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Research Mission

The mission of the research division of Family and Community Medicine (FCM) at Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine (TTUHSC-PLSFSOM) is to advance the science of family medicine through the generation of knowledge to improve the health of the predominantly Hispanic US/Mexico Border population that we serve. The division seeks to become nationally recognized among departments of Family Medicine for engaging in high quality primary care research that improves the health of our community and eliminates disparities in health care.

A major research focus area for the division is cancer prevention and control, and this is very much in line with the Institutional goals of the Cancer Center of Excellence with which the department is closely aligned.  Cancer remains the second leading cause of death in the USA, and although survival from cancer has improved over time, it is very much stage dependent - with the best hope of cure being earlier diagnosis and prevention. Our community suffers from a disproportionately high burden of some cancers, particularly breast and cervical cancer, and has lower rates of screening than other populations.

There is a rich environment for developing a research program in FCM: there is strong institutional and departmental support for the Research Division and access to a diverse clinic and community population for research. The department currently has two federally funded investigators that are focusing on recruiting new investigators to join this team with expertise in behavioral science, epidemiology, patient-provider communication, health promotion, health services research, or community based participatory research.

Since the research division was established in the fall of 2010, we have been funded on 12 different grants from agencies such as the National Cancer Institute, the American Cancer Society, Susan G Komen Foundation, and the Cancer Prevention and Research Institute of Texas.  Our grant portfolio (up until April 2014) includes a total amount of about $6.8 million dollars in funding. In addition we have grants pending that are under review.

FCM departmental faculty and residents have a diverse range of interests which are reflected in the scholarly output from the department.

Current/Ongoing Projects

Colorectal cancer Screening: A New Web-Based Decision Making strategy for Low Literacy and Hispanic Populations

Co-Principal Investigators: Navkiran Shokar, MD MPH, Francois Modave, PhD

Funding: NIH/NCI (total award: $386,671.00, 2013-2016)

The primary objective of this project is to develop, test and determine the feasibility of implementing a bilingual, culturally tailored and theory-based decision-support intervention targeting low literacy Hispanic populations, to facilitate high quality informed decision making at the point of care for patients, in order to increase the uptake of CRC screening. We apply new decision -theoretic methods to help patients make better-informed decisions about CRC screening, utilizing an informatics-based decision aid system.

  

El Paso and Hudspeth County Breast Cancer Education, Screening and Navigation Program (BEST)

Principal Investigator: Navkiran Shokar, MD MPH

Funding: CPRIT (total award: $1,098,920.00, 2013-2016)

The long term goal of BEST is to reduce the burden of breast cancer through early diagnosis and access to treatment in El Paso and Hudspeth Counties. In total, 4,000 eligible women will be offered no-cost mammography screening and diagnostic follow up, navigation and education services.

De Casa En Casa: Preventing Cervical Cancer in El Paso and Hudspeth County Program Agency

Principal Investigator: Navkiran Shokar, MD MPH

Funding: CPRIT (total award $1,096,011.00, 2013-2016) 

De Casa En Casa is designed to reduce the burden of cervical cancer in El Paso and Hudspeth Counties through facilitating early diagnosis and access to treatment in El Paso and Hudspeth Counties. This is an innovative program that combines proven educational strategies, no cost pap and colposcopy services, navigation services and incorporates capacity building for colposcopy through enhanced faculty and resident training. The program will enroll 3,200 women in total.

ACCION: Against Colorectal Cancer In Our Neighborhoods

Principal Investigator: Navkiran Shokar, MD MPH

Funding: Cancer Prevention and Research Institute of Texas (total award: $2,700,000.00)

The project goal is to reduce the burden of colorectal cancer in our community and it brings much needed resources to our area. ACCION will increase community awareness and knowledge about colorectal cancer and the importance of screening, will provide access to no-cost screening and diagnostic colonoscopy, and will increase the use of all needed follow up tests and treatment services for eligible underinsured and uninsured residents of El Paso County. 

 

Self-sampling for HPV Infection Among Low-Income Hispanic Women

Principal Investigator: Eribeth Penaranda, MD

Funding: American Cancer Society-Cancer Control Career Development award for Primary Care Physicians (total award: $300,000.00, 2013-2016)

We are investigating US-Mexico border’s women attitudes towards using self-sampling method to detect cervix/vagina infections with the Human papillomavirus.  This novel method has been proposed as alternative to the Pap smear as part of cervical cancer early detection programs since infection the virus has been linked to most cases of cervical cancer.  The results of this research have the potential of impacting cervical cancer screening recommendations.

US-Mexico border women’s attitudes, preferences and intention to use self-sampling for HPV infection as an alternative to Pap/cytology for cervical cancer screening

Principal Investigator: Eribeth Penaranda, MD

Funding: American Academy of Family Physicians and Foundation Joint Grant Award (total award: $49,984.00, 2013- 2015)

We are investigating US-Mexico border’s women attitudes towards using self-sampling method to detect cervix/vagina infections with the Human papillomavirus.  This novel method has been proposed as alternative to the Pap smear as part of cervical cancer early detection programs since infection the virus has been linked to most cases of cervical cancer.  The results of this research have the potential of impacting cervical cancer screening recommendations.

 Pre-doctoral Training in Primary Care

Principal Investigator: Gurjeet Shokar, MD

Funding: Health Resources & Services Administration (total award: $944,382.00, 2011-2016)

Evaluation of the impact of innovative educational initiatives targeting border health issues on medical student outcomes.

 

Institute for Healthy Living

Principal Investigator: Gurjeet Shokar, MD

Funding: Paso Del Norte Health Foundation (total award: $110,292.71.00, 2013-2014)

This is a partnership with UTEP and UTSPH El Paso to conduct a detailed needs assessment and asset gap analysis of healthy eating and active living resources in five counties.

Diabetes Empowerment Education Program

Principal Investigator: Navkiran Shokar, MD MPH

Funding: TMF Health Quality Institute (total awards: $40,000.00)

To evaluate the effectiveness of a 6 week diabetes education intervention (TMF Health Quality Institute Diabetes Curriculum) in managing diabetes in medically underserved populations. To asses patient knowledge, attitudes, behaviors, and clinical indicators related to diabetes self management before and after intervention.

Web 2.0 Along the Border

Co-Principal Investigators: Navkiran Shokar, MD MPH/Meredith Trubitt

To describe patient experiences and barriers to use of web 2.0 and patient portals for patient health care needs.

 

Physician role in Obesity management

Co-Principal Investigators: Navkiran Shokar, MD MPH/Colton Ragsdale

To understand patient attitudes and experiences with their physicians in the treatment of their obesity.

 

Patient Centered Medical Home Evaluation

Co-Principal Investigators: Navkiran Shokar, MD MPH/Mary Spalding, MD

Ongoing evaluation of the implementation of the patient centered medical home.

 

The Role of Metabolic Syndrome on HPV Infection in US Men and Women from NHANES Survey

Principal Investigator: Eribeth Penaranda, MD

Building on our preliminary work that demonstrated a positive association between the presence of the metabolic syndrome and cervical cancer cases, now we are interested in understanding its association with the Human Papillomavirus infection using secondary data from the National Health and Nutrition Survey. 

Completed Projects

Attitudes and Beliefs about Colorectal Cancer Screening in a Diverse Population

Principal Investigator: Navkiran Shokar, MD MPH

Funding: NIH/NCI: K07 (total cost: $630,929)

To examine the mechanisms through which a person's race/ethnicity determines their colorectal cancer (CRC) screening behavior. To examine patient preference for the array of CRC screenings tests and systematically evaluate other influences on CRC screening such as health care delivery systems and physician factor. To integrate information into the design of a multi-level clinic intervention to increase CRC screening in Hispanics.

AMIGAS: Intervention to Increase Screening for Cervical Cancer in Women of Mexican Descent

Principal Investigator: Theresa Byrd, Dr PH

Funding: CDC (total cost: $1,099,900)

The Purpose is to evaluate the efficacy of the AMIGAS intervention in a randomized, controlled trial. We also propose to evaluate the relative effectiveness of the core components of the intervention, and to describe the intervention characteristics, processes of delivery, and settings that facilitate program adoption, implementation, and maintenance.

Interactive CD-ROM on Breast Cancer Genetics for Hispanics

Co-Principal Investigator: Theresa Byrd, Dr PH subcontract MDACC

Funding: NIH/NHGRI (total direct cost: $1,315,196)

The goals of this project are to develop an interactive CD-ROM to educate Hispanic women about cancer risk and genetic testing, and to conduct a randomized, controlled evaluation that compares the efficacy of the CD-ROM program when used alone vs. when used with a promotora-assisted approach.

Awareness of breast cancer and screening

Principal Investigator: Navkiran Shokar, MD MPH

Funding: Susan G Komen Foundation (total cost: $91,174.88, 2012-2013)

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