Grantees: Frank J. Penedo and Michael H. Antoni

Frank J. Penedo

Frank J. Penedo, Ph.D.

Clinical Health Psychologist
BBPSB FEATURED GRANTEE
Organization:
  • University of Miami Sylvester Comprehensive Cancer Center

Current Title
Sylvester Professor of Psychology and Medicine, Center Associate Director for Cancer Survivorship and Translational Behavioral Sciences
University of Miami Sylvester Comprehensive Cancer Center

Describe your scientific identity.
I am trained as a clinical health psychologist with a focus on psycho-oncology. I study the role of sociocultural, biobehavioral, and psychosocial mechanisms underlying disease activity and health outcomes. This work also involves studying the efficacy of evidence-based psychosocial interventions in promoting optimal chronic disease management and health outcomes in cancer survivors.

What are your research interests?
My research program involves translational research evaluating the impact of multilevel determinants (sociocultural, biobehavioral, psychosocial) of health outcomes in cancer survivors and other chronic disease populations. This work also involves implementing models of symptom and toxicities monitoring and management in ambulatory oncology to optimize patient reported outcomes (PROs) in survivorship care. A major part of my work has also involved the development and implementation of evidence-based cognitive-behavioral stress and self-management behavioral interventions delivered within health systems, eHealth platforms, and the community to improve patient- and system level outcomes and mapping the underlying biological mechanisms (e.g., inflammation, stress reactivity) that explain the salutary effects of these interventions.

What is the significance of your current research project?
Despite the importance of addressing how the cultural context can impact chronic disease management, there are significant gaps in understanding the efficacy of culturally adapted treatments due to various limitations: (a) cultural adaptation has generally involved a linguistic translation, or racial/ethnic pairing of interventionist, with no or very limited attention to cultural and social norms; (b) rarely have studies addressed how culture impacts provision and acquisition of evidence-based treatment (EBT) skills; (c) the vast majority of culturally adapted treatments have been paired against usual care, wait-list or other inert conditions, thus limiting our knowledge on whether the cultural adaptation or the standard EBT mechanisms impacted observed outcomes; and (d) the utility and incremental efficacy of adapted interventions, relative to standard EBTs, remains unknown. This study will provide an opportunity to document whether a culturally adapted cognitive-behavioral stress and self-management intervention has a significantly greater effect over the non-culturally adapted standard intervention providing added value via various mechanisms (i.e., cultural, behavioral, psychosocial, biological) on the study outcomes (i.e., HRQoL and symptom burden).

What motivated you to work in biobehavioral or psychological science research?
As an undergraduate pre-med student enrolled in a dual major in psychology and anthropology, I became interested in the social and psychological impact of the HIV/AIDS epidemic. I had the privilege of working as an undergraduate student with a group of investigators studying the role of stress on immunocompetence in HIV seropositive MSM. After being exposed to several health psychology and behavioral medicine research projects, I learned to appreciate how stress, emotions, and behaviors impacted physiology. I also had the opportunity to observe studies of behavioral interventions that targeted modifiable factors that impacted not only behavioral and psychological outcomes, but also biological mechanisms which at the time were primarily focused on markers of immunocompetence in the context of HIV and to some extent tumor progression (e.g., CD4+ cell counts, NKCC, etc.).

Describe something that had a profound influence on your program of research or scientific interests (an "ah-ha!" moment).
The observation that women with breast cancer who completed a group-based cognitive behavioral stress management program not only reported decreased anxiety, negative affect, and improved quality of life, but it revealed changes in their physiology (e.g., decreased circulating cortisol, improved anti-viral immunity, and decreased leukocyte inflammatory gene expression) during primary treatment, which predicted lower odds of disease recurrence over the next 10+ years. This was my first experience of "connecting the dots" from experimental induction of stress reduction to biobehavioral changes to long-term clinically meaningful physical health outcomes. It is reasonable to assume that these same biobehavioral processes could explain the effects of stress management on many chronic medical conditions, diseases of aging and possibly the effects of cancer on physiological and cellular aging.

Selected training, awards, and honors:
I had the privilege of being trained by Mike Antoni (stress management interventions) and Neil Schneiderman (stress and biobehavioral processes) who today are also close professional colleagues. I also completed a clinical psychology residency under the supervision of Andrew Baum (psycho-oncology). I was honored to receive the Young Investigator Award from the Society of Behavioral Medicine and from the International Society of Behavioral Medicine. I am also the recipient of the Outstanding Alumni Award from the University of Miami and the Mentoring in Underrepresented Minorities Award from the Society of Behavioral Medicine


The most profound a-ha moment early in my career was that stress and other psychosocial factors can truly get "under the skin" and impact critical clinical markers in HIV, cancer, CVD, and other conditions.”
Co-Principal Investigator:
Michael H. Antoni

Michael H. Antoni, Ph.D.

Clinical Health Psychologist
Organization:
  • University of Miami Sylvester Comprehensive Cancer Center

Current Title
Sylvester Professor of Psychology and Psychiatry and Behavioral Sciences
University of Miami Sylvester Comprehensive Cancer Center

Describe your scientific identity.
I am a clinical health psychologist conducting biobehavioral research that examines the effects of stress and stress management processes that affect psychological adaptation, biobehavioral processes (neuroendocrine, immune/inflammatory), and health outcomes in cancer patients and persons with other chronic medical conditions.

What are your research interests?
Modeling the biobehavioral processes to explain the links between stressors, stress moderating resources (e.g., outlook, coping, social support), and health and quality of life outcomes in persons adapting to different cancers. Inspired by this observational research, I developed theory-based psychosocial interventions to facilitate adaptation to cancer and its treatment, conducted randomized trials to establish the efficacy of these interventions for short- and longer-term outcomes, and I am now using community-based, cultural adaptations, and remote technologies to maximize their reach.

What is the significance of your current research project?
Despite the importance of addressing how the cultural context can impact chronic disease management, there are significant gaps in understanding the efficacy of culturally adapted treatments due to various limitations: (a) cultural adaptation has generally involved a linguistic translation, or racial/ethnic pairing of interventionist, with no or very limited attention to cultural and social norms; (b) rarely have studies addressed how culture impacts provision and acquisition of evidence-based treatment (EBT) skills; (c) the vast majority of culturally adapted treatments have been paired against usual care, wait-list or other inert conditions, thus limiting our knowledge on whether the cultural adaptation or the standard EBT mechanisms impacted observed outcomes; and (d) the utility and incremental efficacy of adapted interventions, relative to standard EBTs, remains unknown. This study will provide an opportunity to document whether a culturally adapted cognitive-behavioral stress and self-management intervention has a significantly greater effect over the non-culturally adapted standard intervention providing added value via various mechanisms (i.e., cultural, behavioral, psychosocial, biological) on the study outcomes (i.e., HRQoL and symptom burden).

What motivated you to work in biobehavioral or psychological science research?
After switching my major from chemistry to psychology as an undergraduate, I became interested in how brain processes could account for so many human experiences. As a graduate student, I was fascinated by Seyle's General Adaptation Response to explain the wear and tear of chronic stress on the body. At the same time, I was questioning early reports that techniques such as relaxation and imagery could help patients fight their cancer by mobilizing their immune systems, in spite of the lack of an empirical base for these claims. This led me into a career probing the question: what biobehavioral processes (neuroendocrine and immune/inflammatory functioning) could account for the impact of stress management interventions on health outcomes in cancer patients?

Describe something that had a profound influence on your program of research or scientific interests (an "ah-ha!" moment).
After switching my major from chemistry to psychology as an undergraduate, I became interested in how brain processes could account for so many human experiences. As a graduate student, I was fascinated by Seyle's General Adaptation Response to explain the wear and tear of chronic stress on the body. At the same time, I was questioning early reports that techniques such as relaxation and imagery could help patients fight their cancer by mobilizing their immune systems, in spite of the lack of an empirical base for these claims. This led me into a career probing the question: what biobehavioral processes (neuroendocrine and immune/inflammatory functioning) could account for the impact of stress management interventions on health outcomes in cancer patients.

Selected training, awards, and honors:
My key mentors were Theodore Millon (personality theory and measurement), Neil Schneiderman (stress and biobehavioral processes, behavioral medicine) and Charles S. Carver (stress and coping and psycho-oncology). I was honored to receive Young Investigator awards from the Society of Behavioral Medicine and APA Div 38 (Health Psychology) at the beginning of my career. More recently, I received the Distinguished Scientist Award from the International Society of Behavioral Medicine and the Lifetime Achievement Award from the Society of Behavioral Medicine Cancer SIG.


My first experience "connecting the dots" from experimentally inducing stress reduction to biobehavioral changes to long-term clinically meaningful physical health outcomes was when I observed that women with breast cancer who completed a group-based cognitive behavioral stress management program not only reported decreased anxiety, negative affect, and improved quality of life, but also had physiologic changes during primary treatment, which predicted lower odds of disease recurrence over the next 10+ years.”



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