Hi, everyone. My name is Kathryn Reid, and I just want to spend a few minutes talking with you about the role of the nurse practitioner and how nurse practitioners really bring a lot of solutions with regard to advancing cancer prevention. To introduce myself a little bit, I'm an associate professor of nursing at the University of Virginia School of Nursing. I've been here for quite a few years. I just love being a nurse and I love teaching others to become excellent nurses. But in addition to that, I'm also a family nurse practitioner. I love helping experienced nurses meet their career goals and advance their careers into family nurse practitioner practice and other types of advanced nursing practice. I also practice as a family nurse practitioner. I work in primary care. I've worked with patients who have obesity and type 2 diabetes to help improve health and reduce health risks. I've also worked in urgent care and I also work in a primary practice environment, really providing a lot of health education, disease prevention, health promotion, health literacy, teaching, as well as diagnosing and treating common chronic health problems that we encounter in primary care. You might be wondering, how does someone become a nurse practitioner? When you hear me describe what I do as a nurse practitioner, you might be thinking, wow, that sounds a little bit like my primary care physician or another primary care provider that you see. Well, to become a nurse practitioner, you have to first become a nurse and get some professional experience. That's four years of nursing school, a four-year degree, and then at least one or two years of experience working as a nurse, either in a hospital or in a community-based setting or in a clinic. Then when someone decides they want to be a nurse practitioner, they go back to school and obtain their graduate education either at a master's or doctoral level in an advanced nursing training program. Then after they graduate, they take a board certification exam so that they're eligible to be licensed as a nurse practitioner. You may be wondering, what does a family nurse practitioner do? I'd like to know a little bit more. Family nurse practitioners, we provide the full scope of primary health care services. There are several different types of primary care providers in our country. You might have a physician, a medical doctor or a DO, a doctor of osteopathic medicine. A primary health care provider can also be a nurse practitioner, a clinical nurse specialist or a physician assistant. Different states have different laws about how primary care providers operate. But in most states and about half states, nurse practitioners provide direct care, coordinate continuing care, and help patients access a range of specialized health care services. We do this independently and autonomously in the states where we practice. Primary care is really complex. A primary care provider will help people with their personal health care needs. We develop sustained partnerships with patients and we practice in the context of family and community. Our care is person and family-centered and our goal is to really help our patients and families achieve better long-term health and do this in a lower, more cost effective manner. With our focus on improving health and preventing disease, we use lots of strategies. We promote health, we teach patients about preventing diseases. We help people maintain their health. We provide counseling and health education. We also, if somebody has a symptom, then we can evaluate the symptoms and diagnose and treat both acute and chronic conditions. We provide this type of care in all different settings. Might be a clinic or in a community-based setting or a home care or school setting or by telehealth. Primary care can be provided in a lot of different places. Now that I've introduced you to nurse practitioners and primary care, I just want to talk a little bit about a huge lesson we have learned in the last couple of years related to health literacy. The coronavirus pandemic has taught us a lot about where do people get their health information. Because we have learned that people are getting good information in some places and not so good information in a lot of other places. As nurse practitioners and primary care providers, we really need to re-evaluate, what do we do from a health literacy standpoint? We need for people to trust us as their health care provider to be the health information source. When we talk about trusting our health care providers, I just want to take a minute to point out that since 1999, nurses are consistently rated by Gallup polls as the number 1 most trusted professionals for 19 years in a row. People continuously rank nursing as a very honest and ethical profession. As nurse practitioners, I think we can really leverage this trust to promote our relationships with our patients and families and advance health literacy. The goal is really to help people get good, accurate information and learn about their health in a way that they can understand it and feel empowered to really value and use healthy behaviors in their lives. I think nurse practitioners, because we are so highly trusted, we can leverage the relationships that we have with patients and families to advanced health literacy. How does all this relate to cancer prevention? As a primary care provider, we do a lot related to cancer prevention. We do a lot of assessment and teaching about and helping people understand their risks for cancer and the actions that they can take to reduce their risks. We assess for the biologic or genetic or environmental risks that somebody might encounter, understanding the family history and looking for cues that show us that somebody has an elevated risk for cancer. We can also do a lot of education and health promotion to address the behavioral risks that can increase cancer like tobacco use, sun exposure, exposure to different environmental chemicals, or exposure to different pathogens or communicable diseases, such as things like HPV. Look at what we have achieved in our country as we have promoted reducing cervical cancer risk through HPV vaccination. That's just another example around how the trusting relationship and that health teaching and health promotion can really help reduce cancer in that area. We can also teach people about other healthy lifestyle behaviors that can help reduce cancer risk. Regular activity, good nutrition and body weight management, and good stress management, just to name a few. In addition to helping people prevent cancer and teaching people about all the different ways to reduce risk and prevent cancer, as a primary care provider, it's so important that I also promote recommended routine screening tests for the early detection of cancer. Things like mammograms, colonoscopies, regular GYN exams as recommended, skin exams and so also recommending screening for the high-risk individuals when we have identified that somebody is at risk for other cancer. I just wanted to summarize my comments by offering a few closing thoughts about primary care and health literacy, cancer prevention, and early screening and detection of cancer. Our US health care system is the most expensive in the world. We spend twice as much per person to provide health care. Unfortunately, our system, with all that money, we don't get the results that match the results that our peer developed nations get. We're not doing very well in getting the outcomes. We tend to spend more money on trying to fix the problem after it has already happened, so addressing health needs when somebody already has cancer or a chronic disease. We're spending all our money at the end trying to fix the problem. But our peer countries that get better outcomes and spend less money doing it, they really invest in primary care and health promotion, health education, and disease prevention. I hope that as we consider policies that can impact cancer prevention and reducing cancer, one of the solutions is thinking about how we invest more money in our primary care system and in our ability to help truly prevent cancer. What do we need in addition to money to support primary care? Well, we need more primary care providers because we know access to primary care services is a real problem, particularly in underserved areas, rural areas, so making sure that we have plenty of primary care providers for people to be able to access care and get the education, the health promotion, the screening, and the information that they need. It's really difficult to recruit physicians into primary care. But I just want to point out that as nurse practitioners, we are ready. There's a lot of people interested in becoming nurse practitioners, and we are graduating more and more nurse practitioners every year. As we look to increase access to primary care, look for your local nurse practitioner as somebody who can really help you understand your health, know what you need to do to improve your health, reduce your disease risk, reduce your risk for cancer, and so I think that's everything that I would like for you to know about the general aspects of what nurse practitioners can do to be an important part of the solution in improving health, improving health literacy, and reducing cancer in our country. Thank you so much for listening, and if you ever want to contact me, you can find my contact information on the UVA School of Nursing website in the faculty directory. Again, my name is Kathryn Reid me, and it's really been an honor to speak with you today.