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As a child in Arecibo, Puerto Rico, Dr. Eneida Nemecek learned the effort it takes to earn an education by literally going to college with her parents as they sought their degrees.
“My parents are very young. I kind of went to college with both of them in the back of the classroom,” Nemecek said. “My dad ended up going to graduate school, also when I was still a little kid. We went to law school with him, too.”
Nemecek followed her parents’ footsteps and eventually got her doctoral degree.
Today she’s helping improve Latino health through clinical trial participation as associate director for clinical research at the Oregon Health & Science University (OHSU) Knight Cancer Institute and professor of pediatrics and medical oncology at OHSU.
Developing a Passion for Latino Health
Nemecek was a teenager when she realized she wanted a career in health and medicine.
“It kind of sparked in 10th grade … I was doing health and biology, and all of a sudden, it’s like, oh, I found my place here,” Nemecek said.
Joining an accelerated program, Nemecek went on to complete her undergraduate degrees at the University of Puerto Rico-Mayaguez and begin her journey to her medical degree at the university’s school of medicine.
“I said two things I was not going to do in my interview to medical school when I was 20, and knew nothing about life,” Nemecek said. “That I was not going to work with kids because it was so hard, and that I was not going to work with cancer because it was so hard, and then I did both,” Nemecek said.
Following her education in Puerto Rico, Nemecek began residency training in pediatrics at Case Western Reserve University in Cleveland.
From there, she moved to Seattle for her specialty in pediatric hematology oncology.
In 2005, Nemecek moved to Oregon and started with OHSU, a place she’s called home for 20 years now.
Nemecek credited the mentors she had throughout her educational career.
“I have more mentors than I can count, I think, in every state, in every step, I’ve met one, not just for science, but for career,” she said.
Overcoming Challenges
Although Nemecek had a strong work ethic to lean on, transitioning to a different environment to pursue her education wasn’t always easy.
“That was like the biggest challenge to move to the bigger city, where the pace of living is very different, where I grew up,” she said.
Nemecek also spoke of the first time she ever encountered bias in her field.
“Because I was inside of the internal system of Puerto Rico, we were looked at so differently when we came to the [United States] mainland, and I heard all sorts of interesting questions during my interviews residency,” she said.
“It’s amazing to see how many people on the mainland don’t realize that we’re US citizens, that we don’t need visas to come to US. They kept calling it migration. ‘Oh you’re immigrating.’ I’m like, actually, if you move from Florida to Washington, you’re immigrating too.”
While these experiences didn’t discourage her, it made her realize how important it was to treat and talk to others with respect and cultural humility.
“It makes me very mindful of how difficult it is for people that are in the mainland to go through that process as well, because I think it happens to people here, too,” Nemecek said.
Creating Mi Opción
Nemecek and her team are working hard to increase diversity in clinical research.
That includes clinical trials – studies with volunteers that can help researchers learn how to slow, manage, and treat different cancer and disease – which historically have an underrepresentation among Latinos.
“I just noticed when I started looking at the data for clinical research participation in our center, which is not the best nationwide, we look exactly the same way the rest of the nation looks,” according to Nemecek. “I said, you know, we have a Latina associate director of clinical research, so maybe we can change it.”
After receiving a grant from Genentech Foundation Health Equity Innovation Fund, and connecting with great resources, she launched Proyecto Mi Opción.
The Mi Opción project consists of 18 short videos that are free and available to the public that cover a variety of cancer-related topics.
With the help of the community outreach and engagement office, Nemecek and her team were able to hold community discussions with different Latino populations across Oregon.
“We created a set of very open questions for people just to tell us what they thought about cancer, about what they were afraid of, what they would make them go or not go to the doctor for it,” Nemecek said.
Nemecek also recruited a community educator from Puerto Rico to assist with content and proofreading, along with students from the Latino Medical Student Association to record some of the videos.
With the help of partnership with Elemento Latino, a Latino-owned media company, Nemecek and her team created and launched the educational video series.
Teamwork played a large part in the success of Mi Opción.
The more Nemecek and the team put into the project, the more it grew. So much so, that it also got the attention to the Consulate of Mexico.
“[The Consulate of Mexico] are very good friends with this producer that’s helping us, and they’ve been amazing partners with us. So, they play the videos in the Consulate, and they are very involved,” Nemecek said.
While it’s still early to measure the overall impact of the project, it’s clear that taking time to speak and listen to the community about important health issues can make a difference.
“When we started this project, and before the project got disseminated in any way, the participation of Latino adults in our in our clinical trials, was about 4.9% and a year later, at the dot, when I looked at the data again, the participation was up to 9.1%,” according to Nemecek.
The project team also looks forward to going back to the communities they visited for the videos and discussions to host a premiere nights for the videos.
“Projects like this, it fills my tank,” Nemecek said. “It’s been a really good eye opener for me and for people around me that didn’t know our community very well, and just forming community has been really good for me.”
Taking Opportunities and Promoting Clinical Research
For Nemecek, encouraging Latinos to participate in clinical research is crucial.
“Our community is very altruistic, and our community understands the importance of being part of community, and clinical trials are being part of community,” Nemecek said.
Nemecek also emphasized the importance of educating everyone about the importance of diversity in clinical research participation.
“We have a responsibility, not only to educate our patients to participate, we also have a lot of responsibility to educate the people that are in medical school right now, for every patient that walks through the door, not only the people they’re comfortable talking to. Because that’s where I think a huge part of the bias in participation,” Nemecek said.
To help address bias, healthcare workers can get a free Salud America! Action Pack “Health Care Workers and Researchers: Find If You Have Implicit Bias and What to Do Next.” This Action Pack will help you see if you have implicit bias, learn from others who have overcome their own implicit bias, and encourage colleagues to learn about implicit bias, too.
Nemecek also has advice for Latino medical students looking to achieve success.
“Nobody can stop your dreams, I think, other than yourself. Teaching people to take risk and to know what they’re worth, it’s really what I encourage people to do,” she said.
“Know your worth, take your opportunities, you know what you can do.”
Clinical Research Opportunities for Latinos
Latino cancer cases are expected to rise 142% between 2010 and 2030.
As Nemecek knows, clinical trials are an important treatment option for many Latino who have a cancer diagnosis, according to Dr. Amelie Ramirez, leader of Salud America! at UT Health San Antonio and Mays Cancer Center.
“Latinos who participate in clinical trials have the potential to help themselves, and could contribute to the development of new treatments for people in the future,” Ramirez said.
Ramirez is creating new ways to encourage Latinos to volunteer for cancer and Alzheimer’s clinical trials, with support from Genentech, a member of the Roche Group.
She is raising awareness by using Salud America! to showcase open clinical trials and uplift the stories of Latino clinical trial participants along with social media events and webinars.
Those looking for clinical trial opportunities based in San Antonio can search the Mays Cancer Center at UT Health San Antonio’s Find a Clinical Trial database to learn more about available trials and eligibility requirements.
On a national level, visit clinicaltrials.gov to find a clinical trial near you.
By The Numbers
10
Percent
of clinical trial participants are Latinos
This success story was produced by Salud America! with support from the Robert Wood Johnson Foundation.
The stories are intended for educational and informative purposes. References to specific policymakers, individuals, schools, policies, or companies have been included solely to advance these purposes and do not constitute an endorsement, sponsorship, or recommendation. Stories are based on and told by real community members and are the opinions and views of the individuals whose stories are told. Organization and activities described were not supported by Salud America! or the Robert Wood Johnson Foundation and do not necessarily represent the views of Salud America! or the Robert Wood Johnson Foundation.