Behavioral Medicine Research

The BMED Service and its faculty have secured approximately $11 million in funded research programs primarily through National Institute of Health grant awards and have recruited more than 400 participants into clinical intervention research. Faculty and Fellows within the BMED Service have published or had accepted for publication well over 200 peer reviewed articles and book chapters.

The BMED Service is at the forefront of research focused on developing, validating, and disseminating psychosocial interventions to help individuals with a variety of health and medical issues.

Here is a list of ongoing BMED research projects. If you are interested in participating in one of these projects, please use the information in the “Potential Participants” section of the project description below.

Ongoing Research Studies Seeking Participants

Project: Integrating Tobacco Treatment into Cancer Care
Principal Investigator: Elyse R. Park, Ph.D., MPH
Funding Source: National Cancer Institute (NCI)
Project Number: 1K24 CA197381-01

Description: The mentoring and research aims of this proposal involve expanding our knowledge of how to develop and deliver evidence-based tobacco treatment for diverse/variety of cancer patients.

Potential participants: MGH cancer patients who are smokers, English or Spanish –speaking, with regular telephone access.

Project: Promoting Resiliency among Parent of Children with Special Healthcare Needs
Principal Investigator: Elyse R. Park, Ph.D., MPH
Funding Source: The Marino Foundation
Project Number: N/A

Description: According to the 2011/12 National Survey of Children’s Health, 14.6 million children in the U.S. have special health care needs (e.g., learning disability, ADD/ADHD, developmental delays, chronic mental or physical health conditions). Having a child with special health care needs (CSHCN) is associated with an increased risk of problems with emotional and physical health and social well-being. Resiliency is a multidimensional construct that refers to the ability to maintain adaptation and effective functioning when faced with stressors. Resiliency provides a framework for understanding the adjustment to stress as a dynamic process. We will personalize and target the Stress Management and Resiliency Training- Relaxation Response Resiliency Program (SMART 3RP) to parents of children with special health care needs. We will determine the feasibility, and acceptability, and efficacy of an 8-week group 3RP intervention to parents of children with special health care needs. Lastly, we will pilot test the end-of-treatment effects of the SMART 3RP on parents’ stress levels using health-relevant biomarker measures.

Potential participants: We plan on recruiting patients, nationally, of children (ages 5-16) with special needs.

Project: Resiliency Training for Patients with Neurofibromatosis delivered via videoconferencing with Skype
Principal Investigator: Ana-Maria Vranceanu, Ph.D.
Funding Source: Children’s Tumor Foundation
Project Number: 225832

Description: The major goal of this project is to test the preliminary feasibility, acceptability and effect of the Relaxation Response Resiliency Program (3RP) versus a matched attention placebo control in adolescents with NF1 and NF2. Both interventions are delivered via group videoconferencing. Specific aims: 1) determine the preliminary effect of the 3RP versus control in improving quality of life and psychosocial factors in adolescents with NF1 and NF2.

Potential participants: Adolescents between the ages of 12 to 17 who have been diagnosed with neurofibromatosis type 1 or neurofibromatosis type 2 by a specialized medical provider.

Project: A brief Cognitive Behavioral Relaxation Response (CBRR) intervention for patients with acute pain via videoconferencing
Principal Investigator: Ana-Maria Vranceanu, Ph.D.
Funding Source: Orthopedic Research Education Foundation (OREF)
Project Number: 226344

Description: The major goal of this project is to test the feasibility, acceptability and effect of the Cognitive Behavioral Relaxation Response versus usual care in patients with acute pain at risk for chronic pain and disability, via videoconferencing. Specific aims: 1) determine the feasibility and acceptability of the CBRR; 2) determine the preliminary effect of the CBRR versus usual care in improving pain intensity and disability.

Potential participants: Adults (18 years or older) presenting to the Partners Orthopedic Trauma Service or Hand and Upper Extremity Service who have recently suffered a traumatic musculoskeletal injury.

Project: Depression, Anxiety and Opioid Adherence in Adults with Cancer Pain
Principal Investigator: Lara Traeger, Ph.D.
Funding Source: American Cancer Society
Project Number: ACS MRSG PCSM 1410701

Description: The goal of this study is to examine and address associations of depression, anxiety and adherence to long-acting opioids among adults with chronic cancer-related pain. Study procedures currently are integrated into ambulatory care at the Massachusetts General Hospital Cancer Center. In Project 1 (a prospective observational study), we will examine the extent to which depression and anxiety symptoms are associated with poorer opioid adherence and worse pain outcomes. In Project 2 (an open pilot trial), we will use our results to develop and test a structured intervention to help patients adhere to their opioid regimens while reducing depression and anxiety symptoms. This work has the potential to increase the benefits of guideline-based treatments for chronic cancer pain and to optimize quality of life for patients at high risk for crisis-oriented pain care.

Potential Participants: If you are interested in participating in this research, please contact the study coordinator at 617-643-9907.

Behavioral Medicine

“The interdisciplinary field concerned with the development and integration of behavioral, psychosocial, and biomedical science knowledge and techniques relevant to the understanding of health and illness, and the application of this knowledge and these techniques to prevention, diagnosis, treatment and rehabilitation”. Definition provided by the Society of Behavioral Medicine (SBM).

Project: Perinatal Depression, Stigma, Social Capital Utilization and PMTCT Adherence
Principal Investigator: Christina Psaros, Ph.D.
Funding Source: National Institute of Mental Health (NIMH)
Project Number:1K23MH096651-01

Description: The United Nations Millennium Development Goals (MDGs) illustrate key areas in which the lives of women and children worldwide are in need, including improving maternal health and a reduction in childhood mortality. The success of meeting both these goals depends on reducing rates of vertical transmission of HIV. Sub-Saharan Africa is one of the areas targeted by the MDGs and bears a substantial degree of HIV disease burden, with well over 22 million people living with HIV at the end of 2008, a significant number of whom are women of reproductive age. Depression has been associated with non-adherence to the series of health behaviors known as preventing mother-to-child transmission (PMTCT) of HIV. Women in resource limited settings are likely to face additional barriers to PMTCT adherence, including stigma and structural barriers. While structural barriers may be circumvented by relying on community resources (known as social capital), depression and stigma may make it difficult to access these resources. Thus, understanding the role of modifiable factors that contribute to PMTCT adherence is critical to meeting the goals of the MDGs. The goals of the proposed project are to (1) investigate the relationships among perinatal depression, stigma, social capital utilization, PMTCT adherence, and (2) to test a pilot intervention to treat perinatal depression and improve adherence to ARVs among HIV infected women in a resource limited setting.

Potential Participants: We plan to recruit HIV infected women living in KwaZulu-Natal, South Africa in March 2016.

Project: Integrated Behavioral Treatment for Chronic Pain/Drug Use in Older MSM with HIV (Phase 2) Principal Investigator: Conall O’Cleirigh, Ph.D.
Funding Source: NIH
Project Number: R21 DA038197-01

Description: Men who have sex with men (MSM) in the US are most heavily affected by HIV, representing ~63% of all new HIV infections annually. With highly effective HIV medication and consistent engagement in HIV health care, these MSM are living longer; by 2015 it is estimated that more than 50% of Americans living with HIV will be 50 years of age or older. Evidence is emerging that chronic pain is prevalent in older HIV-infected patients and likely occurs synergistically with substance use and abuse, which predispose to non-engagement and non-retention in HIV care, non-adherence to HIV medications and sexual risk taking. Understanding these relationships and incorporating pain management strategies in health interventions will forge the development of a tailored behavioral-based, integrated intervention that has the potential to improve pain management, reduce substance use (and/or its interference in HIV disease management) and improve ART adherence and engagement in care Design. The purpose of this research application is to develop and openly pilot an integrative intervention for older HIV- infected men who have sex with men (MSM) who report chronic pain and substance-using behaviors that interfere with engagement in care and sexual risk taking. The application has the potential to change the manner in which older HIV infected MSM with chronic pain and substance abuse are treated, thus increasing quality of life and longevity in this population.

Potential Participants: If you are interested in participating in this research, please contact the study coordinator at 617-927-6465.

Project: Nurse-Delivered CBT for Depression-Adherence in HIV Primary Care in South Africa
Principal Investigator: Steven Safren, Ph.D., ABPP; Conall O’Cleirigh, Ph.D.
Funding Source: NIH
Project Number: R01 MH103770-01A1

Description: This is a proposal to conduct a two arm randomized effectiveness trial investigating whether a task shifting/sharing model of treating depression and improving adherence to ART in patients who fail first line antiretroviral therapy (ART) can occur using nurses in South Africa trained in CBT. South Africa is the country with the highest number of HIV infections in the world and the highest number of HIV/AIDS-related deaths, and where access to third line ART treatment is not currently available in the public healthcare system. Clinical depression, like elsewhere, is one of the highest comorbidities to HIV/AIDS, with estimated rates up to 34.9 percent. Depression, in the context of HIV, leads to poor self-care behavior such as non-adherence to ART and worse retention in care, which are critical for treatment success. The U.S. based investigators have developed and successfully tested an approach integrating adherence counseling into cognitive- behavioral therapy for depression in HIV. The South Africa based team, in collaboration with the U.S. based team, has conducted preliminary work to evaluate the cultural appropriateness and feasibility of integrating this approach into the South African HIV treatment setting. Accordingly, we have 1) conducted an open-pilot of the treatment in Cape Town with 6 HIV-infected patients with depression using a clinical psychology PhD student as the therapist, 2) conducted formative qualitative research on the manifestation of depression and ways to adapt this approach for the South Africa HIV care setting, 3) successfully trained two clinic nurses in the adapted version of the intervention, and 4) completed an open pilot feasibility trial with 14 patients with these nurses as interventionists.

Potential Participants: This study will be recruiting HIV-positive adults with a current diagnosis of depression and an uncontrolled viral load in South Africa.

Harvard University Center for AIDS Research (CFAR) Behavioral and Social Sciences Core
Conall O’Cleirigh, Ph.D., Associate Director

Description: In his role as Associate Director of the Harvard University CFAR Behavioral and Social Sciences (BSS) Core, Dr. O’Cleirigh provides consultation on developing and supporting HIV-related clinical research. The Core provides services to behavioral and biomedical researchers; will leverage ongoing biomedical projects to integrate behavioral/social science and conduct add-on behavioral/social science studies; and will engages community stakeholders to increase buy-in of research and acceptance of new biomedical technologies.

Recently Completed Research Studies

Project: Fifteen Years of Epidemic HIV: Novel Risk Behavior in South African Teens in 2010
Principal Investigator: Christina Psaros, Ph.D.
Funding Source: National Institute of Mental Health (NIMH)
Project Number: 1R03MH093237-01A1
Description: Rates of HIV infection among young women in South Africa are among the highest in the world. Adolescent women in South Africa represent part of the "second generation" of HIV affected youth, a cohort that remains understudied. Adolescent women coming of age today likely have different experiences related to HIV than the generation before; we explored how the experiences of these women may impact current HIV risk behavior to learn how to best intervene in order to reduce rates of HIV in the future.

Project: Integrated Treatment for Smoking Cessation & Anxiety in People with HIV
Principal Investigator: Conall O’Cleirigh, Ph.D.
Funding Source: National Institute of Drug Abuse (NIDA)
Project Number: 1R34DA031038-01A
Description: This trial provided important information regarding the potential efficacy and mechanisms of an integrated intervention for and at risk group of HIV+ smokers, namely those who also have clinically significant anxiety problems (>60% of HIV+ smokers). Identifying efficacious treatments for smoking cessation for HIV+ adults has considerable public health significance because cigarette smoking is the leading cause of death and disability in the United States (U.S.), contributing to over 440,000 deaths each year, and HIV+ smokers comprise an overrepresented group among smokers. This study yielded important information in the treatment of drug use and anxiety symptoms in HIV+ individuals, including how best to treat this vulnerable population. Moreover, this study guided advances in the theoretical conceptualization of the mechanisms involved in HIV-anxiety- smoking relations.

Project: Compensatory Executive Functioning Skills Training in Adolescents with ADHD
Principal Investigator: Steven Safren, Ph.D., ABPP
Funding Source: National Institute of Mental Health (NIMH)
Project Number: 5R34MH083063-03

Description: This is a 3-year study to investigate the efficacy of a cognitive behavioral intervention for adolescents with ADHD who are stabilized on medications but still show clinically significant residual symptoms. Self-report, parent-report, teacher report, and independent assessor (who will be blind to treatment condition) data will be used as outcomes.


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