Introducing Moms, Minds, & Medicine (M3): Inside Maternal Health Research

Welcome to the inaugural podcast, Moms, Minds, & Medicine (M3): Inside Maternal Health Research! In this episode, Dr. Kimberly Turner welcomes Dr. Yvonne Bronner to discuss important topics in maternal health. Stay tuned for insightful discussions on pregnancy and women’s health.

Catch full episodes of the Moms, Minds, and Medicine (M3): Inside Maternal Health Research Podcast here on YouTube: https://youtube.com/playlist?list=PLv4qXQ6sECQPdkBvXPng5RXOvh3rUrbLY&si=MerdAjUvSdJQLVQr 📺

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Transcript

Introduction to Moms, Minds, & Medicine: Inside Maternal Health Research

SPEAKER_00 0:00

Hi, I'm Dr. Kimberly Turner, and welcome to Moms, Minds, and Medicine inside Maternal Health Research. This podcast is your trusted companion on the pregnancy journey, where we break down the latest insights, answer the real questions, and empower you to make informed decisions every step of the way.

Welcome to the Inaugural Podcast Episode

SPEAKER_00 0:38

We are so excited to bring this podcast to you. And as our inaugural event, we wanted to welcome Dr. Yvonne Bronner, who is the head of the Maternal Health Research Collaborative. Did I get all the words right? You got them all right. Yay! Yay! Dr. Bronner, can you just tell us a little bit about the collaborative and what its purpose is?

SPEAKER_02 1:05

Well, the collaborative is a very interesting project in the sense that we are 16 universities located around the United States. And our purpose is to help women and their families be more successful, healthier, and what I say is healthier communities because they live in communities. And the collaborative is designed because we discovered a while ago that we did not have maternal and child health at many of our institutions that were located right in the places where the maternal mortality, morbidity needs were greatest. And our students came from those areas, and our students wanted to go back and practice in those areas. And so our collaborative was born out of that idea. And when you look at where we're located, we're located right where those areas, our need is greatest.

SPEAKER_00 2:04

Right. It's so important because we all, most of us, know that there's a problem in the United States with women here dying and having terrible pregnancy outcomes at a much higher rate than other places in the world. So thank you for that work. And I also know that you are the coordinating center's spokesperson and leader. So how does that look different than the collaborative?

SPEAKER_02 2:32

Okay. So the collaborative, if you think about that, there's 16 universities. Right. And so therefore, um we need a lot of help bringing them together. And I like to use the construct of the family. So when we meet, we we say that we are a

The Collaborative's Mission and Structure

SPEAKER_02 2:47

family of 16 universities. But families have to have coordination and leadership if they're to stay focused, right? Yes. And so the coordinating center sees its role as helping us all work together so that we stay focused on our main mission and that we are taking advantage of the opportunities for growth and development that we have. And in fact, our whole mission here at the center is technical assistance to the collaborative. So, in other words, we're trying to, they have the goal to work locally. We have the goal to bring them together so that they work in unit. I love it.

SPEAKER_00 3:28

So tell us a little bit about what brought you to this point in your career. I happen to know, I've known you a long time, that you started out in nutrition and maybe even a little something else before that.

SPEAKER_02 3:40

Yep. Home economics. Really? That is not something you hear much about nowadays, right? I took it. Well, that's a good thing because uh home science is very important. And the first thing we learned there was the only business that most people will ever have is their home. Wow. And so therefore, you want to organize it, you want to have it successful, you set goals and objectives just like you would in a real business. In fact, it is a real business. Oh my gosh, yes. Yes. And then nutrition, public health, and maternal and child health followed that. Okay. And so with that kind of uh mixture of things, I really have sort of a base of understanding of people, of communities, and a love for families.

SPEAKER_00 4:23

Yes. The family is so important. We all know if the mother's not happy, nobody's not happy. And I also have a memory of opening a magazine one day and seeing your beautiful face with I think two other women talking about receiving this grant to study um maternal health. Tell us what that was about.

SPEAKER_02 4:44

Okay. So it goes back a bit because, as you recall, uh, we discovered when we got to Morgan in 1999 that um what was my first love, maternal and child health, did not exist in some of our institutions. And so what we wanted was this to happen here. And so what we were able to do is to meet with a group of about 10 universities who are HBCU's historically black university. Okay. And um we met for a year or so, and then we decided that we know what we want, we know why we want it. Remember, we are located in the same places. Our students come from there, they want to go back and practice there. Let's see what we can do. And so we tried to move this agenda forward, and guess what? We were successful. And so now we are funded to have these 16 universities, and the 16 universities with the coordinating center and a big part of the dream that we had back in those, what, three or four years ago, we now have the opportunity to implement.

SPEAKER_00 5:47

That's excellent. Just imagine what kind of impact you're gonna have, not only here in Maryland, where Morgan State is located, but all over this country. And it's so interesting that I, a clinician, an OBGYN

Bridging Public Health and Clinical Practice

SPEAKER_00 6:02

clinician of 30 years, am a part of this project now because we're trying to figure out how to bring the public health sector and the medical communities together. So, what does that look like to you?

SPEAKER_02 6:14

Very important that uh we not go out and try to work with our communities just looking at the public health site. But one of the things I said to our group is that we really want to know about the body. And most of us know a little bit about the body, but we don't know enough about the body to really help our community. And what we more importantly wanted, and you've done a great job because you meet with us, what, two times a month on Thursday, yes. Yes. Uh, we didn't want just for our um collaborative to know, but we also wanted the community to know. And the way you tell the story, we call it um OBGYN 101 or something like that. OB101. And what that means is that you're making complex information understandable uh to the common person. And why is that important? That's important because people are at the foundation of change. We spoke earlier today about change, right? Uh and what has happened last 40, 50 years is that a lot of these statistics that we're concerned about are the same, actually. They haven't changed much. And the reason they haven't changed is that we haven't really reached the people who can make them change. And so what you're gonna be doing with that clinical piece, when you can tell us in such plain language, uh, you know, how our bodies work, how pregnancy happens, how you can actually prevent the kind of things that can make your pregnancy not be successful, then that is what we want. And that's what you're doing, that's how they come together.

SPEAKER_00 7:52

Thank you. Yeah, I feel like when you're a clinician, you have more of a one-on-one, and we talked about this earlier as well. One-on-one impact, but then how do you have a more global impact? So thank you for including me and the clinical piece.

SPEAKER_02 8:06

Thank you for being able to be included. And why do I say that? Uh, a lot of people can't really speak the language of people. And you would think that physicians trained to do that because that's what you all do, right? Um, but what we uh know a lot about now is people don't feel heard. Sure. And people do speak to them, but people apparently are not, our clinicians are not hearing what we say. So you are special in the sense that you understand and yet you can speak our language. That's huge. Oh, well, thank you.

SPEAKER_00 8:40

This is not supposed to be about me. This is supposed to be about introducing Dr. Bronner to the greater research community and the greater community. So, Dr. Bronner, we had talked quite a bit um a few minutes ago about the power of the mentor,

The Importance of Mentorship in Maternal Health

SPEAKER_00 8:57

and sadly we talked about our aging, and we need to now mentor the future generation of researchers and clinicians. Can you tell us a little bit more like what you exactly were talking, thinking about with the mentorship?

SPEAKER_02 9:09

Well, let me just begin with my own mentors. Um, you know, there were people like Dr. Cornley and Dr. David Page, and Dr. David Page was my dissertation advisor, but he also was the founder of WIC. Oh my goodness. Uh-huh. So I had the Women's Infants and Children Supplemental Program that most people in our project work with. Huge multi-billion dollar program now. But back at that time when I was his student and we were out collecting data in the community, and this is why I really feel strongly about community, because it's what what we learned in the community that allowed us to think big and to engage the government in a program that has such impact. And so that mentorship that I have gotten from them allowed me then to think, how can I pass this on? And so down through the years, uh, we were able to, you know, be engaged in projects at both the local and national level. That national level allowed me to sort of have a network of folks. And I'd just like to mention Dr. Michael Warren, who's the head of the Maternal and Child Health Bureau, uh, the uh Laura Kavanaugh, who is now his replacement as he's moved on, and Carol Johnson, these are people that you come across your landscape and they leave their mark. And that's what I guess mentoring is all about, right? They're they're coming from different perspectives, and at the time you meet them, you don't really know how this is going to have an impact. You mentioned the word impact. But in the long run, everything that happens to you lands somewhere. And so what they've done over the years in my life, uh, I'm feeling great to uh be able to mention their names.

SPEAKER_00 10:53

That's so amazing. For me, WIC always was a program that we sent our patients to when they couldn't afford things like formula and diapers. But you were there from the very beginning. Very beginning when we collected the data. Great

Understanding Research and Community Change

SPEAKER_00 11:07

mentorship. Uh-huh. So once we have established who we're gonna mentor, how we're gonna get the future excited about these things, how do you think that we should frame the research piece?

SPEAKER_02 11:20

Now, you know, the word research was often, uh, at least to me, a novelty. And when I was in training, you know, I didn't even know what it meant. Right. But as I have been a researcher for 40 years, there's nothing mysterious about research. Everybody should do research.

SPEAKER_00 11:37

How so?

SPEAKER_02 11:38

And the reason it is is anytime you want to change what you're doing and make it better, that's research. And I often use the uh common, uh and maybe it's not the best example, but people who dig ditches, something as menial as that. They can dig the ditch one way uh on a given day, and they say, hmm, I think I can do if I did it this way, it might be better. Okay. And when they ask that question, if they systematically improve what they're doing, that's actually research. And what we should do is teach people to think that way. Because earlier in our conversation, you mentioned the single most important thing we want, and that is change, right? But be the reason we don't get as much change as we want is because people think change comes from the top. But actually, change comes from the bottom, it comes from the people. Until people realize their power to change, if they think somebody's gonna come in and change them, it's sort of like when I'm teaching. Um I say to the students, I actually only empower your learning. Excellent. I cannot teach you. If you don't allow what I'm saying to come in, it's not going anywhere, right? And so it is for the community. The community has to recognize that change comes from them. And if they don't change, we don't see change. And so everybody is a researcher. And in line with that, everybody can teach themselves. That's the other thing. I'm not trying to get rid of my job. But I tell my

Overview of Collaborative Institutions and Research Focus

SPEAKER_02 13:08

students it's not about me. It really is about you. You are your own best teacher, and everybody is a researcher. Excellent. Thank you so much.

SPEAKER_00 13:20

Welcome back from a quick break. This is Moms, Minds, and Medicine inside maternal research. And we're here with Dr. Yvonne Bronner talking about the research collaborative and the coordinating center. And you've already told us the difference, but I did want to know a little bit more about the collaborative, who they are, what type of research they're doing, and how that ties in to what I did as a clinician.

SPEAKER_02 13:44

All right. Well, I'm so pleased that we have an opportunity to really share who they are and where they're located. I'm just going to read the list. We have them uh in alphabetical order. Okay. Uh in Alabama, we have Tuskegee. In California, we have Loma Linda University. In Florida, we have Florida International. In Georgia, we have Moorha School of Medicine. All right. Hawaii, we have the University of Hawaii. In Maryland, we have the good Morgan State University. Mississippi, we have Tugaloo, and Tugaloo is our only undergraduate-only institution. Okay. And when you mention the word research, that's very important because Tugaloo does exceptional work, even though he only have an undergraduate program. Excellent. In New York, we have Mercy, and Mercy is one of our minority-serving uh Hispanic institutions. Uh Ohio State is a part of this group because they have three partners. Uh, one is Howard University, and then they have Albizo, who has a location in Puerto Rico, as well as a location in Florida. Uh, in Tennessee, they have three programs as well. Okay. Uh, Tennessee State is the bigger of the three, and then we have two at Maharry. Um, we have the Maharry Um uh Medical College, and then we have the Maharry School of Applied Computational Science, and that's a very important institution looking at AI that we're going to talk about a little bit later. And Texas being a big state, they have four institutions. Okay. We start with Texas Southern, and then we have Texas AM. Uh, we have Texas at Arlington and Texas at the Rio Grande. Okay. Now, an important thing about these universities is that they have collected themselves in terms of the work they do. Um, so let's start with Loma Linda. It's uh the only one that's addressing an issue that's very important, but it is unique in the sense that it's looking at sickle cell. Oh my goodness. And you know that sickle cell is very important. Sickle cell can cause all kinds of problems for the mothers and the children, yes. And we don't know much about that in pregnancy. So we really appreciate that. Then we have three of our institutions that focus on community outreach. And community outreach is so important because we have done it sort of in old models, but we're now using a new model by the National Academy of Medicine, where it requires us as practitioners to learn more about the community. We often talk about landscape analysis, environmental scans, where we're learning more before we go out. And so that's why that's important. And then, you know, fatherhood is very special to me.

SPEAKER_01 16:27

Uh-huh.

SPEAKER_02 16:27

And we have several of our institutions that are looking at fatherhood. And then mental health and maternal health, as you well know, has risen a lot. So the rest of our institutions are focused on the mental health aspects. So we feel that we have a set of issues or domains that are really going to be impactful. You mentioned the word impact earlier, that are going to be impactful toward change. I love it.

SPEAKER_00 16:55

The geographic distribution,

Future Directions and Sustainability in Maternal Health

SPEAKER_00 16:57

the distribution of the different types of research. You're hitting all of the really important, uh, really important points where the clinical community is concerned. Absolutely. It's so exciting. So, what does the future look like? If let's pretend it's the end of the collaborative's work, what is the future gonna look like once we have done some of this work?

SPEAKER_02 17:24

Well, there are a few points I want to make. Uh, and the first one is that we began with the end in mind. And I think that was Stephen Covey who says that, right? I think you're right. And uh a very important point, and this is really important, is that um over the years a lot of research is done, and then when the research is finished after five years, X number of years, communities are left with the project being done. So, what we started out with was sustainability. In other words, we don't want it to be ending. Okay, we want it to be continuing. Excellent. Uh and we want to be continuing because we're thinking about it now. And how do you continue, continue because you do one good work, but you get money. You gotta have money to continue. So sustainability is a big part of the future. The second part of the future, Dr. Turner, has to do with the fact that I am aged. And we both are everybody can see that, right? However, I say to all of the practitioners in the group, I don't want anything old about this project. So we're looking to the future with AI. I'm already learning about AI. Artificial intelligence. That's right. That's right. And we're actually using it. In fact, we're not going backwards in time, we're going forward. And we're not afraid of the fact that this is coming at us. And so the question on the table is how can we make it work for us? Right. And guess what we're thinking? I'm not sure. You know where everybody is as they're on their phones?

SPEAKER_00 18:55

No, not in America.

unknown 18:57

Not in America.

SPEAKER_02 18:59

Well, so what we want to do is to develop an addictive app. Can I say that in public, Dr. Turner?

SPEAKER_00 19:07

Is it okay? So an app that people come back to. That's right.

SPEAKER_02 19:10

We want, however, this app, we want to have um the outcome be positive behavior changes. What? Wow, imagine that. All the things that you know that people need to do to be healthier, we want them to want to do these things. And we think AI has solved a lot of problems.

SPEAKER_00 19:30

Can it help us solve this problem? Right. That would be groundbreaking if I had would have had an app, let's just pretend it's weight loss, uh-huh. Where you're motivated to look at it to help you on that journey, that would have been so impactful in those clinical years. Yeah. How smart.

SPEAKER_02 19:48

So this this summer we're gonna work on that. And then the third aspect of the future is that we're training early stage investigators. So I'm not gonna be around forever, although I'm not homesick yet, right? But the young people that I work with, we want them to really have this new vision, the vision that uh power comes from the people. And that uh no matter how much we know, if we're not able to help other people know this, and I was told people don't care how much you um, they don't care how much you know until they know how much you care. And so we want to use that as our mantra as we go forward. And we want our early stage investigators to truly be educated on the science, but we want them to have even more education on the community, and then even more education on communication. Right. Because this is how you get your messages out. Exactly. Mentorship is so important in this work. And then the last part of our future is you. Because uh what this is the inaugural uh uh podcast, right? Correct. But you have a lot in mind for the future, don't you? You have people and colleagues

The Role of the Podcast in Maternal Health Education

SPEAKER_02 20:59

that you and subject matter that you want to help our communities become acquainted with. And so what we want to do is for you to tell us now what do you think about the future when you think about the podcast?

SPEAKER_00 21:12

So the podcast is not only to introduce the audience to the research centers and collaborative and coordinating center, but it's also going to be about breaking down the areas of clinical medicine where we have the greatest need into bite-sized information for the public and for other investigators that don't really understand the clinical medicine. So, what are the big things right now that are impacting you've touched on some of them? Mental health's a big one, hypertension, high blood pressure, which leads to sometimes pre-eclampsia. That's a big one that's driving these rates of maternal morbidity and mortality up, pre-existing diseases, in particular diabetes and the obesity epidemic. So we want to touch on many of these types of clinical things to again make it easy to understand, fun. Yeah. And we're gonna have all kinds of experts from the clinical realm and hopefully from the research realm as well.

SPEAKER_02 22:13

And what you told me as well, you're not just going to share information about these subjects, but you're gonna have people hopefully show how they actually have overcome, especially in the area of hypertension. Uh, this is something that many people in our communities have lived with, their families have lived with it. They think it's just what we do. What you know is diet, physical activity, and many other things can impact this, right? Sure.

SPEAKER_00 22:38

And you know, in the clinical world, sadly, there's not a lot of time to go over all the things that can prevent disease. And we want to emphasize also that pregnancy is a great time to think about your general health. People are motivated. Highly motivated. Pregnant people, they really do care about what's going on in their bodies. So they are motivated to make change. So we do have a possible possibility of impacting their, not only their present, but also their future. That's the most important. Pregnancy tells you a lot of times, it's like a mirror into your future, what you're gonna get as you age. And some of those things are modifiable. And not only that, you teach the woman, she's gonna teach the family, and we're coming right back to our community focus. Absolutely.

SPEAKER_02 23:27

So you see that you are at the center of all that we want to do in our future. I'm so humbled.

SPEAKER_00 23:34

Thank you so much. Thank you, and thank you to our audience for tuning in.