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 smoking, cancer, 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 studies focus on survivors and supporters 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.

Funder: National Cancer Institute. Study duration: 2014-2019. Study stage: Dissemination.

Student publications: Rivera-Rivera et al. (2021) - Journal of Behavioral Medicine; Borger et al. (in press) - Nicotine and Tobacco Research

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.

Funder: UK. Study duration: 2016-2018. Study stage: All done.

Student publications: Puleo et al. (2020) - Psycho-Oncology; Borger et al. (2021) - Psychology of Addictive Behaviors.

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 induction 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.

Funder: Kentucky Lung Cancer Research Foundation. Study duration: 2017-2020. Study stage: Data analysis.

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

The Markey CARES Tobacco Program implements 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 accredited, online TTS training program and 2) evidence-based patient care that involves population-based assessment, proactive offers of 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.

Funder: National Cancer Institute. Study duration: 2017-2021. Program implementation: 2018-forever. Study stage: Dissemination.

Student publications: Burris, Borger, et al. (in press) - JCO Oncology Practice; Burris, Bernstein, Borger, et al. (in press) - Journal of General Internal Medicine

Kentucky LEADS Lung Cancer Survivorship Care

The Kentucky LEADS Collaborative was originally lead by Dr. Jamie Studts, a clinical health psychologist who is now at the University of Colorado Cancer Center. As a group, those affiliated with Kentucky LEADS are still 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. In the pilot investigation, Dr. Burris was a co-investigator for the Survivorship Care Intervention, which enrolled more than 200 lung cancer survivors and caregivers into a modular intervention program. In response to a RFA from the National Cancer Institute, Dr. Studts and Dr. Burris jointly submitted a R01 application to test the Survivorship Care Intervention in rural survivors and practices throughout the state. As luck would have it, the application was funded and study preparation is ongoing.

Funder: National Cancer Institute. Study duration: 2021-2026. Study stage: Preparation and protocol refinement.

Key Collaborations

Dr. Burris is a Co-Investigator for a NCI Program Project, Take CARE, 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 huge, 3-initiative project 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 began in late 2020, and the study continues until 2023. Dr. Burris and Tia contributed to the authorship of a protocol paper now under review.

Funder: National Cancer Institute. Study duration: 2018-2023. Study stage: Implementation.

Student publications: Peterson, Borger, et al. (2022) - Addiction Science and Clinical Practice.

Lab Members

Tia Borger, MS

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 4th year student in the clinical psychology doctoral program in Dr. Burris’ lab, and I am doing the Health Psychology Concentration. 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, a TA in my third year, and am now a RA in POP Sciences within the Markey Cancer Center. In my free time, I enjoy attending UK sporting events and exercising.

Will Bowling, BA

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 3rd year student in the UK clinical psychology Ph.D. program in Dr. Burris’ lab. My main research interest involves factors that encourage adaptive health behaviors among cancer survivors. Outside of school and work, I like to spend my time watching scary movies, playing volleyball, and touring local breweries like West 6th.

Abigayle Feather, BS

More info forthcoming...

Katie Wakeman

More info forthcoming...

Lab Alumni

Jessica Rivera-Rivera, PhD

B.A. Psychology, University of Puerto Rico, 2012; MPH Biostatistics, University of Puerto Rico, 2013; PhD Clinical Psychology, Univerisity of Kentucky, 2021

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. While in the clinical program, I did the Health Psychology Concentration and several health psych/behavioral medicine practicum. I did my dissertation on the relationship between psychological functioning (distress and wellbeing) and both social support and social constraint in cancer survivors, which was an extension of my master's thesis and qualifying exam. I did my APPIC internship at the University of Florida Health Sciences Center and am doing a NCI-funded postdoc at Moffit Cancer Center in Tampa, FL. 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, PhD

B.A. Psychology, Rutgers University, 2013; M.S. Clinical Psychology, Barry University, 2016; PhD Experimental Psychology, University of Kentucky, 2021

I was born and raised in beautiful Staten Island, NY, and relocated to Miami, FL for my Master’s degree. I was a 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 -- and I stay very busy raising my twin girls.

Announcements

4/18/22: Will kicked off the summer on a high note by successfully defending his master's thesis. Woo hoo!

3/25/22: Honorary undergraduate lab member, Tristan, gets 3 competetive awards/job offers on the same day. The offers included a paid fellowship with the Markey STRONG Scholars Program, an internship at the Harris Psychological Services Center, and a 395 position in Dr. Peggy Keller's lab. Well done, Tristan.

3/14/22: Yancey, an undergraduate lab alum, got a job as Project Coordinator in the lab of Dr. Michelle Martel, another outstanding faculty member in the UK Clinical Psychology Doctoral Program.

2/5/22: Gaby's quals paper is published in Nicotine and Tobacco Research and is selected as the Editor's Choice! So fancy.

2/1/22: Abigayle Feather commits to UK and joins the CARS Lab as the newest member. Welcome to the fam!

10/1/21: Jessica RR had her first baby, Liam, and they're both doing well!

8/1/21: Will started his new position as a RA in the Center for Health Equity Transformation. This is a great opportunity for him, in part, because it allows him to broaden his network of mentors beyond the Psych Dept.

6/15:21: Gaby successfully defended her dissertation, and now has more time to spend with Aspen and Zara who are growing up so, so fast.

5/15/21: I had the pleasure of hooding Jessica RR at a small graduation ceremony with her family present, and then we had a lab reunion at Talon Winery to celebrate the graduation of Jessica RR and Gaby! Huge milestones for everyone involved, and very special moment for me :)

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.

2/21/20: 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 twin girls, Zara and Aspen!

5/30/19: 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 1^st and 2^nd 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, 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 -- the first undergraduate student in the CARS lab -- graduated from UK in May 2018! Congratulations Kelly, and best of luck in PA School at Kettering College.