Nancy Schoenberg: Listening to Communities to Create Equitable Solutions

The best solutions begin when you listen to the people whose problems you’re trying to solve. That community-based focus — the crux of what Nancy Schoenberg says is her approach as a medical anthropologist — has been a guiding value through her 25 years at the University of Kentucky.

“We are not the experts. The experts are the people we are talking to, so we need to listen to people," said Schoenberg, the Marion Pearsall Professor of Behavioral Science. "We need to honor that what they say is important in their lives, and why they do and don't do things. And once we do that, then we can work with them to come up with evidence-based solutions.

“As an anthropologist in the College of Medicine, initially, I think a lot of people did not exactly understand what kind of work I was doing. But when evidence starts to emerge, when I start to get more and more funding, when I start to disseminate my work, start to train students, people start to understand what translational science is — taking existing interventions and making sure they work in a community setting.

“For generations, there has been a tendency on the part of outsiders to pathologize Appalachia,” Schoenberg said. “Too often, even those with good intentions tend to see the region as nothing other than a complex of problems. What typically gets left out of the picture are the tremendous assets the region possesses.”

Chief among those assets is a strong sense of shared cultural identity and community, Schoenberg says. It led to the creation of “Faith Moves Mountains,” a faith-based outreach program that has tackled cervical cancer screening, diabetes treatment and prevention, smoking cessation, and healthy eating and physical activity in Appalachian communities since 2004. 

“It’s an approach that has been employed extensively and with great success in African-American communities,” Schoenberg said. “But there wasn’t much data out there on faith-based interventions in predominantly white, rural populations. Faith Move Mountains changed that.”

Since 2009, Schoenberg has served as principal investigator on more than $10.8 million in sponsored grants and contracts. She currently leads a mobile health (mHealth) research project, based on an intervention designed at Northwestern University, that targets healthy lifestyle choices.

“To our knowledge it’s the first randomized control trial of an mHealth technology-oriented intervention in Appalachian Kentucky," she said. "And our goal for that project is to try to increase fruit and vegetable intake, to increase physical activity, and to decrease screen time. We know that using technology may be a really good substitute for what’s not available in their local communities.”

The impact of her work and the recognition of its importance is evidenced by Schoenberg’s many collaborators at UK.

“People’s doors are open. And that is a hallmark of UK, is our sense of collaboration, our sense of mission, our responsibility, and respect for the land grant,” she said. 

In 2021, Schoenberg and Mark Dignan, a professor in the College of Medicine’s Department of Internal Medicine, received $764,000 from the National Cancer Institute for Addressing Rural cancer Inequities through Scientific Excellence (ARISE) to train 10 postdoctoral researchers to address cancer-related health disparities in Appalachian Kentucky.

Schoenberg’s goal to train a diverse future workforce of clinicians and scientists is evidenced in her many roles: director of the Center for Health Equity Transformation (established in 2018 to enhance innovative, transdisciplinary and impactful research and training to improve the health of vulnerable Kentucky residents), co-developer and director of the Research Scholars Program (established in 2021 to ensure diversity and inclusion in research by promoting faculty success), associate vice president for research in research professional development, and associate director at the Center for Clinical and Translational Sciences.

“Studies have shown, time and time again, that the most creative, most impactful, most frequently cited publications are those from diverse research teams," she said. "So one trend that I am very encouraged by, but recognize we need to go a lot further, is making sure that all people are at the table — people from all backgrounds, all walks of life. Because we need their talent, and we need their input, and it just improves our science tremendously.”

Schoenberg recently accepted an invitation to serve on the leadership team of the Rural Policy Research Institute (RUPRI), an organization that provides nonpartisan, research-based analysis on needs and opportunities facing rural communities to help policymakers understand the rural impacts of public policies. In the past three months, she has given three national talks at the National Institutes of Health, University of Iowa and, upcoming, at Washington University in St. Louis.

“It’s an honor for me to be able to represent UK nationally,” Schoenberg said. “And it’s gratifying to see our work in communities making an impact inside and outside of the Commonwealth.”