Division Research Interests

PSYCHIATRIC EPIDEMIOLOGY NUTRITIONAL EPIDEMIOLOGY
BEHAVIORAL AND CANCER EPIDEMIOLOGY DYNAMICS OF AGING IN THE U.S.
MATERNAL AND CHILD HEALTH

PSYCHIATRIC EPIDEMIOLOGY

The psychiatric epidemiology research program in the Division of Epidemiology, headed by Dr. Briana Mezuk, is focused on examining the determinants of psychiatric and behavioral health conditions in the population and how those determinants change over the life span. This research aims to understand the interface between behavior and physiology to integrate social, psychological and biological approaches to understanding mental health and illness over the life course. Active collaborations with the Virginia Institute for Psychiatric and Behavioral Genetics (VIPBG) and the University of Michigan Institute for Social Research (RCGD) and Center for Integrative Approaches to Health Disparities (CIAHD) contribute to this effort.
Current projects in this research area include:

  1. Stress, coping, and mental health disparities: This project is a partnership with investigators at the University of Michigan Center for Integrative Approaches to Health Disparities (CIAHD) to examine the role of stress-coping behaviors on racial disparities in mental and physical health. Other studies in this vein include the Stress and Sugar Study, an ongoing pilot investigation of the role of stress reactivity and glucose metabolism among African Americans with pre-diabetes funded by the VCU Center for Clinical and Translational Research (CCTR).
  2. Depression, inflammation, and diabetes: exploring shared etiopathology: This project leverages genetically-informed data (e.g., twin and family studies) to examine the interplay of genetic and environmental factors that contribute to the comorbidity between depression and type 2 diabetes. This work is supported by a grant from the National Institute of Mental Health (MH093642-A1). As part of this project, we are examining the relationship between depressive symptoms and expression of immune-related genes in collaboration with Dr. Steve Cole at UCLA.
  3. Neighborhood context, depression, and type 2 diabetes: This project aims to understand how contextual environmental characteristics (e.g., neighborhood deprivation, social capital, walkability, access to goods and services) influences the risk of depression, type 2 diabetes, and their comorbidity. This work is a partnership with Dr. Kristina Sundquist of the Centre for Primary Care Research at Lund University in Malmo, Sweden and is funded by the National Institute for Diabetes, Digestive, and Kidney Diseases (DK8356430-A1).

Other areas of research in this program include:

  1. Depression and frailty in later life: An exploration of the interrelationship between depression and frailty among older adults originally sponsored by the Building Interdisciplinary Research Careers in Women's Health (BIRCWH) Program. Work in this area using data from the Health and Retirement Study (HRS) is continuing through support by the National Institute of Aging (PI: Matthew Lohman).
  2. Job strain and health among older workers: An examination of the influence of employment and occupational stressors (e.g., demand-control imbalance, workplace discrimination, job insecurity) on mental and physical health in later life funded by CIAHD and the University of Michigan Depression Center.
  3. Suicide risk in assisted living and long-term care facilities: This project uses data from the Virginia Violent Death Reporting System (VDRS), in partnership with the Virginia Office of the Chief Medical Examiner, to explore the incidence and risk factors for suicide among older adults in senior living communities.

The goal of this line of research is to inform interventions which reflect an integrative approach to health to effectively reduce the burden of mental disorders in mid and late-life.

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behavioral and CANCER EPIDEMIOLOGY

The behavioral and cancer epidemiology research program in the Division of Epidemiology is focused on examining the behavioral and biological determinants of cancer in the general and underserved populations. This research has four areas of emphasis: (1) assessing the predictors and barriers of colorectal cancer screening and developing interventions to increase screening behavior; (2) developing and evaluating group randomized health promotion intervention among school-aged youth; (3) assessing the role of obesity and other metabolic disorders in the development and survival of cancer; and (4) exploring the role of nutritional factors, in particular vitamins/minerals, in the development and progression of cancer. Active interdisciplinary collaborations with the Departments of Family Medicine and Population Health, Internal Medicine, Psychology, and Social and Behavioral Health contribute to this effort as well as community-based partnerships. Faculty are scientific research members of Massey Cancer Center.

Select projects in this research area include:

  1. Colorectal Cancer Screening With Improved Shared Decision Making (CRCS-WISDM): a large, longitudinal community-based intervention that employs a system enhancement specifically designed to non-obtrusively embed shared decision making in current practice within community-based primary care with broader reaching community-wide features targeted to all community residents in collaboration with Allina Health.
  2. Confusion about the multiple recommended colorectal cancer screening modalities: an investigation of whether providing multiple screening recommendations creates confusion about the recommendations and impedes adherence to them in collaboration with the Departments of Family Medicine and Population Health, Internal Medicine, and Social and Behavioral Health
  3. Development and psychometrics of colorectal cancer screening barriers scales: a collaboration with investigators in the Department of Family Medicine and Population Health and the University of Texas Houston - School of Public Health, Division of Health Promotion and Behavioral Sciences to create and determine the validity of comprehensive scales measuring barriers to four commonly recommended colorectal cancer screening modalities
  4. Structural equation modeling for the effect of educational entertainment on colorectal cancer screening: an investigation of the effects of drama and comedy narrative elements in audio soap operas on transportation of the target audience and their subsequent cancer screening intentions and behavior in healthy African American women in collaboration with the Department of Social and Behavioral Health
  5. Youth tobacco prevention and health promotion: a study to engage public school administrators and teachers to create, implement, and evaluate a model health promotion curriculum based on a previously implemented school-based intervention program in collaboration with the Department of Psychology's Life Skills Center (funded by the Virginia Foundation for Health Youth)

The goal of this line of inquiry is to impact cancer prevention and control and ultimately reduce cancer morbidity and mortality through novel, applied and translatable research.

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MATERNAL AND CHILD HEALTH

The Maternal and Child Health epidemiology research program in the Division of Epidemiology is focused on improving the health and well-being of women, children and families. This research includes issues related to perinatal health, provision of comprehensive care to underserved pregnant women, infant development and school readiness, youth violence, sexual violence prevention, and assessment of women’s health status. Methodological work in this area focuses on the development of probabilistic data linkage methods which can enhance Maternal and Child Health surveillance by tracking mothers and infants longitudinally using existing data. Active collaborations with the Virginia Department of Health (VDH) contribute to this effort.

Current projects in this research area include:

  1. Stress and disparities in poor birth outcomes: an exploration of the influence of stress on poor birth outcomes and its role in perinatal disparities
  2. Reducing perinatal disparities among African-American women: an evaluation of a comprehensive case management program designed to reduce perinatal disparity among the underserved African-American community
  3. Preterm/low birthweight and school readiness: an exploration of the intersection of biologic (e.g., preterm birth) and social (e.g., maternal-infant interactions) determinants on the cognitive and social development of infants and young children
  4. Sexual and reproductive decision making: an exploration of social and environmental factors affecting decisions related to sexual and reproductive health and the contextual factors that influence a woman’s ability to control if and when to have children
  5. Pregnancy Risk Assessment Monitoring System (PRAMS): a collaboration with the Centers for Disease Control and Prevention (CDC) and VDH to collect population-based data on maternal attitudes and experiences before, during, and shortly after pregnancy
  6. Virginia Assessment Initiative Project (VAIP): a collaboration with the CDC and VDH to improve community health assessment practices in Virginia by building assessment capacity at the state and local levels
  7. State Systems Development Initiative (SSDI): a collaboration with the Health Resources & Services Administration (HRSA) and VDH to improve the timeliness, accuracy, and availability of MCH surveillance data, including the development of data linkage methods to track women and children longitudinally across VDH program areas

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Nutritional epidemiology

Research is to understand the biological mechanisms underlying the links between lifestyle factors, mainly diet, and the development of major diseases, such as obesity and cancer.  It involves research to:

  1. engage current complex issues and advanced methods in assessing nutritional status in intervention and epidemiological studies
  2. understand the role of lifestyle factors in children's growth and development
  3. determine the contribution of lifestyle factors to the development of disease
  4. analyze modifiable factors that improve quality of life and survival of patients with cancer and other major diseases
  5. develop and evaluate interventions at the individual and population levels to achieve and maintain healthy lifestyles

The Day and Night Lifestyle and Cancer Survival Study (Day and Night Study) assesses sleep quality, and dietary and lifestyle risk factors in relation to quality of life. The hope is to develop effective strategies to improve quality of life and to prolong cancer survival. For information on the study, call our toll-free number, 866-344-5428.

DYNAMICS OF AGING IN THE U.S.

The dynamics of aging in the United States research in Epidemiology is focused on assessing the population dynamics of aging in the United States and their implications on population health, health care services, and disease patterns. Using the framework and methods of public health demography and social epidemiology, the goal of this research is to enhance epidemiological inquiry so as to better understand the proximate and distal factors impacting aging on both the population and individual levels.

Current research is concentrated in three major areas: (1.) the social epidemiology of informal, family caregiving to older adults and its impacts on the health of the caregiver, (2.) modeling spatiotemporal and demographic trends in Medicare utilization in older adults, and (3.) impacts of the growing population of older adults on the distribution and welfare of the health care labor force in the US.

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