Current Research

Ethnic Disparities in the Impact of Cancer on Health Risk of Colorectal Cancer Patients and Their Caregivers

Cancer affects the quality of life not only of persons with the disease but also of their family members and close friends. The impact on various aspects of caregivers' quality of life (QOL) is significant throughout the trajectory of the illness (the time of diagnosis and treatment, mid- to long-term survivorship, and bereavement). The gaps in knowledge about physical aspects of caregiving are particularly large. We are addressing these gaps in a ACS-funded project, Ethnic Disparities in Cancer Caregivers' Elevated Health Risk, a study that examines the associations between characteristics of cancer-related stress and quality of life outcomes with emphasis on physical health, the roles of ethnicity and cultural factors in the associations, and the biobehavioral pathways (inflammatory cytokines, salivary cortisol, oxytocin, and health lifestyle behaviors) of the links, among family caregivers of colorectal cancer patients.

Dyadic and Individual Effects of Cancer in the Family

Cancer survivors and family caregivers tend to experience somewhat similar levels of distress and each person's distress affects his/her own quality of life. Beyond the impact of cancer at the individual level, we also focus the dyadic, cross-over effects of cancer in the family. In other words, we examine the degree to which each person's cancer experience has an independent effect on the partner's quality of life. In several observational studies, the FAMILY lab has found evidence of dyadic/cross-over effects in psychological distress, spirituality, social support resources, and healthy lifestyle behaviors among cancer survivors and their family caregivers. FAMILY lab is currently investigating cardiovascular reactivity and salivary cortisol responses to laboratory-induced stressors among adult cancer survivors and their spousal caregivers, and among young dating couples, as potential pathways for co-regulating stress between persons in close relationships (FAMILY Co-regulation Studies).

In a recently awarded NIH grant project (Biological and Psychosocial Mechanisms of Cancer Caregivers' Elevated Health Risk), FAMILY lab examines dyadic stress regulation between cancer caregivers and their patients, and test two dyadic stress regulatory pattens (coregulation and coagitation) as predictors of health outcomes. Coregulation and coagitation are quantified by cardiovascular, neuroendocrine, and self-reported affective reactivity and regulation, in response to a standardized stress situation that is relevant both to health and to close relationships. We then examine prospectively the extent to which the indicators of coregulation for this discrete stressor relate to daily outcomes (mood, diurnal cortisol, and sleep) and interim health outcomes (depressive symptoms, resting heart rate variability, and healthcare visits), and the degree to which gender moderates such effects. Findings of this study will help us understand underlying biological and psychological mechanisms that are critical for identifying cancer caregivers and their patients who are at most risk for poor health due to their mutual stress regulation patterns.

Healthy Lifestyle Behavior Interventions

Healthy U, Healthy Us” is a healthy lifestyle intervention, which is guided by self-determination theory. It targets improvement of cancer preventive behaviors, such as increased physical activity and healthier diets. FAMILY lab is currently testing the feasibility and acceptability of the Healthy U, Healthy FAMILY, a 12-week intervention that is delivered via internet (Skype) targeting less declining physical functioning and better longer-term health outcomes in colorectal cancer (CRC) survivors and their partners who are 60 years or older.

International Investigation of Unmet Needs of Cancer Survivors and Their Family Members

IPOS Online Survey project aims to gauge current involvement in clinical services and research with cancer patients/survivors and their family caregivers and to measure unmet needs for providing optimal care to this population across nations and age groups. As the first step, in collaboration with International Psycho-Oncology Society, the survey that is available in 13 languages using RedCap as a platform is underway with healthcare professionals globally.