EP29 The Empower Lab with Anna Chessky and Nicole Acero

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I AM GPH EP29 The Empower Lab with Anna Chessky and Nicole Acero

EP29 The Empower Lab with Anna Chessky and Nicole Acero

Alexandra Arriaga: Welcome to the I AM GPH podcast. My name is Alexandra Arriaga and today, we're talking to Anna and Nicole who work at the Empower Lab. The Empower Lab is a clinical research and advocacy lab that works to further gender equity through scientific approaches to issues of gender based violence. Gender based violence includes sexual violence, sex trafficking, domestic violence, female genital cutting, military sexual trauma, and other issues that disproportionately affect low income women around the globe and in New York. Anna and Nicole are both seniors at the College of Global Public Health in the College of Arts and Science, and they serve as Associate Directors of Research at the lab. Hi, guys. How are you doing today?

Nicole Acero: Good, how are you?

Alexandra Arriaga: I'm doing very well. So could you please introduce yourselves and tell me a little bit more about your background?

Nicole Acero: My name's Nicole. I am a public health student studying public health and sociology as an undergraduate, and I'm a senior at NYU and I work for the Empower Lab as one of the Assistant Directors of Research. I've been in the lab for, going on two years now. Yeah.

Alexandra Arriaga: Very impressive.

Anna Chessky: Hi, I'm Anna. I'm a senior at the College of Arts and Sciences studying global public health and chemistry. This will also be my second year at Empower and I'm also the Associate Director of Research.

Alexandra Arriaga: So guys, what brought you to NYU?

Nicole Acero: For me, I live in New Jersey and I went to a really small, all girls Catholic school, so I really wanted to branch out.

Anna Chessky: I'm definitely a city girl and so NYU really fit that perfectly. I'm born and raised in Brooklyn, so I kind of knew that New York City was where I wanted to spend the next four years of my undergrad career. Simply put, New York City offers so many opportunities such as the Empower Lab, which I don't think I would have had the opportunity to do had I been somewhere else because you're also exposed to so many different cultures and populations, which I think is what makes Empower so unique is the fact that we got to work at Bellevue or recruit from Gouverneur Hospital and really have interactions with specific immigrant communities.

Alexandra Arriaga: Yeah, definitely the melting pot we have going on in general is just amazing. Guys, tell me, what do you do at the Empower Lab? What does your day to day look like?

Anna Chessky: Day to day, it's very different when you talk to anyone in the lab because we have around 12 different projects and all the projects are in various stages of the research process. We have some that are doing study design and protocol development. Whereas, we have other studies that are currently recruiting and other studies that are wrapping up data analysis and writing their papers. So it really depends on who you ask in the lab. Some people could be spending two to three hours recruiting at Bellevue Hospital or Gouverneur Hospital. Some people could be doing a lot of data analysis at home with the data available.

Alexandra Arriaga: What studies are you guys currently working on that have not been wrapped up and are active?

Anna Chessky: I'm currently working on a project called chronic pelvic pain and what it is, it's a scoping review. So past research has shown that trauma is linked to chronic pain, it manifests into physical pain. Knowing that, we wanted to see how many studies that actually evaluate chronic pelvic pain look at trauma as a variable and surprise: not many do. So basically, what we're wrapping up our data analysis and what we're trying to say is that if this link is known, why isn't trauma being evaluated in more studies?

Alexandra Arriaga: That's a very interesting perspective to have and I'm glad that someone's looking into it. Besides from that, I also know that the lab is working with gender based violence. I think that a question that most people would like to know is, how common is gender based violence? How many women or men are affected by it.

Anna Chessky: So in terms of men, prevalence is a very hard data point to obtain when you're talking about gender based violence. There are many statistics out there. It depends on one, how you define gender based violence, whether you include rape in it, whether you include intimate partner violence into the statistic, so the stats vary. In terms of men, there's one stat that says one out of seven men will experience intimate partner violence compared to women, which is around one out of three or one out of four.

Alexandra Arriaga: That's a lot. That's crazy. Given the nature of the data that you're collecting, I bet that low reporting is an issue. How do you deal with obtaining data from sources that are, I don't want to say unwilling, but maybe less prone to give out the information.

Nicole Acero: I think the good thing about our lab is that our PI, Dr. Veronica Ades does work at a clinic, the Empower Clinic, that does have access to this very specific population of sexual based violence and gender based violence survivors. They're also very diverse in their racial composition, as well as country of origin. So we have access to these patients through that clinic, but we also have access to patients through organizations such as, Sanctuary for Families, and partnered organizations that our PI works with on a day to day basis.

Alexandra Arriaga: That's amazing. What measures are being taken in order to improve this reporting? Do you guys have any specific methods?

Anna Chessky: We do have very standardized methods in terms of we write a protocol, we make sure that all of our lab members are on boarded and well versed in the protocol. Everything is really standardized and we really aim to get quantitative data versus qualitative because we really want the numbers to speak for the results. Another good point that Nicole brought up is the fact that we work at Bellevue Hospital, so another team is the Program for Survivors of Torture; that's another team that I'm part of. The interesting part about that is that we get a lot of... The population is asylum seekers and victims of torture or sexual abuse. We also get a lot of people who've experienced female genital cutting and that's a really unique population that not many people get to interview and obtain data from. That's something that the Program for Survivors of Torture does.

Alexandra Arriaga: So that's a very interesting point that you both bring up, which is that you are studying a lot of immigrant populations and then again, it's great that you're in New York because you have access to all these variety of people that come here. What resources would you say that are being offered in order to help these people that come to you guys and are providing data?

Nicole Acero: So there are a lot of hotlines that are available such as Polaris, but also organizations within the city such as Sanctuary for Families that I talked about before that offer comprehensive support to women who have experienced GBV and SPV, as well as our PI coordinates with different legal aids throughout the city and she writes affidavits for people who she does see and can help support get an affidavit to get a visa and seek asylum in this country. We also, in some of our studies offer a little sheet for people who do express that they need financial help or psychiatric help. So we have a list of organizations throughout the city that can contribute and help support these people.

Alexandra Arriaga: This definitely sounds like very important work. I think that oftentimes, immigrants are a susceptible population in terms of maybe they're scared to receive medical attention. They are worried that they may be reported to ICE or some sort of other organism that can potentially just take them back home. A lot of times, we don't realize that these people are coming into the US because of course, they're suffering back where they come from. So I appreciate the fact that you're working with these populations. Another question that I have in terms of all the immigrant populations you're working with is, how do you incorporate their social backgrounds into the care they receive?

Nicole Acero: We're very fortunate that we have many researchers who speak French or speak Spanish or Russian, and so we really try to accommodate our patients or our participants in our study by speaking their native language. It really helps with communication. It also helps to have them feel more comfortable with us when they're revealing such personal information such as intimate partner violence, torture, FGC, whatever it may be.

Alexandra Arriaga: That is extremely true. I think that once you can establish a connection with someone in their native language, they immediately open up and they feel more comfortable. I think that's a great resource. Another interesting project that you guys are doing is the male intimate partner violence study, correct? So what I found innovative about this research is that you guys are focusing on men's experiences with intimate partner violence, both as potential perpetrators and potential victims. Now, that strike me as odd in a way because how is the potential perpetrator perspective helpful and how do you guys obtain this?

Anna Chessky: The question people have is, "Well, people are experiencing intimate partner violence or IPV. How do we reduce that?" Right? So one of the ways to reduce it is by telling the men who are perpetrating it and educating them how to reduce their violence and how to not commit violence against their wife or their intimate partner.

Alexandra Arriaga: Some of these men are just unaware that they are perpetrators.

Anna Chessky: Some are, or some don't have the techniques to express their anger in a different way. This study, we're not... It's still in the survey development phase. It's still in its early stages of research. So we can't tell you any of the data that we've got because we haven't started recruiting yet. But from the literature we have seen, a lot of the research has been done in prisons and that's not relevant to many of the cases and many of the women or men experiencing IPV because most of that happens outside of prisons.

Alexandra Arriaga: It's definitely great to know that research is being started on this topic. I think that it's a very unique perspective that you're taking on this. Hopefully, once you have the data we can bring you back and you can tell us more about your findings. Another thing is that I think we definitely do not talk enough about men being victims of intimate partner violence. What are some examples and how do you think that that stigma of, "Oh, I'm a man, therefore there's no such thing as domestic violence or abuse for me." How do you think that stigma affects reporting of these instances?

Nicole Acero: It definitely affects their reporting, especially that negative stereotype or that constricting stereotype of men because it prevents doctors from asking screening questions about whether a patient is experiencing IPV. But at the same time, it prevents the victim himself from reporting it to his doctor. So just not even the possibility that they are experiencing IPV, but also the fact that they would have to own up to it and that also plays into the power dynamics that we assume that male dominates women is subordinate. That affects the reporting and the screening process.

Anna Chessky: There was also the data that showed that only about 20% to 30% of men come out and say like, "I have been assaulted," whereas if physicians asked the males, then around like 80% of those who were assaulted will say so. So the simple act of a physician taking the initiative to ask a male is a big step forward. We're kind of encouraging that.

Alexandra Arriaga: For sure. It seems like it's very needed and I hope that it's a problem that can be reduced with techniques like this. Switching gears a little bit, I know that you guys have really exciting plans to present at an upcoming conference and you're running a crowdfunding campaign. Can you please tell me more about that? Specifically, what is the money going towards?

Nicole Acero: We're doing a crowdfunding campaign through Rising Violets with NYU and you can go on the Rising Violets website and you'll see our page right in the front. The two conferences that we're going to is the FIGO World Congress for Obstetrics and Gynecology, which is held every three years. This year, it's being held in Rio, so not very cheap to get to. Another one that we are participating in is ISTSS. Which is the International Society for Traumatic Stress Studies.

Anna Chessky: That is being held in DC. So the money will go to helping people who are participating, fly out or take a bus down to DC and as well as help with housing and registration for the conference itself because that in itself is pretty expensive.

Alexandra Arriaga: Conferences can get very expensive, I know. And I want to know, why are you guys so excited to go to this conference? What are you going to be presenting specifically? Why are you so eager to go?

Anna Chessky: Well for the Empower Lab, this is the first time that our students are going to FIGO, or we are going to FIGO or ISTSS. One, it's a great opportunity to meet other people who are doing research in the same fields and really get your research out there and find out what they're doing as well. Some of the research that we are presenting is the chronic pelvic pain study that I've talked about before. We're talking about research that we've conducted on the perceptions of female genital cutting and we got that information base of the people we interviewed from the program for Survivors of Torture. We're presenting data from the Empower Clinic. Some of our students did research and really tried to understand the gynecological needs of the women who've experienced violence. In addition, we have a program called TT. Maybe Nicole, you want to talk a little bit more about that?

Nicole Acero: Yeah, so TT. We are presenting at ISTSS and TT stands for telomeres, epigenetics and trauma. The study itself is looking at whether or not sexual based violence has an impact on a woman's telomeres and their epigenetics, so DNA methylation, which leads to more rapid aging. We're also looking at if the child of the victim has any developmental delays as a result of her experience. The abstract that we are presenting at ISTSS is focused on the screening of all patients, including controls that we were recruiting from Bellevue and Gouverneur because interestingly, a lot of the people that we were trying to recruit as a control were also victims of sexual based violence and gender based violence. So that's an interesting data point in itself. We also are presenting a sugar dating study at FIGO, which is really exciting. We looked at the literature to see if sugar dating is being researched at all in academia because as NYU students, we know that it definitely does exist on our college campus. So we're reporting our findings that there's not many people looking at sugar dating, especially in the United States. Most of the research is focused in various countries in Africa where people are interested in the link between HIV and AIDS and sugar dating. Finally, we're looking at healthcare access, that victims who have been trafficked, how they interacted with the healthcare system and asking the question whether or not the healthcare system can assist in identifying victims of trafficking.

Alexandra Arriaga: So let me ask you quickly, what is sugar dating? That sounds very interesting and I think most of our listeners may not know what it is.

Anna Chessky: Sugar dating is a form of dating where usually it's the man who is older and wealthier and he seeks out what he calls a companionship relationship. He compensates the women via luxury gifts sometimes. So we do want to say it's not prostitution.

Alexandra Arriaga: How is it not prostitution?

Anna Chessky: That's a very interesting question because sexual relationships, although may occur in these relationships, they're not mandatory. The woman herself, from the small amount of literature that does exist, it seems that the woman negotiates for herself, but we have seen that there are many issues with these relationships that have not been studied and total. Because a woman is at a lower financial standing and is younger, she doesn't really have that negotiating power that she may think she has. So what we're going to aim for in the future is to really identify is that the case or not.

Alexandra Arriaga: Do you think that identifying if that's the case or not can actually help you implement some sort of guideline as to how women could may or protect themselves better?

Nicole Acero: I will say that we're not a policy lab, right? With any research, we hope that other people will take that and use that to create policy and to create reform. But what we're really interested in one, identifying prevalence of it happening on campus and two, identify the intricacy of the relationship. So if a woman does decide to engage in a sugar relationship, is she more prone to certain risks, such as intimate partner violence or sexual abuse and harassment.

Alexandra Arriaga: Wow, I had no idea. You're telling me that this is going on campus right now? There are people engaging in this type of sugar relationship?

Anna Chessky: Well, if you look at NYU Local, published a few articles where they interviewed students who claimed that they were sugar babies.

Alexandra Arriaga: So basically this data was obtained through self-reporting.

Nicole Acero: Yes, but also there's a website, Seeking Arrangements, but just kind of like Tinder for sugar babies and sugar daddies. If you sign up with a college email, you get a premium subscription. On there, there are around 4,000 NYU emails that are signed up. It's not just at NYU, it's in colleges across the country. I think we're ranked number three on, Seeking arrangements, but Arizona State I believe is ranked number one. So it's quite interesting.

Anna Chessky: Just to be clear that we haven't obtained any data from our own research because we haven't conducted the research, we're currently again, in the early stages of creating this, but the research we are presenting is a literature review that we've conducted.

Alexandra Arriaga: Okay. And this is like public domain, so if you put your email there, it is out there for everyone to see?

Nicole Acero: On Seeking Arrangements, from what I understand you can't really put your personal identification, but the interesting aspect of it is that they are self-reporting, that a lot of college students are using their personal college emails to sign up.

Alexandra Arriaga: Wow. I am shocked to learn about this. I had no idea this existed. That's crazy, and we are college number three on that list.

Anna Chessky: We don't know the validity of this. We want to be clear, this was not an academic formal study that conducted this information, but-

Alexandra Arriaga: It must have some truth to it, I guess. 

Nicole Acero: I think the fact that Seeking Arrangements claims that we have such a big population and NYU Local did some a few articles, it's known in NYU campus culture, as well as some big name publishers such as like New York Times and Buzzfeed and The Atlantic have been reporting that this has been happening across college campuses. So this is what we're using as an identifier of this phenomenon that appears to be happening, but isn't really looked at in the research which was the focus of our literature review.

Alexandra Arriaga: I'm really glad that you guys are diving deeper into such a controversial topic. This is definitely not your cookie cutter scientific research. So I think it's first of all, super interesting, very important and it will potentially have a really big impact because if you're telling me that's so much of the population is engaging into these types of practices, then there definitely needs to be a little bit more monitoring. Hopefully, and I know you guys said you don't really implement policies, but if we understand better, then maybe we can help these females and maybe males that are engaging in this.

Anna Chessky: Our goal is to, if there are risks to this relationship, we want the women to be fully aware of them. Right now, none of this research is being dealt with. The women entering this relationship may not know of such risks and they may just only know of the benefits that are being advertised of it. So that's really important to us to make sure that women are informed regarding the activities they're engaging in.

Alexandra Arriaga: And of course as this website is making some sort of profit, they're not going to advertise the negative things that women may encounter. So it makes sense that someone who's objective and neutral can vouch for the truth.

Nicole Acero: Oh, and we also want to make clear that our research isn't trying to judge anyone for participating. It's not really about that. It's as Anna said, about empowering women as well as informing people who are participating in this, the risks and possibly benefits of the phenomenon.

Alexandra Arriaga: Definitely, and I appreciate that you guys are doing this and I appreciate the open-mindedness. That's definitely very, very important. And one final question just to wrap up, before you guys leave. What motivates you to do this work and not just in terms of academically, but what makes you want to go in, put in the hours and just do this every day?

Anna Chessky: I think it's the stories you hear. I think at the end of the day, there are many assumptions made about women and sometimes against women. When you really get down to the heart of it and you really see these women really, really traumatized, but what has happened to them sometimes by someone who's really close to them and you see the effects that has on them, it really reminds you that the work you do is so, so, so important. The issue is so prevalent and widespread. There was an article that came out with the New England Journal saying that medical students, almost 50% of female medical students will experience some form of sexual harassment or assault within the four years of their study. I intend to pursue an MD in the future. And so of course, those stats speak volume to us. I know Nicole is also applying. So yeah, and I think with Empower that we're not just talking about one form of sexual abuse or harassment or gender based violence; we're really digging into all different types, whether it be intimate partner violence, whether it be FGC, just all various types and kinds.

Alexandra Arriaga: Finally guys, how do we get in touch with you? Where do we follow your work and how do we contribute to your crowdfunding?

Nicole Acero: For the crowdfunding, you can go to risingviolets.nyu.edu where you can find our page right in the front and donate there. Additionally, you can learn more from our website, EmpowerLab.org and you can follow us on Instagram @NYUEmpowerLab and if you want to sign up for our monthly newsletter, you can email us at nyuempowerlab@gmail.com.

Anna Chessky: If you think our work is important and you want to donate, please do this as soon as possible.

Alexandra Arriaga: Well, there you have it guys. Thank you so much for joining me today. It's really been a pleasure. I wish you all the best with your research. It's definitely very interesting and I hope that everyone listening will go and help you guys out with your goals and your crowdfunding campaign.

Anna Chessky: Thank you so much.

Nicole Acero: Thank you so much.