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  • Centers for Behavioral and Preventive Medicine

  • Health Disparities Research

  • Yoga for Women Attempting Smoking Cessation

    This study examines the feasibility and initial efficacy of yoga as an adjunct for smoking cessation treatment for women. Women smokers (n=60) will participate in a group-based CBT smoking cessation program and will be randomly assigned to either (1) a twice-weekly yoga program or (2) a wellness (contact control) program.

    Principal Investigator:Beth Bock, PhD

    Co-Investigators: Bess Marcus, PhD; David Williams, PhD; Bruce Becker, MD, MPH; Geoffrey Tremont, PhD; Kathleen Morrow, PhD; and Joseph Fava, PhD

    Funding Agency:  National Center for Complementary and Alternative Medicine

    Dates: 2007 - 2009


    Sustaining Cessation in Parents of Kids with Asthma

    A renewal of our prior NHLBI grant, "Motivating the Parents of Kids with Asthma to Quit Smoking," this study compared two nurse-delivered home-based smoking cessation interventions for low-income caregivers of children receiving asthma treatment: one that focused on augmenting risk perception through the provision of biomarker feedback (PAM), and one that focused on building self-efficacy using the Agency for Healthcare Research and Quality guidelines (BAM). PAM achieved significantly greater quit rates than BAM at a 2 month follow-up, but both groups had high relapse rates by 6 months. The first aim of the current study utilized our previously demonstrated smoking cessation intervention (PAM) to examine the cognitive, affective and behavioral processes hypothesized to underlie the teachable moment in smokers with kids who had a recent asthma exacerbation vs. smokers with healthy kids. The second aim attempts to sustain the excellent short-term quit rates we found in our first study by testing whether supplementing PAM with a telephone-based intervention improves and sustains quitting more than PAM plus contact control in the parents of kids with asthma. The telephone counseling is theory-based, targeting the constructs associated with quitting in our first study (perceived risk, precaution effectiveness, and self-efficacy). Our primary outcomes of interest are:  point prevalence abstinence, Environmental Tobacco Smoke (ETS) reduction, asthma morbidity, and health care utilization. We will also examine mediators and moderators.

    Principal Investigator:Belinda Borrelli, PhD

    Co-Investigators: Elizabeth McQuaid, PhD; Bruce Becker, MD; S. Katherine Hammond, PhD; Scott Novak, PhD

    Funding Agency: National Heart, Lung, and Blood Institute

    Dates: 2005 - 2010


    Motivating Smokers with Mobility Impairments to Quit Smoking

    The aim of this project is to use community based participatory research to develop and produce a theory-based DVD for smoking cessation that is tailored for smokers with mobility impairments, and test the efficacy in a randomized clinical trial.

    Principal Investigator:Belinda Borrelli, PhD

    Co-Investigators: Beth Bock, PhD; Rosemary Hughes, PhD and Tom Lasater, PhD

    Funding Agency: National Cancer Institute

    Dates: 2009 - 2014


    Sustaining Cessation in Pregnant Smokers

    The primary aim of this project is to test whether a Sustained Telephone Counseling (STC) intervention can maintain post-partum abstinence from smoking cigarettes vs. standard care among women who quit at the start of their pregnancy.

    Principal Investigators:Belinda Borrelli, PhD (Subcontract PI) and Tom Lasater, PhD (Project PI)

    Co-Investigator: Scott Novak, PhD

    Funding Agency: National Heart, Lung, and Blood Institute

    Dates:  2005 - 2010


    Motivating Asthma Medication Adherence in Urban Pre and Early Teens

    Principal Investigators: Belinda Borrelli, PhD (Subcontract PI) and Cynthia Rand, PhD (Project PI)

    Funding Agency: National Heart, Lung, and Blood Institute

    Dates:  2005 - 2010


    Prevention of Dental Caries among Children in Low Income Housing in Boston

    To test the effectiveness of a motivational interviewing intervention to increase dental health and dental health behaviors in low income public housing residents.

    Principal Investigators:Belinda Borrelli, PhD (Subcontract PI) and Michelle Henshaw, PhD (Project PI)

    Funding Agency: National Institute of Dental and Craniofacial Research

    Dates: 2008 - 2015


    Motivating Smoking Cessation in a Low-income Housing Population

    Low-income smokers are less successful in quitting than higher-income smokers. Interventions to improve the rate of smoking cessation among low-income smokers are urgently needed, or else these smokers will bear an increasingly disparate burden of smoking-related disease and death. Using residents from low-income communities, such as public housing, to help their fellow residents quit smoking may be an effective method to increase the rate of smoking cessation. This is a randomized clinical trial that tests the efficacy of using either a) a peer-counseling model to motivate smoking cessation treatment entry (Motivational Interviewing) or b) standard education for smoking cessation to motivate smoking cessation treatment entry.

    Principal Investigators:Belinda Borrelli, PhD (Subcontract PI) and Daniel Brooks, PhD (Project PI)

    Funding Agency: National Cancer Institute

    Dates: 2009-2012


    Diabetes Care in American Samoa

    As type 2 diabetes prevalence increases in the United States, the burden of diabetes falls more on groups with greater barriers to care, such as language and cultural differences, and lower economic resources. These disparities extend to the US Territory of American Samoa, where the proportion of adults over 18 with diabetes was 19.6 percent in 2002, compared to 6.4 percent of US adults. This project will translate recent advances in diabetes care into clinical practice for the American Samoan community by improving methods of health care delivery and methods of diabetes self management. We will conduct a randomized clinical trial to test the effectiveness of a community health worker and primary-care coordinated intervention to provide outreach, education and support to type 2 diabetes patients and their families. The outcomes at a one-year follow-up will include glycosolated hemoglobin (HbA1c), cardiovascular disease risk factors, diet and exercise behaviors, and adherence to diabetes care guidelines.

    Principal Investigators:Judith DePue, EdD (Subcontract) and Stephen McGarvey, PhD (Project PI)

    Co-Investigators: Michael Goldstein, MD and Rochelle Rosen, PhD

    Funding Agency: National Institute of Diabetes and Digestive and Kidney Diseases

    Dates: 2006 - 2011


    A Lifestyle Intervention to Prevent Recurrent Gestational Diabetes Mellitus

    This study will test the ability of an exercise intervention to prevent recurrent gestational diabetes mellitus. This intervention can readily be translated into clinical practice in underserved and minority populations.

    Principal Investigators:Bess Marcus, PhD (Subcontract) and Lisa Chasan-Taber, ScD (Project PI)

    Co-Investigator: Charles Neighbors, PhD

    Funding Agency:National Institute of Diabetes and Digestive Kidney Diseases

    Dates:2007 - 2011


    Using a YMCA Exercise Program to Enhance Nicotine Dependence Treatment for Women

    This is a Stage III study to test our Commit to Quit (CTQ) smoking cessation program in the community setting of the greater Providence YMCAs. This trial compares cognitive-behavioral smoking cessation treatment plus a program of regular exercise to cognitive-behavioral smoking cessation treatment plus contact control.

    Principal Investigator:Bess Marcus, PhD

    Co-Investigators: Jessica Whiteley, PhD; David Williams, PhD; Beth Bock, PhD; Joe Ciccolo, PhD; Ernestine Jennings, PhD; Alfred Parisi, MD; Anna Albrecht, RN,MS; Joseph Hogan, ScD

    Funding Agency: National Institute on Drug Abuse

    Dates: 2006 - 2011


    Culturally and Linguistically Adapted Physical Activity Intervention for Latinas

    The purpose of the study is to promote physical activity among this at-risk population using a high-reach, low-cost strategy, which has great potential for adoption on a larger scale and thus high potential for reducing existing health disparities in the U.S.

    Principal Investigator:Bess Marcus, PhD

    Funding Agency: National Institute of Nursing Research

    Dates: 2009 - 2013


    The VETSA Longitudinal Twin Study of Cognition and Aging

    This study examines the contribution of genetic and environmental factors to cognitive aging.

    Principal Investigators:Jeanne McCaffery, PhD (Subcontract) and Michael Lyons, PhD (Project PI)

    Funding Agency: National Institute of Aging

    Dates:2008-2013


    Linking Biophysical Functions of Microbicides to User Perception and Acceptability

    This is a project funded through the NIH's Microbicide Innovation Program (MIP). The goal of this study is to explore the potential correspondence between specific omnibus measures of microbicide formulation properties and rheology and similarly omnibus scale measures of women's experiences with those formulations. Using qualitative methods, quantitative scale items were generated and are now being evaluated. A link between biophysical properties and user evaluation of vaginal products would allow the co-optimization of drug deployment and product acceptability, ultimately leading to highly effective anti-HIV topical vaginal microbicides.

    Principal Investigator:Kathleen M. Morrow, PhD

    Co-Investigators: David Katz, PhD; Patrick Kiser, PhD; Joseph Fava, PhD; Rochelle Rosen, PhD; Erna (Milu) Kojic, MD; Lori Panther, MD

    Funding Agency:National Institute of Mental Health

    Dates: 2006 - 2011


    Long-acting Acceptable Microbicides: Novel Delivery, Activity and Pharmacodynamics

    This project isfunded under NIAID's "Integrated Preclinical/Clinical Program for HIV Topical Microbicides" (U19) mechanism. The overall project aims to develop, evaluate and progress new anti-HIV compounds and novel delivery systems through the microbicide pipeline. Specifically, compounds that inhibit viral entry, attachment, and reverse transcription will be tested and developed in novel forms (i.e., long-acting vaginal gels and intravaginal rings). Project 3 (Morrow, PI) is responsible for developing instruments to measure factors related to product acceptability and use, and optimize potential acceptability and use of the products developed in this research.

    Principal Investigator:Kathleen M. Morrow, PhD (PI: Project 3)

    Co-Investigators: Robert Buckheit, PhD (PI: U19, and Core A and C); David Katz, PhD (PI: Project 2); Patrick Kiser, PhD (PI: Project 1); Charlene Dezzutti, PhD (PI: Core D); Todd Parsley, PhD (PI: Core B); Lisa Rohan, PhD (Co-PI: Project 2); Joseph Fava, PhD (Co-I on Project 3); Rochelle Rosen, PhD (Co-I on Project 3)

    Funding Agency: National Institute of Allergy and Infectious Diseases

    Dates: 2008 - 2013


    Evaluation of the Behavioral Measures of Acceptability of Two Vaginal Gels

    The goal of this study is to evaluate novel vaginal gel formulations and the potential correspondence between formulation properties and rheology and measures of women's experiences with those formulations. A link between biophysical properties and user evaluation of vaginal products would allow the co-optimization of drug deployment and product acceptability, ultimately leading to highly effective anti-HIV topical vaginal microbicides.

    Principal Investigator:Kathleen M. Morrow, PhD

    Co-Investigators: David Katz, PhD; Patrick Kiser, PhD; Joseph L. Fava, PhD; Rochelle Rosen, PhD; Erna (Milu) Kojic, MD; Lori Panther, MD

    Funding Agency: CONRAD

    Dates: 2009 - 2010


    Feasibility and Acceptability of SILCS Diaphragm as a Microbicide Delivery System

    The goal of this study is to examine the potential to use the SILCS diaphragm, developed by PATH (Program for Appropriate Technology in Health), as a vaginal microbicide delivery system. Using MRI imagining and behavioral acceptability measures, the study will explore both the actual deployment of vaginal gel as a function of different application processes using the SILCS, and how that deployment is related to acceptability.

    Principal Investigators:Kathleen M. Morrow, PhD (Subcontract); Patricia Coffey, PhD (Project PI); Kurt Barnhart, MD

    Funding Agency: United States Agency for International Development

    Dates: 2007 - 2010


    Maintaining Exercise after Cardiac Rehabilitation

    Maintaining exercise participation among patients who have completed cardiac rehabilitation is integral to secondary prevention of coronary events and cardiac re-hospitalization. To promote exercise maintenance after completion of a 12 week Phase II rehabilitation program, we propose to offer a theoretically-based intervention that we have used successfully to promote exercise among older, primary-care patients. This program (maintenance counseling) includes brief advice from the cardiac rehabilitation case manager at Phase II program discharge followed by telephone-counseling based on the Transtheoretical Model of Behavior Change and Social Cognitive Theory. Using a randomized controlled design, 180 patients will be assigned to maintenance counseling or brief advice plus contact control. Outcome assessments will include an exercise tolerance test (baseline/post-rehabilitation and 6 months), self-reported exercise participation, motivational readiness for exercise, and objective activity monitoring at baseline, 6 and 12 months. These data will help to identify whether telephone-based exercise counseling is an effective strategy for sustaining regular exercise and fitness among cardiac rehabilitation patients, thereby contributing to secondary prevention of coronary heart disease.

    Principal Investigator:Bernardine Pinto, PhD

    Co-Investigators: Michael Goldstein, MD; George Papandonatos, PhD; Bess Marcus, PhD; John Todaro, PhD; Peter Tilkemeier, MD

    Funding Agency: National Heart, Lung, and Blood Institute

    Dates: 2004 - 2010


    Community Volunteers Promoting Physical Activity among Cancer Survivors

    To determine the effects of Reach to Recovery (RTR) volunteers at American Cancer Society (ACS) offices providing brief physical activity (PA) counseling via telephone (RTR Plus) over 12 weeks to 120 women who contact collaborating ACS offices (3 offices) for RTR services.

    Principal Investigator:Bernardine Pinto, PhD

    Co-Investigators: Michael Goldstein, MD; George Papandonatos, Ph.D., Kevin Stein, Ph.D., Susan Richter, Debborah Smith, MBA     
         
    Funding Agency: National Cancer Institute

    Dates: 2009 - 2012


    Maternal Smoking, Fetal Behavior and Infant Withdrawal
    The BAM BAM (Behavior and Mood in Babies and Mothers) Study

    Although Maternal Smoking During Pregnancy (MSDP) has been linked to long-term neurobehavioral deficits in older offspring, relatively little attention has focused on the effects of MSDP on neurobehavioral deficits during the fetal and newborn periods. One key unanswered question is whether exposure to prenatal smoking induces neurobehavioral symptoms of withdrawal/abstinence in newborns. In this study, we are characterizing signs of abstinence and neurobehavior in infants and fetuses exposed and unexposed to MSDP. Specifically, the Behavior and Mood in Babies and Mothers (BAM BAM) study is an intensive, short-term, longitudinal study of signs of abstinence and neurobehavior during the fetal and newborn periods in continuously exposed and unexposed offspring. Results may lead to targeted intervention with newborns, education for parents to improve interactions with exposed newborns, and, potentially, early identification of high-risk infants and novel intervention and prevention efforts for pregnant smokers.

    Principal Investigator:Laura Stroud, PhD

    Co-Investigators: Raymond Niaura, PhD; George Papandonatos, PhD; Barry Lester, PhD; Amy Salisbury, PhD

    Funding Agency:  National Institute on Drug Abuse

    Dates: 2005 - 2010


    Maternal Depression, Placental HPA Regulation and Fetal-Neonatal Stress Response
    The BAMBI (Behavior and Mood in Mothers, Behavior in Infants) Study

    Exposure to maternal depression during pregnancy is common and associated with adverse medical and behavioral outcomes in infants. However, little is known about mechanisms underlying early adverse effects. This information is critical for early identification and intervention efforts with high-risk infants. This study is an intensive, longitudinal investigation of maternal major depressive disorder (MDD), maternal-placental neuroendocrine dysregulation, and fetal/neonatal stress response and neurobehavior. Three groups of mothers and offspring will be identified: a) mothers with MDD during pregnancy (including MDD-only and MDD+anxiety disorder), b) mothers with a history of MDD who remain euthymic during pregnancy, and c) mothers with no history of or current psychiatric disorder (controls).

    Neonatal assessment will involve cortisol and behavioral response to a neurobehavioral examination at 1-2 and 30 days; fetal assessment will include heart rate and behavioral response to vibroacoustic stimulus. Measures of maternal-placental neuroendocrine regulation will include maternal circadian cortisol, and expression of placental genes regulating stress response. Results may elucidate early markers of risk and help to delineate early pathways to later behavioral dysregulation. Early identification of high-risk fetuses and infants may also lead to education for parents to improve interactions with stressed newborns, and, potentially, novel therapeutic targets to protect fetuses from consequences of maternal depression.

    Principal Investigator:Laura Stroud, PhD

    Co-Investigators: James Padbury, MD; Amy Salisbury, PhD; Barry Lester, PhD; George Papandonatos, PhD; Thamara Davis, MD

    Funding Agency: National Institute of Mental Health

    Dates: 2007 - 2012


    Maternal Smoking:  Fetuses in Withdrawal?

    Exposure to maternal smoking during pregnancy is linked to numerous adverse fetal and neonatal health outcomes as well as longer-term neurobehavioral deficits in children and adults. Relatively little attention, however, has focused on effects of maternal smoking on fetal and neonatal neurobehavior. One key unanswered question is whether exposure to maternal cycles of daytime smoking and overnight abstinence results in symptoms of withdrawal/abstinence in the fetus. To examine the possibility of a fetal withdrawal syndrome from exposure to maternal smoking, aims of this study are: a) to characterize differences in fetal behavior including signs of abstinence under conditions of maternal satiation (daytime ad libitim smoking) versus overnight abstinence, b) to characterize links between fetal neurobehavior/withdrawal and newborn neurobehavior/withdrawal and c) to examine the influence of second-hand smoke exposure on fetal and infant neurobehavior/withdrawal (exploratory aim).

    Our group has pioneered the use of ultrasound technology to comprehensively evaluate fetal neurobehavior including signs of abstinence. In this study, we apply these techniques to examine the possibility of a fetal withdrawal process in offspring exposed to maternal smoking and second-hand smoke. This study is the first to examine effects of maternal smoking on fetal withdrawal. Results may lead to critical advances in understanding mechanisms underlying long-term effects of maternal smoking exposure. Results also have important clinical and public health implications, including early identification and targeted intervention efforts to protect at-risk offspring, and novel intervention efforts to help pregnant smokers quit.

    Principal Investigator:Laura Stroud, PhD

    Co-Investigators: Raymond Niaura, PhD; Amy Salisbury, PhD

    Funding Agency: Flight Attendant Medical Research Institute

    Dates: 2007 - 2010