Spirituality and Healthcare: Doctoral Research with CCNY and MSKCC — Dr. Kathleen Isaac

by Judah Duke

When considering how best to provide adequate care for New York City’s diverse population, numerous cultural considerations come into play, and providers are increasingly recognizing the need to understand how different facets of cultural identity factor into patients’ healthcare decisions. The National Institutes of Health suggest that focusing on cultural competency can diminish health disparities and improve the quality of clinical care.

During her research in the City College clinical psychology doctoral program, Dr. Kathleen Isaac, a first generation Haitian American, found that Haitian participants with lower levels of health literacy were more likely to place “a lot” or “some” trust in family, friends, religious organizations and leaders as sources of information about health or medical topics.

The research into health literacy was made possible by a partnership between CCNY and the Memorial Sloan-Kettering Cancer Center. Isaac, now the director of Medical Student and House Staff Mental Health Services at New York University’s Langone Health medical center, credited the partnership and the projects it facilitated for acclimating her to research in clinical psychology.

“If it wasn’t for the partnership, I wouldn’t have been able to get the health-related research that I was interested in,” Isaac said in an interview with The RICC. “I think it really positioned me well for my future endeavors.”

When deciding between several competitive PhD programs, she weighed prestige, cost and training opportunities, eventually finding CCNY’s offer most appealing. Apart from covering her full tuition, as well as a teaching fellowship, City’s research and training through partnerships focused on health psychology helped her make her decision.

“You really want to go to a program where you’re going to get good training,” Isaac said. “And, the [City College] doctoral program in clinical psychology is well regarded in the city for the training that it provides.”

Isaac authored a study, titled “Health Literacy, Information Seeking, and Trust in Information in Haitians,” along with two researchers from MSKCC, Biostatician Emily C. Zabor and Associate Attending Psychologist Dr. Jennifer L. Hay, Associate Medical Professor Dr. Erica I. Lubetkin from CCNY and two directors from Queens Hospital Center: Dr. Debra Brennessel and Dr. M. Margaret Kemeny.

The study saw Isaac, then a doctoral student, spending whole days in the waiting room of Queens Hospital Center interviewing Haitian patients about their health literacy, lifestyles, and spirituality.

“As a research assistant doing recruitment, I had to talk to people, increasing my comfort with speaking to people and helping them,” Isaac said. “Creating an environment where they felt safe enough and they could trust me to get the information that I needed was really crucial.”

Isaac said it also gave her an appreciation for community based participatory research. Through her interviews for the health literacy study, coupled with her experience in the Haitian American community, she became interested in how spirituality’s effect on patients’ decisions can be better understood by care providers.

She co-authored “Incorporating Spirituality in Primary Care,” along with MSKCC’s Hay and CCNY’s Lubetkin from the health literacy study, about incorporating spirituality in primary care. The paper reviewed the leading health belief frameworks — finding that many fail to incorporate spirituality — and outlined ways to integrate spirituality into our understanding of healthcare and health behavior and the value of physicians and health care providers that do so.

“People do tend to trust their faith leaders or their church community with information; there’s a lot of medical mistrust, in a lot of communities of color,” Isaac said. “Part of the emphasis towards the end of the paper was to talk about ways that we could help incorporate people’s beliefs.”

One example she gave of how providers could merge spirituality with their care revolves around the spiritual recognition that the body is a temple — and that it should be cared for with reverence. That belief can lend itself to beginning to talk about blood pressure tests or screening for diseases like diabetes and cancer in communities of color, Isaac said.

At NYU Langone Health, Isaac now has a greater administrative role. She manages a team that works with future healthcare providers to be more aware of how they can help their patients.

Still, Isaac often calls upon her experience in health psychology. In guiding healthcare providers at NYU, the question of patients’ trust in doctors is often prevalent.

“If there’s no trust, or if they feel like their doctors aren’t listening or empathic towards them, that can get in the way of people adhering to doctor’s recommendations or perhaps going to get those screenings that they need,” she said.

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