Principal Investigator: Katherine Y. Tossas, PhD

Funding Source: National Cancer Institute

Project Summary: This award proposes a multi-omic systems biology approach to elucidate the roles of the vaginal microbiome and psychological stress in progression of precancerous cervical lesions to cancer, notably, in the known disparities between Black and White women. The study will provide targeted bioinformatic, statistical and molecular biology training to analyze microbiome and stress experience data, using an integrative systems biology framework to inform future clinically relevant prognostic biomarkers, risk stratification protocols, and interventions to intercept cervical cancer development.

Principal Investigator: Jessica G. LaRose, PhD
Co-Investigator: Autumn Lanoye, PhD

Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Project Summary: This is a randomized clinical trial to test the preliminary efficacy of an integrated lifestyle intervention targeting proinflammatory behaviors and psychological function on adiposity and biomarkers of inflammation and cardiometabolic disease among emerging adult women, compared to a developmentally adapted behavioral obesity treatment program.

Principal Investigator: Katherine Y. Tossas, Ph.D.

The SACRED WOMB Projects consist of a series of research initiatives that investigate multiple layers of the relationship between the microbiome and precancerous cervical lesions.

Project 1
Funding Source: American Cancer Society Institutional Research Grant

Project summary: This project focuses on exploring the role of the vaginal microbiome (VMB) in the risk of developing precancerous cervical lesions. It revealed that specific types of VMB offer protection against cervical lesion development for white women but not for Black women.

Project 2
Funding Source: National Cancer Institute

Project Summary: This project aims to investigate the influence of daily stress experiences and the cortisol psycho-endocrine pathway, on the VMB. It seeks to understand how stress affects differential rates of precancerous cervical lesions among different racial groups.

Project 3
Funding Source: V Foundation

Project Summary: This project further explores the potential mediating role of VMB and HPV dynamics in the psycho-endocrine pathway that links stress to regression of precancerous cervical lesions.

Project 4
Funding Source: Victoria’s Secret Global Fund for Women’s Cancer

Project Summary: This project focuses on assessing the relationship between the VMB and cellular proliferation markers, p16 and ki67. It aims to understand this relationship within the context of stress experiences.

Co-Project Investigator: Kellie Carlyle, PhD

Funding Source: Department of Justice

Project Summary: Many girls become involved with the juvenile justice system through the trauma-to-prison pipeline, which describes myriad forms of abuse and trauma that girls disproportionately experience and how their normal reactions to these traumas are criminalized through intersecting gendered, racial, and socioeconomic structural inequities. This project seeks to disrupt the trauma-to-prison pipeline by (1) providing intervention programming to system-involved girls; (2) training Department of Juvenile Justice staff about the pipeline and how to respond to girls in trauma-informed ways; and (3) building community capacity in high-poverty areas for changing the social contexts influencing public safety and the criminalization of trauma.

Principal Investigator: Vanessa B. Sheppard, Ph.D.
Co-Investigator: Richard F. Brown, Ph.D.

Funding Source: American Cancer Society 

Project Summary: Black breast cancer (BC) survivors experience the worst mortality outcomes. Most are recommended effective systemic therapies (chemotherapy or adjuvant hormonal therapy), but adherence is often suboptimal. Patient-centered communication (PCC) is central to high-quality care and to treatment adherence. Unfortunately, Black patients experience lower PCC with providers. Improving communication in black survivors around systemic treatment adherence may reduce disparities. Our preliminary data found that black breast cancer survivors wanted: more involvement in their cancer care, communication support, peer-based strategies, streamlined treatment information, and culturally relevant materials.

This study is responsive to research priorities and national recommendations to empower cancer patients in their medical encounters. Guided by an integrative theoretical framework and our promising preliminary data we will employ a two-arm RCT to test whether SIS (N=230) vs. enhanced usual care (EUC N=230) improves communication with providers and systemic therapy adherence in newly diagnosed black BC patients. The EUC arm consists of a low-literacy treatment recommendation summary form. To our knowledge this will be the first study to rigorously test a multifaceted intervention to address communication disparities and cancer treatment adherence.

If successful, with the help of key stakeholders (e.g. community partners, clinicians), we will disseminate and implement our intervention and materials in various settings including NIH's Research Tested Intervention Programs (RTIPs) and oncology clinics.

Principal Investigator: Vanessa Sheppard, PhD

Funding Source: National Cancer Institute (NCI)

Project Description: Breast cancer is the most diagnosed cancer for Black women. Black women suffer from more aggressive forms of breast cancer (e.g. triple-negative breast cancer) and higher mortality and recurrence rates than their White counterparts. Additionally, Black women, specifically young Black women, have the highest prevalence of BRCA1 or BRCA2 gene mutations, which significantly increases their lifetime risk of developing hereditary breast and ovarian cancer (HBOC). While genetic cancer risk assessments for women at high risk of carrying a mutation inform treatment for survivors and risk management decisions in unaffected women, Black women underutilize this resource when compared to White women. The reasons for disparities in genetic counseling and testing are multifaceted (e.g. access, lack of knowledge); however, studies indicate that increasing access and awareness alone may be insufficient to address disparities. Addressing cultural and psychosocial factors may enhance uptake of genetic counseling and testing. Culturally appropriate information is needed.  

Our experienced multidisciplinary team will conduct a risk communication intervention designed to target emotions and cultural values. Guided by the two evidenced-based theories (Theory of Planned Behavior, Social Cognitive Theory) and our preliminary data, we will conduct a two-phase mixed methods study. In Phase I we will develop a narrative YouTube video intervention that will target key psychosocial factors. In Phase II we will pilot the intervention in Black women at risk of HBOC. Women will be randomized either the YouTube video arm (n=25) or a Print education arm (n=25); all women will be contacted by a scheduler to make an appointment for genetic counseling. Our primary outcome is genetic counseling at 3-months following the receipt of the intervention or print materials; secondary outcomes include psychosocial factors (e.g. knowledge, self-efficacy).

This study meets the Healthy People 2020 goals to enhance GCT in at-risk populations, and the national priorities to increase diversity in genetics research participation while incorporating emotions into cancer research.  Findings will inform new strategies for behavioral interventions targeting Black women at risk of hereditary breast and ovarian cancer and will inform a future multicenter trial.