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DIY’ing Grief: How Modern Memorials Help Us Navigate the Death of Loved Ones
Americans really don't want to talk about it: Everyone dies, and everyone will experience the death of a loved one. Grief is a universal human experience – and a very challenging one – with its range of difficult emotions and processes. Baylor University researcher Candi Cann, Ph.D., has made it her life’s work to study death and dying. In fact, the associate professor of religion in the Baylor Interdisciplinary Core, is known as a “death scholar,” with media outlets ranging from NPR’s Science Friday to the Washington Post seeking her expertise about the impact of remembering (and forgetting) in shaping how lives are recalled, remembered and celebrated. Cann is the author of “Virtual Afterlives: Grieving the Dead in the Twenty-first Century,” and her research on modern grief has found that some Americans – in a move away from organized religion – have lost the grieving framework that prayer and Christian practices traditionally offered. She calls that framework the “syntax of grief” – the common language once rooted in religious practices – that has evolved over the generations, prompting people to seek more personal ways of expressing grief and memorialization customs. “This new language of mourning is being defined by the culture, rather than religious ritual,” Cann said. “And these new practices are emerging at the grassroots level in response to a popular need to express grief through more personal expressions in almost a do-it-yourself or DIY approach.” These DIY or modern remembrances – such as virtual memorials, tattoos and using cremains in creative ways – can help individuals navigate the grieving process. Virtual memorialization With contemporary grieving practices shifting from the physical to the online world, Cann said these virtual memorialization spaces, such as social media and memorial websites, are just as real and meaningful as physical spaces and can offer a shared space for more people to share in their grief. For example, Cann said funeral services have evolved to incorporate digital services such as a virtual memory page or guest book or live-streaming wakes. Social media profiles and websites are created as virtual locations for people to remember and mourn those who have died. “The internet can democratize grief. It allows people a way to have these conversations about the dead that they may not be able to do on an everyday basis,” Cann said. “You know, you’re at work and you’re grieving, but it’s not really an appropriate conversation. In this way, you can go online and leave a message and find a community of people who are also grieving with you.” Tattoos Tattoos have become a popular way for individuals, especially younger people, to carry their grief with them, Cann said. The inked images can function as a badge or emblem for the person, they tell stories, honor meaningful moments and allow people to carry their grief with them in both literal and virtual ways. "Tattoos allow people to occupy the space as a mourner, while also continuing to carry on with their everyday activities. Many people get tattoos to symbolize their first loss, like their grandparent or pet,” Cann said. “Though the body has disappeared, is remapped onto living flesh to become a symbol of mourning in a world where mourning is denied.” Use of cremains A growing trend is incorporating cremains (cremated remains) into various objects like tattoos, jewelry, records or even fireworks. This practice offers a portable and customizable way to keep a connection with the deceased, which is not an option with burials, Cann said. “Cremation has become much more widely accepted and much more widely practiced because it's cheaper, more economical, but also because of the options of what can be done with cremains in memorial,” Cann said. “Cremains are portable and divisible, so you can share them with other people. Plus, you can carry them in ways that disguise the fact that they are ashes, such as putting cremains in a locket.” The conversation These more personal expressions and do-it-yourself solutions to memorialize a death allow people to find places where they can feel and experience their grief more readily and move from the loss into a place of restoration, Cann said. While death is complete and universal, finding ways to grieve – from the traditional to the contemporary – helps process the loss, but it’s just as vital to have that difficult conversation about preparing for the death of loved ones. “I encourage everyone to have difficult conversations about death and discuss your wishes with your loved ones about what you want when you die,” Cann said. “Allowing death to be part of regular discussions can help your family and your friends deal with their sorrow when you die because the everyday practical matters of sorting through your estate or figuring out what you would have wanted are not compounding the grief. Talking about death is ultimately and way to show how much you love someone.” Looking to know more? We can help. If you're a journalist interested in speaking with Candi Cann, simply click on her icon now to arrange an interview today.
An innovative Baylor University study has shed light on the often-overlooked experiences of women doing “daughtering” in families, particularly during the COVID-19 pandemic, which created immense challenges in their relationships with parents and other family members. “Daughtering” refers to the ways adult daughters contribute to flourishing family relationships, according to Allison M. Alford, Ph.D., clinical associate professor in the Department of Information Systems and Business Analytics in Baylor’s Hankamer School of Business. Alford’s latest research, Daughterwork in Times of Social Upheaval, published in Qualitative Research Reports in Communication, explores how societal changes caused by the pandemic required women to reconfigure their relationships with their parents and emphasizes the critical role adult daughters play in maintaining family connections, particularly in times of crisis. "This study highlights how social upheavals like the COVID-19 pandemic can both challenge and reinforce the essential work that daughters do in their families," Alford said. “Past research has shown that women often bear the brunt of responsibility when crises occur at home, work or in the extended family. Particularly for professional women – those who are balancing changing workplace demands alongside immediate and extended family concerns as well as societal shifts – increased care needs or the perception of such for parents can increase stress and negatively impact well-being, yet women still persist in providing upstream support for a variety of reasons.” Using in-depth, semi-structured interviews of women who identified change to their daughtering, professional and family lives, Alford discovered four themes about how a crisis can provide opportunities for flexible daughtering, meaningful connection and reflection on one’s most important relationships. Daughtering is adaptive action The pandemic forced many daughters to rapidly adjust their caregiving practices with their parents. When normal forms of communication were not an option, many daughters turned to technology to bridge the gap. This included increased use of video calls, social media, and other digital communication tools to maintain contact and promote family connection. Alford’s research found that daughters also took on new, often physically demanding tasks to ensure their parents’ well-being – delivering groceries, managing household repairs and organizing virtual family gatherings. “These actions were not only about adapting to the context of social upheaval but also about intensifying their caring efforts to meet the evolving needs of their parents,” Alford said. Daughtering is adaptive timing The study revealed that daughters had to maintain a heightened state of vigilance, constantly prepared to address unexpected crises, Alford said. Unlike the more predictable daughtering routines of the past, the pandemic introduced a level of uncertainty that required daughters to be in a near-constant state of readiness. One study participant described her experience as being in "constant problem-solving mode," which added significant stress to her daily life. “This ‘adaptive timing’ meant that daughters often found themselves juggling sudden care demands with their own professional and personal obligations,” Alford said. “This theme underscores the mental and emotional toll on daughters who had to manage the unpredictable nature of daughtering during the pandemic.” Daughtering is a priority Despite the challenges, Alford said, many daughters reported that they continued to prioritize their daughtering responsibilities, driven by a deep sense of familial duty and personal values. “For these women, daughtering was not just another task but a core part of their identity, often taking precedence over their professional responsibilities,” Alford said. “This commitment was evident in the time and resources they dedicated to maintaining their relationships with their parents, even when it meant sacrificing their own well-being or career advancement.” One participant noted, “I value family, so I still made it a priority,” reflecting a sentiment shared by many women in the study. This theme, Alford noted, highlights the internal conflict that many daughters faced, balancing their dedication to family with the competing demands of their own lives. Daughtering involves reflecting Challenges prompt many daughters to reflect deeply on their roles and relationships, and the COVID-19 pandemic was no different, Alford said. “This period of social upheaval generated a moment of introspection, leading daughters to reassess their priorities, boundaries and the nature of their relationships with their parents,” she said. “For some, this reflection led to a greater appreciation for the importance of family, while for others, it was a time to set new boundaries and redefine their roles within the family structure.” One participant observed, “COVID was a catalyst for emotional support,” while another reflected on the need to “carve out time mentally” to fulfill her roles as both a daughter and a professional. This theme illustrates how the pandemic not only challenged daughters but also provided an opportunity for personal growth and redefinition of their familial roles, Alford said. Key strategies to recognizing daughters’ “invisible” labor The research underscores the critical need for greater recognition and support for the invisible labor performed by adult daughters, suggesting that both families and society at large have a role to play in alleviating the burden on these women. “It’s crucial that we not only acknowledge the burden placed on these women, “Alford said, “but also seek ways to support them, whether through family empathy, shared responsibilities or societal recognition.” Alford emphasizes the importance of three key strategies: Awareness and acknowledgment Families should recognize the labor involved in daughtering and ensure it is acknowledged and appreciated. This can help prevent the exploitation of this labor and ensure that daughters feel valued for their contributions. Outsourcing and support Where possible, families should consider outsourcing some care tasks or providing additional support to relieve the burden on daughters. This might include hiring help for household chores or seeking external emotional support through counseling. Expressing gratitude Expressing gratitude and acknowledging the efforts of daughters can significantly enhance their sense of well-being and fulfillment. This recognition is vital in helping them feel that their contributions are meaningful and valued. National Daughter’s Day National Daughter’s Day is Sept. 25, and while this holiday has been around since 1932 to honor the daughters in our lives, it can often quietly pass us by. Alford recommends parents using this day to officially acknowledge all the ways in which daughters support their families.
At a gala event for Harmony Healthcare Long Island (HHLI), Martine Hackett, chair and associate professor of the Department of Population Health, School of Health Sciences (SHS), received the Mission Driven Award for her long-standing dedication to improving public health and advocating for underserved communities. The event honored community leaders who have made significant contributions to advancing healthcare access and equity. Hackett has been a tireless advocate for maternal and child health and health equity. Over the years, she has spearheaded numerous initiatives aimed at addressing racial disparities in healthcare, particularly in minority and low-income communities. Hackett’s leadership and passion for public health have left a lasting impact on the communities she serves. Corinne Kyriacou, vice dean for administration, SHS, associate professor of population health, a longtime colleague and member of the HHLI Gala Planning Committee, praised Hackett’s contributions. “Martine has always been driven by a genuine commitment to improving the lives of others. Her work goes beyond the classroom and touches the hearts of the communities she works with. She truly embodies the spirit of service and dedication,” Kyriacou said. Reginald Alston, dean of SHS, echoed these sentiments. “Martine’s impact on the field of public health and the students she mentors is immeasurable. She is a model of what it means to use education and research for the betterment of society. We are incredibly proud to have her as part of our Hofstra family,” Alston said. The gala, which celebrated HHLI’s growth and accomplishments over the past 15 years, highlighted Hackett’s numerous community partnerships and her ongoing work to promote health equity.
#Expert Opinion: 'Gun laws need an overhaul'
In the aftermath of last week's school shooting in Georgia, Jennifer Necci Dineen and Kerri M. Raissian from UConn’s ARMS Center contributed this compelling piece to The Atlanta Journal-Constitution. The entirety of the article is available here: On Sept. 4, the United States experienced its 45th school shooting of 2024, this time at Apalachee High School in Winder, Georgia. Barrow County Sheriff Jud Smith called the shooting “pure evil” and reported the suspected shooter would be tried as an adult. Since then, the shooter’s father has also been charged. A criminal justice response is vital, but it cannot be our only response. Gun laws need an overhaul. The failure to do so means that we will continue charging shooters and their families and attending the funerals of those senselessly killed. Laws are the role of government. Should elected officials fail to act (again), we think it is also fair to hold them responsible for the firearm violence killing our nation’s children. Georgia lawmakers have passed legislation to protect children in other ways. Georgia requires that children be at least 16 years old and to have held a learner’s permit for a year before they can drive: minors under 16 cannot be employed in dangerous or harmful jobs; and those under 17 cannot marry. These restrictions recognize that children’s prefrontal cortex, the part of their brain responsible for reasoning, impulse control and decision-making, is not yet fully formed. Yet, despite firearms being the leading cause of death for children in the United States, Georgia has minimal regulations governing children’s firearm access. There is no minimum age for purchasing or possessing rifles or shotguns, no permit required for carrying firearms in public (whether open or concealed) and no mandate for secure firearm storage (such as unloading, locking and storing ammunition separately). Details of the shooting in Winder continue to emerge, but let’s start with what we know. Reports indicate that the shooter and his father were questioned by the Jackson County Sheriff’s Office in May 2023 following multiple anonymous tips about online threats, including images of guns. The suspect’s father claimed that his child did not have unfettered access to the guns. The authorities did not have probable cause for an arrest, and so they left and the guns stayed. And, in fact, the father bought his son a new gun — an AR-15 — as a Christmas present. Perhaps more disturbing is that this kind of negligence and indifference is not an anomaly. A similar set of facts surround the Nashville Waffle House shooter and the Michigan Oxford High School Shooter. In both cases, parents ignored warning signs and helped their sons keep or procure firearms that were used in mass shootings. Moreover, almost three-quarters of guns used in gun-related incidents at schools come from the home or someone the shooter knows. It’s fair to ask: Where are the parents? However, we also want to know where are the elected officials charged with keeping us and our children safe when they are at school, the movies, a parade or otherwise living their lives? Laws mandating secure firearm storage, permitting, minimum age requirements and background checks have been proven to lower firearm homicide rates. Emergency risk protection orders, or red-flag laws, which temporarily prevent individuals deemed a danger to themselves or others from possessing or purchasing firearms, have also been effective in reducing firearm homicides. Georgia’s failure to implement such regulations, allowing a child with underdeveloped decision-making skills to access a gun, means the state shares the blame for the gun-related injuries and deaths at Apalachee High School. Georgia Gov. Brian Kemp is right. It’s not the time to “talk about safety and policy.” The time was years ago, but it’s never too late to do the right thing. Kerri Raissian is an associate professor in the School of Public Policy at the University of Connecticut; director of the University of Connecticut's UConn’s Center for Advancing Research, Methods, and Scholarship (ARMS) in Gun Violence Prevention; and co-director of the Institute for Collaboration on Health, Intervention, and Policy (InCHIP) Gun Violence Prevention Research Interest Group. Her research focuses on child and family policy, with an emphasis on understanding how policies affect fertility, family formation, and family violence. She is available to speak to media about this important topic - simply click on her icon now to arrange an interview today.
In Ancient Egypt, One Villanova Professor Sees Modern Lessons
During the Old Kingdom (2700-2200 B.C.E.), Memphis was the epicenter of Egyptian civilization. A key strategic point in the Nile Delta region, it long served as the seat from which the Pharaoh ruled his domain, exerted his influence and marshaled his military might. Bustling with activity, it teemed with craftspeople, clerics and courtiers, and its whitewashed walls reverberated with the sounds of enterprise, exaltation and empire. Four-and-a-half millennia later, sifting through the silent sands near Mit Rahina, Villanova University associate teaching professor Kelly-Anne Diamond, PhD, is working to recover the last traces of this once-thriving metropolis. In collaboration with a team of academics, graduate students and Egyptian artisans, she hopes to shed new light on what life was like in the "lost city" of Memphis—and to explore its long-buried connections to the present day. The Memphis Kôm el-Fakhry Archaeological Project "We call our initiative the 'Memphis Kôm el-Fakhry Archaeological Project,' or 'MKAP' for short, and we're excavating one particular mound in a series that make up the ancient city," said Dr. Diamond, who co-directs the effort. "I was very excited when I was invited to join the project, especially at its inception. There aren't many settlement sites [like this one]. We could probably count them on one hand." With its focus on "settled" land, MKAP is contributing to a growing body of research in Egyptology, or the study of ancient Egyptian history, culture and society, that centers on the experiences of everyday people. It's an area of significant interest for Dr. Diamond, who's previously investigated mourning traditions and sex and gender in the pharaonic era. "Currently, most of our knowledge is about the king, his extended family and the people who worked for him," she said. "This is one of the reasons why I think working at Memphis is so fascinating. When you work at a settlement site, this is where you're going to find information about regular people—about women, about children, about the elderly, about family structure." Already, MKAP has yielded findings that could challenge contemporary understandings of life in ancient Egypt. In particular, the discovery of an Old Kingdom-aged adult skeleton, within the bounds of the excavated mound, has spurred questions. "What we found doesn't necessarily line up with what we currently believe about Old Kingdom burial practices, because other evidence suggests that where people lived and where people buried their dead were two separate locations," shared Dr. Diamond. "Generally, we say that they lived in Kemet—which is the 'black land,' or the land where there's very, very rich soil—and were interred in Deshret, or the 'desert.' "Now, we do know that there was a First Intermediate Period (2181-2055 B.C.E.) cemetery at the site, adjacent to the settlement. We also know that, as the town progressed and people continued to live there, access to the cemetery was cut off. As we were going deeper into the settlement, which means that we were going into earlier levels, this is where we found the adult skeleton. The pottery in the area seems to suggest that we hit Old Kingdom levels, which would take us earlier than the First Intermediate Period cemetery. "Potentially, we need to reevaluate what we know about Egyptian burial customs." From the Past to the Present For some, the significance of a centuries-old corpse might be lost. And, in an age of smartphones, electric cars and highspeed Internet, the world in which the Memphians lived might seem on its face absolutely foreign. But, in unearthing the contents of the MKAP mound and in studying the minutiae of ancient life, Dr. Diamond sees important lessons—lessons that echo throughout time. As she maintains, the remnants of communal meals, religious rituals and day-to-day work, and their existence in the distant past, serve as powerful reminders of our enduring humanity. "One of the things I find, with my students, is that they're surprised that ancient Egypt was such a complex civilization," said Dr. Diamond. "They're surprised when we talk about technologies and social mobility—that these early people, whether improving on weapons and farming tools or seeking promotions, had a sense of progress, efficiency and change. "But, most of all, they're surprised at how similar life in ancient Egypt was to what they experience on a regular basis today. And that's how I often introduce my courses: What you know about life, or life as you know it, started back in the ancient Near East, in Egypt and Mesopotamia. So, we can find the origins of all these things that we know by going back to the ancient Near East. "And history did not start in Greece and Rome. We have to go back earlier." Editor's note: Following the filming of the videos above, Dr. Diamond was promoted from assistant teaching professor to associate teaching professor.
Veronica Chandler’s north Wilmington home is her sanctuary, and it shows. From the soft instrumental music to the scent of lavender to the comfy seats that invite visitors to put up their feet, the message is clear – rest, relax, recharge. Original artwork by Veronica Chandler In this space, Chandler celebrates her rediscovered self, and it’s a journey she shares with all who visit. Part of the cozy feeling in her home comes from the artwork that lines the walls – mostly her own paintings and drawings created over the last six years as she navigates the challenges and triumphs of motherhood and discovers new ways to care for herself and those she loves. After experiencing anxiety, panic attacks and profound depression following the birth of her daughter in 2018, Chandler sought help at the ChristianaCare Center for Women’s Emotional Wellness, where a combination of medication and therapy helped her feel healthier and reconnected. She also returned to a former passion – art. “When I started painting, I found a way of silencing my brain, of calming it down. Being able to just focus on one thing on its own let my body regulate my nervous system,” she said. “I didn’t know what was happening to me. I just felt amazing.” More than ‘baby blues’ Perinatal mood and anxiety disorders are among the most common complications that occur in pregnancy or in the first year after delivery, according to the American College of Obstetricians and Gynecologists. Although many parents experience feelings of anxiety, fatigue and sadness in the first days with a new baby, postpartum depression can occur several months after childbirth. Symptoms are often more severe and can include extreme stress. Despite increased awareness efforts in recent years, perinatal mood and anxiety disorders – including postpartum depression, which occurs in up to 20% of all births – remain underdiagnosed, untreated or undertreated, even though the health impact extends beyond the person giving birth, said Malina Spirito, Psy.D., MEd, director of the Center for Women’s Emotional Wellness. The center opened in 2013 to help patients and their loved ones understand the challenges associated with perinatal mood and anxiety disorders. Since then, the program has tripled the number of clinicians and expanded services to include inpatient and outpatient consultations, ongoing psychotherapy and psychiatric medication management. “Just because we know something is common does not mean we have to put up with it, especially because the effects will be lasting if we don’t address them,” Spirito said. “Perinatal mood disorders have an impact on the overall health of a family. When a mom feels better, the relationships they have with the people around them are better as well.” Breaking the ‘super mom’ stereotype Looking back, Chandler recognizes her struggles with sleeping and anxiety following the birth of her first child may have been signs of postpartum depression. The symptoms went away only to return after her daughter was born two years later. Veronica Chandler sought help from the ChristianaCare Center for Women’s Emotional Wellness for postpartum depression. Caring for herself helped her rediscover her love of creating art. Although overjoyed by her growing family, Chandler deeply missed her mother, who lived in her native Ecuador. Added to those challenges were longer stays in the hospital for Chandler, who had a Caesarean section birth, and for her daughter, who had some minor health issues. In the weeks after giving birth, Chandler battled dizziness caused by anemia. Though exhausted by caring for a newborn, she couldn’t sleep. She constantly felt on edge, and her skin itched without relief. Worried when her symptoms didn’t abate after three months, Chandler’s husband broached the idea of postpartum depression. For Chandler, it was a relief another person noticed something was wrong, but she was scared to think about what might be needed to get better. “I think we’re programmed by our cultures and by our beliefs to think that we need to be ‘super moms’ and give everything we have,” said Chandler, who grew up in Ecuador and moved to the United States after marrying her husband. “I was in such a fog that I didn’t know I could still shine and be happy and content. The default for so many moms is to pour until there’s nothing left.” ‘Rediscovering who I was’ Chandler sought help at the Center for Women’s Emotional Wellness and soon began taking an anti-depressant as part of her treatment. She also saw a therapist to talk about the feelings she was experiencing. “Therapy was such a big part of this whole journey of rediscovering who I was. When you talk and someone listens, you figure things out,” Chandler said. While on a trip to Arizona with a cousin, Chandler discovered kachina dolls, a Native American art form often used to provide guidance to young people and instill the connection between nature and the spirit. The intricately designed images further fueled Chandler’s reignited passion for art. That passion helped Chandler manage the additional challenges brought on by the COVID-19 pandemic when her anxiety and depression resurfaced. Using painting, sculpture and other media, she has examined her own feelings relating to motherhood, family and society. Her work has been featured internationally in Vogue and closer to home in local art galleries. “Some people like to cook, and some people like to write. Art is my creative outlet that allowed me to come back to who I am,” she said. “We all have to release that creativity in some way.” Entering care sooner While the Center for Women’s Emotional Wellness has always focused on pregnant and postpartum patients, it has grown to address mental health needs related to preconception health, including artificial reproductive technology such as in vitro fertilization, Spirito said. The center also sees patients grieving a pregnancy or neonatal loss. More people are thinking about their mental health before they give birth, said Malina Spirito, Psy.D., MEd, director of the ChristianaCare Center for Women’s Emotional Wellness. “One of the most notable observations I’ve seen over the years is that birthing people are entering care sooner. It isn’t uncommon for women to seek out consultation prior to getting pregnant about how to manage their mood disorder should they become pregnant,” said Megan O’Hara, LCSW, a behavioral health therapist with the Center for Women’s Emotional Wellness. “Patients are educating themselves now and expecting their providers to consider their mental health as well as their physical health when getting care.” Women’s mental health care also has become more accessible, said Cynthia Guy, LMSW, MSCC, a women’s health behavioral consultant with the Center for Women’s Emotional Wellness. Behavioral health services are available in every ChristianaCare women’s health practice, including virtual and in-person care. “I can be the bridge connecting the patient with the resources they need to help them manage symptoms and what they are going through,” Guy said. Filling the cup As a result of her own experiences, Chandler teaches classes to help other mothers create their own art as a means of expression. It’s a small way of helping them to fill their own cup. The woman who once hid in her own closet to hide her feelings speaks openly about mental health with the hope people will lose their preconceived ideas about depression and anxiety. “I am so thankful for the journey and the many people I’ve met that have postpartum depression,” she said. “When we talk about what makes the best moms, I think the best mom is a healthy mom who is in balance and harmony.”
Forbes Ranks ChristianaCare Among America’s Best Employers for Women in 2024
ChristianaCare has been recognized as one of America’s Best Employers for Women by Forbes for 2024, marking the first time the company has received this prestigious recognition. In a survey of 150,000 women working for companies of at least 1,000 employees in the U.S., ChristianaCare ranked 150 on the list of 600 employers that were recognized. “This important recognition is a testament to our culture and the remarkable women who have chosen to build meaningful careers at ChristianaCare,” said Chris Cowan, MEd, FABC, ChristianaCare’s Chief Human Resources Officer. “Empowering women to succeed is integral to our culture and strengthens our organization. Together, we’ll continue to advance equity and inclusion in the workplace while transforming health and clinical care.” Forbes partnered with market research firm Statista, which surveyed employees on various aspects such as workplace environment, growth opportunities, compensation, diversity, parental leave, schedule flexibility and family assistance. ChristianaCare continues to cultivate a strong, inclusive, and diverse culture for women inside and outside the company by investing in professional development through its Women’s Employee Network (WEN) and providing a comprehensive benefits package that includes various flexible leave options for employees, including at least 12 weeks of paid parental leave. “Receiving this recognition from Forbes is an honor,” said Pamela Ridgeway, MBA, MA, SPHR, chief diversity officer and vice president of Talent and Acquisition at ChristianaCare. “In addition to offering workplace benefits such as paid maternity and paternity leave, ChristianaCare is firmly committed to empowering and advancing talented individuals within the workplace. Receiving this award for the first time signifies our unwavering dedication to ensuring that every individual has a voice and feels truly valued within our organization.” The Forbes recognition follows other national recognitions of ChristianaCare’s commitment to an inclusive workplace. Earlier this year, Forbes ranked ChristianaCare as one of the best employers for diversity in the U.S. Additionally, Forbes ranked ChristianaCare as the top health care employer for veterans in the United States. Both ChristianaCare’s Wilmington Hospital and Christiana Hospital have been named Leaders in LGBTQIA+ Healthcare Equality since 2012.
Expert Insight: Training Innovative AI to Provide Expert Guidance on Prescription Medications
A new wave of medications meant to treat Type II diabetes is grabbing headlines around the world for their ability to help people lose a significant amount of weight. They are called GLP-1 receptor agonists. By mimicking a glucagon-like peptide (GLP) naturally released by the body during digestion, they not only lower blood sugar but also slow digestion and increase the sense of fullness after eating. The two big names in GLP-1 agonists are Ozempic and Wegovy, and both are a form of semaglutide. Another medication, tirzepatide, is sold as Mounjaro and Zepbound. It is also a glucose-dependent insulinotropic polypeptide (GIP) agonist as well as GLP-1. Physicians have been prescribing semaglutide and tirzepatide with increasing frequency. However, both medications come with a host of side effects, including nausea and stomach pain, and are not suitable for every patient. Many clinics and physicians do not have immediate access to expert second opinions, as do the physicians at Emory Healthcare. Creating a Digital Twin That lack of an expert is one of the reasons Karl Kuhnert, professor in the practice of organization and management at Emory University’s Goizueta Business School, is using artificial intelligence to capture the expertise of physicians like Caroline Collins MD through the Tacit Object Modeler™, or TOM. By using TOM, developed by Merlynn Intelligence Technologies, Kuhnert and Collins can create her “decision-making digital twin.” This allows Collins to reveal her expertise as a primary care physician with Emory Healthcare and an Assistant Professor at Emory School of Medicine, where she has been leading the field in integrating lifestyle medicine into clinical practices and education. Traditional AI, like ChatGPT, uses massive amount of data points to predict outcomes using what’s known as explicit knowledge. But it isn’t necessarily learning as it goes. According to Kuhnert, TOM has been designed to learn how an expert, like Collins, decides whether or not to prescribe a drug like semaglutide to a patient. Wisdom or tacit knowledge is intuitive and rooted in experience and context. It is hard to communicate, and usually resides only in the expert’s mind. TOM’s ability to “peek into the expert’s mind makes it a compelling technology for accessing wisdom.” “Objective or explicit knowledge is known and can be shared with others,” says Kuhnert. "For example, ChatGPT uses explicit knowledge in its answers. It’s not creating something new. It may be new to you as you read it, but somebody, somewhere, before you, has created it. It’s understood as coming from some source." Karl Kuhnert “Tacit knowledge is subjective wisdom. Experts offer this, and we use their tacit know-how, their implicit knowledge, to make their decisions. If it were objective, everyone could do it. This is why we hire experts: They see things and know things others don’t; they see around corners.” Mimicking the Mind of a Medical Expert Teaching TOM to see around the corners requires Collins to work with the AI over the course of a few days. “Essentially what I do is I sit down with, in this case, a physician, and ask them, ‘What are thinking about when you make this decision?'” says Kuhnert. “The layperson might think that there are hundreds of variables in making a medical decision like this. With the expert’s tacit knowledge and experience, it is usually between seven and twelve variables. They decide based on these critical variables,” he says. "These experts have so much experience, they can cut away a lot of the noise around a decision and get right to the point and ask, ‘What am I looking at?’" Karl Kuhnert As TOM learns, it presents Collins with more and different scenarios for prescribing semaglutide. As she makes decisions, it remembers the variables present during her decision-making process. “Obviously, some variables are going to be more important than other variables. Certain combinations are going to be challenging,” says Collins. “Sometimes there are going to be some variables where I think, yes, this patient needs a GLP-1. Then there may be some variables where I think, no, this person really doesn’t need that. And which ones are going to win out? That’s really where TOM is valuable. It can say, okay, when in these difficult circumstances where there are conflicting variables, which one will ultimately be most important in making that decision?” The Process: Trusting AI After working with TOM for several hours, Collins will have reacted to enough scenarios for TOM to learn to make her decision. The Twin will need to demonstrate that it can replicate her decision-making with acceptable accuracy—high 90s to 100 percent. Once there, Collins’ Twin is ready to use. “I think it’s important to have concordance between what I would say in a situation and then what my digital twin would say in a situation because that’s our ultimate goal is to have an AI algorithm that can duplicate what my recommendation would be given these circumstances for a patient,” Collins says. “So, someone, whether that be an insurance company, or a patient themselves or another provider, would be able to consult TOM, and in essence, me, and say, in this scenario, would you prescribe a GLP-1 or not given this specific patient’s situation?” The patient’s current health and family history are critical when deciding whether or not to prescribe semaglutide. For example, according to Novo Nordisk, the makers of Ozempic, the drug should not be prescribed to patients with a history of problems with the pancreas or kidneys or with a family history of thyroid cancer. Those are just the start of a list of reasons why a patient may or may not be a good candidate for the medication. Kuhnert says, “What we’re learning is that there are so many primary care physicians right now that if you come in with a BMI over 25 and are prediabetic, you’re going to get (a prescription). But there’s much more data around this to suggest that there are people who are health marginalized, and they can’t do this. They should not have this (medication). It’s got to be distributed to people who can tolerate it and are safe.” Accessing the Digital Twin on TOM Collins’s digital twin could be available via something as easy to access as an iPhone app. “Part of my job is to provide the latest information to primary care physicians. Now, I can do this in a way that is very powerful for primary care physicians to go on their phones and put it in. It’s pretty remarkable, according to Colllins.” It is also transparent and importantly sourced information. Any physician using a digital twin created with TOM will know exactly whose expertise they are accessing, so anyone asking for a second opinion from Colllins will know they are using an expert physician from Emory University. In addition to patient safety, there are a number of ways TOM can be useful to the healthcare industry when prescribing medications like semaglutide. This includes interfacing with insurance companies and the prior approval process, often lengthy and handled by non-physician staff. “Why is a non-expert at an insurance company determining whether a patient needs a medication or not? Would it be better to have an expert?” says Collins. “I’m an expert in internal medicine and lifestyle medicine. So, I help people not only lose weight, but also help people change their behaviors to optimize their health. My take on GLP-1 medications is not that everyone needs them, it’s that they need to be utilized in a meaningful way, so patients will get benefit, given risks and benefits for these medications.” The Power of a Second Opinion Getting second, and sometimes third, opinions is a common practice among physicians and patients both. When a patient presents symptoms to their primary care physician, that physician may have studied the possible disease in school but isn’t necessarily an expert. In a community like Emory Healthcare, the experts are readily available, like Collins. She often serves as a second opinion for her colleagues and others around the country. “What we’re providing folks is more of a second opinion. Because we want this actually to work alongside someone, you can look at this opinion that this expert gave, and now, based on sourced information, you can choose. This person may be one of the best in the country, if not the world, in making this decision. But we’re not replacing people here. We’re not dislocating people with this technology. We need people. We need today’s and tomorrow’s experts as well,” according to Kuhnert. But also, you now have the ability to take an Emory physician’s diagnosing capabilities to physicians in rural areas and make use of this information, this knowledge, this decision, and how they make this decision. We have people here that could really help these small hospitals across the country. Caroline Collin MD Rural Americans have significant health disparities when compared to those living in urban centers. They are more likely to die from heart disease, cancer, injury, chronic respiratory disease, and stroke. Rural areas are finding primary care physicians in short supply, and patients in rural areas are 64 percent less likely to have access to medical specialists for needed referrals. Smaller communities might not have immediate access to experts like a rheumatologist, for example. In addition, patients in more rural areas might not have the means of transportation to get to a specialist, nor have the financial means to pay for specialized visits for a diagnosis. Collins posits that internal medicine generalists might suspect a diagnosis but want to confirm before prescribing a course of treatment. “If I have a patient for whom I am trying to answer a specific question, ‘Does this patient have lupus?’, for instance. I’m not going to be able to diagnose this person with lupus. I can suspect it, but I’m going to ask a rheumatologist. Let’s say I’m in a community where unfortunately, we don’t have a rheumatologist. The patient can’t see a rheumatologist. That’s a real scenario that’s happening in the United States right now. But now I can ask the digital twin acting as a rheumatologist, given these variables, ‘Does this patient have lupus?’ And the digital twin could give me a second opinion.” Sometimes, those experts are incredibly busy and might not have the physical availability for a full consult. In this case, someone could use TOM to create the digital twin of that expert. This allows them to give advice and second opinions to a wider range of fellow physicians. As Kuhnert says, TOM is not designed or intended to be a substitute for a physician. It should only work alongside one. Collins agreed, saying, “This doesn’t take the place of a provider in actual clinical decision-making. That’s where I think someone could use it inappropriately and could get patients into trouble. You still have to have a person there with clinical decision-making capacity to take on additional variables that TOM can’t yet do. And so that’s why it’s a second opinion.” “We’re not there yet in AI says Collins. We have to be really careful about having AI make actual medical decisions for people without someone there to say, ‘Wait a minute, does this make sense?’” AI Implications in the Classroom and Beyond Because organizations use TOM to create digital twins of their experts, the public cannot use the twins to shop for willing doctors. “We don’t want gaming the system,” says Collins. “We don’t want doctor shopping. What we want is a person there who can utilize AI in a meaningful way – not in a dangerous way. I think we’ll eventually get there where we can have AI making clinical decisions. But I don’t think I’d feel comfortable with that yet.” The implications of using decision-making digital twins in healthcare reach far beyond a second opinion for prescription drugs. Kuhnert sees it as an integral part of the future of medical school classrooms at Emory. In the past, teaching case studies have come from books, journals, and papers. Now, they could come alive in the classroom with AI simulation programs like TOM. "I think this would be great for teaching residents. Imagine that we could create a simulation and put this in a classroom, have (the students) do the simulation, and then have the physician come in and talk about how she makes her decisions." Karl Kuhnert “And then these residents could take this decision, and now it’s theirs. They can keep it with them. It would be awesome to have a library of critical health decisions made in Emory hospitals,” Kuhnert says. Collins agreed. “We do a lot of case teaching in the medical school. I teach both residents and medical students at Emory School of Medicine. This would be a really great tool to say, okay, given these set of circumstances, what decision would you make for this patient? Then, you could see what the expert’s decision would have been. That could be a great way to see if you are actually in lockstep with the decision-making process that you’re supposed to be learning.” Kuhnert sees decision-making twins moving beyond the healthcare system and into other arenas like the courtroom, public safety, and financial industries and has been working with other experts to digitize their knowledge in those fields. "The way to think about this is: say there is a subjective decision that gets made that has significant ramifications for that company and maybe for the community. What would it mean if I could digitize experts and make it available to other people who need an expert or an expert’s decision-making?" Karl Kuhnert “You think about how many people aren’t available. Maybe you have a physician who’s not available. You have executives who are not available. Often expertise resides in the minds of just a few people in an organization,” says Kuhnert. “Pursuing the use of technologies like TOM takes the concept of the digital human expert from simple task automation to subjective human decision-making support and will expand the idea of a digital expert into something beyond our current capabilities,” Kuhnert says. “I wanted to show that we could digitize very subjective decisions in such areas as ethical and clinical decision-making. In the near future, we will all learn from the wisdom codified in decision-making digital twins. Why not learn from the best? There is a lot of good work to do.” Karl Kuhnert is a Professor in the Practice of Organization & Management and Associate Professor of Psychiatry, School of Medicine and Senior Faculty Fellow of the Emory Ethics Center. If you're looking to connect with Karl to know more - simply click on his icon now to arrange a time to talk today.
Small Changes Can Save Lives: How a Police Officer’s First Words Can Transform Communities
Britt Nestor knew something needed to change. Nestor is a police officer in North Carolina. Unlike many in her field, who recite interview-ready responses about wanting to be a police officer since childhood, Nestor admits that her arrival to the field of law enforcement was a serendipitous one. Told by teachers to start rehearsing the line “do you want fries with that?” while in high school, Nestor went to college to prove them wrong—and even graduated with a 3.9 GPA solely to prove those same people wrong—but she had absolutely no idea what to do next. When a local police department offered to put her through the police academy, her first thought was, “absolutely not.” “And here I am,” says Nestor, 12 years into her career, working in Special Victims Investigations as an Internet Crimes Against Children detective. A Calling to Serve Community Brittany Nestor, New Blue Co-Founder and President Though she’d initially joined on a whim, Nestor stuck around and endured many growing pains, tasting some of the problematic elements of police culture firsthand. As a woman, there was particular pressure to prove herself; she resisted calling for back-up on dangerous calls for fear of being regarded as weak, and tried out for and joined the SWAT team to demonstrate her mettle. "It took time to realize I didn’t need to make the most arrests or get the most drugs and guns to be a good cop. What was important was recognizing that I was uniquely positioned and given opportunities every single shift to make a difference in people’s lives—that is what I wanted to focus on." Britt Nestor Nestor found she took great pleasure in interacting with different kinds of people all day. She’s deeply fond of her community, where she is also a youth basketball coach. One of her greatest joys is being on call or working an event and hearing someone hail her from the crowd by yelling, “hey, coach!” When she landed in the Juvenile Investigations Unit, Nestor truly felt she’d found her calling. Still, what she’d witnessed in her profession and in the news weighed on her. And she’s not alone; while there is continued debate on the urgency and extent of changes needed, 89% percent of people are in favor of police reform, according to a CBS/YouGov poll. A few weeks after George Floyd’s murder in 2020, Nestor’s colleague Andy Saunders called her and told her they had to do something. It felt like the tipping point. “I knew he was right. I needed to stop wishing and hoping police would do better and start making it happen.” Andy Saunders, New Blue Co-Founder and CEO That conversation was the spark that grew into New Blue. Founded in 2020, New Blue strives to reform the U.S. Criminal Justice system by uniting reform-minded police officers and community allies. The organization focuses on incubating crowd-sourced solutions from officers themselves, encouraging those in the field to speak up about what they think could improve relations between officers and the communities they serve. “Over the years I’ve had so many ideas—often addressing problems brought to light by community members—that could have made us better. But my voice was lost. I didn’t have much support from the police force standing behind me. This is where New Blue makes the difference; it’s the network of fellows, alumni, partners, mentors, and instructors I’d needed in the past.” Nestor and Saunders had valuable pieces of the puzzle as experienced law enforcement professionals, yet they knew they needed additional tools. What are the ethical guidelines around experimenting with new policing tactics? What does success look like, and how could they measure it? The Research Lens Over 400 miles away, another spark found kindling; like Nestor, Assistant Professor of Organization & Management Andrea Dittmann’s passion for making the world a better place is palpable. Also, like Nestor, it was an avid conversation with a colleague—Kyle Dobson—that helped bring a profound interest in police reform into focus. Dittmann, whose academic career began in psychology and statistics, came to this field by way of a burgeoning interest in the need for research-informed policy. Much of her research explores the ways in which socioeconomic disparities play out in the work environment, and—more broadly—how discrepancies of power shape dynamics in organizations of all kinds. When people imagine research in the business sector, law enforcement is unlikely to crop up in their mind. Indeed, Dittmann cites the fields of criminal justice and social work as being the traditional patrons of police research, both of which are more likely to examine the police force from the top down. Andrea Dittmann Dittmann, however, is a micro-oriented researcher, which means she assesses organizations from the bottom up; she examines the small, lesser-studied everyday habits that come to represent an organization’s values. “We have a social psychology bent; we tend to focus on individual processes, or interpersonal interactions,” says Dittmann. She regards her work and that of her colleagues as a complementary perspective to help build upon the literature already available. Where Dittmann has eyes on the infantry level experience of the battleground, other researchers are observing from a bird’s eye view. Together, these angles can help complete the picture. And while the “office” of a police officer may look very different from what most of us see every day, the police force is—at the end of the day—an organization: “Like all organizations, they have a unique culture and specific goals or tasks that their employees need to engage in on a day-to-day basis to be effective at their jobs,” says Dittmann. Theory Meets Practice Kyle Dobson, Postdoctoral Researcher at The University of Texas at Austin What Dittmann and Dobson needed next was a police department willing to work with them, a feat easier said than done. Enter Britt Nestor and New Blue. "Kyle and I could instantly tell we had met people with the same goals and approach to reforming policing from within." Andrea Dittmann Dittmann was not surprised by the time it took to get permission to work with active officers. “Initially, many officers were distrustful of researchers. Often what they’re seeing in the news are researchers coming in, telling them all the problems that they have, and leaving. We had to reassure them that we weren’t going to leave them high and dry. If we find a problem, we’re going to tell you about it, and we’ll work on building a solution with you. And of course, we don’t assume that we have all the answers, which is why we emphasize developing research ideas through embedding ourselves in police organizations through ride-alongs and interviews.” After observing the same officers over years, they’re able to build rapport in ways that permit open conversations. Dittmann and Dobson now have research running in many pockets across the country, including Atlanta, Baltimore, Chicago, Washington, D.C. and parts of Texas. The Rise of Community-Oriented Policing For many police departments across the nation, there is a strong push to build closer and better relationships with the communities they serve. This often translates to police officers being encouraged to engage with citizens informally and outside the context of enforcing the law. If police spent more time chatting with people at a public park or at a café, they’d have a better chance to build rapport and foster a collective sense of community caretaking—or so the thinking goes. Such work is often assigned to a particular unit within the police force. This is the fundamental principle behind community-oriented policing: a cop is part of the community, not outside or above it. This approach is not without controversy, as many would argue that the public is better served by police officers interacting with citizens less, not more. In light of the many high-profile instances of police brutality leaving names like Breonna Taylor and George Floyd echoing in the public’s ears, their reticence to support increased police-to-citizen interaction is understandable. “Sometimes when I discuss this research, people say, ‘I just don’t think that officers should approach community members at all, because that’s how things escalate.’ Kyle and I acknowledge that’s a very important debate and has its merits.” As micro-oriented researchers, however, Dittmann and Dobson forgo advocating for or dismissing broad policy. They begin with the environment handed to them and work backward. “The present and immediate reality is that there are officers on the street, and they’re having these interactions every day. So what can we do now to make those interactions go more smoothly? What constitutes a positive interaction with a police officer, and what does it look like in the field?” Good Intentions Gone Awry To find out, they pulled data through a variety of experiments, including live interactions, video studies and online experiments, relying heavily on observation of such police-to-citizen interactions. "What we wanted to do is observe the heterogeneity of police interactions and see if there’s anything that officers are already doing that seems to be working out in the field, and if we can ‘bottle that up’ and turn that into a scalable finding." Andrea Dittmann Dittmann and her colleagues quickly discovered a significant discrepancy between some police officers’ perceived outcome of their interactions with citizens and what those citizens reported to researchers post-interaction. “An officer would come back to us and they’d say it went great. Like, ‘I did what I was supposed to do, I made that really positive connection.’ And then we’d go to the community members, and we’d hear a very different story: ‘Why the heck did that officer just come up to me, I’m just trying to have a picnic in the park with my family, did I do something wrong?’” Community members reported feeling confused, harassed, or—at the worst end of the spectrum—threatened. The vast majority—around 75% of citizens—reported being anxious from the very beginning of the interaction. It’s not hard to imagine how an officer approaching you apropos of nothing may stir anxious thoughts: have I done something wrong? Is there trouble in the area? The situation put the cognitive burden on the citizen to figure out why they were being approached. The Transformational Potential of the “Transparency Statement” And yet, they also observed officers (“super star” police officers, as Dittmann refers to them) who seemed to be especially gifted at cultivating better responses from community members. What made the difference? “They would explain themselves right from the start and say something like, ‘Hey, I’m officer so-and-so. The reason I’m out here today is because I’m part of this new community policing unit. We’re trying to get to know the community and to better understand the issues that you’re facing.’ And that was the lightbulb moment for me and Kyle: the difference here is that some of these officers are explaining themselves very clearly, making their benevolent intention for the interaction known right from the start of the conversation.” Dittmann and her colleagues have coined this phenomenon the “transparency statement.” Using a tool called the Linguistic Inquiry & Word Count software and natural language processing tools, the research team was able to analyze transcripts of the conversations and tease out subconscious cues about the civilians’ emotional state, in addition to collecting surveys from them after the encounter. Some results jumped out quickly, like the fact that those people whose conversation with an officer began with a transparency statement had significantly longer conversations with them. The team also employed ambulatory physiological sensors, or sensors worn on the wrist that measure skin conductivity and, by proxy, sympathetic nervous system arousal. From this data, a pattern quickly emerged: citizens’ skin conductance levels piqued early after a transparency statement (while this can be a sign of stress, in this context researchers determined it to reflect “active engagement” in the conversation) and then recovered to baseline levels faster than in the control group, a pattern indicative of positive social interaction. Timing, too, is of the essence: according to the study, “many patrol officers typically made transparency statements only after trust had been compromised.” Stated simply, the interest police officers showed in them was “perceived as harassment” if context wasn’t provided first. Overall, the effect was profound: citizens who were greeted with the transparency statement were “less than half as likely to report threatened emotions.” In fact, according to the study, “twice as many community members reported feeling inspired by the end of the interaction.” What’s more, they found that civilians of color and those from lower socioeconomic backgrounds —who may reasonably be expected to have a lower baseline level of trust of law enforcement—“may profit more from greater transparency.” Talk, it turns out, is not so cheap after all. Corporate Offices, Clinics, and Classrooms The implications of this research may also extend beyond the particulars of the police force. The sticky dynamics that form between power discrepancies are replicated in many environments: the classroom, between teachers and students; the office, between managers and employees; even the clinic, between medical doctors and patients. In any of these cases, a person with authority—perceived or enforceable—may try to build relationships and ask well-meaning questions that make people anxious if misunderstood. Is my boss checking in on me because she’s disappointed in my performance? Is the doctor being nice because they’re preparing me for bad news? “We believe that, with calibration to the specific dynamics of different work environments, transparency statements could have the potential to ease tense conversations across power disparities in contexts beyond policing,” says Dittmann. More Research, Action, and Optimism What could this mean for policing down the road? Imagine a future where most of the community has a positive relationship with law enforcement and there is mutual trust. "I often heard from family and friends that they’d trust the police more ‘if they were all like you.’ I can hear myself saying, ‘There are lots of police just like me!’ and I truly believe that. I believe that so many officers love people and want to serve their communities—and I believe a lot of them struggle with the same things I do. They want to see our profession do better!" Britt Nestor “When I get a new case and I meet the survivor, and they’re old enough to talk with me, I always explain to them, ‘I work for you. How cool is that?’ And I truly believe this: I work for these kids and their families.” The implications run deep; a citizen may be more likely to reach out to police officers about issues in their community before they become larger problems. An officer who is not on edge may be less likely to react with force. Dittmann is quick to acknowledge that while the results of the transparency statement are very promising, they are just one piece of a very large story with a long and loaded history. Too many communities are under supported and overpoliced; it would be denying the gravity and complexity of the issue to suggest that there is any silver bullet solution, especially one so simple. More must be done to prevent the dynamics that lead to police violence to begin with. “There’s a common narrative in the media these days that it’s too late, there’s nothing that officers can do,” says Dittmann. Yet Dittmann places value on continued research, action and optimism. When a simple act on the intervention side of affairs has such profound implications, and is not expensive or difficult to implement, one can’t help but see potential. “Our next step now is to develop training on transparency statements, potentially for entire agencies,” says Dittmann. “If all the officers in the agency are interacting with transparency statements, then we see this bottom-up approach, with strong potential to scale. If every interaction you have with an officer in your community starts out with that transparency statement, and then goes smoothly, now we’re kind of getting to a place where we can hopefully talk about better relations, more trust in the community, at a higher, more holistic, level.” While the road ahead is long and uncertain, Dittmann’s optimism is boosted by one aspect of her findings: those community members who reported feeling inspired after speaking with police officers who made their benevolent intentions clear. "That was really powerful for me and Kyle. That’s what gets me out of bed in the morning. It’s worth trying to move the needle, even just a little bit." Andrea Dittmann Looking to know more? Andrea Dittman is available to speak with media about this important research. Simply click on her icon now to arrange an interview today.
Researchers find ‘narrow’ depictions of fatherhood in children’s literature
When children read picture books, they are often greeted with depictions of family and life lessons their young minds soak up. What happens then, when those depictions don’t offer a thoughtful image of gender or family as they have changed over the years? That is one of the questions University of Delaware Professor Bill Lewis and Social Science Research Analyst and UD alumna Laura Cutler explored in their recent paper, published in the quarterly journal Children's Literature in Education. In “Portraits of Fatherhood: Depictions of Fathers and Father–Child Relationships in Award-Winning Children’s Literature,” Lewis and Cutler looked at more than 80 children’s books to analyze how authors and publishers depicted fathers and fatherhood. What they found was that over a span of nearly 20 years, from 2001 to 2020, these books presented "a narrow view of fatherhood," both in what roles fathers have in familial units and which types of fathers are presented. They also noted that these portrayals have remained relatively static over the last two decades. Lewis, a professor in the College of Education and Human Development’s School of Education, broke down what spurred the research and what he and Cutler hope changes as a result of the research in a new Q&A. Contact mediarelations@udel.edu to set up an interview with Lewis.
