Clara Berridge, Ph.D. was an Agency for Healthcare Research and Quality postdoctoral fellow for two years, focused on chronic disease and aging, at the School of Public Health’s Center for Gerontology and Healthcare Research. She is now assistant professor in the University of Washington School of Social Work.
Tell us about why you choose Brown for your post-doctoral training?
I pursued a postdoc at Brown because the Center for Gerontology is very well regarded for its impactful, policy-relevant, interdisciplinary work. It was also clear to me from my interview visit that when they accept you as a postdoc, they are invested in your success.
I was excited about this opportunity and yet, to my embarrassment, I couldn’t hold back tears when I had to leave the Bay Area for New England; I wasn’t too sure about moving here. I didn’t know anyone in Rhode Island, but on my first night, I decided to check out WaterFire. Seeing that display gave me some relief about what was to come. I actually ended up meeting my husband in Providence a few months later; we had our first date at the Providence Athenaeum.
What was your experience at Brown like? How did it prepare you for the role you are in today?
I was given time and support to pursue my own research projects while also being plugged into larger studies. Immediately upon arriving, I felt like I was a member of a team. This had a lot to do with the shared mission of highly-skilled and dedicated people and their experience. Professor Vince Mor, my primary advisor, has led this fellowship for 33 years. Over time, he and the other center faculty have perfected the integration of postdocs into the center.
My research required in-person interviews. It’s daunting to attempt study recruitment in a new location without personal connections, but my Brown colleagues, especially Professor Kali Thomas, enthusiastically connected me with local organizations where I recruited study participants. Professors Fox Wetle, Susan Miller, Renee Shield, and Richard Besdine all took time to help me with my research and were generous mentors.
I also learned what I know about grant writing at Brown. Mentors reviewed my proposals and we had weekly grant review meetings where new study ideas or aims pages were workshopped. These were attended regularly by everyone from other postdocs to senior researchers, the center director and deans. As a doctoral student, I had submitted a proposal to obtain funding for what should have been a fundable dissertation study, but I failed because I didn’t know a lot of things about grant writing. During my postdoc, I applied for and received three small foundation grants. The Center’s staff were fun to work with and provided the smoothest and most attentive grant submission and management support that I can ever hope to receive. My K01 proposal was just funded through the National Institute on Aging upon first submission. I credit the training I received at Brown for making that possible.
Currently, I’m an assistant professor at a large school of social work where faculty study an expansive range of health and social problems. I’m not the only gerontologist on faculty, but at Brown, I valued working and learning in a collaborative multidisciplinary center where a health economist sits next door to an anthropologist; all united by a common concern for bettering the lives of older adults.
You’re trained in social work and your work draws upon many different fields; like science, technology, and society (STS); disability studies; and medical anthropology; but you completed your postdoc at the School of Public Health.
I appreciate unique things about both public health and social work. I have a dual identity as a gerontologist and social welfare scholar, but my primary association is with the field of gerontology. I suspect many at the center feel that way, too—perhaps identifying as gerontologists first and then health services researchers.
You work in the area of health care technology, especially network-connected technologies that allow caregivers to remotely monitor people where they live. How widespread is this technology in the U.S. and what are its applications?
The active to passive shift in elder care technology first interested me because I study the social aspects of aging and the tensions between care and control. By “active,” I’m referring to the personal emergency response systems (infamous for the “I’ve fallen and I can’t get up” commercials), which require the wearer to push a button to call for help. Whereas passive remote monitoring is a category of network connected tech, which may, for instance, track and transmit someone’s location or movement or activities within their home, typically through tiny sensors. They’re “passive” because there’s no action or even knowledge of the system required by the older adult. There had been very little research on how older adults experienced these systems in practice, which really surprised me given the potential power shift they represent.
It’s hard to say how widespread this technology is with certainty because we don’t yet capture any data about the number of people who use it. Much of the tech focuses on predicting and enabling the prevention of adverse health events—monitoring deviations from personalized norms, including indicators for cognitive performance, social interaction, location, movements, and so forth. Some are beginning to use AI in the form of what’s being called “conversational agents,” the idea being that we can use AI to monitor risk of and mitigate loneliness. Just think about all the questions these new practices might raise.
I’m interested in how these practices open or close ways of being an older person. I’m studying how to enable older adults with mild dementia to be meaningfully involved in decisions about how they are, or are not, monitored. My research has generally found that we should expect people to have different priorities and preferences and that adult children and their older parents may disagree. It’s probably not surprising that the use of these technologies impacts the person monitoring differently than it does the person being monitored— risks and benefits fall differently to each; but engineers and designers have focused largely on meeting the needs of caregivers.
A lot of people are worried about privacy as it pertains to new technologies. What are the concerns we should have about network connected technology?
There’s much to be concerned about. Earlier, I participated in the Privacy Law Scholars Conference, where attendees discussed something my own older adult research participants were telling me when I interviewed them about activity sensors, geo tracking, and webcams—that privacy isn’t valuable only for privacy’s sake. Privacy is inextricably linked to other values that we all care about, like freedom, trust, autonomy. A silly example I often give is to imagine if the powers that be at my university decided to install movement sensors on my desk. Your first thought may be “that’s a privacy invasion!” But consider how that privacy invasion might impact my behavior. I might want to go for a second cup of coffee, remember the sensor, and reconsider, or decide against getting up to talk with my colleague down the hall. There’s that privacy-autonomy connection. We’re pretty invested in the U.S. in the idea that technology is value neutral, and I suppose this is where an STS analysis is especially helpful—studying how values are impacted in practice is critical.
What is the one thing you wish you could tell people about your field?
I teach a policy class on Social Security, Medicaid, Medicare, and the Older Americans Act with a focus on how each has a significant effect on multiple generations of people at once. So much of what I study is driven by the resource restricted environment of care in the U.S. This context limits our imagination about what technology could do for older people beyond risk management and cost reductions. We are in desperate need of a public long-term care insurance program that also strengthens the direct care workforce.
What is your advice for future post-docs at Brown?
It’s not easy to uproot for a short-term position in a place where you lack a social network. Postdocs have a lot to accomplish quickly with the pressure of the academic job market. That said, you probably won’t regret allocating time to socialize and develop friendships, even if you envision a brief life in Providence. If you want a sense of community, create it. After the other postdocs and I learned that we all lived within walking distance of each other, we organized a progressive dinner to explore the region’s great food. Come for the appetizing research opportunities, stay for the dessert at Al Forno and North! Try the great Portuguese cuisine in Providence or Fall River. Unfortunately for me, there is only one Portuguese restaurant in the Greater Seattle Area.