RESEARCH

The aim of this longitudinal cohort study is to evaluate the comparative safety and risk of opioids and psychotropic drugs in women with breast cancer who suffer from chronic pain due to cancer or its treatments.

To advance the understanding of the impact of air pollutant mixture and the built environment on pregnancy complications (gestational diabetes, gestational hypertension, and pre-eclampsia/eclampsia) and outcomes by leveraging prospectively- recorded and high-quality maternal clinical data from the electronic health record and address data with state-of-the-art spatiotemporal air pollution modeling and novel statistical methods that examine both individual and composite exposure profiles.

The goal of this randomized intervention study is to evaluate the effectiveness of a quarterly mailing intervention on human papillomavirus vaccine three-dose regimen completion.

This study examines drug interactions between tamoxifen and antidepressants in nearly 23,000 breast cancer survivors diagnosed with early stage disease in the two largest health plans in California.

The goals of this study are to assess pregnancy risks among female AYA cancer survivors; assess risk of adverse infant birth outcomes; and examine factors that may contribute to risk of pregnancy loss or adverse birth outcomes

The major goal of this project is to compare two implementation strategies to facilitate adoption of primary HPV testing for routine cervical cancer screening measured by patient-, provider- and system-centered outcomes. A sub-analysis and survey data collection will evaluate the impact of the COVID pandemic on this practice change and cervical cancer screening.

Mindfulness Based Cognitive Therapy (MBCT) an 8-session in-person intervention using mindfulness meditation and cognitive-behavioral strategies, has shown effectiveness in reducing residual depressive symptoms and risk for recurrence among pregnant women with histories of depression. A digital adaptation of MBCT for pregnant women, Mindful Mood Balance for Moms (MMBFM), was recently developed to overcome access barriers to in-person groups and increase potential for scale-up in OB care settings. We will address the following aims for this study: 1) Compare the clinical effectiveness (i.e. engagement and symptom reduction) of MMBFM supported by clinician vs. peer coaches among women with a history of prior depressive episodes; 2) examine specific mechanisms of action for MMBFM participants receiving clinician vs. peer coaching; 3) examine the effects of specific implementation strategies on reach of the MMBFM program; and 4) estimate the cost-effectiveness of MMBFM supported by clinician vs. peer coaches. We hypothesize that MMBFM will be more cost-effective when supported by peer vs. clinician coaches.

The goal of this project is to estimate the impact of bariatric surgery versus routine non-surgical care on the incidence of cancer (all types) in all severely obese patients (men and women).

Examining the recent trends in ectopic pregnancy among women of childbearing ages.

The aim of this cohort study is to examine if management of comorbidities can help mitigate the disparities seen in survival among women with metastatic breast cancer.

Aims: 1. Determine maternal preconception weight trajectories associated with (a) recommended GWG (total and trimester-specific) and (b) lowest PPWR at 4-6 weeks and 12 months postpartum. 2. Determine maternal preconception weight trajectories associated with the lowest risk of adverse pregnancy outcomes: gestational diabetes, gestational hypertension/preeclampsia, and cesarean section. 3. Determine maternal preconception weight trajectories associated with the lowest risk of adverse child outcomes: preterm birth, size for gestational age at birth (small [SGA], appropriate, large [LGA]), infant growth trajectory, and BMI at 3 years of age.

Evaluating the effect of treating mild-to-moderate hypertension in pregnancy, compare the risks of clinically important outcomes with different medications, and determine whether the benefits and risks vary by maternal race/ethnicity or obesity status.

The aim of this prospective study is to examine the association between sleep disturbance, cellular and genomic markers of inflammation, and depression occurrence in breast cancer survivors.

Effective treatments for severe obesity are particularly needed in racial/ethnic minority populations. Rates of severe obesity are as high as 36% for middle-aged non-Hispanic black women compared to 16% for their white counterparts in the U.S. Research on bariatric weight loss outcomes among racial/ethnic minorities is limited. What evidence does exist suggests that black patients consistently lose less weight than whites over 2–3 years of follow-up. The evidence for differences between Hispanic and white or black bariatric patients is equivocal. Hispanic patients have been shown to lose more, less, or the same amount of weight as non-Hispanic black and white patients. Across studies, the disparities in % total weight loss vary from less than 2% to 10%. This variability is twice as much as the amount of weight loss considered clinically meaningful. This study will extend the work done by our team during the Bariatric Experience Long-Term (BELONG) study which addressed how self-reported behavioral, psychosocial, and perceived environmental factors predicted weight loss over 3 years following gastric bypass and sleeve. Patients (n = 1,975) were 41% Hispanic, 17% non-Hispanic black, and 37% non-Hispanic white. The proposed study will expand the work of BELONG by incorporating: 1) A focus on weight regain during 3-5 years after surgery; 2) measures shown to contribute to health disparities in severe obesity (vigilant coping style and internalized racism); and 3) innovative qualitative methods (photo-elicitation and ethnography) to understand the patient experience.

The goal of this prospective recruitment study is to determine if ovarian cancer screening is enhanced by more frequent biomarker testing (CA125 & HE4) versus usual testing frequency in women with BRCA1/2 mutations.