Research Abstract
In my research, I use my expertise in occupational therapy theory and practice to develop treatments to better target and ameliorate difficulties that adult cancer survivors face when engaging in daily activities within the home and community. I lead studies developing and testing interventions that directly target disability and foster full participation in meaningful activities. My approach to intervention development is informed by my training in implementation science and mixed methods research.
I spent 18 years conducting behavioral intervention development research at Dartmouth College within an interdisciplinary team. I completed my career development award in 2018 and initiated three other pilot studies while pursuing my first R01 (awarded in 2019; R01CA225792). I recently left Dartmouth to join the faculty at Massachusetts General Hospital Institute of Health Professions where I had the opportunity to establish the Cancer Rehabilitation (CaRe) laboratory.
My post-doctoral fellowship and career development award both involved training in experimental methods and developing and testing an intervention to reduce disability for older adult cancer survivors. As part of my career development award, I completed the NIH Training Institute for Dissemination and Implementation Research in Health in 2018. I applied those skills as the project principal investigator and lead author for two global health studies internally funded by the Norris Cotton Cancer Center (NCCC) at Dartmouth. Since leaving Dartmouth, I have maintained my role as the implementation science methodologist for the global health team at NCCC; we are now conducting a study to identify and characterize implementation strategies utilized during the COVID-19 pandemic to maintain radiation treatment for cancer patients in Central America. I am also currently a Co-investigator on a full scale randomized controlled trial (RCT) of two implementation strategies to explore their effectiveness in promoting uptake of early palliative care within community oncology practices. My role on that project is to facilitate a learning collaborative to help oncology practices implement the evidence-based palliative care intervention that our team developed fifteen years ago.
Throughout the intervention development and testing process, I use qualitative methods to elicit and incorporate stakeholder feedback regarding research priorities and the interventions we test. I completed coursework in qualitative analysis during all phases of my graduate work and was mentored by a medical anthropologist during my career development award. In turn, I have served on the dissertation committees of four students conducting qualitative studies. I have designed and conducted studies using qualitative data collection methods including participant observation, interview, and videotape analysis and analysis techniques of content analysis, thematic analysis, and Delphi procedures, resulting in 19 publications. Many of those studies have employed mixed methods, integrating both qualitative and quantitative data to describe concepts.
In summary, I have been a principal investigator or co-investigator for studies all along the intervention development pipeline. My team science has ranged from efficacy to implementation studies regarding early palliative care for people living with advanced cancer. My own line of inquiry ranges from descriptive to feasibility to efficacy studies of cancer rehabilitation approaches. I am committed to studying ways to maximize quality of life and minimize disability in people living with or recovering from cancer.
