By Maureen Passmore
Photo by Joshua Franzos
Sarah Belcher was pursuing her clinical doctorate at the University of Pittsburgh School of Nursing, planning to be a clinical nurse specialist, when a series of conversations with a mentor changed the course of her career.
“She said, ‘You know you’re a scientist, right?’,” says Belcher, assistant professor of health and community systems, School of Nursing, and of medicine, School of Medicine. “She identified in me that inquisitive nature of a scientist and that way of thinking about problems and wanting to understand how things work.”
Belcher then reminded herself that there are many ways to be a nurse. She delved into her research interests and found an academic home with a strong cadre of nurse scientists in the School of Nursing. After years of providing bedside patient care as an oncology nurse, Belcher is now a PhD clinician-scientist, caring for patients and communities by studying how to better understand their outcomes through a broad, multilevel approach.
On Feb. 21, Belcher will be presenting her latest research on equitable adherence to oral anticancer medications as part of the 2025 series of Senior Vice Chancellor Research Seminars.
Belcher knows from personal and professional experiences that patients with cancer are generally eager to do anything they can to have good outcomes. Many newer cancer therapies involve taking oral medication. And, in some ways, taking a pill seems much easier than going to a health care provider's office. Patients don't have to find the time or deal with the extra costs, like gas, parking fees or bus fare. But people may forget to take a prescription as directed, dislike the side effects, or find that they are too costly to afford in the context of their other expenses and income. Also, oral anticancer medications may require special insurance approvals or involve specialty pharmacies with cumbersome refill and delivery policies. The processes surrounding these oral medications aren’t always advantageous to the patient, so Belcher’s work focuses on health equity and understanding the barriers and breaking them down so that all patients can benefit from the therapies.
“The initial study told us that we've got a group of patients that, for reasons that we're still trying to understand, are struggling [with adherence]. But, they know how important these pills are. They want to be taking them,” says Belcher. “We want to know if and how cancer medication adherence is different from other chronic illnesses and what special things need to be considered as we think toward interventions to support, in an equitable way, the patients who are taking them.”
Belcher says no one at Pitt has ever said “no” when she suggested an interdisciplinary collaboration. She is a member of UPMC Hillman Cancer Center’s Biobehavioral Cancer Control Program and the School of Medicine’s Palliative Research Center and affiliated with the School of Medicine’s Center for Pharmaceutical Policy and Prescribing and the School of Public Health’s Center for Health Equity.
Even though she no longer does direct patient care, Belcher’s foundation as a clinical oncology nurse drives her research. She says she wants to ask questions and design studies that are clinically meaningful to patients, their families and health care providers.
“I have patients’ faces that come to mind when I design studies, “she says. “I think about this person or that person and things that were really influential in terms of how outcomes might have been different based on barriers that they faced during their cancer care. It matters to me that I'm doing this work in a way that's meaningful to people.”