Unveiling a Transformative Partnership: Dr. Kathy Tossas & Charles City County
In the heart of Virginia, amidst the serene landscapes of Charles City County, a transformative partnership is reshaping the narrative of community health and trust. Today, we shine the spotlight on Dr. Kathy Tossas, whose unwavering dedication to community engagement through the Chickahominy TRUTH project has illuminated the path toward equitable health solutions and profound collaboration.
Unearthing Truths, Transforming Lives
For Dr. Tossas, the journey began with a call from a member of the Chickahominy Tribe, a call that echoed the concerns of a community grappling with heightened cancer risks and water safety fears. Two years into the Chickahominy TRUTH project, funded by the Jeffress Trust, Dr. Kathy Tossas has been instrumental in navigating the intricacies of community perceptions and structural factors affecting health outcomes.
Join us in celebrating the transformative power of community engagement, embodied by Dr. Kathy Tossas and the Chickahominy TRUTH project, as we pave the way toward a healthier, more connected future for all.
Please find Dr. Kathy Tossas’ responses to our inquiries regarding her work in relation to our Priority Partner Community, Charles City, and community engagement below.
Community Engagement Overview:
Can you tell us about your engagement in the Charles City community? How long have you been engaged with this community? Could you share some highlights of your efforts/partnerships with this community?
“I have been actively engaged with the Charles City County community through a meaningful partnership with the Chickahominy Tribe on the Chickahominy TRUTH project, an initiative now in its second year. This project, funded by the Jeffress Trust, focuses on investigating community perceptions around the increased cancer risk and overall water safety concerns in this area.
Our engagement began upon being contacted by a member of the tribe, who had been noticing and tracking an unusual number of cancer diagnoses in her neighborhood, near the tribal center and their local church, areas close to the Charles City County Landfill which has been operational since 1990. The proximity to the landfill and historical mistrust in healthcare among Native American communities seem to have exacerbated fears and decreased trust in local water sources, making this study both crucial and challenging.
To quantify the issue, we employed a standard incidence ratio calculation, which confirmed a significant excess of cancer cases in the census tracts surrounding the tribal center and landfill. Armed with the compelling data, we crafted a grant proposal alongside the tribal council. This proposal was designed to dig deeper into the health issues affecting the community, especially cancer. It outlined plans for in-home interviews with those in the proximity of the tribal center, particularly within a four-mile radius, prioritizing residents with either a personal or familial history of cancer in the past two decades. To bring this initiative to life, we trained interested community members in research conduct, qualitative interviewing, and IRB procedures, transforming them into what we proudly call the TRUTH brigadiers. These individuals are not only participants in our project but also its driving force, receiving compensation for their invaluable contributions. With their deep local knowledge, they assist in identifying interview candidates and extending participation invitations through general mailings.
A crucial aspect of our engagement is the provision of comprehensive home water testing kits to interview participants. Given the reliance on well water by most residents, testing for over 200 potential contaminants has not only been a practical measure but a highly valued one. Our collective efforts have led to the successful completion of 125 interviews and water tests, along with approximately 600 quantitative surveys that reflect the broader health and cancer risk perceptions within Charles City County.
Furthermore, this project has extended our impact beyond immediate health concerns. A VCU team member has been welcomed onto the Charles City County Steering Committee to contribute among others, to their Forces of Change Assessment (FOCA) which will inform their strategic health priorities and enhance their capacity to address the community’s health over the coming years.
With our project nearing completion, our collaborative efforts have contributed to developing a clearer picture of the community’s health landscape, revealing not only heightened cancer fears but also a pervasive mistrust in healthcare and water safety. Importantly, this project has showcased the power of community-engaged research to address complex public health issues. We hope these findings not only inform our final steps in this project but will also lay the groundwork for continued, proactive community health engagement, as we are committed to continuing this engagement and working alongside the community to seek solutions and improve health outcomes in Charles City.
Here’s our first publication: Tossas, K.Y., Owens, B.D., Reitzel, S., Wilt, J.K., Mejía, P.T.R., Hunley, R., Groesbeck, H., Boucher, H., Schifano, K., Brown, S.L. and Adkins, D., 2024. The Chickahominy TRUTH (Trust, Research, Understand, Teach, and Heal) Project—A Tribal Community–Academic Partnership for Understanding the Impact of Structural Factors on Perceived Cancer Risk in Rural Virginia. International Journal of Environmental Research and Public Health, 21(3), p.262.
Here’s the video from the State of the University 2023: https://my.vcu.edu/faculty-staff/videos/index?feed=vcu_youtube&id=KgHWRBwNvdo
I also like this one from Massey because the Chief talks more about what this means to them: https://youtu.be/wxzdh38Ksh8 “
Core Elements of Your Community Engagement Approach
In your approach to community engagement, could you identify a few fundamental principles that guide your work within Charles City or community engagement in general? Specifically, if you were to advise others on best practices for engaging with communities, what two key elements would you emphasize?
“If I were to summarize two key elements that underpin our engagement with the Charles City County community, especially through the Chickahominy TRUTH project, I would summarize them as (a) equitable partnership and (b) adaptive contextuality.
Equitable Partnership: At the heart of our engagement is a deep commitment to ensuring that our partners from the Chickahominy Tribe, the visionaries behind this project, are on an equal footing with us in every aspect. This entails sharing decision-making power and resources on a level playing field. Our interaction has been frequent and dynamic, evolving from weekly to bi-weekly meetings, where every voice is valued. This collaboration has manifested in shared authorship and presentation opportunities, equal say in the project’s direction, and a strict adherence to the principle of ‘nothing about us without us.’ The result has been a profound mutual trust and respect that has extended beyond the project, fostering a deeper connection with the VCU and its health systems.
Adaptive Contextuality: The second element is our capacity to be flexible and responsive to the community’s context. We’ve learned that engagement goes beyond just adhering to the research question or project aims; it’s about being present and willing to pivot based on the community’s needs. It means being accountable not just as researchers, but as members of the community. Our involvement has spanned the spectrum of community life – from celebrations to mourning, from academic pursuits to cultural events – fostering a spirit of unity and shared experiences. This profound engagement has also catalyzed a significant surge in trust towards VCU and its health centers. This sentiment was powerfully echoed by the tribal chief who confided that the relationship built through this project was pivotal in deciding to trust VCU with his wife’s care during her critical heart event. The trust has reached a level where members of the community feel comfortable directly contacting us for physician referrals or for assistance in navigating healthcare services. They rely on us to engage with their community at a grassroots level, whether it’s speaking at schools and churches, hosting informational booths at cultural gatherings, or organizing vital health events like community cancer screenings and educational seminars. This relationship has become a conduit for the community to not only seek out medical advice but also to actively participate in our regular community information sessions, such as ‘Facts and Faith Fridays’, and has led to a heightened interest in health careers among the Charles City community students.
In essence, community engagement, to us, is about building and nurturing relationships, grounded in equality and flexibility. It’s a long-term commitment that demands patience, but it is unequivocally worth the investment for the enduring bonds and mutual benefits it creates.”
Lessons Learned from Community Engagement:
Could you share any significant lessons learned that have been invaluable to you and might benefit others in their community engagement efforts?
“The most profound (though not new) lesson I’ve learned from community engagement is the importance of being adaptable. For example, with the TRUTH project, while we initially set out to conduct interviews with 150 households and distribute 1,000 surveys, it became clear that our community partners were becoming fatigued. This taught us to be attuned to the community’s rhythm and recognize when to recalibrate our efforts. Regular, open dialogue is crucial in gauging the community’s energy and commitment levels, allowing us to make informed decisions together.
Moreover, our role in the community transcends the specific focus of any single project. The community views us as a broader health resource, not limited to issues of water safety and cancer risk. This perspective has reinforced the need to respect the community’s multifaceted concerns and to remain responsive to their evolving needs, even when they extend beyond our original research agenda. Being responsive to these needs builds a two-way street of trust. By truly listening to what the community tells us, acknowledging their holistic health interests, and valuing their input, we cultivate a relationship where they, in turn, are more receptive to our work. This mutual respect and communication are the keystones of successful and meaningful community engagement.”
Closing Remarks: A Journey of Impact and Inspiration
As we draw the curtains on this faculty spotlight, we invite you to delve deeper into the personal journey and passion of Dr. Kathy Tossas. Through her UNwavering commitment to community engagement, Dr. Tossas has not only illuminated the path toward equitable health solutions but has also embodied the transformative power of collaboration and trust. Her story serves as a testament to the profound impact of individuals dedicated to fostering positive change within their communities. Now, join us in experiencing Dr. Tossas’s heartfelt reflections and insights in the accompanying video spotlight, as we celebrate the spirit of resilience, empathy, and empowerment.
Story from the Division of Community Engagement by Alliannah Hamilton
Categories Faculty News