Cancer, Adjustment, and Risk of Smoking (CARS) Lab













An Unfortunate Trifecta

Normally, if you win a trifecta it’s a good thing (especially if you’re betting on the races at Keeneland!), but in this case, not so much: Based on nationwide data, Kentucky has one of the highest rates of smokingcancer, and poverty. Given this, the CARS Lab is well positioned to explore smoking cessation (or the lack thereof), cancer survivorship, and social determinants of health and disease. Thus, it should come as no surprise that the CARS Lab focuses on prevention and control of smoking-related cancers and under-served, under-resourced cancer survivors in Kentucky. Our main goal is to identify (and ultimately modify) the psychosocial variables that play a key role in adjustment to cancer, including the clinically important process of smoking cessation after cancer diagnosis. Some of the psychosocial variables we study are distress, posttraumatic growth, motivation, self-efficacy, causal attributions, social support, social constraint, and socioeconomic disadvantage, and our current studies focus on survivors and supporters/caregivers of head/neck, cervical, and lung cancer.

Lab Studies

Cancer And Tobacco Study (CATS)

In this intensive longitudinal study, we are interested in identifying the factors that contribute to a cancer diagnosis being a “teachable moment” for smoking cessation. More specifically, we are trying to uncover which affective and cognitive variables play a role in the quit attempts, lapses, and relapses that occur in the context of a new cancer diagnosis. To do so, we recruit recently diagnosed head/neck and cervical cancer survivors who smoke from the UK Markey Cancer Center, and ask them to furnish select psychosocial and behavioral data for 30 days in a row. Sponsor: National Cancer Institute. Study period: August 2014 - July 2019. Study Stage: Data analysis.

Cancer And the Kentucky Experience (CAKE)

In this mixed-methods pilot study, we explore the quality of life and tobacco use of cervical cancer survivors and their supporters (i.e., whomever the survivor considers her “go to” person for support). We are also evaluating whether social resources and socioeconomic status play a role in achieving tobacco cessation after cervical cancer diagnosis. For this study, we are collaborating with Kentucky Cancer Link (, a non-profit organization that provides assistance to low-income and under-insured cancer survivors across the state, and the Kentucky Cancer Registry. Study period: August 2016 - July 2018. Study Stage: Published.

Consultation, Advice & Tailored Support for Cancer Survivors (CATS 2)

This randomized clinical trial is our initial investigation into the feasibility, acceptability, and efficacy of an intervention with two complementary goals: 1) engage cancer survivors in the process of making a quit attempt and 2) empower cancer survivors who smoke to use local, regional, and national resources to address unmet social support needs that might otherwise undermine their quit attempts. In this study, we hope to uncover a powerful smoking cessation intervention for cancer survivors who are coping with the social challenges inherent to living in rural, Appalachian, or otherwise low SES areas, and we're partnering with the UK Markey Cancer Center and Kentucky Cancer Registry in order to do so. Sponsor: Kentucky Lung Cancer Research Foundation. Study period: July 2017 - June 2020. Study Stage: Data analysis.

Markey Cancer Assessment, Referral, Engagement, and Support (CARES) Tobacco Program

The Markey CARES Tobacco Program will implement the highest quality tobacco cessation treatment via two pathways: 1) widespread provider education around the importance of tobacco cessation after cancer diagnosis, and for some individuals, free enrollment in an online, tailored TTS training program and 2) evidence-based patient care that involves population-based assessment, proactive treatment, systematic follow-up, and integrated support consistent with the conceptual model of the 5 As (Ask, Advise, Assess, Assist, and Arrange). This comprehensive plan to address the high burden of tobacco use in Markey cancer patients through a 2-pronged approach will considerably strengthen Markey’s commitment to reduce cancer morbidity and mortality in KY via both educational and treatment avenues. Sponsor: National Cancer Institute - Administrative Supplement to the P30 Cancer Center Support Grant. Study period: July 2017 - September 2021. Study Stage: Program implementation and data analysis.

Key Collaborations

Dr. Burris was a Co-Investigator on the Kentucky LEADS Collaborative, which is multi-institutional project led by Dr. Jamie Studts of the University of Colorado Cancer Center. The Kentucky LEADS Collaborative is dedicated to reducing the burden of lung cancer in Kentucky and beyond through development, evaluation, and dissemination of novel, community-based interventions to promote provider education, survivorship care, and prevention and early detection of lung cancer. Dr. Burris and Jessica RR contributed to the development of two modules (Healthy Living & Tobacco Cessation) for the Survivorship Care portion of the project. In the end, more than 150 lung cancer survivors and their caregivers were recruited for this intervention study. Data analysis is ongoing and Will is contributing to dissemination efforts. Currently, a NCI R01 that would serve as a follow-up randomized controlled trial for the Lung Cancer Survivorship Care Program is under review, with fingers crossed for a favorable decision. For more information about the Kentucky LEADS Collaborative, go to

Dr. Burris is a Co-Investigator for a NCI Program Project called "Take C.A.R.E." that centers on cervical cancer prevention throughout primary care practices in the Appalachian region of four states (Kentucky, Ohio, Virginia, and West Virginia). Led by Dr. Electra Paskett of OSU, this study involves both provider education and multi-faceted intervention with women at high risk for cervical cancer. Dr. Burris contributes to the smoking cessation initiative which is innovative in its approach (e.g., treatment is offered to women who are and are not ready to quit in the next month) and has potential for high impact (e.g., it was "designed for dissemination" and is a scalable intervention). Full implementation begins in 2021 and Tia is coauthoring a protocol paper. Stay tuned...

Lab Members

Jessica N. Rivera-Rivera

B.A. Psychology, University of Puerto Rico, 2012; MPH Biostatistics, University of Puerto Rico, 2013

I was born and raised in Puerto Rico. Before joining Dr. Burris’ lab, I worked for two years as an advisor in Biostatistics for Puerto Rico’s Health Department. Currently, I am a 6th year student (now on internship) in the clinical psychology Ph.D. program at UK, and I am did my dissertation on the relationship between psychological functioning (distress and wellbeing) and both social support and social constraint in cancer survivors. Overall, I am interested in how cancer survivors and their supporters cope after a cancer diagnosis. I am also interested in conducting research in underserved communities and with minority populations. Outside of research, I like running, dancing, and trying new restaurants.

Gabriella Puleo

B.A. Psychology, Rutgers University, 2013; M.S. Clinical Psychology, Barry University, 2016

I was born and raised in beautiful Staten Island, NY, and relocated to Miami, FL for my Master’s degree. I am currently a 5th year clinical turned experimental psychology Ph.D. student in Dr. Burris’ lab. I’m interested in health behaviors specifically linked to cancer diagnosis, treatment, and quality of life, with particular interest in adult and geriatric patients. My previous research experience has involved a wide range of health-related interests from reward-based behavioral health interventions for preschool children to orthopedic implant studies in chronic pain patients. As a first-year, I won the Kentucky Psychological Foundation's Multicultural Professional Development Award, which allowed me to host an expert in health equity research. Finally, I enjoy spending my free time outside with my dogs, crocheting, and baking.

Tia Borger

B.A. Psychology, University of Kentucky, 2018

I was born in Springfield, Ohio and moved to Lexington for college in 2014. During my undergraduate career at UK, I was a research assistant in a neuropsychology lab as well as a clinical health psychology lab, which is how I became interested in working with Dr. Burris. Currently, I am a 3rd year student in the clinical psychology doctoral program in Dr. Burris’ lab. I am interested in the quality of life of cancer survivors who smoke and interventions to improve quality of life post-cancer diagnosis. I was funded as a NIDA T32 Pre-Doctoral Fellowship in my first two years and I am now a TA. In my free time, I enjoy attending UK sporting events and exercising.

Will Bowling

B.A. Psychology, Berea College, 2018

I grew up in the mountains of eastern Kentucky in a small town called Booneville. After high school, I moved to central KY to pursue my bachelor’s degree in Psychology at Berea College. This expereince prompted my move to Lexington for graduate school, and I am now a 2nd-year student in the UK clinical psychology Ph.D. program in Dr. Burris’ lab. My main research interest involves factors that encourage maladaptive health behaviors among cancer survivors. When I am not in the lab, I like to spend my time watching scary movies, playing volleyball, and touring local breweries.

Yancey Sizemore

Honors College Student & Psychology Major, UK

While I was born and riased in Lexington, I have roots in Hazard, Frankfort, and Louisville, KY as well. I'm currently a senior at UK, majoring in psyhology and minoring in criminology. I met Dr. Burris while taking her class for my minor, and it was her work that convinced me to concentrate on health psychology as a career focus. Working in the CARES Lab has allowed me to gain a better perspective of the nuances of cancer survivorship in KY. I am interested in quality of life of cancer survivors and how social support (or lack thereof) may impact that. In my free time, I love being with my friends, baking, and trying different types of tea.


Student Publications

Burris, J. L., Rivera-Rivera, J. N., Armeson, K., Zapka, J., Alberg, A.J., Day, T. A., & Sterba, K. R. (2019). Causal attributions and their impact on psychosocial functioning in head and neck cancer patient-caregiver dyads: A preliminary, longitudinal study. Quality of Life Research, 28, 1105–1109.

Puleo, G. E., Borger, T., Rivera-Rivera, J. N., Montgomery, D., & Burris, J. L. (2020). A qualitative study of smoking-related causal attributions and risk perceptions in cervical cancer survivors. Psycho-Oncology, 29, 500–506.

Rivera-Rivera, J. N. & Burris, J. L. (2020). A systematic literature review and head-to-head comparison of social support and social constraint in relation to the psychological functioning of cancer survivors. Annals of Behavioral Medicine, 54, 176–192.

Borger, T., Puleo, G. E., Rivera-Rivera, J. N., Montgomery, D., Bowling, W., & Burris, J. L. (In press). A descriptive study of cervical cancer survivors’ persistent smoking behavior and perceived barriers to quitting. Psychology of Addictive Behaviors

Leger, K. A., Turiano, N. A., Bowling, W., Burris, J. L., & Almeida, D. M. (In press). Personality traits predict long-term physical health via affect reactivity to daily stressors. Psychological Science.

Rivera-Rivera, J. N., Badour, C. L., & Burris, J. L. (In press). The association between psychological functioning and social support and social constraint after cancer diagnosis: A 30-day daily diary study. Journal of Behavioral Medicine.


12/6/20: We had a Zoom lab meeting so Tia could practice her thesis defense presentation. It was great to see everyone together again!



8/1/20: Devin started the UK PharmD program, but since she's at UK, she still hangs out with us from time to time!

2/21/19: Jessica RR matches to her #1 choice for internship: University of Florida Health Sciences Center!

2/13/20: The CARS Lab grows significantly with the birth of Gaby's twins, Zara and Aspen!
















5/15/19: Jessica RR received a couple of awards this month, including an APA Travel Award and Academy of Psychological Clinical Science "Flexibility Fund" Award, both of which will support her attendance at an upcoming APA Advanced Training Institute on Racial and Ethnic Minority Research Methods! Congrats!

5/15/19: Tia and Gaby took 1st and 2nd place, respectively, for their Clinical Science poster presentations at the 2019 Markey Cancer Research Day! Woo hoo CARS Lab! In addition to some awesome mugs (picture below), there was a cash prize!

5/1/19: Devin was selected as a participant in a UK Summer Research Program in Pharmaceutical Sciences! Because she plans to attend Pharmacy School next year, this is an amazing opportunity for her - congrats Devin!

9/1/18: Jessica RR was selected as a DREAM Scholar Associate! The DREAM Scholars program is a new initiative on campus that focuses on training the next generation of health equity researchers, and it is supported by the UK College of Nursing, Center for Clinical and Translational Science, and Center for Health Equity Transformation. This award includes funding for Jessica's research and professional development. Yay!

5/1/18: Kelly -- one of the original CARS lab members -- graduated from UK in May 2018! Congratulations Kelly, and best of luck in PA School at Kettering College!



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