Ashley Butler, PhD, is a fellowship-trained Associate Professor, Behavioral Scientist, and Education Program Administrator at Baylor College of Medicine and is a Clinical Pediatric Psychologist at Texas Children’s Hospital in Houston, Texas. Dr. Butler is a T1D Exchange HEAL Advisor and principal investigator on multiple NIH-funded research grants. She is currently pursuing an Executive MBA at Rice University. 

 

Interview with Ashley Butler, PhD Ashley Butler

In this interview, Ashley Butler, PhD, discusses her involvement with the T1D Exchange Quality Improvement Collaborative (T1DX-QI) as a behavioral scientist focused on community-engaged research and implementation science methods to promote equity in diabetes outcomes across populations.

The T1DX-QI was established in 2016, with the support of The Leona M. and Harry B. Helmsley Charitable Trust, to refine best practices and improve the quality of care and outcomes for individuals living with T1D. Growth has been tremendous, with over 60 endocrine clinics across the US participating in the Collaborative.  

Fueled by top diabetes care leaders, the T1DX-QI has become an engine of innovation and inspiration. Clinics have seen unprecedented success in their approach to diabetes management by engaging with the shared, data-driven, and systematic methods.  

With members working closely to identify gaps in care, discover and refine best practices, and share research, the process has become knowledge-sharing at its very best. While collated data gives clinics a clear sense of “where they are,” it also demonstrates “where they can be” by applying shared, evidence-based methods for improving care.  

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Take me back to the beginning. What was your path into behavioral science and clinical psychology?  

“When I was in 11th grade, we had an assignment to research and report on a career path that interested us,” said Butler. “I explored careers in behavioral health, and that’s when I became very interested in becoming a psychologist.” 

When her high school senior yearbook asked, “Where will you be in 10 years?” Butler responded, “I’ll be a psychologist.” True to her word, she later obtained a Ph.D. in Clinical Psychology from the University of Florida.  

Initially, Butler thought she would focus on clinical care, therapy, and assessment as a psychologist. However, her experience working alongside a child psychologist during graduate school shifted her focus towards research, where she could leverage grant funding to develop programs improving outcomes for children and families. 

“I focused on applying for fellowships, internships, and practicum experiences that would give me greater exposure to that career path,” explained Butler. “I ranked the internship program at Children’s Hospital of Philadelphia as my top choice because it offered the combination of research and clinical experience I needed to complete my training.” 

Later, at Baylor, she pursued opportunities to build a research career. “Early on, as a psychologist and behavioral interventionist, I recognized that many existing programs and  evidence-based practices didn’t capture the broad needs and experiences of all children and families.” 

“I wanted to build a career where I could ensure the programs that we develop — and the practices that we implement as psychologists or behavioral interventionists — address the entire population’s needs.” 

 

How did you become involved in type 1 diabetes?  

“When I started my career, I wasn’t focused on type 1 diabetes — or diabetes at all,” said Butler. “I considered myself a researcher focused on more vulnerable populations, aiming to ensure interventions were appropriate and effective for those facing greater challenges, due to social determinants of health or socioeconomic factors.” 

“At first, I was having success in applying for smaller grants, but I knew that to sustain a long-term research career, I would need to secure larger grants to maintain my position.” 

“At the time, I had a wonderful mentor, Dr. Barbara Anderson —  a well-known leader in psychology and pediatric diabetes. She said, ‘There’s not really anyone focusing on vulnerable populations or equity research in type 1 diabetes. You could bring your expertise into that space.’” 

“She’s the one who truly brought me into the field of type 1 diabetes research. Since then, I’ve expanded my work to include type 1 and type 2 diabetes in children,” said Butler. “She taught me so much early on, and about a year later, I secured my first major research grant.” 

 

What inspired you to return to school to pursue an MBA? 

“As a researcher, I’ve seen a wealth of evidence that shows we can improve care for children and families. Too often, those evidence-based practices aren’t implemented at scale to have a larger impact.”  

Butler explained that this prompted her to ask, “Why is this the case? Why do we have proven interventions that are not always implemented widely in healthcare settings to improve outcomes?” 

To explore these questions, she completed some training in implementation science to gain a deeper understanding of “what levers need to be pulled to ensure science and evidence are actually applied in real-world settings, not just in research environments.” 

“Over time, I recognized how organizational factors play a major role in determining what gets implemented in healthcare,” said Butler. “Pursuing an MBA would help me better understand the business, administrative, and operational aspects of healthcare systems and how these factors impact what’s accomplished at the organizational or healthcare system level.” 

 

If you could share a snappy summary about your research, what would it be? 

“My work has focused on centering the voices of youth and families from vulnerable populations — particularly in how we create pediatric diabetes programs. My focus has always been on listening to what these families say they need, where they see the gaps, and how they’d like programs to be delivered in a way that’s meaningful and valuable to them.” 

“In the healthcare system, we often develop programs through a particular lens on health — focusing on glycemic outcomes, dietary patterns, or psychosocial outcomes like depression, for example.” While those are important, they don’t always reflect what families themselves prioritize, explained Butler.  

In her studies, Butler frequently hears that families value connection — whether it’s support from other parents, opportunities for their children to meet peers with type 1, or access to community resources. Outcomes such as feeling supported, connected, and understood are deeply significant to them.  

A big part of Butler’s work centers on asking: Are we building programs that support those outcomes? Are we measuring those outcomes? Are we incorporating program components that truly address what families say matters most to them? 

“I think that’s the main thing — really centering the voices of youth and families who are from more vulnerable populations, or where there’s been less research conducted,” said Butler, whose most recent NIH-awarded grant is concentrated on developing and piloting an intervention to address food insecurity in youth with T1D. 

 

Let’s discuss your experience with the T1DX-QI at Texas Children’s Hospital 

“I feel fortunate to be in such a supportive environment, especially given the recent policy changes and legislation that can make it more challenging to serve vulnerable populations, whether that’s from a research or clinical perspective.” 

“That’s why being part of a core group of experts focused on centering equity and ensuring the services and interventions we’re creating and implementing improve outcomes for all individuals with diabetes.”  

“In any organization or institution, there are always competing priorities and a focus on different initiatives. The T1D Exchange HEAL committee is one space where I’m actively involved with a laser focus on vulnerable populations. Because the experts are geographically located across the country, we have a wide range of perspectives that shape innovative solutions,” said Butler.  

“I’m especially interested in how we can address social determinants of health in diabetes care. Traditionally, diabetes centers have been focused on medical care and the clinical aspects of caring for those with type 1,” said Butler. However, it’s becoming increasingly clear that addressing social factors is just as critical. 

Through nationwide collaboration with colleagues, Butler has had the opportunity to learn about innovative approaches at other centers — such as integrating community health workers and screening for social needs as part of routine care.  

“We’ve taken inspiration from those models and incorporated similar approaches at our own center, including a community health worker focused on social determinants of health.”  

Through their new research grant, they’re building on that foundation to explore how partnerships with community-based organizations — particularly in areas like food insecurity — can improve psychosocial and clinical outcomes for children and families. 

“Being a part of the Collaborative has allowed us to learn what’s going on nationally, adapt and implement some of the strategies locally, and layer on more intensive evaluation and research.” 

Looking ahead, Butler hopes to use the tools from her MBA training to consider broader policy and systems-level changes — how they can scale their efforts, secure sustainable funding, and create incentives to support improved outcomes for children and families — not just in Texas, but nationwide. 

 

What do you enjoy outside of work? 

Outside of her professional work, Ashley enjoys spending time with her 8-year-old son, who plays baseball, swims, and enjoys chess. She values time with a close group of fellow moms who gather for family activities, dinners, or a relaxing spa day. She also loves to travel and is an avid fan of spin and cycling.