Penn alumna, School of Nursing professor, and “around-the-way girl” Loretta Sweet Jemmott is working to get mothers and sons in Philadelphia’s housing projects talking about preventing teen pregnancy and HIV infection.
By Jon Caroulis
“I LAUGHED, it was the most precious thing they said,” recalls Loretta Sweet Jemmott, GNu’82, Gr’87, of being described as an “around-the-way girl” by the woman living in the Philadelphia
housing project where Dr. Sweet Jemmott was conducting a workshop on mothers and sons talking about teen pregnancy and HIV prevention. “An around-the-way girl is a girl from the ‘hood, from the community — who grew up poor, just like they did,” she explains. “One of the mothers said to me, ‘You’re real cool. You’re just like us. You’re an around-the-way girl with a brain. You used it to get out of here, and you did good, and you’ve come back to help us.'”
This pattern of “getting out” and “coming back” has marked Sweet Jemmott’s life at least since 1965, when she was an 11-year-old girl who didn’t want to be bussed from her West Philadelphia neighborhood to a previously all-white elementary school. She hated the angry looks. The school wouldn’t let her run for class president. She and her black classmates weren’t allowed to use the cafeteria and had to be shipped back to their neighborhood to eat lunch. But her mother — who had grown up in the segregated South before moving to Philadelphia — insisted. “This is important,” she told her daughter.
So Loretta returned to Lamberton Elementary in Overbrook Park, one of Philadelphia’s first public schools to be integrated. After she graduated two years later, she went on to Beaver Junior School in the same neighborhood — her parents made a choice for her to continue attending an integrated school. But this time, the atmosphere was different. Sweet ran for class president in seventh grade. She won. She ran in eighth grade. And won. She ran in ninth. And won.
After middle school, Sweet Jemmott returned to her West Philadelphia neighborhood to finish high school at Overbrook High, then went on to Hampton Institute (now University), a historically black college in Virginia, where she earned her undergraduate degree in nursing in 1978. Later, after she had applied to Penn’s master’s degree program in nursing, she cried for joy on receiving her acceptance letter. “The only way kids in my neighborhood went to Penn was for the relays,” she says.
Today, Sweet Jemmott is an associate professor at the School of Nursing and director of the Center for Urban Health Research, working at the place she didn’t think she could get into and working to help the people she did not leave behind. The program in Philadelphia’s housing projects — the largest of its kind ever attempted — comes out of her conviction that if mothers were trained and encouraged to talk to their sons about sex, both would learn about birth control and safe sex — and start communicating more generally.
BEING HURT in a car accident is not generally viewed as a good thing. But if you’re a seven-year old and are so impressed at the sight of black people in the hospital wearing those stiff, fine white uniforms that it makes you decide you want to be a nurse, then it might be one. From that point on, becoming a nurse was the underlying force in Sweet Jemmott’s life; being one remains her touchstone. Though she no longer practices clinical care and spends much of her time doing the work of academics — writing grant proposals, publishing articles, sitting on university committees — her view of her calling hasn’t changed since that seven-year old girl decided what she wanted to be when she grew up. “I’m still a nurse,” she says.
She focuses on health promotion and disease prevention — especially as they relate to adolescent pregnancy and healthcare problems. “What we want to do is get people to actively change the behaviors that lead to those health problems so they don’t have to go [to the hospital],” she says. “HIV and AIDS is a terrible disease; I don’t want to see adolescents get infected. So what you have to do is use a condom, or not have sex; and let me show you how — because I care about you. Show you how to make sure it doesn’t happen to you, show you the skills you need so that I don’t have to see you in the clinical setting. You’re a future leader for me; what do you want to do when you grow up? How are you going to do that if you’re out here doing these things that are getting in the way?”
After graduation from Hampton, Sweet Jemmott’s first job as a nurse was with pregnant teenagers. “Why are they here?” she recalls asking herself. “If I could do anything in the world I would help this kid not be here. I’m 22, and I’ve got a 14-year-old girl pregnant and delivering a baby and having complications. I knew then I had to do something to stop this; I didn’t know how. Well, when you don’t know what to do, you go back to school.”
Sweet Jemmott’s work on her master’s degree was in psychiatric mental health nursing, focusing on childhood, adolescent, and family therapy. “I learned that if you’re just talking to kids, focusing only on the individual, you lose the larger picture: what are their relations with peers, parents, with the school, the community? What are the reasons for behavior?”
Though thrilled at having been accepted by Penn, she was unsure of herself when she began her studies in 1981. “She was very hesitant about whether or not she could succeed in the master’s program in nursing,” says Dr. Barbara Lowery, the Independence Foundation Professor of Nursing and interim secretary of the University who was then Sweet Jemmott’s adviser. “I recall several times, including on her interview for admission, having to convince her that she could succeed.”
And she did succeed — despite working two jobs while she pursued her degree. Later, a profile of Sweet in the Hampton University alumni magazine included this quote from Lowery: “Hampton, send more Lorettas to Penn!” (Under the direction of Sweet Jemmott and with funding from the Teagle Foundation, Penn’s and Hampton’s nursing schools are working together on establishing a Ph.D. program in nursing at Hampton.)
When she started the master’s program at Penn, Sweet Jemmott’s plan was “to get my degree and get out.” But her continuing quest to find solutions to the health problems plaguing poor communities — HIV and AIDS, teenage pregnancy — sent her back to school again, this time to Penn’s Graduate School of Education, in the division of Human Sexuality. She suffered a mild stroke while studying for her Ph.D., but was back in less than a year and won the Fontaine Award for outstanding minority doctoral student.
Her Ph.D. dissertation was on the sexual behavior of African-American male teenagers. At this point, she thought a university position — where she could teach and research — would be the next logical step in her career. She accepted a post at Rutgers University in Newark, New Jersey, and, with a $1,500 grant given by Rutgers to new professors, conducted a study of condom use among inner-city college students.
During this time, she met her future husband, John Jemmott, professor of psychology at Princeton University. They were married in 1989. With him, she conducted several larger studies. One was to investigate ways to reduce the risk of HIV infection among black teenagers; another was aimed at reducing the risk of sexually transmitted HIV infection among black junior high school students; there were several grants worth $2 million to $6 million to study the behavior of populations at-risk for HIV infection and to develop strategies for changing it.
This past April, with funding from the National Institutes on Mental Health (NIMH), they began a four-year, $6 million project in New Jersey on HIV prevention. The state-wide study is designed to evaluate whether a curriculum they have developed to reduce HIV-risk-related behavior among adolescents — which has been demonstrated as successful in reducing HIV and related health problems in small-scale studies — will work when implemented by community-based organizations. Results from organizations using the curriculum will be compared with those from control groups receiving more general health education.
In addition, the Division of Adolescent and School Health of the Centers for Disease Control and Prevention selected the Jemmott curriculum — “Be Proud, Be Responsible: Strategies to Empower Youth to Reduce Their Risk for AIDS” — as a national model. The five-hour program is aimed at 13-18 year-olds and includes short exercises involving educational videos and films designed to trigger discussion, role-playing, condom demonstrations, and other activities; it is currently being used in more than 26 states around the country in schools, community-based organizations, and clinical settings.
With more than $20 million in research grants, Sweet Jemmott and her husband are the leading HIV-prevention researchers in the United States. She left Rutgers for Columbia University in 1993, but the commute from her Princeton home was too much, and in 1995 she accepted a post at Penn, which “felt like I was coming home,” she says.
For the past three years, a key part of Sweet Jemmott’s work has taken her to the housing projects of Philadelphia. On a scale never before attempted, she is working with families in all 42 housing developments in the Philadelphia Housing Authority in the Mothers & Sons Health Promotion Program, a five-year, $3.9 million project funded by the NIMH targeted to single African-American mothers and their adolescent sons living in the same household.
Communication — the lack of it — is at the core of the problem of teen pregnancy and HIV infection, says Sweet Jemmott. Nobody — mothers and daughters, mothers and sons, parents and children — was talking. So, she thought, why not get them together? She spent months working with mothers to devise a curriculum that would teach them to learn about HIV/AIDS and related issues, and then to approach their sons about those subjects. In turn, these women would be able to teach other mothers about health and how to talk to their sons, so the program would be self-sustaining, continuing long after the formal study is completed.
In the program, which covers health problems such as hypertension, heart disease, cancer, diabetes, and lead poisoning, in addition to sexually transmitted diseases, mothers attend day-long education and training sessions that mix small group discussions, role playing, videos, and interactive activities on four consecutive Saturdays. Sons come for two hours during the first and last sessions, and both mothers and sons return for follow-up sessions at three, six, 12, 18, and 24 months. Program T-shirts and breakfast and lunch are provided to participants.
Initially, housing authority director John White was skeptical about Sweet Jemmott’s proposal, but her presentation won him over. “The more she talked about the problem, and I began to read her proposal and the plan for how she wanted to implement it, I became much more comfortable,” he explains. Residents had their doubts also. “‘Who is this coming here?'” White says, recalling that initial reaction. “But I think one meeting with her — hearing her and seeing how energetic she was and how straightforward she is and her approach to dealing and working with people — I sensed almost right away a comfort level that our resident leadership began to establish with her,” he says. “Somewhere in the area of about 300 people have participated in the program, and it’s just been a godsend; in fact, at one meeting, a women got up and just thanked us because she had just completed the mother-son project and training and talked about how helpful it had been to her in her relationship not just with her son, but with other family members as well. I wish the resources were available for all 20,000 heads of households to be able to benefit from this program.”
WHILE SWEET Jemmott was in a leadership program as a nursing student at Hampton Institute, the group was treated to a reading by a young writer, who dedicated a poem to them. The work was titled, “And Still I Rise.” The writer was Maya Angelou. When discussing her work and life, Sweet Jemmott likes to use the phrase from the Angelou poem. There was the difficulty of being bussed, of being rejected because she was black. “And still I rise,” she says.
But there is one challenge in her life that Sweet Jemmott could not overcome: the death of her brother, John. While Loretta grew up to be an honors student, a college graduate, a university professor, John, three years and one day older than she, was delivered with complications and deprived of oxygen during birth, resulting in cognitive problems. “You’re supposed to be the smart one,” he’d tell her when she made a mistake or dated a boy he didn’t like. “You have to be smart.”
Three years ago, he told the family he wasn’t feeling well. Two days later he was found dead. A cyst had ruptured in his abdomen, poisoning his system. John’s passing is the one subject that Sweet Jemmott talks about in a soft voice, that drains the energy from her. She was glad to have him, she says, and only regrets that her daughter will not get to know him. “His death made her even more determined,” says their mother.
Sweet Jemmott and her husband now have a daughter, Jolie, and plan to adopt more children. Despite the several major studies she has under way, she insists she will slow down. Yet something — the memory of seeing those 14-year-old girls giving birth; or the death of her brother, who might have been helped; or the mothers and sons trying to make a life in America’s ravaged inner cities, faced with the added scourge of HIV and AIDS — pushes her onward.
“You can’t give up, no matter what. With some teens — you can’t get through to all of them, but if you can save one life, you’ve got something,” she says. “I believe in the ‘So what?’ theory [of research]. So what if you publish in top journals and present your findings in top conferences, what have you really done? People are dying from these diseases and issues, and you might have an answer, but you never came off the ivory tower to give it to someone else who could help. I want to put my research into practice.
“So my focus is on finding those answers, dealing with those issues, publishing [the research], and in the process linking it with communities and teaching in a community setting to continue the message. Try to see if it really works, so that these people in the community don’t die waiting. If we can teach and train some of them, we’ve got hope. One day at a time, never give up, never give up, gotta keep it going. That’s what we do in nursing.”
