Research in Behavioral Medicine

The Behavioral Medicine Program at Massachusetts General Hospital 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.

Overview

The research conducted by the clinicians of the Behavioral Medicine Program is focused on developing and validating new psychosocial interventions to help individuals with a variety of health and medical issues. This research is conducted both domestically and internationally across three continents.

We always have a number of studies running, many in need of participants.  If you are interested in participating in our research, please see our lists of active research to learn more:

Domestic Research

  • Striving towards empowerment and medication adherence (STEP-AD)

    Principal Investigator: Sannisha K. Dale, PhD, EdM
    Funding Source: National Institute of Mental Health (NIMH)
    Project Number: 1K23MH108439-02

    Description: Among women in the U.S, Black women are the most impacted by HIV. Relevant psychosocial and contextual factors facing Black women with HIV include having a history of abuse, posttraumatic stress, racial discrimination, HIV-related stigma/discrimination, and prescribed female traditional gender roles; each of which are associated with worse HIV outcomes. Despite the need, there is currently no evidenced-based psychosocial intervention for Black women with HIV that addresses these contextual factors. The purpose of the current study is to develop and assess the feasibility and acceptability of an intervention for Black women with HIV that combines evidence-based strategies for trauma symptom reduction, strategies for coping with racial and HIV-related discrimination, gender empowerment, problem solving techniques for medication adherence, and other resilient coping techniques.

    Specific aims:

    1. Develop an intervention and conduct an open pilot trial of the intervention to initially assess feasibility of all study procedures and intervention delivery and acceptability
    2. Conduct a small randomized control trial (RCT) comparing the newly developed intervention to an enhanced treatment as usual control
    3. Prepare for conducting a large community based hybrid efficacy/effectiveness randomized control trial in community clinics through engagement with community members and potential deliverers of the intervention


  • Promoting resiliency among parent of children with autism spectrum disorder (ASD)

    Principal Investigator: Karen Kuhlthau, PhD (Elyse R. Park, PhD, MPH, Co-Investigator)
    Funding Source: HRSA
    Project Number: N/A

    Description: In addition to running the SMART-3RP with parents of LD, we are developing an adapted program for parents of children with ASD. To learn more about the experience of raising a child with ASD, we are running focus group interviews with parents of ASD. These interviews will inform an 8-week virtual-delivery program for parents of ASD.

    Potential participants: We are recruiting parents, nationally, of children any age with Autism Spectrum Disorder to take part in a 1 hour-long interview to help us learn more about parenting a child with ASD.

    Contact information: For more information, please email ParentalStressStudy@partners.org, or contact Emma Chad-Friedman at 617-643-6036.


  • Evaluating recovery coaches to improve treatment outcomes & reduce health care costs among patients

    Principal Investigator: Jessica Magidson, PhD and Sarah Wakeman, MD
    Funding Source: Partners Population Health Management
    Project Number: N/A

    Description: This grant aims to evaluate the clinical and cost effectiveness of integrating peer recovery coaches into primary care for outpatient management of substance use disorders, examining whether recovery coach involvement can improve substance use treatment outcomes and reduce health care costs among patients with substance use disorders.


  • Integrated behavioral treatment for chronic pain/drug use in older MSM with HIV

    Principal Investigator: Conall O’Cleirigh, PhD
    Funding Source: NIH
    Project Number: R21 DA038197

    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 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.


  • Integrated behavioral treatment for chronic pain/drug use in older MSM with HIV (Phase 2)

    Principal Investigator: Conall O’Cleirigh, PhD
    Funding Source: NIH
    Project Number: R21 DA038197

    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.


  • Harvard University Center for AIDS Research (CFAR) Behavioral and Social Sciences Core

    Principal Investigator: Conall O’Cleirigh, PhD, 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.


  • Promoting resiliency among parent of children with learning and attention disabilities (LD)

    Principal Investigator: Elyse R. Park, PhD, 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), and learning disabilities (LD) are the largest category of students receiving special education services. Having a child with LD 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 LD. 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 are recruiting parents, nationally, of children any age with learning or attention disabilities. For more information, please email ParentalStressStudy@partners.org, or contact Emma Chad-Friedman at 617-643-6036.

    This program is for parents and is once a week, for 1 hour/ week for 8 consecutive weeks. Participation will be done virtually (via videoconferencing).  To participate in this study, we ask you to complete three questionnaires over the course of 6 months, as well as to provide two hair samples to measure cortisol levels.

    If interested in participating, please complete the pre-screen questionnaire. We will contact you soon to let you know about beginning the program.


  • Integrating tobacco treatment into cancer care

    Principal Investigator: Elyse R. Park, PhD, MPH
    Funding Source: National Cancer Institute
    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: Mass General cancer patients who are smokers, English or Spanish-speaking, with regular telephone access.


  • Integrating tobacco treatment into cancer care: A comparative effectiveness trial

    Principal Investigator: Dr. Elyse R. Park, PhD, MPH
    Funding source: National Cancer Institute
    Project number: R01 CA166147

    Description: A multi-site randomized controlled comparative effectiveness trial will enroll 295 current smokers with suspected or newly diagnosed melanoma, lymphoma, thoracic, breast, genitourinary, gastrointestinal, head and neck, or gynecologic cancer. Participants will be randomly assigned to receive the Intensive Treatment (IT) or Standard Treatment (ST) condition. Both groups will receive an initial motivational counseling session and 3 weekly follow-up counseling sessions with a tobacco treatment counselor, conducted in-person or by telephone. The IT arm has the option to also receive an additional 4 biweekly and 3 monthly proactive counseling sessions and up to a 12-week supply of FDA-approved smoking cessation medication at no cost.

    Potential participants: Mass General patients who have smoked a cigarette, even a puff, within the last 30 days with newly diagnosed or suspected cancer, who are English or Spanish-speaking may be eligible. If you are interested in participating, please contact the study coordinator at 617-643-4765 or email smokefreesupportstudy@partners.org.


  • Integrating tobacco treatment into cancer care: Supplement to promote diversity in research

    Principal Investigator: Elyse R. Park, PhD, MPH
    Co-PI: Giselle K. Perez, PhD
    Funding Source: National Cancer Institute (NCI)
    Project Number: 3R01CA166147-03S1

    Description: Although there is a clear need for tobacco treatment among black and Hispanic smokers, little is known about their smoking behaviors and engagement in tobacco treatment following a cancer diagnosis and initiation of cancer care. Understanding the contribution of racial and ethnic factors on tobacco treatment during cancer care will help inform the development of tobacco programs that target the needs of this group. The proposed supplement aims to understand attitudes and barriers toward tobacco cessation treatment among black and Hispanic cancer patients.

    Potential participants: Mass General cancer patients who are racial/ethnic minorities, are current smokers, and are English or Spanish –speaking. Contact Emily Friedman (erfriedman@mgh.harvard.edu) or Julia Rabin (jtrabin@mgh.harvard.edu).


  • Promoting stress management and resiliency among lymphoma survivors transitioning off treatment

    Principal Investigator: Giselle K. Perez-Lougee, PhD
    Funding Source: American Cancer Society (ACS)
    Project Number: ACS IRG 2016S000828

    Description: Lymphoma survivors are faced with a number of psychosocial and physical sequelae related to their cancer type and treatment that makes them susceptible to experiencing higher rates of distress compared to other survivor groups. This study proposes to develop and test a virtual group program to promote stress management and coping among lymphoma survivors transitioning off treatment.

    Potential participants: Mass General cancer patients who are within two years of having completed treatment for lymphoma. Contact Emily Friedman (efriedman@mgh.harvard.edu) or Katharine Quain (kquain@mgh.harvard.edu).


  • Exploring oncology providers’ attitudes toward cancer clinical trials

    Principal Investigator: Giselle K. Perez-Lougee, PhD
    Funding Source: Lazarex-Mass General Cancer Care Equity Program
    Project Number: NA

    Description: Cancer clinical trials represent the “gold standard” of comparing and testing the safety and effectiveness of novel therapies for the treatment of cancer. Adequate participation of eligible populations is critical to ensuring the accuracy and generalizability of trial findings across diverse groups; however, trial enrollment rates remain suboptimal. The proposed study intends to expand this body of research by using mixed methods strategies to describe oncology providers’ perspectives of enrolling eligible patients into cancer clinical trials. Specifically, we aim to describe their attitudes, experiences, and barriers with recommending and enrolling patients into cancer clinical trials, purposely attending to concerns related to the enrollment of minority and underserved groups. In addition, this study aims to identify strategies to improve trial accrual rates. Findings will help guide the development of an educational intervention for cancer care providers to improve clinical trial enrollment among vulnerable and underserved populations.

    Potential participants: Oncology providers across Boston. Please contact Katharine Quain (kquain@mgh.harvard.edu) for more information.


  • Developing a resilience intervention for older, HIV-Infected women

    Principal Investigator: Christina Psaros, PhD
    Funding Source: National Center for Complementary and Integrative Health (NCCIH)
    Project Number: 1R34AT009170

    Description: The number of older, HIV-infected women in the U.S. is growing. In fact, it is estimated that approximately 50% of the HIV-infected population will be over age 50 by 2020, and a significant percent of women, particularly women of color, continue to be impacted by HIV/AIDS. Additionally, the experience of aging with HIV results in complex biopsychosocial challenges for women, which are experienced as stressors. Despite this, few interventions have been developed for older adults with HIV, and none have focused on women. The goal of this project is to adapt a mind-body resiliency intervention to the needs of HIV-infected women over 50 and conduct preliminary testing of the group intervention via an open pilot study with up to 40 participants. Based on our qualitative work, we will conduct an open pilot study of the intervention in groups of 5-8 women with HIV to assess feasibility and acceptability. We will conduct individual exit interviews to solicit feedback on the intervention, including experiences with the assessment protocol, intervention consent, number and duration of sessions, etc.

    Potential participants: We are looking to recruit biologically born woman age 50 or over who are living with HIV, speak English, and may benefit from learning additional skills to improve resilience. The program is designed to occur in groups of 5-8 women (total of up to 40 participants), and consist of eight weekly 90-minute sessions. 

    For more information, please contact: Elsa Sweek, 617-643-4566


  • Developing a lifestyle intervention to prevent cardiovascular disease in HIV-infected midlife women

    Principal Investigator: Greer A. Raggio, PhD, MPH
    Funding Source: Harvard University CFAR/NIH/NIAID

    Description: Cardiovascular disease contributes to 10-15% of deaths among people living with HIV in North America, and HIV-infected women have a 50% greater relative risk for incident cardiovascular disease than HIV-infected men. Older HIV-infected women in particular face unique challenges that may impede adherence to healthy lifestyle behaviors and increase the risk of cardiovascular disease. However, no existing lifestyle interventions target older HIV-infected women. 

    In this study, we will:

    1. Conduct qualitative interviews in a sample of older HIV-infected women in the Boston area, many of whom will demonstrate moderate to high risk for developing cardiovascular disease
    2. Develop and pilot test a scalable lifestyle intervention based on the qualitative data and modeled on the CDC-recognized Diabetes Prevention Program (DPP)

  • Depression, anxiety and opioid adherence in adults with cancer pain

    Principal Investigator: Lara Traeger, PhD
    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.


International Research

Hybrid effectiveness-implementation trial for ART adherence and substance use in HIV care in South Africa
Principal investigator: Jessica Magidson, PhD
Funding Source: NIDA
Project Number: K23DA041901

Description: This project aims to evaluate the effectiveness and implementation of a lay counselor-delivered cognitive behavioral therapy intervention for HIV medication adherence and substance use in primary HIV care in Cape Town, South Africa. The first phase is qualitative and consists of interviewing patients, providers, and public health officials on their views on HIV and substance use treatment integration, and how to adapt evidence-based treatment for substance use and HIV medication adherence for this setting. The intervention developed based on Phase 1 will be evaluated in a hybrid effectiveness-implementation trial in Phase 2.

Potential participants: Recruitment taking place in Cape Town, South Africa.


Fostering resilience to psychosocial and HIV risk in Indian men who have sex with men (MSM)
Principal Investigator: Conall O’Cleirigh, PhD; Steven A. Safren, PhD; Matthew Mimiaga, ScD
Funding Source: National Institute of Mental Health (NIMH)
Project Number: 1R01MH100627-01A1

Description: The goal of this multi-site randomized controlled trial is to examine the efficacy of an intervention to reduce HIV and STI risk among MSM in India. This 2-arm RCT compares a self-acceptance based HIV risk reduction intervention with voluntary HIV/STI counseling and testing (VCT) to VCT among MSM in Chennai and Mumbai, India.

Potential participants: Recruitment taking place at two sites in India.


Falling off the HIV treatment cascade cliff: Understanding postpartum attrition to HIV care
Principal Investigator: Christina Psaros, PhD
Funding Source: NIH
Project Number: R01MH112385

Description: The province of KwaZulu-Natal, South Africa, has the highest prevalence of HIV among pregnant women in the world: 40% of women enrolled in antenatal care are living with HIV.  Pregnancy is an important time to engage women in HIV care to eliminate perinatal transmission through prevention of mother to child transmission programming (PMTCT), but it also presents an opportunity to engage women in lifelong HIV care.  Many women leave HIV care during the postpartum period, even though ongoing care is imperative to maintaining their health and the health of their infants.  The research community does not know enough about why women leave HIV care during the postpartum period, thus we cannot yet design interventions to retain more women in HIV care.  The goal of this study is to better understand barriers to and facilitators of remaining in HIV care after having a baby in the province of KwaZulu-Natal, South Africa, with the ultimate goal of developing interventions to best support the health of women living with HIV and their children.


Perinatal depression, stigma, social capital utilization and PMTCT adherence
Principal Investigator: Christina Psaros, PhD
Funding Source: National Institute of Mental Health (NIMH)
Project Number: 1K23MH096651

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
  2. Test a pilot intervention to treat perinatal depression and improve adherence to ARVs among HIV infected women in a resource limited setting.

Nurse-delivered CBT for depression-adherence in HIV primary care in South Africa
Principal Investigator: Steven Safren, PhD, ABPP; Conall O’Cleirigh, PhD
Funding Source: NIH
Project Number: R01 MH103770

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
  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.

Completed Projects

Domestic Projects

Integrated Treatment for Smoking Cessation & Anxiety in People with HIV
Principal Investigator: Conall O’Cleirigh, PhD
Funding Source: National Institute of Drug Abuse (NIDA)

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.


Compensatory Executive Functioning Skills Training in Adolescents with ADHD
Principal Investigator: Steven Safren, PhD, ABPP
Funding Source: National Institute of Mental Health (NIMH)

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.


Identifying critical elements of real-time discussions between providers, patients and families at the end of life
Principal Investigator: Lara Traeger, PhD
Funding Source: American Cancer Society

Description: The goal of this study is to examine the nature and characteristics of discussions between palliative care providers and patients/families with metastatic cancer during key transitions in end-of-life care.


International Projects

Fifteen Years of Epidemic HIV: Novel Risk Behavior in South African Teens in 2010
Principal Investigator: Christina Psaros, PhD
Funding Source: National Institute of Mental Health (NIMH)

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.

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