, we just knew at that point that you were the one. That’s the story that we tell about how we met, and that’s the match made in heaven, as we’d like to think. So tell us about your experience with getting connected with us, with IRL, what resonated with you specifically about the work that we’re trying to do here with IRL?

Luis Ortega  08:31

Yeah, certainly I remember a few items that you just highlighted that immediately align with my ethos and how I think about the role of storytelling, not only in forming and shaping beloved community, but also in the context of healing equity work, and just more broadly speaking, transformation work. I would say that there was also a great deal of alignment when I heard that you were engaging with Dr Shawn Ginwright’s work, particularly his book The Four Pivots. And even before that book, I was already correctly influenced by Dr Ginwright’s work around healing centered engagement, which has played a huge role in helping me to integrate an intentional healing framework within my narrative and storytelling work. I remember us having a lot of conversations to your point, Robin, not only about what it means to engage in storytelling as an outcome, as a product, right, a story that you tell. But the importance of creating a holding space where the process through which we craft the stories is intentional, is relational, is inviting us to see ourselves and each other, the process itself, it’s healing. It’s not just telling stories about health equity, but how do we actually find equitable relationship building. How do we find healing within ourselves and each other as we craft those stories? So that conversation was very energizing for me, because I found a lot of alignment in your language and the scholars and practices that were informing your work, which mirror a lot of some of the fine words that inform my work, and I would say, lastly, just with you and Krystal, as we engage in that initial conversation, for me was also important to see that there was a resonance around not just talking about storytelling as a skill, which certainly it is, you can cultivate storytelling as a skill, but what does it mean for us to engage with storytelling as an embodied practice? In other words, how do we honor each other as storytellers? And that, to me, is essential to the systems transformation work that we need to do. And ultimately, I left that initial call feeling energized and hoping, crossing my fingers, that this would work out for us to partner. And it did, and it’s just been truly beautiful to be with you in this journey since then. 

Robin Moon  11:12

Since then, we are so grateful that we found you, we discovered you, and we take all the credit, and I personally have become your disciple, learning and training how to be a collaborative and community-centered storyteller. Tell us, Luis, what connection do you see there is between health equity work, because we’re really talking about health equity in the end now, between health equity work, community-engaged research, and storytelling?

Luis Ortega  11:43

Yeah, certainly. And I’m going to give you a more personal micro answer, and then, I’ll expand, and I’ll talk more from a macro and meta perspective, systematically. I think the first thing that I want to offer is that I fundamentally believe that our well being, as individuals, as a society, as communities, is directly interconnected with the stories that surround us, and by extension, I would say, the stories that live within us. So, to give you a very micro example, I came into this world. I’m from 1987 March, 28 at around 1:30 am and when I came to this world right, almost 38 years ago, I came to this world right in Tenochtitlan, today, known as Mexico City, with a mother who I dearly love and really loves me, with a grandmother and a couple months later, but a year and eight months later, my two younger sisters joined me, and that was my upbringing, right? My mother, my grandmother and my two sisters. Growing up, the stories that I knew were stories that affirmed me. I felt loved, I felt cared for, I felt meaning, I felt connected. I spent a lot of time with my grandmother, drawing and learning how to express myself through, as someone a bit more introverted. I found a great deal of expression through the arts. In my sisters, I found not only a sense of friendship, but also responsibility and wonder. In my mom, I found and to this day, I continued to find tremendous guidance and wisdom and a friend. And as I grew up, I began to encounter other stories.

As I began to reckon with my sexuality as someone that’s queer and bisexual, I began to encounter narratives that told me that I was wrong, that I was wrong to the point where I did not actually come out to my family, to my mom, to my sisters, those same people that made me feel so loved and affirmed I did not come out to them until my mid 20s. I began to encounter narratives about my mestizaje, right, or this idea of being mestizo, the explanation, the story that we give to why is it that I speak the way I speak? Why do I speak Spanish and not Nawat? Why is my skin this particular color, right? Why is my hair texture the way it is? I began to encounter narratives also about how I should relate to others or not, and eventually, when I was 14 years old, and I moved to this country, and I had to deal with other racial narratives. I had to deal with immigrant narratives. I had to navigate, and continue to navigate this political landscape as an undocumented immigrant, I kept encountering stories. Now, why do I start with this? Because for me, there’s a tremendous contrast in the type of stories that I encountered as a child that fundamentally allowed me to hold myself and hold others with a profound sense of love and connection and what feels to me as a persistent and ongoing struggle that I’ve had to navigate as I deal with all these other stories that made me feel extremely disconnected from self and from others, and I think from a systemic perspective, and this is where I began to be informed by the work of Dr Shawn Ginwrightt and others. I begin to analyze and understand how these stories, stories that are fundamentally rooted in a belief system that has created a hierarchy of human value, is a tremendous barrier to any effort to actualize equity and health. And health, it’s just not compatible – an ideology that sustains a belief that there is a hierarchy in human value with the idea of achieving health equity. And therefore the challenge is that if we live in a society where racism, sexism, homophobia, transphobia, right, where we continue to have tremendous hate directed towards immigrants and refugees, particularly those who are black and brown, particularly directed towards people who are suffering because of displacement.

We have a challenge, and so much of what we have today systematically and structurally built in the US, certainly, although this is the case in many other places across the world, is systems that are driven by these ideologies and that are embedded within the logic of how these systems operate. So they are working exactly how they should be working. And these narratives are fundamentally also connected to what I think MIT scholar, Otto C., Charmer, correctly diagnoses as the most important challenge that we have to tackle in the 21st century. And that is the challenge of disconnection. And from that perspective, I think there are three big narratives that we need to counter and tackle if we are to address issues of health equity. He characterizes them in the following way. He talks about the challenge of ecological separation, social separation, and spiritual separation, or disconnection. The first one is this idea that we as human beings are separate from nature, right? This is the narrative that tells us that we are here to exploit nature and that that’s just the way it is. The second narrative social separation is this idea that there is a ‘we’ and there is a ‘them’, and this is what scholar John A Powell also refers to as the challenge of othering, right with other people. This is returning to this idea of a hierarchy of human value. And last but not least, this idea of spiritual separation is the idea of, how do I separate myself from myself? So those narratives that tell me I’m wrong, I don’t belong in myself. I’m broken, right? So this is where we can talk about these, this crisis in loneliness, right? That oftentimes gets cited now in all kinds of different articles, we can talk about this complete sense of isolation, of suffering, and even diagnosing trauma or sickness through an individual lens, instead of thinking about the collectivist nature and or systemic nature of why are these symptoms emerging? And if we have, I firmly believe this, if we have any hope in addressing any of these isms, any of these issues of separation. I believe that we need narrative and storytelling to counter these narratives. 

And I’ll offer one more item before, before I close this particular reflection. I think countering these narratives is essential, because we do have to name them and understand them and unpack them. And on the other end, we also need to generate new possibilities. And this is where going back to Dr Ginwright’s work, it’s really important his pivot around going from problem loving, right, or just naming problems, unpacking problems. So this is where my background as a researcher, as an educator, is a bias, right? Because I was taught to analyze problems first and foremost. Even in my early training around storytelling, I was taught to always help your audience understand the problem. That’s fantastic. That is a type of storytelling tactic that we need, and it’s also limiting, because we need other paradigms and other forms of engaging with narrative that invite us to also create new ways of being. So this is where I’ll close by just offering. Lee Ann Bells, an educator and scholar from Columbia University who created something called the storytelling project model. And in it, she names four types of narratives that are part of what I refer to as our narrative ecosystem. She calls our attention to the stock narrative, which is the dominant story. I already spent time unpacking that right now, hierarchy of human value. Concealed stories – What are the stories that are concealed by these dominant ideologies, both stories of trauma and neglect and marginalization, but also stories of joy, of resilience, resistance stories, the stories of people, movements, organizations that have always struggled against and pushed back on the dominant ideology, right? And this is where the countering piece comes into play, right, and countering storytelling comes into play. But then there’s this fourth quadrant, and I think this is where we need to be for us to engage in health equity work. Lee Ann Bell refers to these as the emerging or transforming stories’ space, and this is where we need to focus our attention. I believe not to ignore the consultant resistant stories or to counter and name and unpack the stock, but we need to critically  analyze ourselves and our efforts and our work as organizations and practitioners and researchers and ask ourselves, how much time are we actually spending in the paradigm shift in practice of proposing new possibilities and new ways of being? If we are going to achieve health equity, we need emerging and transforming stories that help us visualize, imagine, and believe in the possibility of health equity.

Krystal Lee  21:44

Luis, as always, every time you speak, I try to take copious notes. 

Robin Moon  21:51

Yeah, I saw you were doing that, Krystal!

Krystal Lee  21:55

That’s exactly right! So I just want to ask a follow-up question as it relates to some of the things that you have said before. I want to, I really want to highlight this for our listeners, one of the things you talked about is the ideologies that are embedded in the logic of how our systems operate and how the systems are operating as intended, right, based on those ideologies upon which they are built. And you talked about the need to have narratives that counter these ideologies in order to change these systems. And then you also mentioned one of the ways to do that is to name, understand, and unpack these narratives, and then beyond that, to create new paradigms that create new ways of being. So I want to ask you to go a little deeper with us, in around those concepts that you have highlighted, and talk to us about what do you see as the role of storytelling in dismantling the systems that are operating as intended, but to change those to promote and perpetuate health equity instead of what we are seeing right now?

Luis Ortega  23:07

Yeah, certainly. And I can again start with a personal example, and then I can offer some thoughts, insights around how these could manifest at a macro or meta level. I recall a few years ago now, I participated in a storytelling program, and I was passed by one of the lead mentors, facilitator for the session, asked the question, what does it mean to feel whole, to feel well, and to be in a just relationship with yourself and others? That was the entire purpose of this particular program. And mind you, at this point, I’ve spent a lot of time reflecting on those questions without necessarily phrasing them in that particular way. But what I can tell you is that what emerged for me and what was reaffirmed, because I feel like I had already articulated this, yet I realized in a profoundly, deeply way that I would have to continue to practice this, is that my external systems work requires internal systems work.

In other words, if I’m going to seek to change any of these narratives, right, any of these isms and phobias externally, through my narrative change strategy, through my storytelling, I have to do the work of shifting those narratives internally as well. And I’m not going to get into the nuance right now of thinking through, Is this a chicken or egg situation? Which one goes first? We need to do both things. We need to move in a flow between working externally and internally, and the external world will support our internal work, and most certainly, the internal world will support the external work. The one thing that I will say though, is that too often, what I see organizations and systems do is completely externalize this work. So I would say about 90% of the time, and this is just me on the spot reflecting on this, about 90% of the time when I’m engaging with large systems, that is the ask: help us figure this out externally. They are eager, ready, and willing to tell the story externally, but there are tons of barriers and hesitation to do any of the internal work. And I asked them critically, what happens when the external narrative is in dissonance with internal narrative – misalignment? There’s no wholeness, there’s no wellness, there’s no just relationship. So this is where transactional storytelling happens. This is where the speaker gets a standing ovation, right? And maybe brings in the dollars, right? And the funding also perpetuates harm and also perpetuates inequity and also right, perpetuates these practices that are extremely, extremely harmful to our long-term work of building relationships, building trust, building solidarity, building community.

So there has to be an alignment there that think we continue to struggle with these questions that allow me to, and by the way which I don’t have answers to any of them, I have an ongoing process of me seeking wholeness, of me seeking wellness, of me seeking just relationship with myself. I think we need to think of those questions collectively as well. What does it mean for us to think of ourselves as part of a whole? What does it mean for us to be well, not just individually, but a society? And that’s not how our systems think. That’s not how our healthcare system was designed to work. We are not diagnosing, although I would say there’s definitely research. I don’t want to say that there’s no there’s complete absence of dialogue around this. I’m just my critique is towards how our system, our healthcare system, works, right and by default, many other systems, our education system works. We see individual students. We create individual students. We are not thinking about the quality of a learning community, although too often that is where precisely some of the issues that we need to tackle, access in the collective and we need to think about, what does it mean for us to have justice to ourselves, to each other. Stories that allow us to pursue, not, you know, complete answers. Because I think that I don’t believe in absolute answers. I believe in the process of us seeking what it means to do this all seeking stories that move us in that direction, is the type of narrative work that would allow us to reimagine what these new ways of being right, new structures, new ways of relating to each other, new systems can help us achieve health equity.

Robin Moon  28:05

Oh, that’s so great. Thank you. Luis, speaking of tension between inside and outside, when discussing systems change, there’s another kind of tension, the tension between system change versus local change, like a local community change. So in recent years, we have heard about the need for structural change, and in particular, IRL has been pursuing structural racism, dismantling structural racism, and for investing in that, which wasn’t really the case, say, like 20 years ago. So there is progress towards health equity in that sense. But there is this still, this tension, the structural change is hard. It takes a long time while our local communities need help here and now. So it’s like a long-term, short term, like the tension between, in terms of temporality we need “evidence,” “rigorous science,” ROI, or a return on investment”, scalability, etc, to ensure the structure change that we pursue is worth the investment. But then do we really? And that’s an age-old question that social epidemiologists struggle with. So I wanted to ask you, how do we balance these two ends of the spectrum, long-term, system change and short-term and more localized community change, and possibly the role of storytelling? I think you already got into talking about it in terms of outcomes versus the process of this work.

Luis Ortega  29:40

Yeah, certainly. And I think I’ll start by saying that I welcome the tension as long as the tension is guiding us towards healing and solidarity with each other as we navigate the challenges ahead. I think the tension will allow us to be good relatives to each other. I think a lot about the seven generation principle from indigenous teachings that tells us that as we make decisions, we need to be thinking about the impact of our decisions seven generations ahead, and on the other end, I spent a lot of time reflecting on what decisions were made seven generations ago that impact how I’m showing up in the world today. And I think about Mexica and my Nawa ancestors, and what they faced and what they went through  – the process of colonization, through the process of resisting and persisting through that process and how that struggle is still alive today, but also that resilience and that wisdom and those teachings are still there today. And it gives me both a sense of humility and also responsibility to think about the longer arc of just history, and this is where the tension of the change that takes time and the change that’s possible within the now. And again, if we embrace it and it allows us to be in closer relationship with each other and to have greater discernment In how do we take care of each other, our ancestors as well as our future generations? Then, I’m all for struggling with that tension. However, what I do have to name, and I think it’s in the subtext of the question, I think, is that too often, the source of these tensions that your naming, Robin, from my perspective, they are the product of dominant ideology and narrative, like a sense of urgency, scalability, “success,” “best practices” and knowledge. Who holds knowledge? Who holds valid knowledge? How is this probable? What is the return on investment, and who gets to set the terms of that particular agenda, and that tension I’m not here for it. It Is the dissonance that I was naming earlier, right? It does not facilitate trust, it does not facilitate relationships, it does not facilitate healing. It does not facilitate a way for us to cultivate introspection and see ourselves in a way that allows us to engage in the transformation work that is required. So I don’t understand how processes that are inherently inequitable and completely decoupled from the community can in any way lead us to equitable outcomes; it just makes no sense to me. So we need different stories and narratives that reshape that logic for us. And this is not to say that we cannot talk about accountability. Or that we cannot talk about how we engage in research. We absolutely can have those conversations, and even for having a conversation of, how do we redefine what rigorous research is, if and only if, in that process, we’re centering community, wisdom, equity, healing, justice as part of our definition of what it means to be rigorous and who is accountable to that type of rigor. So I think from that perspective, I’ll come back to Dr Shawn Ginwright, honestly, how do we answer that question of, how do we balance this work? Dr Shawn Ginwright oversaw some pretty good ideas, right? Those four pivots going from from lens to mirror, seeing ourselves right, doing the internal work, being relational and not transactional in the work, pivoting from problem to possibility, moving into flow, instead of just the hustle and the grind of just producing and producing and producing work without us actually engaging in the process of flowing through that work. So to me, holding space for those pivots and for us to understand how we move there is how we deal with that tension in a way that allows us to build that solidarity and to facilitate healing.

Robin Moon  34:19

Thank you so much. Luis, you could not have said it better, our intention and aspiration for this podcast to be. My spiritual meter gauge went up by four times! I know that we rattled off a lot of great citations and resources from the very beginning for our listeners, we will definitely list those out in our show notes. But for our listeners, for the time being, Luis, who want to learn how to use storytelling as a tool in their health equity work, and who might not have thought about this before to the extent that we might have so far, where do they start? Are there any books, blogs, websites, podcasts, YouTube, videos, something simple, key resources that you might recommend?

Luis Ortega  35:07

Yeah, absolutely. So I would say Storytelling for Social Justice by Lee Ann Bell to just offer a brief framing around that this particular book will introduce you to the concept that we discussed earlier in the podcast about stock stories, concealed stories, resistance stories, emergent, and transforming stories. It’s a slightly different storytelling book, because I think oftentimes when we think about storytelling, we are wanting to think about characters and the plot of a story, setting and model which are we do need to understand what it means to engage with those different elements of narrative, and I think it’s fundamentally important for us, especially in the context of this podcast right like health equity, for us to understand what is the role of power and what is the role of systems in shaping our experience of story. And I think Lee Ann Bell’s work and this particular tool of thinking of this quadrant right of narratives to analyze our narrative ecosystem is crucial to that work. So I definitely recommend that book is a very short read, heavy on theory, but it also has some very practical elements to it. And I even though it has a focus on education, is very applicable to all kinds of different settings, I think to have more of a focus on personal narrative, collective narrative. You mentioned Marshall Ganz work earlier in the podcast as well. And I certainly think that there’s probably no other framework out there that I can think of that offers a best introduction to what it means to engage with storytelling as a practice of leadership and community organizing than Marshall Ganz’ Public Narrative. There’s way too many resources to name them all, but honestly, any Google search that just puts like Marshall guns public narrative like you’ll find so many YouTube videos of Marshall lecturing on the topic. Like, the same lectures that he delivers at the Kennedy School are available freely on online. He just published a new book. There’s tons of toolkits out there, there’s worksheets. There’s just so many, so much out there that’s accessible for those who just want to read an article and kind of get started to those that want to take a deep dive. Absolutely recommend Marshall Ganz work. And then I think lastly, I’ll go back to just the four pivots. I think even though it’s not a book that teaches you how to tell your story. I do think that Dr Shawn Ginwright, writing engages with story in a really good way. So if you want to see an example of what it means to engage in that introspection, Dr Shawn Ginwright role-models for us through his own reflections, through his own mirror work in the book right of how he’s thinking about these pivots in the context of his own life, and how he’s witnessed these in the lives of others that he’s worked with across his career. So I think that’s another wonderful example as well.

Krystal Lee  38:17

Thank you. Thanks. Luis. What I wanted to do was mention that the things that I have learned about narrative and storytelling and the relationship between narrative and systems, I’ve actually learned from you over the last several months, those of us in IRL have been engaging with you through your work with Storytellers for Change, and I would like for you to share with our listeners a little bit about Storytellers for Change, and you know the resources that are available to them there as well. So whatever you’d like to share about your organization for our listeners.

Luis Ortega  38:49

Thank you, Krystal. So absolutely, I think there’s a couple of resources. We have a toolkit that’s available for free that was part of another collaboration that it’s called Crafting Anti-racist Narratives for Community Development, and it’s a toolkit that guides you through the process of unpacking dominant narratives and then intentionally crafting and envisioning emerging and transforming narratives that advance anti racist and equitable healing center work. It has a focus on community development, but the toolkit itself is pretty accessible to be modified to apply to other fields, and that’s freely accessible online. And then we have a handful of different storytelling courses and resources that focus on everything from developing personal narrative to developing organizational narrative to developing and crafting narrative strategies to engaging with the practice of thinking about, how do we center equity and asset-based practices in our storytelling work? There’s a variety of different lenses. With each one of our courses, but all of them are meant to deepen many of the practices and concepts and apply them into our respective fields and areas of work that we’ve been discussing in this podcast.

Krystal Lee  40:15

Thanks for sharing Luis, and we encourage our listeners to check out Storytellers for Change, at www.storytellersforchange.com Luis, we know that doing this work and working towards equity and against systems of oppression can take its toll. Right? We’ve mentioned Dr Shawn Ginwright many times in this episode and his book Four Pivots, and one of the quotes that speaks to me is it says that changing things that are broken in our society requires individual and collective healing. And I just wonder, like as a final thought, kind of as a check out question, can you share with our listeners? How do you engage in self-care as you continue to engage in this difficult work.

Luis Ortega  41:06

Yeah, certainly there are a few things, but I’ll be brief. I’ll start with rest and sleep. That’s more and more over the years, I’ve shifted my mindset around what it means to prioritize that, and then that’s also just carried into shifting how I start my days. It’s not with my work email. It’s waking up and taking time to stretch and to read and to slow down and to have a steady, calm heart and spirit as I engage with the world. And of course, as you can probably imagine, my capacity to do that shifts depending on what else is happening in my life. However, I think the biggest takeaway for me has been creating a space for me not to feel like a couple of years ago, the time between me waking up and me being in front of my laptop, reading emails and responding to emails and working. I trained myself a long time ago to think that my best writing, my best work, my best output, is in the morning. So I was always thinking, Oh, as soon as I’m awake, I need to go and do this work, because this is when the quality work’s gonna happen. And that was so intrinsically connected to my sense of value and worth and contribution to justice work as well that I did not realize, like what was that was doing to my subconscious also, and to my sense of worth and to what was happening in my life. And now it’s at least two hours, if not more, sometimes between the time I wake up and the time that I actually move into beginning to do what here we would call, quote, unquote work. But also like realizing right that that rest itself, the purpose of that rest is not so that I can be better at work, although I am, I believe better at my work because I give myself space for rest. The purpose of that rest space is rest, and the joy of rest and the joy that I find in reading science fiction or magical realism or novels or writing or poetry, whatever I’m engaging with, although I’ve given up a lot of what I call, like my work reading during that time, and I’ve loved that. So I find that has given me much-needed space. And I’ll close with this, like, a couple of years ago that was catching up with a friend I was talking about, like, how I didn’t have time for reading, for joy, and my friend sort of laughed and said, What do you mean? Like you like you’re reading all the time, and you make time, like time is a construct, right? It’s sort of going back to this idea of these tensions, right, and just realizing how much of my agency I was giving up in even beholding myself to a statement like that. So I’m not going to say that it’s necessarily easy to just suddenly shift your schedule and rethink and imagine what that looks like. I know this can look very differently for any of us.. I just know for me, it’s been progressively over the last few years, shifting how I spend my time so that I can honor this rest that I know I need and holding on to it, because I’ve also learned that is also very easy to give it away, so I’m still very much here and now, how do I practice this in an ongoing basis? And I started by saying in my check-in, that I feel rooted, and I feel like a big reason why is because of this practice.

Robin Moon  44:40

Transforming oneself before we transform our community, right? And doing this revolutionary work internally first, that is one of the first things we actually sensed, Krystal and I, the humility and the depth and character building that you took on for yourself, and that in and of itself, just distinguishes yourself from others that we have spoken to. So thank you. We and IRL are so grateful that our paths crossed, and we certainly hope that we continue crossing our paths, and we appreciate your time today that you spent with us to record this podcast. Thank you so much. Luis, 

Luis Ortega  45:23

Thank you, Robin. Thank you, Krystal. 

Krystal Lee  45:25

Thank you, Luis, and thank you so much to our listeners. As always, we want this to be a two-way conversation, so we’d love to hear from you. What promising practices have been impactful in your work to achieve health equity? How do you think storytelling can support or play a part in your health equity work? Share your thoughts with us via our LinkedIn page, where we will also share our show notes and the resources that Luis has highlighted in today’s episode. And don’t forget to subscribe to the Promising Practices for Health Equity podcast so you never miss an episode. You can find us on Apple podcasts, Spotify, YouTube or wherever you get your podcasts. Thanks again for joining us today, and remember we’re all on this journey together, and every step we take together brings us closer to a healthier, more just world. Until next time. Thank you.

Mandy LaBreche  46:23

Promising Practices for Health Equity is produced by the Interdisciplinary Research Leaders Program, a national leadership program of the Robert Wood Johnson Foundation. A special thanks to our guests, our production team at Studio Americana, and to you, our listeners for being a part of this important conversation.

Prologue

SEASON 1, EPISODE 1  |  May 5, 2025

Hosted by:  Krystal Lee, J. Robin Moon, Mandy LaBreche, and Cody Cotton

Mandy LaBreche  00:00

This is the Promising Practices for Health Equity podcast brought to you by the Interdisciplinary Research Leaders Program, a national leadership program of the Robert Wood Johnson Foundation.

Krystal Lee  00:11

Hello and welcome to promising practices for health equity, the podcast created by the Interdisciplinary Research Leaders Program, affectionately known as IRL. Drawing on nearly a decade of experience, we explore innovative and actionable strategies to meaningfully advance health equity. I am your host, Krystal Lee, and I have had the pleasure of serving as a Senior Advisor for IRL since 2021. I am a curriculum development specialist and educator who creates transformative, equitable and just learning experiences so that all students can experience the joys and rigors of learning. I am thrilled to be here with my amazing colleagues and Co-hosts, J. Robin Moon, Mandy LaBreche and Cody Cotton. In each episode, one of our co-hosts will join me to talk with our guests about how they approach their health equity work. This podcast is for public health and social sciences researchers, public health practitioners, educators, students and funders. We’re here to share stories, insights and tools to amplify your efforts to create a healthier, more equitable world. First and foremost, let’s get to know our fabulous team. Robin, tell us a little bit about yourself and how you came to this work.

Robin Moon  01:31

Hi, Krystal. Thank you. Hi. I am J. Robin Moon. I am the Associate Director of Research at IRL. I am a transdisciplinary scholar in social epidemiology, a practitioner and entrepreneur for Health Justice and an educator in public health. I joined the IRL in 2020 in the thick of the pandemic, to bring in the expertise of implementing robust scientific research on the ground with real people, letting the rubber meet the road, as we say, bringing together the community leaders and members and academic researchers and creating programming to support these activities. Mandy, I’ll toss it to you. 

Mandy LaBreche  02:12

Thanks Robin. Hi everyone. My name is Mandy LaBreche, and I work as the Associate Director of Operations for the IRL program. I consider myself a day one person, because my first day working for the IRL program was actually the launch day for the inaugural call for applications for Cohort One. All the way back in February 2016 I came into my role as the person in charge of Program Operations, working with a small team, mostly behind the scenes to help make the program come alive. A lot of the early work was focused on recruitment and selection for our annual call for applications. We now have seven cohorts of fellows and teams. Another big part of my role was helping shape the program experience that included things like the curriculum, networking, webinars and in person and virtual and hybrid meetings, I’ve had the enormous privilege of being able to contribute to almost all areas of IRL, and now I’m so excited to be working with Krystal, Robin and Cody on this podcast. Working on IRL has been a really amazing ride for me, both personally and professionally, as a program. We’ve learned so much since day one, and I can’t wait to share about the evolution of the program and how truly inspired we’ve been by the work of IRL fellows and teams. Cody tossing the mic over to you.

Cody Cotton  03:31

Thanks Mandy! Peace, everyone. My name is Cody Cotton, Director of Culture and Human Engagement for the Interdisciplinary Research Leaders Program. In this role, I focus on fostering an inclusive and collaborative environment that supports our teams of researchers and community partners. By integrating principles of cultural agility and human centered engagement, I aim to enhance our collective efforts towards advancing health equity. Additionally, I serve on IRL Community Action Advisory Board, also known as the CAAB, where I collaborate with fellow members to provide guidance and support to leadership and IRL teams. Our goal is to ensure that research initiatives are deeply rooted in community engagement and effectively address health equity challenges. Krystal, back to you.

Krystal Lee  04:19

Thank you, friends. So the goal of this podcast is to amplify what we are calling promising practices for health equity. Robin, can you help us do some level setting for our listeners? Tell us what is a promising practice and what is health equity.

Robin Moon  04:34

Sure! Promising practice means an activity, procedure, approach, policy or technique that has shown positive results in a given local situation. It is to be distinguished from the best practice, as we say all the time, in that it might not have the kind of statistically significant or robust by the number defined by the. academia and research community for different reasons, for internal and external, but that it is worth understanding what makes it promising and worth replicating, adapting or adopting it elsewhere. Health Equity means that everyone has a fair and just opportunity to be as healthy as possible. And note that healthy here means not only an absence of infirmity but thriving to live up to one’s best potential in life. This requires removing structural obstacles to health, such as poverty, discrimination and their consequences, including powerlessness and lack of access to good jobs and their pay, quality, education, housing, safe environments, financial credits, so on, and of course, including healthcare, both of these concepts require individuals being in and with the community, not in their own vacuum, and that is where this podcast comes In.

Krystal Lee  05:59

That’s right. Thanks, Robin. Each episode, we’re going to be talking with members of the IRL community about the strategies that they are using to promote and achieve health equity. Mandy, you’re one of the original members of the leadership team. Tell us a little bit about the IRL program. 

Mandy LaBreche  06:18

Yes, happy to. I always like to describe IRL as a hybrid research and leadership development program that supports teams of researchers and community leaders who are focused on community engaged, action oriented and equity focused Health Research. Each year since 2016 we’ve had an annual call for applications for teams of three people, two researchers and one community partner to apply for the program. Each call for applications has had one to two annual research themes that explore various social determinants of health, and more specifically, I’ll just do a quick power jog through each of our themes. So starting with Cohort One, the themes are early childhood and health and housing community development and health. Our cohort two themes are individual and community resilience and youth development and violence prevention. For both of our themes for cohort three, they are focused on rural America, and they are social and economic determinants to promote health in rural America and solutions for better healthcare delivery in rural America. Our cohort, four themes are clinical practice, social services and health and community development and health. Our cohort five themes are community environment and health and Families and Child Health. And then moving on to our cohort six, themes, the focus was structural racism and community health and well being and structural racism and health care. And last but not least, our cohort seven just has one overall theme, and that is structural racism and health. So during the three-year experience, IRL teams conduct a community engaged research project, and they actively participate in curriculum and networking activities to advance their research leadership. Most of IRL programming is done remotely. We consider ourselves a distance learning program, with the exception of two to three in person meetings per year. The IRL program is a 10-year initiative of the Robert Wood Johnson Foundation, and we are currently in our ninth and final year. To date we have seven cohorts in the program. Each cohort is made up of 12 to 15 three person teams and 36 to 45 individuals that we refer to as fellows. And just a few numbers to share, pretty impressive, if I do say so myself, we have a total of 297 fellows in the program, and 99 teams with research projects in 46 states and Puerto Rico.

Krystal Lee  09:03

Thanks. Mandy, sounds like there’s never a dull moment in the IRL universe, huh? Cody, you are the Director for Culture and Human Engagement. Tell us about where the idea for promising practices came from, and a little about the audience that we have designed this podcast for.

Cody Cotton  09:23

Yes. Thanks, Krystal. Our goal is to build capacity among people who are working towards health equity. I believe that every person has a part to play in this work, but specifically we want to reach people who are looking for innovative approaches and lessons learned from personal experience. This includes researchers, educators, students, community organizations, policy makers and foundations and other funders who are working in the field of public health. I want to note that while we’re talking specifically about the public health space, we also believe that the promising practices that we will highlight throughout this podcast can be applied in any discipline or field. Everyone could take something away from this podcast.

Krystal Lee  10:06

Thanks, Cody, so this will be a time limited podcast series, right? Meaning that it’ll be limited to three seasons. Can you all tell our listeners what they can expect to hear and learn about over the course of each season, Mandy, I’ll go to you first.

Mandy LaBreche  10:25

Over three seasons, members of our IRL community will share their stories, experiences, reflections and lessons learned. Season one examines the development and evolution of the IRL program. In this first season, we’ll hear from our program directors and members of the National Program Center. They’ll share their perspectives and insights from the creation and evolution of the fellowship program, the strategic decisions made along the way, and the value that IRL aimed to bring to the health equity landscape. We’ll then discuss how the promising practices of emergent strategies and restorative justice have contributed to honing our approach to community engaged research.

Robin Moon  11:04

In season two, we’ll hear stories, reflections and lessons learned from IRL fellows who, in their own communities and teams, conducted this community engaged, action oriented, equity focused health research and together reimagine new possibilities for true health equity. We will hear about real and honest challenges that they have experienced and had to overcome that are individual, community oriented and structural, and they will share the promising practices that they have created through it all to bring about true, meaningful health equity.

Cody Cotton  11:44

And finally, in season three, we will dream together. We’ll talk about what the future looks like for health equity, looking beyond our current challenges. We’ll dig deep into the promising practices highlighted by our fellows in season two, and the ones we use as a program, such as restorative practices, asset based storytelling, critical self-reflection and many more.

Mandy LaBreche  12:07

By the end of season three, we hope our listeners will feel inspired to use these and other promising practices to connect with each other, engage with their communities and advocate for the systemic changes needed to ensure health equity for all.

Krystal Lee  12:22

Thanks, y’all. For the benefit of our listeners, it’s probably prudent to take some time to talk about some of the terminology that we will use and some of the beliefs and assumptions that we hold terms like community engaged research, interdisciplinarity, beloved community and health equity. Robin, can you tell us about these terms and what they mean within the context of the conversations that we’ll have throughout this podcast?

Robin Moon  12:52

Yeah, sure. The IRL program is based on five major beliefs and assumptions. Number one, we believe that change can be accomplished through research, specifically community engaged research, which we define as a research approach, where members of the community actively participate as partners throughout the research process, from the beginning to the end, contributing their insights and perspectives to ensure that the research is relevant and beneficial to their needs, rather than just being studied on by researchers. It emphasizes collaboration and mutual benefit between researchers and community members. Number two, the quality of community engaged research is better when it is led by the community and when it is interdisciplinary, which goes beyond integrating knowledge and perspectives from multiple academic disciplines, by actively involving stakeholders outside academia, like community members or practitioners to Create a shared understanding and solution to a complex issue, often transcending traditional disciplinary boundaries. It essentially aims to bridge the gap between academia and real-world applications by including diverse perspectives. Number three, the change we are working and dreaming towards is health equity for all. As mentioned previously, health equity refers to that everyone has a fair and just opportunity to be as healthy as possible. Number four, we also believe that this work is most effective when done in community, and one of the promising practices we have committed to is building a beloved community. A beloved community is a term coined by Josiah Royce, a philosopher and a theologian from the 19th century, but it’s been popularized by Dr Martin Luther King, Jr. The Beloved Community is a concept that has inspired social justice work for decades. Dr King believed that the beloved community would be achieved by replacing racism, bigotry and prejudice with an all-inclusive spirit of brotherhood and sisterhood, and that poverty, hunger, homelessness will be eliminated. It is described as a society that is practical, realistic and achievable. Finally, fifth, we believe that if the promising practices we discuss on this podcast are implemented far and wide, that we can achieve health equity.

Krystal Lee  15:42

Thanks, Robin, and I want to thank you all for your incredible insights and thank you to our listeners for starting this journey with us. In our next episode, we will talk with Luis Ortega of Storytellers for Change, about the use of storytelling as a promising practice for creating a just and equitable world by fostering empathy, harvesting collective wisdom and facilitating healing. 

We want this to be a two-way conversation, so we’d love to hear from you, our listeners, what promising practices have been impactful in your work to achieve health equity, what are some key challenges you’ve had to overcome? Share your thoughts with us via our LinkedIn page, where we will also share our show notes and resources discussed in each episode. And don’t forget to subscribe to promising practices for health equity so you never miss an episode. You can find us on Apple podcasts, Spotify, YouTube podcasts, or wherever you get your podcasts, thanks for joining us today, and remember, we’re all on this journey together. We’re all learning together, and every step we take together brings us closer to a healthier, more just world. Until next time, keep innovating, keep collaborating and keep pushing for change.

Mandy LaBreche  16:59

Promising Practices for Health Equity is produced by the Interdisciplinary Research Leaders Program, a national leadership program of the Robert Wood Johnson Foundation. A special thanks to our guests, our production team at Studio Americana, and to you, our listeners for being a part of this important conversation.