My name is Steve Veg. I serve as the Associate Director of the Center, and it's a pleasure to welcome you here today. I would like to share my screen with you to remind us of a few important things as we get started. We'll be talking today with doctor Lisa State. And we'll get more into her program a little bit. But I want to introduce you, if you have never met. Our founding director is doctor Professor Emeritus Sandra Petrono, who conceived of this great idea to understand that IUPI is a hotbed of what we would call translational research. Doctor Petrono's research is translational. She has a whole theory about understanding privacy management. And has worked hard to invite everybody on our campus and in our community to embrace the idea that we have a lot of research that we would call interdisciplinary, and that is taking or generating evidence to solve complex community problems. This was during the time of our Chancellor Bans when he was the chancellor of our campus, He helped to bring this to life here at IEPY and currently serves as the executive director of our program. And his goal is to advance this opportunity across our campus so that folks, both on campus and community can take advantage of the opportunities we have to work together to solve complex problems. The Center for translating research and practice does a lot of things, and so we're so happy that you're here today to be with us. We want to remind you about a little bit of Zoom etiquette. We've all been on Zoom for a long time. But during the comments by doctor State at the beginning, please keep your microphone muted, but please turn your camera on so we can see who's here. You're welcome to type comments or questions into the chat, although we will have time to converse and we'll invite you to turn on your camera and your microphone at the right time. Just so you know, this presentation is being recorded for future viewing. So if folks couldn't be here today, they'll have a chance to see that, and you are going to receive one of those ever coveted post event evaluations. You'll get it in an e mail, and we hope, you could look in the chat right now and take to open that up so you'd have it ready. We love to get your feedback about these events and to help us know what we could do in the future. Please keep up to date with us. If you don't know, these sessions are available for continuing education units, and you can visit I U Expand to learn more about that. You can follow us on social media in lots of different ways. You can follow us on Instagram. You can check out our YouTube channel to find past videos and some information about our scholars, where they're talking very briefly about their research and the work that they do. And of course, we're on Twitter and Facebook, so please take a moment to like us and follow us and keep up to date on the many things that are happening. You can sign up for a monthly newsletter by e mail. It's chock full of information. And there you can also learn about, if you go to our website and click on any of our featured scholars, for example, if you took a look at the page and went down to doctor Staton today, you can click on her lovely picture, find out a little bit more about her research. And then below, you'll see a handy link to some of her Uh, our journal articles that are about this work that are freely accessible on I UPI Scholar workks page. You could also just click on the Scholar Works link to go directly to the IUPUI Scholar Works, where you could find Lisas, as well as many of our other translational scholars work easily accessible to you at no charge. So we are excited about a couple of upcoming events. So this is award season. So any of the faculty today that are part of this or for your community partner working with somebody at IUPY. And you think this might be an opportunity to advance translational work. The Bans Awards Information Session is coming up on Thursday, December 1. And again, next year on January 11, and these are just information sessions to explain what these awards are. And in December, our final of the year conversation series will be featuring Professor Jamie Levine Daniel, and we'll be doing that on December 16 at 12 noon. And of course, we have a whole bunch planned for 2023, and we'll be announcing that as soon as it's all planned and available. But today, we are super excited to have with us, doctor Lisa Staton, who is an associate professor and chair of the Social and Behavioral Sciences Department of the IU Fairbank School of Public Health. And she's also Associate Director of the Community Health Partnership or Chef of the Indiana Clinical Translational Sciences Institute. And today, she's inviting our conversation About the Diabetes impact project, Indianapolis neeighborhood. So we're delighted to have you here today and welcome you and invite you to share your screen and turn on your microphone so we can hear all about this project and engage in a conversation with you. All right. Thank you very much. So it's exciting to make sure all the technology buttons are pushed. So thank you very much for that introduction, and I am so pleased and thrilled to be here today. The whole concept of translated research practice is near and dear to my heart and really the focus of probably almost my entire career. I'm really excited to be here and to talk about the projects that that I'm working with the most at this point in time. And I'm also really appreciate everybody taking time over their lunch and hopefully enjoying a lovely lunch while you participate in this conversation. What I'd like to do is really start off, and I will be giving an overview of our project, the Diabetes Impact project, and really focusing and talking a little bit about some of the partnerships along the way. Please feel free to ask questions into the chat or even, turn your video on and say something and ask questions along the way. There's no need to hold that all to the end if you have a question you'd like to ask, really, it would be great for this to be conversational. And then towards the end, one of the pieces that is really important to me is this piece of partnerships. And I'm always really looking for ways to think outside the box on partnerships. From a public health perspective, with my bias is that public health is part of everybody's life. Every organization should be thinking about the connections to health and what they do. And but I think we don't always involve as many different organizations as we should. And so I'm always looking for interesting unique partnerships that others have had. And so that'll be something that I would love to talk about towards the end. So I wanted to put that in your mind. So hopefully, you have time to think about something that you might want to share related to a unique or interesting partnership. And I know a lot of folks are from within academics, but if there are any community members or anything also here, I'm also looking to learn about partnerships that have been really valuable to you as well. So please be thinking about that. I want to start off and talk a little bit about the Diabetes impact project, Indianapolis neighborhoods, which we use the very catchy title of dip in as our acronym for the project. And this project is ongoing for eight years. We are currently just past our midpoint at 4.5 years and was originally funded in 2018. And as you can see, What's interesting about the project is that it's funded by the Eli Lilly Company, and I'll talk a little bit more about how that evolved. And as part of their global health partnership program, which has a goal of reaching 30 million people by 2030. And so this is one of the first projects they've had that has been US based. All the other global health partnerships and projects have been outside of the United States. We are the lead organization at IU Fairbank School of Public Health, and our key key partners. I'll talk about many partners that we have, are three neighborhood areas within Indianapolis. And as you can see, I capitalize the width because it truly is width and we're not just working in those geographic areas. We are working with the neighborhood residents. Now, why diabetes, how did the project come about? Just for those of you who are not, I know that we have a lot of folks who have a health background, so this may not be new news to you, but wanted to bring everybody up to speed. That worldwide estimates around diabetes prevalence rates are really about 9% of the global adult population. That includes both people who have been actually diagnosed with it formally diagnosed, as well as estimated percentages of the population that we are pretty sure have it, but don't know that they have it. So then those numbers increase. The US, are we are at the higher end of that. We are at about 14, almost 15% of the adult population. And the numbers, as you'll see, just keep getting higher as we get closer into the neighborhoods we're working with with Indiana being at 16%. And then our communities the three areas that we're working with are at 23%. So 2.5 times the prevalence rates of the global rates. So it's pretty horrifying and shocking and to me, unacceptable that rate that these communities are being burdened at this high level. At the same time, so around 2017, 2018, that we were which is why you see some of these numbers. We were some key stakeholders in the city were having conversations with Eli Lilly and as those of you, I'm assuming most folks are local, know. Eli Lilly's headquarters is sitting here in the middle of Indianapolis. And there were conversations happening about the fact that there's a lot of work being done in countries that have lower rates than the communities surrounding us, and that there really is something important for us to be dedicating not us, but for Lily to start focusing some resources into the local area. At the same time, one of my colleagues, Tess Weathers, who I think is on I think I saw that she's on this call, led up a study in 2017 2018 around life expectancy rates, and many of you may have seen these where the big takeaway message was that there was a 14 year difference in life expectancy between some of the northern suburb areas in the Metropolitan service area compared to Central Indianapolis. And so 14 years, one year of life expectancy difference is significant, 14 years is again, another really horrible indicator, and something that should be done about. She has repeated that study more recently that ran up with life expectancies up through 2018, so right at the starting point of this project, which unfortunately showed that the gap had increased to 18 years. So we're not quite going in the right direction at all. So I bring this up because these things were happening at the same time, and in many ways, it resulted in multiple organizations being really interested in this kind of work at that time because it really had the spotlight on these health inequities. What happened was Eli Lilly facilitated bringing together a group of key stakeholder community organizations, primarily focused on health, but included the mayor's office and local and Lisk Corporation and a variety of state health department, Marion County Health Department, our school, a lot of different folks to start talking about what would something look like if you were going to focus in Indianapolis. And through that time, informally evolved these principles that I would say that are a foundation to how we operate, which is really this piece of building a multi sector partnership for community health. It's not these big 18 year gaps in life expectancy and 2.5 time rate, double rate of diabetes prevalence are not going to be turned around by one organization or not the gaps aren't going to be closed by just doing one small program. And so this really does require this larger project, I, larger partnership, operating in a way around collective impact, that we're all moving in the same direction towards improving quality of life and reducing health equity. Whether we're trying to get to different pieces of that, but all trying to move in that general direction. Another piece, as I just mentioned, is the focus on health equity, really focusing on the communities most affected by some of the challenges. In our case, we're focused on diabetes burden. In many ways, this could be cardiovascular, many other things that are also impacting these communities very highly. Third piece is really this practicing and focusing on real community engagement, meaning, and I'm going to talk about that a little bit more if I have time is that it's really about a partnership that goes both ways and not just going into a community. It's actually involving people having real decision making in the hands of the communities and the ability to say no or yes to things and all of that. So that's a major piece of this project. We also heard loud and strong from communities that don't come in for one year, don't come in for one short project and leave. So it really was so we're really lucky that Lily heard this and was willing to have this longer term investment. Because our goal is at the end, we have created structures and things that will outlive the project. And then finally, we really realize that we have to do this holistically. We can't just work with the folks who already have diabetes if we expect to make a dent in reducing the rates in the long term. So these are kind of some of the main factors that we are working with. So I just want to highlight for you the three areas in the city that we're working with. See over here on the left hand side, is a data dashboard that we partnered with the Polar center on to create that is specific to the three areas that we're working with, the Northeast, the near Northwest, and the near West communities. These are areas that have high diabetes prevalence rates. They have our predominantly lower income, very diverse and ethnic and racial composition and age composition. And then each of those areas also has an Eskenazi federally qualified health center located within the boundaries, and I'll explain why that's important. And then finally, but last, but definitely not least is the fact that we were wanting to so these areas were identified prior to any community involvement, just for full transparency. But we're also identified as areas where there were already active community partnerships. People residents in the area we're working with the Health Department, as well as Lisk. And so there were partnerships that we already established because we know that the partnership piece of any of these things can take a very long time take years to really develop. So we were lucky in that we were being as a lead organization. We had some connections, but we were being connected to the communities as well by trusted partners. So these communities were approached and asked whether they were interested in partnering. We had It was very important to us that we made sure that they knew that they could say no, and that they could give input, and they did give input. And so some of the aspects of the design actually evolved because of the input from the resident members. I'm happy to say they all agreed to participate and many of the members that we met with at the very beginning in 2017 are actually still working with us now. Here's just a real quick snapshot. I'm not even going to really talk about the numbers, but except for to say the first, I'm not sure if that's cut off on newer screen, but the first column really is Marion County, and then the other 23 columns are the areas that we're working with. And you can see that there are higher rates of lower income, lower poverty, higher rates of people of color, access to grocery stores. So they are at higher risk for many factors that influence health compared to the broader Marion County area. Then this diagram, I don't expect you to be able to read the whole thing, but it's really just to show you along the arrow, that we're really working with many populations, everything from the whole community to people who already have diabetes, and that we have specific components of the project that are addressing these different areas. And how are we doing that? And I would say the main ways that we're addressing this is through this concept of collective impact, trying to move in directions that everybody can moving together because the old adage, we're greater than the sum of our parts. So we want to be doing that as well as making sure that the community is involved to make decisions about the community. The first aspect of the project I want to talk about is our project that is working with people already living with diabetes, and we're doing that in partnership with Eskenazi Health. Through a community health worker outreach program. We have six community health workers that are focused in the DIP in areas who work closely with three of the federally qualified health centers, and in fact, we have expanded to working with two other health centers that also serve people that live in the DIP in ZIP code areas. The community health workers services lovely bridge between the medical system and everyday life. You know, we all know there's not a lot of time when we talk with our providers. The community health workers go out to people's homes and can see what are some life barriers that are happening that result in them not being able to really think about their own personal health. So they're working with folks who've had already had challenges in controlling their blood glucose levels, but then we'll work and provide social support. Do things like help to make sure that they're not being evicted or that there are not issues around food insecurity and a lot of these things that are really the things that people worry about first. We have been doing that particular piece of the project for about 3.5 years now and have just been undergoing an evaluation of it and have found that people that have been working with the community health workers have had a significantly greater reduction in their blood glucose levels when compared to those who have not been working with the community health workers. So that is really what we would have expected to see based on this is an evidence based practice that we expected to see this kind of result. And what was lovely is we have seen And I want to remind you about the little blip that we've all experienced, which called COVID over a couple of years, that really changed the face of what this intervention normally is, right? To be able to go out to people's houses, and so the fact that in my mind, the fact that we've seen a similar as expected change really is a huge testimony to the community health workers because that was that's been a hard hard thing. And if you watch the news, you also know that folks with diabetes have been at higher risk for complications for COVID over the years. We through the concept of collective impact, we have worked with our partners and expanded our partners around expanding the community health work for us both with Escanazi as well as kind of some newer initiatives value health. So that's our piece of working with folks who areay living with diabetes. Now, our second piece is that we know that there's a lot of people who may have diabetes and who have not been diagnosed with it or who have pre diabetes in the communities. And so we have a structure of comm neighborhood community health workers. And these folks are housed with local community based organizations, such as Krista More House Flaner House, Unique up in the Northeast United Northeast Comunity Development Corporation. And our partner on this is the Local Initiative Support corporation List who helps really coordinate this part of the activity and works with each of those three on the contracting aspect of the project. And what they have done is you drop to the bottom line, been involved in over 500 community outreach events, again, over the past 3.5 years. We keep saying 3.5 years, even though I said at the beginning, we're 4.5 years in. And that's because our first year was spent a lot of structural development, creating systems and Esquinazi health epic systems and things like that. So the first year was really a planning year. And so these folks have been working to raise awareness and encourage folks to seek out screenings if they're at high risk and also providing education around what can be done to help reduce your risk with Diabetes. Our next piece is our primary partner is our local steering committees that are made up of residents in each of our three communities. The goal of this is really our primary prevention p. How are we going to reduce the hopefully reduce the new cases of diabetes in the future. It's this is a long game, right? This is not going to happen in a year or two. And it's unlikely that it's really going to happen in eight years that we're involved. But it's hopefully putting structures in place that can help make this happen. And so the steering committees have been meeting monthly since the project started and have been involved in a number of different aspects of the project, including helping us on design for community surveys that we've done to try to understand some of the needs of the community. And I don't know for many of you who do community work, may realize how community surveys are not something that the communities are particularly fond of. And so trying to make sure and our steering committees helped us by looking at it because Standard epidemiological practice. We just tend to focus on deficits in survey survey questions quite frequently. And that was pointed out pretty heavily by our neighborhoods. Folks who would say, why would you want to live in a community after answering this kind of these kind of questions? And so it forced us to go back to the drawing board and really look for more assets based, which was what we thought we were getting there, but, you forget certain pieces, and that's the beauty of having community partners there. So the information we've gathered in lots of different information sources and used that information and with the resident steering committees for them to decide what areas they want to focus on. Right now, we've got one area focusing on physical activity, infrastructure and building a culture of health in the area. Another is focusing on healthy food access, and a third is focusing on stress reduction. And those are all factors that contribute to diabetes to diabetes. And so we're moving towards expanding that, so all three areas are working in all three areas. There's also a important thread across all of them, which is increasing social connections and increasing that sense of community. So how are they doing that? I've got a few items up at the top that I'm not going to read through. But one of the main things that the steering committees are doing is that they have fun, identified, and funded and supported 27 projects so far in the three communities. These projects have to be focused on the dip in areas. They are They have to submit a proposal, they come and present to people present to the steering committees and the steering committees vote on whether to support them. The ultimate goal is that these are projects that contribute to something that's sustainable. And so sometimes there are these one time events, but we really are trying to support things that are building for the future. And so here's some examples of a few things that have been funded. So for example, in one of the areas, there has been a lot of support towards increasing and expanding the diversity of fitness programming. And providing opportunities that maybe have not been present in the community before. And what's been fun is that has sparked an interest with the Indy Park system. And so we're now working on a plan so that they start assuming some of the programming that we've been supporting. And so that allows us to continue to bring in new and diverse ideas, and then if they work, they can then be picking them up. So it's still in the initial stages, but it's very exciting. Another piece we've supported our community gardens, but doing things like infrastructure, building greenhouses, putting in water systems, things like that that are hopefully going to be able to be in place for the long haul. There have been some stress reduction videos in partnership with the School of Medicine, faculty and health nutrition classes through the health department, as well as a very cool pros project called Sunday dinners happening. This is run by a community organization, but bringing community residents out experience healthy food, not experience, but it has healthy food and lots of physical activity opportunities, and it really just is building the sense of community in the area. We also have some non funded partnerships where folks have come to us to ask because they're interested in having community input. And so we see if there's a steering committee member who's interested in being serving on advisory groups. And so we do have steering committee residents participating in these variety of different advisory groups now. So, I just wanted to talk a little bit about. So those are the main pieces of our project. And I honestly, I apologize if I've spoken really fast, but I can take an hour and a half, 5 hours, however much time you want to give me to talk about the project. So that's the whirlwind view. But I wanted to come back to this idea of community engagement because community engagement really is integral to this project. And here's an slide of a continuum of community engagement. And all of it's community engagement, but to me, it's important to understand where we're falling along along this spectrum because it's not all the same. So ranging from outreach, where something may be community based happening in a clinic or happening in a community location, but there's not really any actual conversation or feedback or it's not really a bi directional partnership there all the way up to where there's decision making happening by community residents. And so I encourage people if you're doing this kind of work to make sure you're familiar with this kind so that you can really identify where you fall within this spectrum. And we I don't want to say we're perfect because we're absolutely not, and that there are aspects of the program, probably, as you've listened, though, how much community involvement is in. The Haskinazi community health worker piece of our intervention. And I would say that's more on a consult level because community health workers do get feedback from our steering committees around then if you move up to our resident steering committees, they do have decision making and the funds they decide how to spend the funds that they have and tell us what they want. So it ranges all across that range. So now I'm going to do a poll. Nuri, if you could put up the poll, And what I would love to do is have you identify if you've been in part of these collaborative partnerships that have included community. We have you fall fell along this continuum? Where do most of the projects tend to fall? And if you're a community partner, have you worked with other organizations and how do you feel that that relationship has fallen? I know this is kind of a lot of information. But hopefully, somebody will take our poll. Got some takers already, but please, if you have a moment just to find the poll on your screen, folks are going ahead and you get to pick one of these choices out of the five. So Lisa is inviting us to think about our own experience around having been involved in a project like this. And where where would you put the level of community engagement? We have 60% of the group has already responded. So you're getting some nice results. Oh, that's good because I looked at my screen, and I see zero people have rep zero out of one answer. You have to respond. That's why. Yeah. You don't get to see it till it's over. You just have to trust the process here. I was like, Wow. Silence. No, that's right. We'll just give you another moment here in case you want to respond. Okay. Let's see what the results are Mary. Now you can see. Here's what folks. Right. So that's I mean, it's a nice range of participation in the different types of community engagement, which is wonderful. I didn't know if anybody who had been part of any of those would like to share an example of the relationship that they've had, but anybody who has done kind of a more console oriented project or an involved kind of project want to share a little bit of details about that partnership. We would invite you to turn on your camera and open your mic if you would be willing to share this experience as lighted by doctor State. And that's okay, if not, you can fold it until we get to the next question and that might come through in the next question as well. I don't want to jump in case somebody had something to say. All right. Nobody somebody's coming out. Come on. Wonderful. We can't hear you though. It says your mic is on, but we are unable to hear you. You might need to tell Zoom to select a microphone. If you go to the bottom left corner of your screen, you'll be able to where it says, Mike. There's a little carrot, you might need to select something different because we'd love to hear what you have to say. So it's a challenge, isn't it every time? I different So he's going to come back later. L on to your next question, while he tries to this out. Well. So I see David. You just came on. I did. I will just make a comment that the shared leadership, broader health outcomes affecting broader community is a really big step up. From the collaborate level. And also moving from console to involve to collaborate. Each of these is certainly a step forward. But that kind of partnership building and trust building have been parts of experiences I've had with learning communities and a collaborative community of practice with congregations. But it's hard then to move on to sort of instituting lasting change on a broad basis, which really comes through in the DIP in project impressively. That's what I will say. Thank you. But I mean, but it's never easy because not on not only do you have to have the desire to do it. All of the different organizations have to be will be able to the flexibility to support that happening. And to help keep the process going. So it's not easy, and I also though all of it it is kind of a huge jump between each of the columns, I agree. And it's not always the appropriate partnership to try to go you don't want to leap right into, Let's go into shared leadership day one. That to me, never works very well. But we are trying. I'm not sure. Always room for keeping a day to day process. The next thing, I just wanted to kind of raise back. I talked about a bunch of different partnerships we have in place. We have some that are funded directly through the project, some that are funded with the community organizations in our steering committees. This is a constantly a growing group of people, which is a lot to manage and keep on top of, I will say, and to do and to keep that partnership and lines of communications going really smoothly. So that leads me to the question my last question. So this is it. So this is our time to talk, and I managed to leave about 2.5 minutes, a little bit more than that to allow the rest of you all to talk as well. But again, have any of you been involved in partnerships that maybe you would have thought at the beginning, why is that organization at the table? Or halfway through realize we really needed this organization that we didn't realize we needed them at the beginning. Again, it's to me, in the world of Health, we a lot of times talk to the folks that all speak the same language and all the folks that are working on health and we forget about the other people. So I would love to hear it if anybody has suggestions of partnerships that perhaps if you saw that quick list and memorized our quick list, who should we add as a partner that we don't have? Suggestions will be really appreciated. Lisa, Hi, Lisa. This is Sylvia. Can you hear me? I can. Hi, Sylvia. Hi. So for your last game, which is the prevention component. It sounds like everything you're doing is going to help with even children and growing into adulthood. But have you considered maybe in the future, expanding into schools to reach there? So I think that's a really excellent point. We've done a little bit around reaching out to the adults, through the parent PTA and PTO, and we want to do more of that. We do have some activity programs that are aimed at children and some of the gardening programs are aimed at children. But it's it's not a consistent focus. I think that's really hugely important. And I am making sure to make a note of this, but we have been talking about expanding relationships with schools, and I think that is a really great idea to put a little bit more effort into that as well. Thanks, Sylvia. And I have another one also with kids. How about sports organizations like soccer or even the JCC Jewish Community Center, which is super good for health issues. Have you guys thought about that? So we haven't worked with the JCC at this point. We have, through Indy Parks, been working with some of their organizations, and right now, one of the things that's in the works is to bring a Rgby league in and a Lacrosse? I both aimed at children being sponsored by local organizations. One of the things that we really, really try to do is work with the organizations that are located within our DiPID boundaries. That doesn't mean that we do have those partnerships that go broader, like the JCC would be. So as long as folks organizations have been working in our areas, we are up for that partnership. It's a matter of just making that connection. So if you have connections, I would love to have that, and then we can get some folks to reach out. Super cool, Lisa, thank you. Thanks. So Armando, did you get son? No, we still can't hear you. What about now? No, we can't. Yes. Okay. Yeah. I don't know why my computer does that. So I had to reconnect it somewhere else. Yeah. This is fascinating because I just started a post doc here at IU. I live in Indianapolis, but I'm at IU Bloomington. Interested in diabetes prevention. My issue is focused on pediatric diabetes prevention specifically in Latinos. Obviously there in Phoenix, Arizona, there's a huge Latino population that's burdened by diabetes, and the kids are at high risk of developing diabetes. And so we ran something pretty similar to this, I think. We had a community based, culturally grounded program where my mentor there has built relationships with community partners and one of them is a federally qualified health center in Phoenix, and then another is a community organization that delivers diabetes prevention material. They're certified for the DPP education materials, and then also the DS MES, I think is what it is. And so they're all latino too, they come from the culture and they're able to speak to their patients and those who enroll in our studies, the participants, you know, both in English and Spanish, depending on what their needs are and Anyways, I thought this is neat because I come from a lab that is really focused on community work, and so we're always trying to build these connections and it looks like my mentor down there has this long standing collaboration that had lasted over ten years in their newer in his last SRO one, they were focused on the on the kids. We measured data on the kids, not in the family, but really it's a family based program. And he just renewed that RO one to now expand it to the entire family. And so we delivered at the YNCA, so they're invested. The statements of the Paul Family Wellness program are who deliver the DPP nutrition curriculum. And then we have physical activity instructors from the YMCA that also delivers the program the physical activity. One I ask you a question. Who is your mentor? Gage Shi. Okay. So and I asked that because I was at the University of Arizona before I came here and we did diabetes prevention control along the US Mexico border. And that was kind of a model that a lot of this is very similar to. And so I was there for a long time as well. I don't believe I know him, but there are other folks in the area. Yeah. So one of his aims on his recent renewal of his RO one is to actually look at implementation and taking that next step from two YMCAs to, you know, 50 YMCAs across Arizona. And I was just going to say that he's working with the Department of Health in Arizona. To kind of think of expanding that stakeholder network because they have a small one now within the research group, but now they're looking to really take this to scale. So yeah, that should be in the works and in the pipeline. That's great. I would love to talk to you later on about that too. I mean, we're doing a little project here with the Diabetes DPP folks. More just an implementation in the area. But I would love to hear more about the work you do. Definitely. Last thing, I was going to say there's a Latino community organization here in Indianapolis that maybe of the, I think they're called a Plaza. But yeah, they really seems that they're rooted in the community and so they would be something that I would suggest at least to prioritize the Latino population. And I would say that that is a group that we need to do more in with our project for sure. Well, I love the collaborate. I'm interested in the specific group, so interested to talk more. And Many e mail. Let's talk. Sounds great. Well, I appreciate that both Sylvia and Armando brought up the pediatric population, which is near dear to my heart. But I would invite us to consider that pediatric starts long before school. And so another group perhaps that you might reach out to would be early care education, care kinds of components and even before that, because babies, it turns out there's no such thing as a baby. There's only a baby and someone else. So that's a reach back into the adult population, but so much happens from birth to three that that's super important. So it's another group. And I would throw into your question about unlikely partners. In my own work in early childhood, I discovered that libraries were an important partner that I hadn't thought of right away, but have been super important in reaching families of very young children. And some unique ways. Yeah. You. Are there other thoughts before we need to wrap up our time together today for this conversation about a super important topic. I know, a takeaway for me was the sobering update that in terms of the best predictor of your future is your zip code, and that my goodness. We have a lot of work to do in our community. I had seen this research before, but I'm sobering with the update that it's now an 18 year difference? That's not okay. We have a lot of work to do. Well, at this time, we do want to thank doctor Lisa Stayton for engaging us in a conversation today that is super important. Gave us a lot of things to think about not only about a health condition, but also a model to think about community engagement. And I appreciate that you started your conversation saying, You know what? We've learned a lot about this along the way. We dove into it. Not necessarily engaging our community, but realizing that we needed to, and fortunately, that has been a huge partnership because as we're all learning about the importance and value of engaging with our communities as we engage in these ideas about research and what to do. So thank you for helping remind us of that and to giving us some information about how we could do that in some good ways and to help us to know where we are in our stages so that we could get to that place of long lasting sustainable change that makes a difference. So, a reminder that we have events coming up in December, and of course, again, next year, we thank you for joining us. Again, we have the upcoming award sessions. To learn about the Vance community Awards. There's a couple of different things that folks might be eligible for. If you want to learn more about it, then you can come on December 1, or again on January 11, and our December Scholar of the Month conversation will be a little early. It's December 16 and honor of the end of the year activities that we all engage in. And then we'll be back again in January starting continuing with our conversation series of the Month. And we'll stay on board here for a little bit if you'd like to stay along and just have some more conversation with Lisa, but we know that people have a lot to do. You need to get to your 1:00 or wherever you are on the hour activities. One more reminder that you're going to get an e mail with an invitation to participate in a survey. If you haven't already seen it in the chat, it'll be there again. But take a minute, just give us some feedback about your participation today. So thank you, doctor Staton, we appreciate your work, and we'll hang out here for a little bit for those that want to just hang out afterwards before we all go to our 1:00 session to have some conversation.