Research
Community Engagement Research Projects
Principal Investigator: Jamie Zoellner
Co-PIs: Kathleen Porter, Emma Mitchell
Goals of project: 1) Build and strengthen the research capacity among members of two Community Action Teams, focused on Cancer Prevention and Early Detection. 2) Identify actionable, cancer priorities based on existing local data and stakeholder/patient input. 3) Plan and mobilize resources for cancer control research projects in rural, southwest Virginia communities.
Funding Source and Time Frame: Patient Centered Outcomes Research Institute, 2018 – 2020
Update: The Southwest Virginia Community Advisory Board developed two action teams for prevention and early detection. Action Teams created casual models and prioritized cancer control needs. Through 10 CPPE-driven meetings, the group led to the identification off our priority needs: (1) increasing HPV vaccination, (2) reducing tobacco use, (3) increasing advocacy to support colorectal cancer screening, and (4) increasing lung cancer screening rates. The CAB has developed action teams specific to these priorities and are working on addressing the priorities through research and cancer control activities within their community.
Outcomes: PCORI Prevent Cancer Poster
Contact person for project: Lindsay Hauser; LH7YN@virginia.edu
Principal Investigator: Roger Anderson
Co-PIs and Collaborators: Emma Mitchell, Melissa Little, Electra Paskett (Ohio State University), Mark Dignan (University of Kentucky), Stephenie Kennedy (West Virginia University)
Goals of project: 1) Test the effectiveness of an integrated cervical cancer prevention program consisting of three established intervention components, designed to address three causes of cervical cancer in a region with one of the highest cervical cancer incidence and mortality rates in the US; 2) Evaluate the impact of the cervical cancer prevention program including implementation and acceptability, with attention to both short- and long-term impact and sustainability at clinics.
Funding Source and Time Frame: National Institutes of Health, National Cancer Institute, 2019 – 2024
Contact person for project: Lindsay Hauser; LH7YN@virginia.edu
Principal Investigator: Jamie Zoellner
Co-PIs and Collaborators: Wendy Cohn, Kathleen Porter, Roger Anderson, James Werth and Tom Roatsey at Stone Mountain Health Systems
Goals of project: 1) Build research capacity among a multidisciplinary Cancer Control Leadership Team from SMHS and the UVA Cancer Center, aimed at increasing and sustaining CRC screening rates among rural residents in Southwest Virginia. 2) Assess and understand system-level and patient-level barriers and opportunities to CRC screening. 3) Plan for the feasibility testing of an evidence-based CRC screening program integrated into SMHS’ clinics.
Funding Source and Time Frame: National Institutes of Health, National Cancer Institute, 2018 – 2019
Updates: Engaged with 6 clinics through patient and provider interviews and interviewed 26 provider and 60 patients who were noted as not being up to date with screening in their medical record. Among staff, inner setting factors that could promote CRC screening included high workplace satisfaction, experiences tracking other cancer screenings, and a highly active Performance Improvement Committee. Inner setting hindering factors included electronic medical record inefficiencies and requiring patients to physically return fecal tests to the clinic. Among patients, perceived screening benefits were rated relatively higher than barriers. Top barriers included cost, no symptoms, fear, and transportation. Patients reported high likelihood of getting a stool‐based test and colonoscopy if recommended, yet self‐efficacy to prevent CRC was considerably lower.
Publications: Zoellner, J., Porter, K., Thatcher, E., Kennedy, E., Werth, J.L., Jr., Grossman, B., Roatsey, T., Hamilton, H., Anderson, R. and Cohn, W. (2020), A Multilevel Approach to Understand the Context and Potential Solutions for Low Colorectal Cancer (CRC) Screening Rates in Rural Appalachia Clinics. The Journal of Rural Health. doi:10.1111/jrh.12522
Contact person for project: Erin Kennedy; emk2fz@virginia.edu
Principal Investigator: Kathleen Porter
Co-PIs and Collaborators: Jamie Zoellner, Virginia LeBaron, Sarah Ramey, Dianne Morris, Marilyn Maxwell, Deb Clarkston, Zilipah Cruz, Margie Tomann
Goals of project: This pilot project proposes community-based participatory approach to identify and evaluate the feasibility of an evidenced-based behavioral intervention that targets modifiable behaviors associated with cancer recurrence (e.g., nutrition, physical activity, tobacco use) in southwest Virginia.
Funding Source and Time Frame: UVA Cancer Center, 2018 – 2019
Updates: An advisory team (n=10) of community stakeholders and researchers engaged in a participatory process to identify desirable features for an intervention targeting rural cancer survivors. The resulting multi-modal, 13-week weSurvive intervention was tested with two cohorts of participants (n=12). Indicators reflecting five feasibility domains (acceptability, demand, practicality, implementation, and limited-efficacy) were measured using concurrent mixed methods. Participants reported high program satisfaction (acceptability). Indicators of demand included enrollment of cancer survivors with a variety of cancer types and attrition (8%), recruitment (59%), and attendance (62%) rates. Dietary (59%) and physical activity (83%) behaviors were the most frequently chosen behavioral targets. Implementation indicators showed 100% researcher fidelity to delivery and retention protocols, while practicality indicators highlighted participation barriers. Limited-efficacy outcomes demonstrated pre-post changes in the desired directions with small and moderate effect sizes for dietary and physical activity behaviors. Findings suggest weSurvive has the potential to be a feasible intervention for rural Appalachian cancer survivors
Contact person for project: Kathleen Porter; kjp9c@virginia.edu
Principal Investigator: Pam Deguzmen
Co-PIs: Mark Jameson, Emily Couric Cancer Center (Debbie Lewandowski, Allen Cupp, Christi Sheffield), Uva Office of Telemedicine (Brian Dunn)
Goals of project: To determine the feasibility and preliminary efficacy of a nurse-led telemedicine intervention delivered to head and neck cancer survivors approximately 6 weeks following treatment completion.
Funding Source and Time Frame: UVA Cancer Center, 2018 – 2020
Update: The study is closed. Currently analyzing data and submitting publications. The expansion of this project for additional funding is under review.
Publication: Beyond broadband: digital inclusion as a driver of inequities in access to rural cancer care. Journal of Cancer Survivorship. 2020
Contact person for project: Pam DeGuzman; deguzman@virginia.edu
Principal Investigator: Jamie Zoellner
Co-PIs: Kathleen Porter, Wen You, Phillip Chow, Lee Ritterband
Goals of Project: To determine the effectiveness of Kids SIPsmartER in improving sugar-sweetened beverages behaviors among 7th grade students. Secondary aims are to determine (1) changes in secondary student outcomes (e.g. quality of life, BMI z-score, theory-related variables, health and media literacy), (2) changes in caregiver SSB behaviors and home environment, (3) maintenance of outcomes at 19-months post-baseline, (4) assess the reach and representativeness of Kids SIPsmartER, among students and caregivers, and (5) implementation, adoption, and maintenance among teachers and schools.
Funding Source and Time Frame: National Institutes of Health, National Institutes for Minority Health and Health Disparities, 2018 – 2023
Publications: Zoellner J, Porter K, You W, Chow P, Ritterband L, Yuhas M, Loyd A, Brittany McCormick B, Brock D. Kids SIPsmartER, a cluster randomized controlled trial and multi-level intervention to improve sugar-sweetened beverages behaviors among Appalachian middle-school students: Rationale, design & methods. Contemporary Clinical Trials, 83:64-80, 2019. https://doi.org/10.1016/j.cct.2019.06.011
Yuhas M, Porter KJ, Brock DJ, Loyd A, McCormick B, Zoellner J. Development and Pilot Testing of Text Messages to Reduce Sugar-Sweetened Beverage Intake in Rural Caregivers and Adolescents: A Mixed-Methods Study. Journal of Medical Internet Research, 7(7):e14785, 2019. doi: 10.2196/14785
Yuhas M, Loyd A, McCormick B, Porter K, Ritterband L, Chow P, Tate D, Zoellner J. Response patterns and effects of a text message based sugar-sweetened beverage intervention for rural caregivers and children. The UConn Center for mHealth and Social Media (CHASM) 2020 Annual Conference. May 2020. Link to Award Winning Video Poster: https://www.youtube.com/watch?v=hXt5pskkFVg
Clinicaltrials.gov: NCT03740113
Contact person for project: Annie Loyd; aml8ap@virginia.edu
Co-Principal Investigator: Jamie Zoellner & Lee Ritterband
Co-Is: Kathleen Porter, Wen You, Deb Tate
Goals of Project: The proposed RCT is guided by the RE-AIM framework and targets 244 adults from rural Appalachia. The overall goal is to examine the efficacy of iSIPsmarter in improving sugary beverage intake using a 2 group design [iSIPsmarter vs. static Patient Education website]. Secondary and tertiary aims are to: a) assess changes in secondary outcomes (e.g. overall dietary quality, weight, quality of life) and maintenance of outcomes at 6- and 18-months post intervention, b) examine reach and representativeness, c) explore patterns of user engagement, d) determine costs, and e) apply a systems-level, participatory process to understand context for future organizational-level adoption of iSIPsmarter.
Funding Source: R01 National Institutes of Health, National Institutes for Minority Health and Health Disparities
Funding Time Frame: 2020 – 2024
Contact person for project: Annie Loyd; aml8ap@virginia.edu
Electronic-health and Mobile-health Research Projects
Principal Investigator: Philip Chow
Co-PIs: Wendy Cohn, Shayna Showalter, Matt Gerber
Goals of project: 1) Examine the feasibility and acceptability of a smartphone-based mental health intervention; 2) Examine the preliminary efficacy of the intervention in reducing symptoms of depression and anxiety; 3) Examine the potential usefulness of smartphone-based sensor data in determining breast cancer patients’ mood, to reduce the burden of self-report.
Funding Source and Time Frame: UVA Center for Engineering in Medicine, 2017 – 2019
Update: Preliminary work gained from collaborations resulted in NCI-funded R01
Contact person for project: Phil Chow; pic2u@virginia.edu
Principal Investigator: 
Virginia LeBaron
Co-PIs and Collaborators: John Lach, UVA Cancer Center
Goals of project: 1) Test 
the ability of a smart health in-home sensing system called Behavioral and Environmental Sensing and Intervention for Cancer (BESI-C) to detect and predict episodes of cancer pain; 2) Understand how cancer pain impacts both patients and their family caregivers; 3) Explore how to best share collected information with key stakeholders (patients, family caregivers, healthcare providers).
Update: Due to COVID, research team is working on adapting the system and making the deployments “contact-less.” Pre-COVID, research team used to travel to people’s homes and set everything up which took 1-2 hours. Research team is now developing and testing a ‘BESI-Box’ which we can ship or drop off and people set it up themselves.
Funding Source and Time Frame: 
American Cancer Society, 2019 – 2021
Contact person for project: Virginia LeBaron; vtl6k@virginia.edu
Principal Investigator: Kelly Shaffer
Co-PIs: Wendy Cohn, Philip Chow, Shayna Showalter, Anita Clayton
Goals of project: For this study, we will ask breast cancer survivors and partners of breast cancer survivors about their thoughts on how we could make an Internet-based tool most helpful for ensuring that all breast cancer survivors and their partners get the treatments and information they need to address their sexual problems following breast cancer.
Funding Source and Time Frame: UVA Cancer Center, 2019 – 2020
Update: We are no longer recruiting for this study; we are currently preparing data for publication.
Contact person for project: Erin Kennedy; emk2fz@virginia.edu
Principal Investigator: Kelly Shaffer
Co-PIs: Lee Ritterband, Phil Chow, Tri Le, Matthew Reilley, Mark Jameson
Goals of project: The overarching purposes of these studies are to understand caregivers’ day-to-day emotions and behaviors, and how these experiences relate to their depressive symptoms. Studies will recruit caregivers at UVA Cancer Center and cancer centers across Southwest Virginia to understand caregivers’ differing experiences across our region. Findings will help to inform the next generation of scalable technology-based psychosocial interventions for supporting caregivers.
Funding Source and Time Frame: American Cancer Society Institutional Research Grant, 2019 – 2021
Update: We are no longer recruiting for this study; we are currently preparing data for publication.
Contact person for project: Kelly Shaffer; kshaffer@virginia.edu
Principal Investigator: Philip Chow
Co-PIs: Wendy Cohn
Goals of project: Examine the feasibility and acceptability of a novel app-based intervention that uses psychology principles to improve mood, plus phone coaching.
Funding Source and Time Frame: American Cancer Society; Kincaid Charitable Trust, 2017 – 2019
Publication: A novel mobile phone app intervention with phone coaching to reduce symptoms of depression in survivors of women’s cancer: Pre-post pilot study. JMIR Cancer. 2020
Contact person for project: Phil Chow; pic2u@virginia.edu
Principal Investigator: Kelly Shaffer
Co-PIs: Lee Ritterband, Jamie Zoellner, Bethany Teachman, Laura Barnes
Goals of project: The long-term goal of this research is to address the high prevalence of insomnia among family cancer caregivers using an evidence-based Internet-delivered insomnia treatment. Towards that aim, the overall objective of this study is to characterize sleep, behavioral, and cognitive characteristics of insomnia among cancer caregivers and to collect preliminary usability data of a fully-automated Internet-delivered insomnia intervention, Sleep Healthy Using the Internet (SHUTi). We are currently recruiting for this trial – for more information and to complete an interest form, please visit our study website: https://www.BessiStudy.org.
Funding Source and Time Frame: Integrated Translational Health Research Institute of Virginia, 2019-2020
Contact person for project: Kelly Shaffer; kshaffer@virginia.edu
Health Disparities Research Projects
Principal Investigator: Raj Balkrishnan
Co-PIs and Collaborators: Roger Anderson, Thomas Guterbock, UVA Center for Survey Research
Goals of project: We will systematically collect and share detailed information about barriers to care, use of technology, attitudes towards genetic testing, and prevention and screening behaviors within the UVA Cancer Center’s “catchment area,” or the geographical area where over 80% of UVA patients reside. This study will produce data that is specific to our patient population that we can then use to help plan health or policy interventions to improve health outcomes or to improve services among this population.
Update: We are no longer recruiting for this project. Currently working with VCU on three joint papers for publication.
Funding Source and Time Frame: National Institutes of Health, National Cancer Institute, 2018 – 2019
Contact person for project: George Batten; gbatten@virginia.edu
Principal Investigator: Raj Balkrishnan
Co-PIs and Collaborators: George Batten, Raj Desai, Zachary Daniels, Ballad Health
Goals of project: Find out access to cancer care services and barriers to receiving cancer care services for female cancer patients in Southwest Virginia Appalachia region.
Update: A follow-up proposal is currently being developed relating to breast cancer medication adherence.
Funding Source and Time Frame: TRRC, 2017 – 2018
Contact person for project: George Batten; gbatten@virginia.edu
Principal Investigator: Emma Mitchell
Collaborators: UVA Mobile Breast Screenings, The Health Wagon
Goals of project: We want to explore the feasibility and acceptability of pairing mobile mammography with cervical cancer screening through HPV testing of self-collected samples.
Funding Source and Time Frame: TRRC, 2018 – 2021
Contact person for project: Emma Mitchell; emm6z@virginia.edu