Lisa Ross DeCamp is an early-career investigator in patient and family engagement and an assistant professor of pediatrics and adolescent medicine at Johns Hopkins University. She conducts research on improving pediatric primary care access and quality for Latino children in Spanish-speaking families, with a particular focus on increasing engagement of Spanish-speaking Latino families in pediatric primary care.
Lisa also leverages information from large databases to better understand the health and health care use by Latino children in the U.S. and is engaged with the local Latino community to improve health and health care access for Latino children in Baltimore.
In this installment of Beyond the Lab,, she discusses her work helping children whose families have limited English proficiency navigate the U.S. health care system.
What inspired you to become a scientist/researcher?
When I was in college, I served as a volunteer Spanish interpreter at the affiliated hospital. During each encounter, it was clear that the language barrier was only one of the factors impacting the quality and safety of patients’ care. The complex U.S. health care system presented so many challenges to patients who were unfamiliar and lacked support for navigation and fully engaging in their care.
As an aspiring physician, I realized that while I wanted to help patients one-on-one, I could also make a difference in patients’ lives and health if my career also included research that addressed health care barriers for patients and their families with limited English proficiency. During medical school this led to me taking a year to obtain a master’s degree in public health focused on maternal and child health programming. My time in that program solidified my interests and helped me to better understand research and evaluation focused on vulnerable populations.
What topics/areas/problems in science are you most interested in solving?
Often when people discuss Latino populations in the U.S. they focus on health care access barriers due to lack of health insurance. While Latinos are the least insured racial/ethnic group, most Latino children do have insurance. During my training, I was frustrated that much of the conversation focused on lack of insurance, but very little discussed all of the quality and safety gaps in care for those patients with access but whose parents did not speak English well. Ensuring my patients got to their needed specialty care or other health care services was fraught with difficulty.
I envision a health care system that has support structures in place so that patients do not experience delays in care, or miss needed care because of complexities and inefficiencies in the system. Engaging patients to speak up when things are not going smoothly and to discuss their barriers and potential solutions with health care providers is an important component.
The health care system, however, has to have capacity to respond in a systematic way to address health care navigation challenges. Patients and their families are the best people to help us design this systematic response to meet their needs in a user-friendly way. During my career, I hope to figure out how to more effectively partner with patients to achieve health system change that is inclusive of diverse and vulnerable populations.
How do your colleagues, mentors, students/postdocs, others help you achieve your goals?
Research is a team sport, and I am incredibly grateful for my collaborators, staff and mentors. My mentors have been incredibly gracious with their time and creative with funding to support early pilot work.
One of the unanticipated joys of research, however, has been working with students and trainees. I have been fortunate to work with several students with limited English proficient parents who faced difficulty navigating the system. These students have approached the research with incredible insight and dedication. We have engaged in mutual learning about research questions, interventions and what our data mean for next steps.
It is often a bittersweet process, as the students who have worked with me have moved on to their next goal facilitated by their experiences as part of our research group.
What gets you going every day (besides coffee) and how do you stay motivated?
I am a huge believer in a good night’s sleep! If I am well-rested the challenges of the day are less daunting and I am focused and motivated…that and making sure I take a break and unplug and take some vacations.
However, my day to day my motivation comes from my patients. Unfortunately, more than ten years after entering the practice of medicine, the challenges facing patients with limited English proficiency have improved only a little. As I partner with patients, I am continually reminded of the significant task at hand. In addition to clinical interactions, my work with community members also is a great motivator. There are so many people who are selfless with their time and energy to improving the health of the local Latino community it is hard not to be excited about what the future holds.
What are your greatest limitations/challenges as a scientist/researcher?
Right now there are so many competing demands in health care; highlighting the need for and importance of our work is difficult. More and more resource constraints require that programming or additional patient support is a focus for cuts. In the long run, that may mean that patients are worse off and their care is more costly.
The process of moving from research to sustainable programming support is difficult if the time horizon on return on investment is more than a year or two. I am also concerned that we aren’t making enough progress connecting the health care system to other sectors to consider how more effectively might improve health. For example, if we support families engaging in health care and identify a child with a need that must be accommodated at school and in the community, but haven’t yet made linkages between programs, we will not serve this child as well as we could.
Read more about Lisa’s work at Johns Hopkins’ Center for Salud/Health and Opportunity for Latinos here.