Jefferson Investigates: Art and Medicine, Social Media and Public Health Messaging, Lung Cancer Disparities

A group of 15 medical students sit in silence, studying a projected image of Frida Kahlo’s Self-Portrait on the Border Between Mexico and the United States. The residents point out the contrasts in the painting:  the industrial, smog-filled U.S. side versus the lush, nature-filled Mexican side. One resident notes that Kahlo, arms crossed, is holding a cigarette in one hand, pointed towards the industrial landscape. Another observes the Mexican flag in her hand held toward the natural side.

“Those are really important details,” said Nazanin Moghbeli, MD, a Jefferson Health researcher and cardiologist who led the session. “Kahlo’s 1932 painting reflects a personal and cultural divide.” She explains that this exercise in observation directly mirrors the kind of observation and reflection that physicians must bring to patient care.

“When I’m at the bedside of a patient and I look around at the patient and their surroundings, how much am I interpreting before I slow myself down to observe?” says Dr. Moghbeli. "And that’s a really important skill that you can learn from looking at a painting.”

The idea is at the heart of a long-running art-based workshop series called “Using Art for Professionalism and Communication Skills in Medical Education,” that Dr. Moghbeli developed to help medical residents strengthen their communication skills and professionalism. In a recent study, Dr. Moghbeli surveyed a cohort of internal medicine residents at Jefferson Einstein Hospital who took part in the six-part workshop series, co-led by a museum educator from the Philadelphia Museum of Art. The findings suggest that art may be an effective tool for shaping more observant, empathetic and communicative physicians.

Of 106 residents invited, 32 volunteered to participate. They then answered a survey about their experience. The responses indicated that the sessions helped them reconnect with their role as medical providers. And 81% reported improved communication skills.

Even though it is hard to quantify, Dr. Moghbeli believes that integrating the medical humanities into residency training can help form more well-rounded physicians—ones who are not only clinically competent, but also better observers.

By Deborah Balthazar

Human papillomavirus (HPV) is a sexually-transmitted infection that causes about 37,800 cases of cancer in the U.S. annually. The HPV vaccine protects against the most dangerous strains of the virus, and it’s extremely effective at preventing cancer.

“It’s an amazing cancer prevention tool that we have available to us,” says public health researcher Amy Leader, DrPH, MPH. “But uptake of the vaccine hasn’t been as widespread as we’d like, especially for a treatment that prevents cancer in men and women.”

To help change that, a new study by Dr. Leader finds success in an unconventional approach: influencer marketing. Published in the journal Vaccine, the research found that social media posts by influencers improved parents’ attitudes about vaccines and encouraged them to vaccinate their own children.

The research team recruited 10 social media influencers with small but dedicated followings. The study focused on Black and Hispanic influencers because the impact of HPV is higher in these groups. The influencers were provided with fact sheets about the HPV vaccine and given creative control to make a post that would resonate with their followers.

Dr. Leader then surveyed the influencers’ followers before and after they viewed the informational posts. She found that the posts helped improve viewers’ knowledge and attitudes about the HPV vaccine. The followers also reported they were more likely to vaccinate their children against HPV after viewing the informational posts.

Dr. Leader says the trial’s success stems from the fact that people are more likely to take health advice from “trusted messengers” such as social media figures who they feel a bond with. She hopes the technique could be scaled up to help address even more public health issues.

“All of the influencers wove the scientific facts that we gave them into personal stories,” Dr. Leader explains. “I think that's where influencers are influential, because people respond to narratives. Public health has to tell its science more in narrative engagement than just straight facts like we're so used to.”

By Marilyn Perkins

Lung cancer is the leading cause of cancer related death in the United States. With cases often being diagnosed at later states, the five-year survival rate is less than 30%. There are sex and racial disparities that contribute to differences in survival – namely, females with lung cancer have higher survival rates than males with the disease and Black individuals have lower survival rates than white individuals. However, it’s unknown whether improved survival among female lung cancer patients apply uniformly across different racial groups.

“Looking at gender or race separately does not paint an accurate picture of lung cancer survival,” says Olugbenga T Okusanya, MD. “There is a complex interplay between these factors that is not well understood currently.” In a new study, Dr. Okusanya and his team were determined to investigate the nuanced impacts race and gender may have on lung cancer survival.

The investigators, members of Sidney Kimmel Medical College, performed a retrospective study of ~200,000 lung cancer patients from the National Cancer Database. The study confirmed that female sex was associated with higher overall survival across every racial group. However, there was significant variation in the size of this association. The largest gap between male and female survival was seen between Asian Pacific Islanders. Female Asian Pacific Islanders had a 14.4% higher survival rate compared to male Asian Pacific Islanders. Across race and gender, Asian Pacific Islander females had the highest survival rate (90%) while white males had the lowest survival rate (60%). A resident on Dr. Okusanya’s team, Isheeta Madeka, MD, indicates that these studies are only the beginning of better understanding lung cancer trends.

“Whatever patterns we can point out to providers will help them better address and understand their patient needs,” says Dr. Madeka.

She stressed the need for stronger databases to address more granular issues linked to lung cancer survival, like the disease stage, socioeconomic status, and access to healthcare.  This will allow researchers and doctors to identify the most vulnerable populations and design more targeted and timely interventions to reduce disparities.

By Moriah Cunningham