Approximately 40% of the Duncan Family Institute's portfolio investment is targeted towards research infrastructure, a critical but severely underfunded area essential for scientists to develop their research ideas and compete successfully for extramural funding.
Clinical Cancer Prevention Research Core
Director: Powel Brown, M.D., Ph.D., Professor and Chair, Clinical Cancer Prevention; Co-directors: Therese Bevers, M.D., Professor and Medical Director, Clinical Cancer Prevention; Abenaa Brewster, M.D., Professor, Clinical Cancer Prevention, Medical Director, Nellie B. Connally Breast Center
The Clinical Cancer Prevention Research Core (CCPRC) supports collaborative translational and clinical research investigating risk assessment, risk reduction interventions, cancer risk and early detection markers, and cancer screening. This support is administered through the Clinical Trials Support (CTS) group and the High-Risk Breast Cohort and Biorepository (HRBC) resource.
The CTS group provides infrastructure for the development, implementation and conduct of all phases of clinical prevention research studies including: investigator-initiated National Cancer Institute (NCI) multicenter chemoprevention Phase II and III clinical trials, multicenter cooperative group Phase III clinical trials, industry sponsored clinical research and investigator-initiated clinical research studies. Type and level of support varies based on need in combination with available sponsor funding. The CTS group includes research nurses and data coordinators providing varying levels of expertise and effort that would not otherwise be available.
The HRBC is designed to prospectively follow cancer-free women at high risk of developing breast cancer with the serial collection of biological specimens, clinical and epidemiological data, and clinical outcomes. It provides a ready-access resource for researchers interested in developing breast cancer risk and early detection studies. This resource is distinct in that it is a mature and ready resource for the exploration of biomarkers, lifestyle risk factors and for use in studying energy balance interventions.
The CCPRC's personnel are highly experienced in prevention clinical trial protocol development, study operations and regulatory oversight. They are extending their expertise to cancer prevention research in populations representative of MD Anderson's catchment area through collaborations with leaders from the MD Anderson Oncology Program at Lyndon B. Johnson hospital (LBJ), Community-Engaged Translational Research (CCETR) and Clinical Research Support Center (CRSC) Priorities include expanding the CTS to support recruitment of patients onto cancer prevention trials from the MD Anderson Oncology Program at LBJ and the MDACC Houston-area Locations (HALs) and enrichment of the HRBC with African American and Hispanic women at high risk of developing breast cancer from the MD Anderson Oncology Program at LBJ, with plans to follow these individuals longitudinally for the development of invasive breast cancer. The overall goal is to pool resources and expertise to ensure the institution’s cancer prevention research priorities are inclusive of populations who suffer disproportionally from cancer incidence and mortality.
Center for Community-Engaged Translational Research
Director: Lorna McNeill, Ph.D., Professor and Chair, Health Disparities Research
The mission of the Center for Community-Engaged Translational Research (CCETR) is to bring communities and researchers together to create long-term solutions to prevent cancer and improve health. CCETR’s overarching goals are to facilitate research development and implementation between MD Anderson investigators and diverse communities, establish and maintain equitable research partnerships, and increase the capacity of investigators to recruit and retain diverse patients to clinical studies. Its new directions include scaling up patient navigation to clinical trials, developing cross-institutional partnerships in health disparities – including partnerships with University of Houston and Texas Southern University (TSU), scaling up community partnered research in cancer prevention nationwide through MD Anderson Network, and building community capacity for research engagement.
CCETR offers researchers a broad range of services, including advising researchers on aspects of community-engaged research, identifying community research partners, facilitating research collaboration agreements with community partners, developing clinical trial recruitment plans for minorities and women, and providing technical assistance to ensure project implementation and dissemination. CCETR also leads efforts to track and report progress on minority and women participation on clinical trials, helping researchers to ensure equitable access to interventional clinical trials for all patients with cancer.
Engaging with both investigators and community partners, the Center is ensuring that MD Anderson is conducting research that is relevant and applicable to populations that are most at risk for developing cancer as well as those who are undergoing treatment. CCETR engages junior faculty and trainees to develop the next generation of cancer disparities researchers on projects that include helping patients make informed decisions about cancer screening and treatment, addressing obesity among African American families, improving health behaviors of patients and survivors, engaging community members to be active members of research teams, and increasing minority patient access to clinical trials. Researchers, trainees and staff accessing CCETR resources are engaged in impactful community-academic collaborations to advance cancer prevention and treatment discovery and intervention delivery in real-world settings. Successful community-based research requires that projects and activities benefit both the community and the researchers. CCETR serves both the research community and the community at large with an explicit goal of integrating research and service into existing community infrastructure and social norms.
Digital Health and Fitness Collaborative
Co-directors: Karen Basen-Engquist, Ph.D., Professor, Behavioral Science; Susan Gilchrist, M.D., Professor, Clinical Cancer Prevention
Obesity is a risk factor for 12 types of cancer. Aside from not smoking, maintaining a healthy weight throughout life is the single most important way to protect against cancer. However, obesity rates continue to rise. A recent analysis projected that most of today’s children will develop obesity before they reach the age of 35.
Effective and efficient intervention approaches are needed to address the problem of obesity in order to reduce the likelihood of large increases in obesity related cancer and other chronic diseases. The overarching goal of the Digital Health and Fitness Collaborative is to intervene in high-risk populations to reduce the risk of obesity-related cancer and cardiovascular disease in Texas adults.
The aims are to 1) Develop innovative technology-based weight loss intervention strategies/products (can address eating behavior, nutrition, physical activity), 2) Test strategies in the context of an evidence-based weight management program delivered to individuals in MD Anderson cohorts, 3) Create a data resource for investigators focused on predictors of project participation; effects of intervention components on weight, nutrition, physical activity, and fitness; and the relationship between nutrition/dietary intake, physical activity, fitness, body composition, and cancer risk.
The data from these pilot studies will provide a rich resource of highly diverse and well-characterized participants for investigators to use in developing competitive larger projects for funding from extramural sponsors, such as NCI and American Cancer Society, both of whom have identified weight management and its association with cancer risk as a funding priority.
One of the goals of the DHFC is to build a bank of evidence-/theory-based intervention products for investigators to use or adapt for their research to facilitate project development. Investigators review existing intervention products, propose new product ideas, and prioritize products and pilot studies.
Network of Primary Care Physicians in Texas
Co-director: Sanjay Shete., Ph.D., Professor, Biostatistics; Lewis Foxhall, M.D., Vice President, Health Policy
Texas is a massive, diverse and wealthy state. However, it underperforms other states in several key categories and substantial disparities are evident. Importantly, among the 254 counties in Texas, 167 did not meet the Center for Disease Control’s 2020 goal of decreasing the overall cancer death rate, and several counties have witnessed an alarming increase in cancer mortality.
The under- and uninsured rate in Texas remains the highest in the nation and 177 out of 254 counties are rural with limited access to medical
care. Critical issues in Texas include the four-fold higher incidence rate of hepatocellular carcinoma in South Texas Hispanics versus non-Hispanic whites, and the fact that HPV-associated cancers are projected to increase by 65 percent. Moreover, in Texans older than age 50,
compliance with the U.S. Preventative Services Task Force guidelines for colorectal cancer screening is dismal (41st among 50 states). Powered by these data and shortfalls, the Network of Primary Care Physicians is designed to build bridges that facilitate intensification of MD Anderson’s catchment area activities. The overall goal is to cultivate a network of primary care physicians (PCPs) across Texas to develop MD Anderson-led collaborative research endeavors on cancer control, prevention and early detection.
Resources previously supported by the Duncan Family Institute include:
Shared Decision-Making Collaborative
Director: Robert Volk, Ph.D., Professor, Health Services Research
The mission of the Shared Decision-Making Collaborative (SDMC) is to enhance the quality of decision making in cancer prevention by providing patients and their health care providers with evidence-based tools to facilitate their working in partnership to make difficult decisions that are consistent with the personal values and informed preferences of patients. The SDMC supports research in shared decision making (SDM) by bringing together MD Anderson’s growing decision science faculty with its world-class clinical faculty, working in collaboration to design, evaluate and implement novel strategies for engaging cancer patients and their health care providers in making difficult decisions about cancer prevention. The collaborative serves as a “research laboratory” to stimulate new approaches to SDM by providing an infrastructure for encouraging multidisciplinary collaboration, conducting feasibility studies of novel interventions, and creating essential preliminary data to pursue large-scale, extramural funding.
Assessment, Intervention and Measurement (AIM)
Core director: Susan Peterson, Ph.D., Professor, Behavioral Science; Core co-director: Karen Basen-Engquist, Ph.D., Professor, Behavioral Science
The Assessment, Intervention and Measurement (AIM) facility provides expertise in the science of collecting and managing patient-generated health data, and behavioral intervention development and implementation utilizing web, mobile and other technology applications.
AIM leadership and staff work with collaborators across MD Anderson to provide expertise in the science of collecting and managing participant-reported outcome (PRO) and behavioral data, energy balance research, and the development of e-health behavioral interventions. PRO data are important in many treatment trials (e.g., to evaluate the impact of treatment on quality of life and symptoms), survivorship studies, and cancer prevention research. Given the increasing evidence of the impact of healthy weight and physical activity in cancer survival and recurrence, more investigators are including fitness, body composition and physical functioning assessments as part of their research, and in testing exercise and weight management interventions. AIM is responsive to an ever-increasing demand by investigators to incorporate data collection and interventions strategies using technology-based approaches. These approaches include web and mobile applications for survey data collection, ecological momentary assessment, and intervention delivery, as well as wearable sensors for objective assessment of behavior.
Mexican American Cohort
Director: Paul Scheet, Ph.D., Professor and Chair, Epidemiology
Mexican Americans represent the largest and fastest growing ethnic minority in the US and are the largest Hispanic subgroup in the US and Texas. The Mexican-American community in Houston through its long presence has established distinct neighborhoods and cultural practices that now includes first through fourth generation Americans, thus offering a great insight into the effects of acculturation. This community has a high prevalence of diabetes and obesity, and it has seen for the first time a major shift to where cancer has surpassed cardiovascular diseases to become the leading cause of death.
The Mano a Mano Cohort Study was launched in 2001 by the Department of Epidemiology at The University of Texas MD Anderson Cancer Center with resources from Texas Tobacco Settlement, Duncan Family Institute and philanthropic funds. To our knowledge, this research represents the largest longitudinal population-based cohort study of Mexican Americans (MAs). Through personal interviews, data are collected on characteristics such as socio-demographics, lifestyle, acculturation, medical history, and family history of cancer. Specimens (blood, saliva, and/or urine) are collected and banked for future use.
This unique resource with a well-characterized population for which data and specimens are available will facilitate health-related research. Studies utilizing the Mexican American Cohort data and biological samples, integrating acculturation, socio-demographic and epidemiologic/behavioral information along with biomarkers, will allow the identification of individuals at high risk of developing specific types of cancer and other chronic diseases. This will allow the development of tailored cancer prevention programs and their implementation in this under-represented and under-served population.
Health Services Research Core Data Resource
Director: Sharon Giordano, M.D., Professor and Chair, Health Services Research
Health services research (HSR) is a multidisciplinary field that is growing rapidly due to increasing national attention to issues of health care cost, quality, and delivery. According to the Coalition of Health Services Research, HSR is defined as “a field of scientific study that explores health care costs, quality, and access and looks for ways to improve health care delivery, safety, availability, and affordability.” The importance of this field of research is due to the current realities that the US health care system is the most costly in the world, the cost of care is growing on an unsustainable trajectory, and yet significant gaps exist in health care quality and care coordination. Large population-based datasets are one of the most important resources for studying health care delivery, economics of care, cost-effectiveness, quality of care, and outcomes. The goal is to create a core data resource consisting of large datasets to promote HSR studies at MD Anderson. A multidisciplinary investigative team of faculty across four Divisions has been established, all of whom have expertise in using national datasets. The team consists of investigators in Health Services Research (Giordano, Elting and Suarez-Almazor), Radiation Oncology (Smith), and Surgical Oncology (Chang).
Bionutrition Research Core
Co-directors: Carrie Daniel-MacDougall, Ph.D., Associate Professor, Epidemiology; Karen Basen-Engquist, Ph.D., Professor, Behavioral Science
The Bionutrition Research Core (BRC), a component of the Center for Energy Balance in Cancer Prevention and Survivorship, provides expertise and resources to investigators who study the links between diet and cancer along the cancer continuum, from prevention through treatment to survivorship. The core provides expertise and resources for scientists to advance state-of-the-art nutritional science research. The BRC is equipped to provide services related to the design and implementation of nutrition-related research including, well-controlled human feeding trials, nutrition interventions, eating behavior and dietary assessment, and dietary data processing and analysis. Services include grant and protocol consultations; the design, preparation, and delivery of research diets; assisting with dietary data collection and analysis; and connecting investigators with other services that may be necessary to implement their nutrition-related research.