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Street scientist: Research program goes where the people are

This article first appeared in the St. Louis Beacon, Feb. 1, 2011 - Have you ever been rushing to catch MetroLink, only to be waylaid by a stranger asking if you would like to be part of a research study? If so, chances are excellent that the experience was a surprisingly pleasant encounter with part of a research team led by Linda Bauer Cottler, professor of epidemiology in the Department of Psychiatry at Washington University School of Medicine.

Since 1986, Cottler has been teaching epidemiology, considered the "basic science of public health," the branch of medicine that deals with the study of the causes, spread and control of diseases in the community.

She returned to St. Louis, her hometown, in 1980, to conduct the first study of mental illness in the general population. In 1989, she founded and continues to lead Washington University's HealthStreet, one of the most recognized epidemiological programs in the nation.

She guides the organization, said HealthStreet's Project Manager Dan Martin, with a threefold passion: science, social justice and speaking and working on behalf people who have fallen out of the health-care fold.

HealthStreet is a community-based research program that has always focused on substance abuse and HIV prevention research. It has expanded to include many areas of medical research that link people to research opportunities and the social and medical services they need. As the name implies, Cottler and her team have a unique recruitment method.

Taking It To The Streets

Most people are recruited into research studies through public advertisements and notices or a medical contact. Cottler's group pretty much eschews such conventional outreach. With the assistance of the city of St. Louis Health Department, the St. Louis Police Department and others, HealthStreet does it differently.

"It's about taking it to the streets, getting the pulse of the community, educating the community and bringing the community into the fold of care and science," Martin said.

HealthStreet staff approach people in parks, grocery stores, at bus stops and beauty salons, at social service agencies and at hundreds of other area locations. And they do so, Martin said, in an organized, respectful fashion.

"It's the model that Linda developed, where we are ambassadors to research, working to re-instill trust in medicine and in research."

Cottler and her team work with groups that often do not show up in research studies: out-of-treatment crack cocaine and heroin users, extremely heavy drinkers, injection drug users, people who misuse prescription drugs, prison inmates and working professionals, even former NFL players. A special emphasis of her work has been changing high-risk behaviors among women who use drugs and who are in the criminal justice system.

HealthStreet documents high-risk behavior rates, develops prevention programs and interventions and creates a model for re-engineering an affected community.

"We wanted to get people who were not in treatment, people who weren't connected," Cottler said, gesturing animatedly as she spoke about the program. "We go into areas that we were told are high-risk neighborhoods. We ask people if we can hear about their health concerns and if they'd like to hear about medical research.

"We are meeting the community's needs by trying to improve the health of the community, and I think we've had an impact," Cottler said.

Global Impact

Cottler is the director of Washington University's Epidemiology and Prevention Research Group, the master of psychiatric epidemiology program and the Center for Transitional Science Activities Center for Community Based Research, which is home to HealthStreet. She has appointments in Occupational Therapy and Anthropology at Washington University and in psychiatry at the University of Florida, Gainesville.

Her work has influenced psychiatric epidemiologists throughout the world, and she is internationally known for the development of reliable, widely used assessments for substance abuse and other psychiatric disorders in the general population.

Serendipity

Cottler, 60, laughs and hugs easily. She came to her present through a circuitous past . Her St. Louis beginning was traditional enough, graduating from Notre Dame High School in South St. Louis County in 1969.

"Women of my age were steered into nursing," Cottler laughed.

And so that was her path, for a time. She graduated from Jewish Hospital of St. Louis School of Nursing as a registered nurse in 1972, and worked for several years as a pediatric nurse at St. Louis Children's Hospital and later at Tufts-New England Medical Center in Boston. It was a first career that has stood her in good stead.

"I always go back to my nursing days where I want to help people in the community where I live," Cottler said.

Though she had wanted to be a public health nurse, she went into pediatrics instead. "But that's how I found my way to Boston, where I met my husband; he was my neighbor," Cottler recalled.

"Serendipity has been very important in my life. You just have to go with the flow."

And go she did, graduating from Emmanuel College in Boston in 1977 with a bachelor's of art in biology, then a master's of public health in epidemiology in 1980. In 1987, she received her Ph.D. in psychiatric sociology from Washington University. She returned to her first love - public health - as a full-fledged scientist.

Support And Recognition

Cottler lives in Kirkwood with the husband she found in Boston and brought home with her to St. Louis. Matthew R. Cottler is a communications specialist at Boeing. They have three daughters: Emma Haugh, who works in finance at Frito-Lay in Chicago and is married to Patrick; Laura Cottler, a pastry chef in St. Louis, and Sara Cottler, who works for the World Health Organization in Geneva, Switzerland.

"I've always had a very supportive family -- mom, dad, four sisters and a brother, my daughters and husband," Cottler said. "And I've always been lucky to be able to work with terrific people. Without a team like I have here, I couldn't do anything. "

In addition to her family and her scientific team, Cottler has chosen to give her support to numerous professional and community organizations, including Washington University's College on Problems of Drug Dependence , which she has been a member of since 1987. She was also the 2010 Centennial Year president of the American Psychopathological Association.

When Cottler gets the  Academy of Science-St. Louis Trustees Award on April 13, she'll probably hug the presenter.

Gloria Ross is the head of Okara Communications. 

Gloria S. Ross is the head of Okara Communications and AfterWords, an obituary-writing and design service.