Position: Assistant Professor, Departments of Obstetrics and Gynecology and Medicine (Geriatrics), University of Chicago, Pritzker School of Medicine and Biological Sciences Division
Clinical Scholar: 2000–2002, University of Chicago
Research Projects: Novel Biophysiological Pathways Through Which Social Factors and Sexuality Influence Health Throughout Life
Clinical Specialty: Gynecology, cervical dysplasia, female sexual function
Trading the fast-paced life of a practicing obstetrician and gynecologist for the quieter life of a researcher had an unanticipated effect on Robert Wood Johnson Foundation Clinical Scholar Stacy Tessler Lindau, MD.
"It was a difficult transition physically," Lindau recalls. "You're on your feet all day as an OB-GYN versus a more sedentary, pensive lifestyle where delivery of a manuscript is much fewer and far between."
"It's much easier to deliver ten babies than ten manuscripts," she says.
But taking a hiatus from the delivery room allowed Lindau to conduct population studies that she hopes may one day will have an impact on clinical practice.
"I have become very interested in harnessing the strengths of population samples to get more generalized information about Americans' health," says Lindau. "This is different from clinical research, where we tend to draw subjects from our clinics and there is a limit to our research because we can only study those who come to our care."
For one of her projects, Lindau drew from a database at the Illinois Department of Children and Family Services to find HIV-positive women who had given birth to two children after being diagnosed. "We wanted to know from these women what factors contributed to their sexual behavior and health practices around prenatal care and HIV care," says Lindau.
In-depth interviews revealed that most of the women received inadequate or no prenatal care and did not disclose their HIV status at delivery. The women told of many barriers, both social and institutional, that got in the way of accepting care for themselves and their newborns.
In another study, Lindau and colleagues interviewed some 500 women getting Pap test screenings at ambulatory women's clinics. They discovered that the women who read below a ninth grade level were less likely to understand the purpose of the test or to seek proper follow-up care if the results indicated precursors to cervical cancer. Complicating patient comprehension was the fact that physicians tended to overestimate patient literacy, thereby missing opportunities to communicate adequately with lower-literacy women.
Such failure in physician-patient communication leaves many women in "a precarious limbo between diagnosis and treatment," Lindau told Reuters Health (an internet supplier of health and medical news), as they may not know how to interpret test results mailed days after their doctor's visit.
These studies led to a larger population study—the National Social Life Health and Aging project, funded by the National Institute on Aging—and a more ambitious research goal:
To discover how social relationships, in particular intimate relationships, influence health as people age. For this study, investigators are not only interviewing subjects but also collecting biological data in people’s homes.
"One of the limitations in home settings is that we don't have the convenience of the laboratory or a phlebotomist down the hall," says Lindau. "We have developed minimally invasive methods for collecting data in this setting—ranging from blood pressure to heart rate to more high-tech data collection like finger stick blood samples, self-collected vaginal samples or salivary samples.
"It's literally a laboratory in a wheelie bag," she says, "and it allows interviewers to collect this objective health data at the same time we collect really high-quality, in-depth social self-report data."
So far, the study has gathered data from some 3,000 people, ages 57 to 85. "My hope is that this national study will inform public policy and health policy about important issues related to the social lives and relationships of older people," Lindau says, "and the importance of those relationships for health at older ages."
Lindau credits the Clinical Scholars program with helping her think broadly and creatively about these important research issues. "Clinical Scholars offered an environment where I took full advantage of connections to scientists of all kinds," she says. "I was able to interact regularly with sociologists and economists, in addition to physicians across all disciplines.
"I was exposed to a variety of ways of thinking about human behavior as it relates to health, and various methodologies to better understand human health behavior. I can't imagine how I would have gotten to this point without the Clinical Scholars program."