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Current Research Studies

The research goals of the Department of Preventive Medicine are to conduct epidemiologic, behavioral, clinical, health-services research and community participatory research in the areas of chronic disease, cancer, health of underserved populations and child neurocognitive development.

Strategies to Promote Cessation in Smokers Who Are Not Ready To Quit (University of VA Subcontract USPHS R01-CA-193245) PI: Klesges; UT PI: Karen Derefinko
This study is: (1) To test a tobacco Quit Line for Smokers not ready to quit (SNRTQ); (2) To randomize 2100 SNRTQs; (3) To evaluate the efficacy of the intervention. The primary endpoint will be point prevalence at the 6-month post-intervention follow-up (12 months after randomization); and; (4) To determine the cost effectiveness (cost per quit smoker) of each of the interventions.

Behavioral Weight Management for Pregnant and Postpartum Women in the Military (USHPS R01-DK104872) PI: Rebecca Krukowski
This NIH-funded randomized controlled trial will determine whether a gestational weight gain intervention, a postpartum weight loss intervention, or a combination of the two interventions is most beneficial in improving postpartum weight loss, maternal/child health, and military readiness in a sample of Tricare beneficiaries. For additional information on the study, please see:

Dissemination of the Look AHEAD Weight Management Treatment in the Military (USHPS R01-DK-097158) PI: Rebecca Krukowski
This NIH-funded randomized controlled trial examined the efficacy of translating and tailoring the Look Ahead weight loss intervention for overweight/obese active duty Airmen. The 1-year intervention was delivered over the phone. For additional information on the study, please see:

Efficacy of Two Novel Behavioral Post Cessation Weight Gain Interventions (USHPS R01-DK0107747) PI: Rebecca Krukowski
The purpose of this NIH-funded project is to determine whether a weight stability intervention (based on the evidence-based Small Changes intervention) or a weight loss intervention (based on the evidence-based Look AHEAD intensive lifestyle intervention) followed by a smoking cessation intervention are more efficacious for reducing postcessation weight gain at 12 month follow-up, compared to a self-guided condition prior to cessation. For additional information on the study, please see: or call 901-448-2000.

Internet Assisted Obesity Treatment Enhanced by Financial Incentives (Univ of South Carolina Subcont USPHS R01-DK-056746) PIs: Harvey and West, UT PI: Rebecca Krukowski
This randomized controlled trial will determine whether incorporating financial incentives increases the amount and duration of weight losses achieved by Internet-delivered behavioral treatment. A secondary, exploratory aim is to quantify the incremental cost-effectiveness of each intervention strategy compared to established cost-efficacy thresholds.

Implementation of Resources for Enhancing Alzheimer's Caregivers Health in Tribal Communities (REACH into Indian Country) (Rx Foundation Grant) PI: Jennifer Martindale-Adams
This project will implement a proven dementia caregiving behavioral intervention into Indian Country. The intervention, Resources for Enhancing Alzheimer's Caregivers Health in Tribal Communities
(REACH into Indian Country), provides a strategy and framework for health and social support professionals from Indian Health Services and Tribal Public Health Nursing programs and ACL/AoA’s Native American Caregiver Support programs to help family caregivers with behavioral problems and their own stress and coping. Progress, outcomes, and impact will focus on the fit and utility of the intervention in Tribal communities and on the optimal design and requirements for adaptation and spread.

Dementia Caregiver Intervention for Non-Responders. (From New York Harbor VA Medical Center.) PI: Cory Chen, J Martindale-Adams, Linda Nichols, Mentors
The VA Health Services Research and Development Career Development Award will identify predictors of non-response to the REACH VA intervention for Caregivers of individuals with dementia.  It will then develop treatment designed for family caregivers who continue to experience clinically significant depression and caregiver burden following intervention.

Interventions for Parent Caregivers of Injured Military/Veteran Personnel (W81XH-17-C-0022), 4/1/17-3/30/20, Co-PI: J Martindale-Adams, Linda Nichols
This randomized clinical trial, funded by the U.S. Army Medical Research and Materiel Command, will test a well-established behavioral caregiver intervention, compared to attention control, to provide education, support and skills building including problem solving, cognitive restructuring, communication, and stress management to parent caregivers of post deployment military personnel (active duty, Guard, Reserve, veteran).

Adapting and testing an Alzheimer’s family caregiver intervention in Vietnam.  (1R21AG054262-01). PI: WL Hinton and Huong Nguyen.  Co-I: J Martindale-Adams, Linda Nichols
The goal of this NIA-funded pilot is to adapt and test the REACH Community Program with Alzheimer’s family caregivers in Vietnam.

Cancer Caregiver-driven Text Messaging. PI: M Martin and J Martindale-Adams
The goal of this program would to employ an automated caregiver-driven text messaging program as an m-health intervention that practitioners could integrate into real-world clinical settings. 

Methods for genetic association testing (Project leader: CY Chiu, S Sen; contributors: H Kim; funding: NIGMS)
Testing for genotype-phenotype associations in large-scale genetic studies is a key step toward discovering biological mechanisms underlying disease.  Drs. Chiu and Sen are taking complementary statistical approaches in human and non-human populations respectively.  Dr. Chiu is investigating the use of functional data analysis (FDA) techniques to model the effects of multiple genetic variants in gene level association testing.  This allows information compression from large number of genetic variants, fully utilizing linkage disequilibrium (LD) and genetic physical position information.  Dr. Sen and his group are developing algorithms to extend linear mixed models (LMMs) to multivariate phenotype-genotype association testing. Their approach enables genetic researchers to consider both phenotypic and genotypic correlations when testing for genetic association. Linear mixed model code:

Statistical computing for large omic datasets (Project leader: S Sen; contributors: X Hu, H Kim, G Farage; funding: NIGMS, NIDA)
Statistical analysis of large omic datasets (such as those obtained from microarrays, mRNA sequencing, and mass spectrometry to study the transcriptome, proteome, microbiome, metabolome, and other "omes") present computational challenges.  A major issue is that algorithm prototyping is done in a high-level language such as R or Python, but some elements have to be coded in a low-level language such as C/C++ for speed.  Our approach is to use the Julia programming language for prototype development focusing on estimation of multivariate linear mixed models for large-scale and high-dimensional data. In our initial work Julia has speed comparable to C++.  We are also using Julia's interface to GPU (graphical processing unit) computing to speed computations as many computations with high-dimensional datasets may be sped up exploiting parallelisms suitable for GPUs.
The web interface to these computational modules will be put on Gene Network [].

Tools for enhancing statistical collaborations (Project leader: F Thomas, contributor: T Hayes)
This project develops tools that allow for better statistical analyses by shifting labor (time) from the data reading and processing phase to the phase of statistical modeling and conclusions.  The developed tools also lead to better science by facilitating reproducibility of the statistical results, because the source code for the documents contains all computational steps in the same sequence as actually executed in the analysis.  The project harnesses recent developments that allow creation of dynamic documents that weave text and statistical computations.  Project software is available at

Statistical analysis of activity data (Faculty: Z Bursac, M Kocak, R Krukowski, S Sen, F Thomas; contributor: G Farage; funding: NIDDK)
Accelerometer-based wearable devices are widely used for assessing physical activity. Recorded accelerometer data provide information about the intensity, frequency and duration of physical activity. We are using physical activity data from wearable tracker devices of women in the military during pregnancy and the postpartum phase. Our research is aimed at developing methodology to characterize activity patterns and determine correlations between physical activity and weight gain or weight loss during and after pregnancy.  More generally, we will develop a framework for associating activity patterns with health outcomes, accompanied by a software implementation.

Diabetes Enhanced Patient Centered Medical Home (Delta Health Alliance) PI: Ilana Graetz
This study conducts  a randomized controlled trial to test whether an enhanced Patient Centered Medical Home (PCMH) model with more intensive management for patients with complex healthcare needs living in the Mississippi Delta can improve patient outcomes and reduce costs for self-pay and Medicaid beneficiaries with diabetes.

Optimizing Treatment of Older adults with Hypertension: A Net Benefit Analysis of Falls Injury vs Cardiovascular (University of Michigan Subcontract USHPS AG-047178) PI: Min; UT PI: William Cushman
The study shows how a national healthcare system SSE for Study # 17530 m, the Veterans Health Administration (VHA), delivers aggressive hypertension care (AHC) and whether AHC results in net benefit or harm due to cardiovascular events and severe fall-related injury.

Communication App to Manage Symptoms and Improve Adjuvant Endocrine Therapy Adherence. (USPHS R01- CA218155), PI: Ilana Graetz
This study tests the use of a web-enabled app that is integrated directly with patients’ electronic health records, with and without tailored feedback. The app-based intervention is designed to improve patient-provider communication outside of clinic visits, resulting in improved symptom management and adjuvant endocrine therapy adherence among diverse patients with hormone receptor-positive breast cancer. We will evaluate the impact of the intervention on a comprehensive set of outcomes, including rigorous measures of long-term adherence, quality of life, and costs.

Online vs. in-person lay health advisor training for weight loss. (Cornet Award- Cancer- UTHSC VC of Research Award) PI: Ilana Graetz
Lay health advisors (LHAs) or trusted community members can help increase access to obesity interventions in underserved regions facing provider shortages. This study will: (1) adapt an evidence-based LHA training for online use, (2) assess the usability of the adapted training in a target population of African American adults, and (3) pilot test the feasibility of the online vs. in-person training with 20 LHAs over 8 weeks. We will compare costs and knowledge and skills acquisitions between the two training modes.

Vitamin D and Type 2 Diabetes (Tufts Medical Ctr Subcont USHPS U01DK98245  PI: Pittas; UT PI: Karen Johnson
The overall objective of the study is to test whether optimizing vitamin D status with vitamin D3 supplementation is associated with reduction in the rate of progression from pre-diabetes to diabetes.

Action for health in Diabetes Extension Study Research Project (USPHS U01DK057078) PI: Karen Johnson   
Look AHEAD is a multicenter, randomized clinical trial to examine the effects of a lifestyle intervention designed to achieve and maintain weight loss over the long term through decreased caloric intake and exercise and to determine the long term effects of weight loss on physical functioning, aging, and mortality.

The Effect of a Microprocessor Prosthetic Foot on Function and Quality of Life in Transtibial Amputees Who are Limited Community Ambulators (VALOR) (Army Grant W81XWH15-1-0470) PI: Richey
This project will evaluate the efficacy of a using a microprocessor prosthetic foot on functional performance, decreasing the risk of falls and improving quality of life in transtibial amputees.  The project will utilize a patient-centered approach for veterans who function at a limited ambulatory level.  

The effect of a powered ankle foot orthosis (PAFO) on function, safety & quality of life in military service members and veterans who wear a prescribed orthosis  (Army Grant W81XWH17-1-0451) PI: Richey
This project will evaluate the efficacy of a using a powered ankle foot orthosis (PAFO), that assists with toe clearance and provides push-off power when taking a step, on functional performance, decreasing the risk of falls and improving quality of life, in military service members and veterans who walk with a prescribed AFO.

ASPirin in Reducing Events in the Elderly ASPREE (Minneapolis Medical Research Foundation  Subcont USHPS U01 AG029824) PI: Catherine Womack
The study is examining whether the potential benefits of low dose aspirin (particularly the prevention of heart disease, stroke, certain cancers and dementia) outweigh the risks (particularly severe gastrointestinal bleeding and hemorrhagic stroke) in this age group. Participants were eligible for the trial if they did not have a current clinical indication for (i.e. overt cardiovascular disease) or contraindication to (i.e. allergy or increased risk of bleeding) aspirin, did not have dementia, disability, low hemoglobin levels, or a condition that was likely to be fatal within five years of enrollment and were capable of providing informed consent.

Community Alliance for the Homeless Agreement (Community Alliance Subcontract - DHHS 90CA1792) PI: Connor / Nouer
The goal of this contract is to conduct an evaluation of the local Memphis Strong Families Initiative (MSFI). The process evaluation for the MSFI includes a combination of qualitative and quantitative data collection methods for infrastructure development and effectiveness, along with implementation of the project. The outcome evaluation utilizes data pulled from the Homeless Management Information System (HMIS), which MSFI uses to track and collect data on all program outcome measures. TFACTS reports for DCS administrative data are also being utilized. Evaluation results are used to determine how the MSFI is functioning in terms of: collaboration, engagement with participants, participants’ response to the program, data quality, effectiveness of program services, and changes in child welfare practices.

Model for Holistic Young Child Wellness (LeBonheur Community Health and Well-Being) PI: Connor /Nouer
This contact focuses on conducting an evaluation of the Project LAUNCH local demonstration site in Memphis TN, led by LeBonheur. The local level evaluation follows a participatory mixed methods (qualitative and quantitative) approach. The goals of the evaluation are to provide data for continuous improvement and quality control within Project LAUNCH activities, with an overarching goal of developing a replicable model that can be used to establish statewide systems of strength-based, family-centered, culturally and linguistically competent services for promoting holistic young child wellness. Monthly, as well as annual, evaluative reports focus on determining project effectiveness, documenting process, and analyzing outcomes, aiming to provide as much formative feedback as possible in order to guide and inform project planning and implementation.

Elder Abuse Professional Education For Current and Future Healthcare Professionals (H W Durham Fdn Grant) PI:  Nouer
The second-year funding has made the Elder Abuse Prevention Professional Development training (created in year 1 funding), freely available to UTHSC students and community healthcare professionals. The training informs participants regarding recognizing and reporting incidents of elder abuse, exploitation, and neglect in Shelby County, Tennessee. UTHSC is targeting future healthcare providers, currently attending UTHSC, as well as the community healthcare providers working in Shelby County, Tennessee. Elder Abuse Professional Education training will be provided to a cohort of future healthcare professionals in the Colleges of Medicine, Dentistry, Nursing, and Health Professions (physician assistants), as well as a set of community physicians and clinicians, by the end of Year 3 funding.

Prostate Tissue Gene Expression Patterns Predict Prostate Tissue Inflammation, Aggressive Prostate Cancer, and a Poorer Prognosis among Black and White Men (Vanderbilt Subcont DoD W81XWH-17-PCRP-HDRA) PI: Dai; UT PI: Fowke  
Our objective is to determine the connection between immune cell infiltration and gene expression of pro- and anti-inflammatory messengers in prostate tissue in black and white men with PC. We also will determine the link between differential gene expression on aggressive vs. non-aggressive PC and clinical progression following treatment in black and white men with PC. We hypothesize increased immune cell invasion believed pro-carcinogenic in the prostate will increase the expression of genes involved with immune system signaling and cell cycle regulation in the prostate, leading to an aggressive PC. This effect may be stronger in black men with a greater systemic inflammation.

Racial Differences in Systemic and Prostatic Inflammation (Cedars Sinai Subcont DoD W81XWH-16-1-075) PI: Freedland, Stephen. UT PI: Fowke
This is a multi-centered investigation of prostate tissue inflammation and prostate cancer in black and white men.

Vanderbilt Development Center for Translational Research in Benign Urologic Diseases (USPHS P20-DK 112080-02) PI: Fowke
The goal of this center is to develop the capacity to investigate the etiology and response to treatment of benign prostatic hyperplasia using epidemiologic and bioinformatics approaches.

A Prospective Analysis of Obesity and Progression from HGPIN to Prostate Cancer (AICR #315753) PI: Fowke
We propose to first expand our HGPIN cohort, and re-contact HGPIN patients to ask them about their PC status, health, and medication use since initial recruitment. We will expand our analysis of obesity measures to include body composition measurements, and we will also look at the association between blood inflammatory markers and conversion to PC. Our results will provide a comprehensive assessment of immune system regulation associated with centralize fat deposition and conversion from HGPIN to PC.

Maternal Traumatic Stress, Oxidative Stress, Antioxidant Exposures, and Child Asthma and Lung Function (Vanderbilt Univ. Subcont USHPS R01 HL132338) PI: Carroll; UT PI: Frances A. Tylavsky
This study will concurrently examine relationships among maternal prenatal stress, oxidative stress, and dietary antioxidant factors on child wheeze/asthma and lung development in a largely low-SES, African-American population to (1) better delineate mechanistic pathways linking prenatal stress to child respiratory health and (2) provide insight into dietary interventions that may help mitigate stress-induced effects. Findings may also inform health disparities.

Prenatal and Early Childhood Pathways to Health:  An Integrated Model of Chemical and Social Exposures (Univ of Washington Subcont USHPS OD-023271) PI: Frances A. Tylavsky
PATHWAYS is a consortium of 3 established cohorts. CANDLE, TIDES and GAPS. PATHWAYS will investigate how chemical (air pollutants and phthalates) and non-chemical (psychosocial stress) exposures during pregnancy are related to placental gene expression (transcriptome) and childhood neurodevelopment and airway health (at ages 4-6, 8-9, and 10-11 years). Each cohort has rich resources of prenatal data and banked specimens (urine, blood, and placenta) that will be harmonized for the PATHWAYS study and will contribute to the ECHO consortium. We will develop a national model with high spatiotemporal resolution of key air pollutants and assess urinary markers of maternal exposure.

DNA methylation and gene expression study of aging and lifespan differences (USHPS R21-AG055841) PI: Khyobeni Mozhui
This grant evaluates changes in DNA methylation and gene expression in the context of aging and lifespan differences. The work will use a cohort of recombinant inbred mouse strains that serve as a genetic reference panel and will evaluate conserved features of the aging epigenome.



The Role of Adverse Symptoms and Clinical Response on Racial Disparity Outcomes in Breast Cancer (USPHS R21-CA208161-01A) PI: Ilana Graetz
This study will investigate whether black and white patients with hormone receptor-positive breast cancer report adverse symptoms differently, contributing to diverse treatment decisions and ultimately disparities in health outcomes. Despite significant reductions in breast cancer mortality over the past two decades, Black-White mortality disparities continue to widen. Results from this study will provide actionable mechanisms for targeted interventions to reduce racial disparities in breast cancer outcomes.

Impact of Integrated Patient-facing Health IT Tools on Quality and Resource Use for Patients with Diabetes (Kaiser Fdn Research Inst Subcontract USHPS R01- DK085070) Site PI: Ilana Graetz
Emerging patient-facing health information technologies have the potential to improve health care access, care coordination and self-management for the growing population of patients with diabetes, many of whom have complex conditions. Our research questions about the impact of patient -facing technologies that are well-integrated with existing electronic health records and health care providers, are broadly applicable given high interest in patient-facing technologies and the need for improvements in the quality of patient care and in health care resource use.

Impact of Medicare Part D Coverage gap Closure on Health Outcomes (USPHS R01-AG54424) PI: Cameron Kaplan 
This study will provide important information about how prescription cost-sharing affects healthcare utilization and health outcomes, as well as disparities in these important endpoints, and will provide important information to policy makers about how to design insurance benefits and to lessen the consequences of poor adherence.

Tobacco Surcharge: Affordability and Enrollment among Tobacco Users (ACS RSGI-17-234-01-CPHPS) PI: Cameron Kaplan  
Our study will examine the extent to which tobacco surcharges affect under-enrollment, under-reporting of tobacco use, and sorting (selecting different types of plans than non-users).
Specific Aims: Our study has three aims: (1) Examine the impact of tobacco surcharges on enrollment, plan choice, and under-reporting of tobacco use, (2) Estimate how many tobacco users tobacco users lack affordable care as a result of the tobacco surcharge, and (3) Evaluate changing affordability of plans and enrollment decisions of tobacco users over time. 

Last Published: May 10, 2018