EP139 Psychosocial Insights from Vietnam and Beyond with PhuongThao (PT) Le

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EP139 Psychosocial Insights from Vietnam and Beyond with PhuongThao (PT) Le

Aman: Folks, welcome back to another episode of, "The I AM GPH Podcast," and today's guest is PT Le. PT is a dedicated public health researcher with a profound passion for improving the lives and wellbeing of marginalized populations across the globe. PT's research portfolio is so diverse that I have to read it right now. It's ranging from addressing psychological issues among trafficked women to maternal and child health, mental health interventions and support services for cancer patients in resource constrained environments. Her journey through academia in various roles at institutions such as Boston University and NYU reflects her commitment to advancing public health research and practices. PT is from Vietnam and she brings a unique perspective shaped by her upbringing to her work. As a professor, she not only conducts groundbreaking research, but also shares her wealth of knowledge and wisdom with the student. We're so excited to learn about her journey. PT, welcome to, "The I AM GPH podcast."

PT: Thank you so much for having me!

Aman: I mean, let's hop right in. So I wanna start with this. You're, "The first Vietnamese guest," quote unquote I'm speaking to, so I'm really curious, how did that influence your path? Where did everything start for you? When I was reading about you, it all started in Vietnam. There's something to do with that, it's a part of your core. Can you tell us where your whole public health journey started?

PT: Yes, yeah, so I was born and raised in Vietnam. When I was 12 years old then my family immigrated to the United States. We went to Southern California where there was a very vibrant Vietnamese-American community. So that was in the 1990s, mid 1990s. And then I started going to school there in high school, in college. I went to UCLA and then I decided at the end of my undergraduate education that I wanted to pursue public health, because I wanted to make a big impact on a population level as opposed to the individual level. So that's why I started my journey to New York at Mailman Columbia School of Public Health and after that, I went back to California for my PhD, also in public health, and then went back to New York at NYU. At that time, it was the Institute for Global Health and I was the faculty fellow, which is essentially a postdoc position. So that's when I started at NYU.

Aman: Yeah, you're an LA-New York person right now.

PT: Yes. Bi-coastal, yeah.

Aman: Let's talk about, there's this double major thing that happened that I remember. It was in your bachelor's, if we go back to UCLA, mathematics and women's studies. How does mathematics and women's studies, the collaboration, move you into public health?

PT: Yeah, yeah, that's a really interesting question. So, I was pre-Med like many other Asian-immigrant children. So I was pre-med, but I wanted to get some training in kind of logical thinking more so than the pre-med students were getting. So that's why I strategically chose applied mathematics as my major, but at UCLA, which was a very conducive environment for like social studies, Asian-American studies. So I was exposed to a lot of the student activism there and so I picked up a course in women's studies and I loved it and I think what that brings to my perspective is that it trains me to think logically, in like using formulas and stuff like that, but also really understanding the social issues, the social structures, that we all live in and how society functions and how we can change society for the better. And I think that the convergence of those two perspectives led me to public health, where it marries very nicely, the sciences, but the social behavioral sciences. So like, how do we understand how people behave? How do we change that behavior? And how do we implement policies at the policy level, at the institutional level, to make people live better lives?

Aman: That's amazing, I mean, a lot of students that I've been speaking to around the building as well here at NYU, they say how much data is influencing their public health journey and how important, "The mathematical side, the statistics side," so I know, where it's coming from, but for someone that might not be understanding, like, "Oh, well, what's mathematics public health?" Because you said I wanna have a global impact and then where does math come into that? But it's the numbers and everything that you're talking about.

PT: Yeah and as a student, I now see the value in challenging yourself so that you learn the skills that are needed to like really understand, you don't have to understand the specific techniques, like the specific methods that are required, but you have to understand why we apply certain statistical methods, for example, and how do we interpret data.

Aman:Can you tell me, you said you were in Vietnam til' you were around 12 years old. What part of Vietnam had an impact on your journey as you were going through… You mentioned a lot about academia, I'm curious to hear about the Vietnam portion of things.

PT: Yeah, so, okay. So it goes back to how I was born in the early 1980s and during that time, that was shortly after the end of the war in Vietnam and actually, the reason that my family was able to immigrate to the United States was because my father served in the South Vietnam War and he was imprisoned, he was in reeducation camps for more than five years. The US has this program called Humanitarian Operations to sponsor families of individuals who were serving in the reeducation camps. So anyway, so all of that is to say that we didn't have a sheltered childhood. I didn't have a sheltered childhood, not a lot of people did during that time. So we came to the US and we were, like, on government support. So I realized the importance of the safety net in the United States. We were uplifted, I had to learn a whole new language. But yeah, like realizing that it is super important to support people, to provide that social safety net for marginalized populations. So that has been the core of what I do in public health, in my personal life as well.

Aman: How lovely, I mean, that's so interesting to say. Now tell me, you've done a lot of things. I mean, in your intro as well, I only mentioned three, there's probably 30 more. And how, where did it start? So you went Mailman, UCLA and then back to NYU. You have a bunch of… how did your interest evolve over time?

PT: Yeah, so I knew for sure that I wanted to go into public health at Columbia. At Mailman, I did the MPH in Health Policy Management in effectiveness and outcomes research. So, like, making sure that the interventions, like calculating the cost benefit, costs, effectiveness, effectiveness ratios of our interventions. But at Columbia, I was exposed to a lot of community-based participatory research projects in the US. So I volunteered for Memorial Sloan Kettering Cancer Center, that was my practicum in New York and then after at Mailman, I did an eight month internship in Hanoi, Vietnam, in between the MPH and the PhD program. And I think that was a turning point in that after that experience, I was able to see how simple effective solutions can really improve the lives of people in especially low and middle income countries, so that's when I switched over to global health and yeah and that informed the way that I thought about what topic to choose at UCLA. At that time, the issue of human sex trafficking was getting a lot of attention and also at that time, a lot of Vietnamese women were being trafficked for commercial sexual exploitation. So that's why I decided to focus my dissertation topic on examining the psychosocial issues among the people who were trafficked and then they were returned. So they had to navigate the reintegration process into the society.

Aman: You seem to have a big heart in these matters, like, you see it and you wanna invest. What was it like for you, that whole, when you see, oh my God, this is happening, this strikes a chord for me. What's that whole journey like for you?

PT: Yeah, I guess it's because of my connection to Vietnamese people, knowing that I am a very fortunate person where I received my education in the US, but wanting to do good. So coming back to Vietnam, learning about the issues, the struggles of the people and how I can uplift their voices through my research, through my work to raise awareness about the certain issues or how do we create programs, policies, interventions to help them.

Aman: Has there been a common theme with your interests? Or has that evolved over time since you started?

PT: The common theme has always been about mental health. So, psychosocial issues, because it is something that I think, and mental health is getting a lot of attention nowadays, deservedly so, especially after we've gone through the pandemic. But I also think that mental health is a pervasive issue, that it pervades each aspect of our lives. And if we don't feel well, we're not emotionally supported by the people that we love around us, then we can't function. And the link between physical and mental health is very well established. So that's a common link, is to address, understand, improve the mental health burden in marginalized populations.

Aman: What was it like? you said mental health now obviously has a much bigger awareness around it. 10 years ago at least, I had no idea that this is even a concept and you have been working with this for a very, very long time. So how has that evolved for you? What was the kind of the mindset around mental health when you first started and how has that changed over time?

Pt: Yeah, so I think in what we have talked about previously, people have focused on the traumatic aspects. So sex trafficking survivors, for example, we understand that they have gone through a lot of trauma, but a lot of times we don't know how to address that and integrate that into daily activities, for example. So the conversation around mental health has changed, I think from the focus on more deteriorate effects of traumatic experiences to now improving. And that access to mental health and psychosocial support is something that everybody should receive if they feel like they have the need for it. So it's not just focusing on the negative and very traumatic, you don't have to have experience of like warlike conditions or like a very traumatic experience, people are living every day with adversity and they have to overcome that. So I think that's the shift that I welcome in the public discourse.

Aman: This word, you mentioned a few times, psychosocial. It sounds like something that to me, when I hear it, I don't hear this word often, so when I hear this word often, when I hear this word right now, I hear psychology and then social aspects impact the psychology. Can you tell me more about psychosocial?

PT: Yeah, yeah, so as a social scientist, so I prefer the word psychosocial over the word psychiatric or the word psychology, because like that is more encompassing. So exactly like you mentioned, that we are factoring in how social environmental factors affect our psychological wellbeing and vice versa as well. And yeah so that's why I prefer to use the word psychosocial.

Aman: So, I'm curious, you have done a lot, I'm curious to hear about success stories and can you gimme the success stories with the psychosocial lens?

PT: Okay, success stories. So I'll take an example, maybe two examples. One, the first one is from the work that I did with human trafficking. So I did a mixed method study, I actually spent about eight months in Vietnam doing ethnographic research, I partnered with an NGO there who has a shelter, so what I try to do, so I worked with the NGO, with government entities to train them to how to assess the physical and mental health needs of the people that they were repatriating back to the country. So I think at a certain level, that capacity building was much needed and it was much appreciated by the border guard officials who are getting trained to do these health assessments because they understand that these women who were returning and girls who were returning, they experienced a host of issues, but they don't know where to start in terms of understanding that. So that's one and related, because I did a lot of qualitative interviews with the survivors of sex trafficking. So I interacted with them. I really try to understand their experience, their journey and how they think about their life going forward. And it is this whole mix of it's not just about what they experienced while they were trafficked in China, Cambodia or the nearby countries, but it's also the social environments around them and how their family members, how their different, maybe ethnic cultures, because Vietnam actually has 54 ethnic minority populations in the country and many of the people who were from ethnic minority populations were being tricked because they didn't know about the risk of being trafficked. So yeah, to really understand the issues, I think you have to take that social ecological model in public health and understand at the individual, family, community, societal level. So what I tried to do was to integrate that into my research, like the analysis of the data. Let me think. So another ongoing project that I'm doing is related to the cancer population. So I'm currently implementing a K1, that's a mentored research project, and it is adapting and piloting stress management intervention among cancer patients. And so we actually have not implemented the study yet, the pilot RCT, randomized control trial part, but the first two steps that we have taken to talk to the local stakeholders to understand, so we had this idea, this intervention model, will this work? So the process of actually just speaking to them, we call that formative research, but just the process of communicating, engaging stakeholders, I learned so much about how people think about mental health issues among cancer patients and how I can better engage them in the implementation of the project later. So that's something that I'm learning and that's how I think the psychosocial approach would be very beneficial, because it provides a more comprehensive, holistic outlook.

Aman: You have a very big heart, it's very nice, I think this should apply to all humans, even beyond. This is a very necessary environment, obviously, but imagine if everyone is simply communicating like that from the psychosocial lens in terms of everything in general. I mean, I got very inspired even listening to it. It makes me want to change the way I communicate tomorrow.

PT: I'm glad.

Aman: So I know you mentioned the mental health is a common theme for you and a lot of people are perhaps getting inspired listening to your story right now. Let's go back to a student that's 21 or even people that are, I don't know, thirties, forties, whatever it may be, whoever's listening to this and they feel like they don't know what their why is, they don't know what their direction is. How did you find yours and how can someone find theirs?

PT: So I've worked with a lot of students and especially NYU students, 'cause I've been here for a while and what I would advise people to do, if you are in a space where you are not sure of where your passion lies and I was thinking this too, where even if you don't think you wanna do research, like later on, I think it will be a very good experience to be part of a research lab. So if you are a GPH student at NYU, get into a lab so that you learn how the professors think, what goes behind the scenes and hopefully you'll learn very specific skills that you didn't know you wanted to or liked, before. And that's what I try to do in my lab, where, I recruit people, even undergraduate students, because I think NYU undergraduate students are phenomenal, where they might have like a vague interest in mental health, psychology, global public health, but then once you get your hands dirty, so to speak, like working on a specific project, working on a specific, like designing a study or analyzing data from a study, then you'll get that experience and you will dig deeper into certain areas of research that will be applicable as well, even if you're not gonna be conducting your own or designing your own research studies later on.

Aman: The infrastructure formulates a direction for a lot of people is what you're saying within public health?

PT: Yeah, yeah and it's also the exposure to other teammates, your colleagues in the future, like we have a great applied practice experience, kind of requirements and infrastructure here. So yeah, like really take advantage of that, so that you get exposed to different things and know what you like and what you don't like. I think that's very helpful.

Aman: Okay, I mean, this is very good feedback. This is the first time I've heard someone give this feedback, find a research lab and there's plenty of research labs. We've had them on the podcast as well.

PT: Yes, yes. All the centers, all the labs. We live in New York city, probably the greatest city in the world, where we have a great health department, get to know them, get to know the projects, the community-based organizations. Even if you're not interested in research, you can find out the CBOs are in the city and volunteer with them. Yeah and that's how you start building networks and reach out to your professors. It is okay to make a cold call kind of email, a cold call email if it's somebody that you really admire for the work.

Aman: Couldn't have said it better. Speaking of NYU and NYC, what's your New York journey been like? What's your relationship with NYU and how has that evolved for you to the day we're recording this?

PT: NYC, New York City, has definitely grown on me. So, as I mentioned before, I came here for school, it was only a year and a half program and then I went to Vietnam to volunteer for eight months and then went back and then, anyway, so, but the vitality that you feel in New York is nowhere, you cannot experience it anywhere else. So that's what I love about New York City, and I'm still in New York at the moment, I will definitely miss it if I end up going somewhere else. Yeah and it's so much the vitality, the vibrancy of the city, like people from all walks of life are here. That's something that I desperately miss, especially when I spent a couple weeks in Vietnam, "Oh, how can I get back to New York? Be part of Central Park? Et cetera." So, yeah and it's been a great space for me to grow personally and professionally.

PT: And how about NYU? So what's your relationship been with NYU?

Aman: Yeah, so I've always been with NYU, so from the two educational institutions that I've been in, in New York City, Columbia and NYU,  NYU is great. I started, like I mentioned before, when the school was still an institute. So it was a very, I think relatively small, one floor only.

Aman: Oh wow, okay! I hadn't seen that either.

PT: So yeah, maybe, maybe two floors. Yeah, so it's very small and then we have grown tremendously under the leadership of Dean Hilton previously, and now I'm sure Dean Holden will take it into… great strides will come to NYU. And I think one also great thing about NYU is that one, we live in New York City, I mean, it's located in New York City, but there's also this global universities network or Global Networks University, where the students can spend a semester at Shanghai…

Aman: Abu Dhabi. And many others, I'm assuming.

PT: Italy, Abu Dhabi. Or even DC. So that's one of the other great things about NYU and NYU School of Public Health, with the various city health departments, the UN connection, it's also great to grow your social and professional network as well.

Aman: Yeah, the city health department is so interesting. This morning I went on a run where I go, I run up these stairs and down and when I went to the park, I saw Department of Aging, New York City Department of Aging, I'm like, "There's a department for aging as well over here?" And they were doing free hearing tests, so you don't lose your hearing for all of them and there were a bunch of people of an elderly age around, and I was surprised that that even existed. So it shows how, like you said, how research labs have structure, New York City in general also has this structure that has different departments, you can do whatever you want in the realm of public health.

PT: Yeah, yeah, definitely, yeah.

Aman: So I get a lot of guests on that have transitioned into teaching from being a student, but I never really asked their relationship with teaching. So I'll ask you this final area of questions as we end the podcast. Your relationship with teaching and what does teaching give you? You've taught all these students, is it fulfilling? All these things, you've done, these projects, you've done so many things, how is it when you guide the students, how does that teach you more as a leader and a facilitator?

PT: Yeah, yeah, so when I was a faculty fellow, that was the postdoc position at NYU, I taught a couple of classes. So I taught an undergraduate epi course and a graduate level migration and health course. And I also helped design the health and human rights of migrants as part of the Health and Human Rights Certificate. So what I've learned from the teaching experiences are that obviously you need to review all of the material, so that even though you might know the material, it takes so much time and effort to prepare the slides, and the assignments for the students, but I get so much joy in delivering the content and hearing and seeing, observing, witnessing how students grow from day one to the last day of classes and how this beautiful transformation could happen over a span of just a couple of months, where some people can actually like, really soak up and try to apply that. So I still to this day get emails or LinkedIn messages from students that I taught a couple of years back. So that's what I've learned about teaching, obviously, like those of us who teach, put a lot of effort into it. So appreciate your professors! Give them some slack at times. I think that there's teaching in the formal kind of classroom and then there's also mentoring. And mentoring is most of what I do now, because I don't teach, currently. So the students that I interact with are participating in my research lab. But I find teachable moments during the lab meetings where I assign people certain things, but then I also make the effort to explain what goes on behind a particular method or the particular reason why we chose a certain study design. So that's what I try to do. And I also make a conscious effort to support and encourage people, students, who are from historically disadvantaged backgrounds to pursue the scholarship, the fellowship or to pursue a postgraduate education as well.

Aman: There's a lot of great feedback in there, research labs, infrastructure, finding a mentor, future fellowships, scholarships and graduate degrees. There is endless options for everyone and it's about finding what strikes a chord with them, perhaps, and then taking it into that direction?

PT: Yeah.

Aman: I love it, well, PT Le, not only a great advancer in the public health realm for psychosocial issues and beyond that, even a great mentor and instructor and I don't even know what's gonna come next when I speak to you after that. It was a pleasure to have you on the podcast.

PT: Thank you so much for having me.

Aman: Amazing, see you next time.