Learn by Doing: Ashleigh LoVette

Ashleigh LoVette, a doctoral student in behavioral and social health sciences at the Brown University School of Public Health, studies resilience in young people living in the context of HIV risk.

How did you first become interested in health?

My interest in health actually began after my very first visit to South Africa, when I was an undergrad studying communications at Michigan State University. As part of the program, I completed an internship at a public relations firm in Cape Town. It was a great experience, but I realized public relations was not a career I could see myself in for the rest of my life. I didn’t want to start over with a completely new major, because I knew that the skills I had developed were valuable. So, I thought, what area can I shift to that builds on the skills I already have? That’s when I learned about health communication.

“ In the School of Public Health, you have room and a little bit of independence that’s needed to help you grow as a scholar, but you also have the support to help you move through those processes. ”

And you went on to complete a Master’s degree at Michigan State.

Yes. My master’s degree in health and risk communication built on those communication skills but in an area that I was passionate about and thought I could make a difference in. That’s how it all came together. Once I shifted to health communication coursework, I knew that public health was the right career path for me. After graduating, I completed a health communication fellowship at the National Cancer Institute.

What was your experience working at the National Institutes of Health like?

It was an amazing learning experience. My fellowship was based in the National Cancer Institute, which is the oldest and largest of all the centers and institutes at the NIH. I was placed in the overarching communications office for the entire Institute. I had to learn a little bit about all of the different centers and offices.

That experience probably informs your current work, writing grants, seeking funding?

Definitely. I had previous experience with grants administration and cross-disciplinary collaborations from when I worked in the Office for Research during my master’s degree. I got to see the finer details of the pre- and post-grant process at a university and I worked with administrators, and with faculty members to find different grant funding mechanisms. When I went to NIH, I learned about health research and grants from the government perspective, both internally and externally. That experience also confirmed how important it is to share the results and implications of your research with the public.

When you decided to pursue a PhD, why did you choose to come to Brown?

I chose Brown for the people and the environment. I could see myself being able to do the work that I was interested in. In the School of Public Health, you have room and a little bit of independence that’s needed to help you grow as a scholar, but you also have the support to help you move through those processes. The research and funding opportunities offered by Brown also played a role in my decision, and I think it’s these opportunities, particularly when it comes to funding, that are critical for making graduate studies more inclusive and accessible for all students. Being at a place like Brown, doors have opened that I didn’t even know existed.

You study resilience. Tell us what you mean by that and how you first conceptualized studying this topic.

Growing up, I faced significant adversity, and that made life more difficult to navigate. But I also had support from family members; I had a nurturing environment in school. When I read or heard things related to risk or adversity, it was almost always framed in the negative. All these things were trauma or risk factors. I didn’t hear about the family member that was supportive or about the resources and support that help young people navigate the world. And, at the time, I didn’t have a word that captured the experience of overcoming adversity, but I knew it existed, because I had experienced it.

As I moved through the world and through my education, I began to have little moments, or little nudges that this was worth looking at more closely, even though I didn’t have a name for it. When I was first in South Africa, I got another nudge. I had finished up my PR internship and was volunteering at a school. It was great, the kids would come up and talk to me. One afternoon, one of the students came up to me, said, “Miss, Miss,” and gestured for me to lean down so they could whisper something into my ear. I expected it to be classroom gossip, but they whispered something private about their home life, and instantly, it just took me back to when I was that age.

I was speechless for a moment, processing what they confided in me, but then I thought about what I would’ve wanted from an adult as a young person. I asked if they were okay and if they were getting support. The student said yes and then just went back, playing with their friends like nothing had happened.

This student had a negative experience, but I could see that that school environment was supportive and took a holistic approach to education. They asked parents to engage with the school community on a regular basis. They did HIV testing. They made sure students had regular meals. All of these things that I knew were important, especially for young people navigating experiences of adversity.

During my master’s work, I finally found a word that described this process of overcoming adversity: Resilience. I was like, Ah ha! That’s what it is! This is what I’ve experienced. This is what I’ve seen and heard about. So how can we talk about this and tell a fuller, richer, more nuanced, more complex story of someone’s life in relation to their health, rather than just focusing on one aspect of it? That’s why I do resilience research.

Your doctoral research is focused on girls and young women who face sustained HIV risk in South Africa. How are you working to understand mental health and resilience in this population?

Generally, what I’m doing is trying to push the conceptualization of resilience forward and also bring it more into the realm of public health. Traditionally resilience is a concept that’s used in psychology, often related to stress or anxiety. It tends to be focused on the individual. Now, when it does include aspects of community, it’s often related to responses to natural disasters or wars.

I see resilience as a framework that’s more strength-based than some of the frameworks that we use in public health, and one that could potentially shift us to think more about community and less about the individual. That’s my goal with bringing resilience-based research into public health.

It’s also to get away from problematizing individuals and behaviors and understanding that people exist within social structures that aren’t ideal in many cases. And while we want to support people to be able to overcome adversity, a public health approach would be to understand how we can intervene so that people don’t need to be so resilient in order to live full, whole lives.

From a research perspective, I use both quantitative and qualitative data to increase our understanding of how resilience is related to health among South African girls and young women. These health factors are linked to both poor mental health and sexual health outcomes, but the role of resilience in these associations has largely been unexamined.

My hope is that my work will tell a different story than the one that is often told in public health. A story that shows the inherent strength of people navigating spaces that were not necessarily made for them to survive in, let alone thrive. I don’t want my work to end there, but I think it’s a good place to start in a field that focuses so much on disparities and risks, without having the necessary conversations on how and why those differences exist.

Does what you’re learning about mental health and resilience in this population have relevance for other places, other populations?
In many places, people have to be extremely resilient to barriers placed in their way. When they are unable to overcome these barriers, they are often told that they are not resilient enough. This is relevant when studying resilience across various settings and populations. It also demonstrates the importance of, not just creating programs and interventions to build resilience, but also working to shape policies so that people don’t have to be extremely resilient in order to maintain well-being. This shift from programming to policies, I think, is key for individuals and groups who have historically had to carry the burden of being resilient. In other words, it is really a shift to focusing on health equity, which can certainly be applied to health issues in other places and populations.

This work also has some common threads for young people across contexts. Adolescence is a time of experimenting, change, and growth. It’s a time of learning how to be independent or responsible, and maybe what that looks like or entails is different across contexts and countries, but the developmental process is similar, and helping young people to become empowered, healthy adults, that is something that crosses all boundaries.