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Psychosocial and behavioral factors associated with cancer prevention, risk management and survivorship
Biobehavioral pathways in stress and health, including stress-related immune dysregulation in at-risk and cancer patient populations
Community-based interventions to address cancer health disparities in Asian Americans
Our lab is interested in elucidating how psychosocial and behavioral factors influence cancer risk and outcomes, particularly in racial/ethnic minority or underserved populations. In several ongoing research studies, we are investigating whether psychosocial stress is associated with immunologic changes that may contribute to cancer progression. In addition, our lab has been developing interventions to enhance physical activity and quality of life outcomes in cancer patients. Other projects involve collaborating with community partners to implement community-engaged interventions targeting cancer screening and risk reduction behaviors in underserved Asian Americans, and this work has made significant contributions to informing evidence-based approaches for addressing cancer health disparities.
As a health psychologist, the overarching goal of my lab is to reduce the burden of cancer through understanding how psychosocial, behavioral, and biologic factors interact to influence cancer risk and outcomes, particularly among racial/ethnic minority populations. To address this goal, my lab has been conducting research in three interrelated areas: (1) biobehavioral mechanisms in cancer; (2) cancer health disparities in Asian Americans; and (3) biobehavioral determinants of immigrant health.
Biobehavioral mechanisms in cancer – One of my primary research interests lay in understanding how psychosocial and behavioral factors impact biologic pathways involved in cancer risk and progression. Guided by a biobehavioral model of cancer stress and disease course, we incorporate the use of comprehensive psychosocial assessments along with cutting-edge molecular techniques in our multidisciplinary research studies. My lab was the first to demonstrate an association between psychological stress and cell-mediated immunity to human papillomavirus (HPV) among women at risk for cervical cancer. I have also conducted related work among patients with head and neck cancer (HNC), in which we observed that depressive symptoms were associated with greater tumor expression of pro-angiogenic vascular endothelial growth factor (VEGF) and shorter disease-free survival. Currently, our laboratory is investigating stress-immune pathways among patients diagnosed with indolent forms of non-Hodgkin lymphoma. We are also developing interventions to enhance physical activity and quality of life in cancer patients. Together, these studies contribute to a greater understanding of how psychosocial, behavioral, and immunologic pathways interact to influence cancer risk and patient outcomes.
Cancer health disparities – Other projects in the lab examine cultural, psychosocial and environmental determinants of cancer health disparities among underserved Asian Americans, one of the fastest growing ethnic/racial groups in the US. We have developed and implemented a number of community-engaged interventions to enhance cancer screening and risk reduction behaviors. In these studies, we have demonstrated that we can significantly improve cervical cancer screening and prevention behaviors by utilizing a multifaceted approach that addresses social, personal, and access barriers to care in underserved Asian American populations.
Biobehavioral determinants of immigrant health – More recently, I have integrated my interests to develop a unique and comprehensive biobehavioral framework of Asian American immigrant health that models how individual- and neighborhood-level factors may interact to confer biologic vulnerability to disease risk. Our lab established one of the first cohorts focused specifically on US Chinese immigrants, which enabled us to examine how stressors associated with the immigrant experience (e.g., acculturative stress) contribute to disease risk via inflammatory pathways, and how the specific neighborhoods in which immigrants reside may modify these effects. This research incorporates geospatial approaches and the assessment of neighborhood-level factors to understand how ethnic density (or segregation) may impact immigrant health trajectories. Ultimately, our findings will enable us to identify the most vulnerable individuals and at-risk communities to target for outreach, and the neighborhoods in which community-based programs might have the greatest impact for promoting health and well-being.
Bauman J.R., Panick J.R., Galloway T.J., Ridge J.A., Chwistek M.A., Collins M.E., Kinczewski L., Murphy K., Welsh M., Farren M.A., Clark Omilak M., Kelly J., Schuster K.A., Lucas L.A., Amrhein S., Bender F.P., Temel J.S., Egleston B.L., El-Jawahri A., Fang C.Y., A pilot study of a collaborative palliative and oncology care intervention for patients with head and neck cancer. J Palliat Med. 24(11): 1673-1681, 2021. PMC9022134. https://www.ncbi.nlm.nih.gov/pubmed/33848193.
Sorice K.A., Fang C.Y., Wiese D., Ortiz A., Chen Y., Henry K.A., Lynch S.M., Systematic review of neighborhood socioeconomic indices studied across the cancer control continuum. Cancer Med. 11(10): 2125-2144, 2022.PMC9119356. https://www.ncbi.nlm.nih.gov/pubmed/35166051.
Longacre ML, Miller MF, Fang CY. Racial and ethnic variations in caregiving-related physical, emotional, and financial strain during COVID-19 among those caring for adult cancer patients. Support Care Cancer. 2021 Jan 6. doi: 10.1007/s00520-020-05933-9.
Freedland KE, Dew MA, Sarwer DB, Burg MM, Hart TA, Ewing SWF, Fang CY, Blozis SA, Puterman E, Marquez B, Kaufmann PG. Health psychology in the time of COVID-19. Health Psychol. 2020 Dec;39(12):1021-1025.
Fang CY, Galloway TJ, Egleston BL, Bauman JR, Ebersole B, Chwistek M, Bühler JG, Longacre ML, Ridge JA, Manne SL, Manning C. Development of a Web-Based Supportive Care Program for Patients With Head and Neck Cancer. Front Oncol. 2020 Dec 15;10:602202. PMC7771721.
Almeida R, Fang CY, Byrne C, Tseng M. Mammographic Breast Density and Acculturation: Longitudinal Analysis in Chinese Immigrants. J Immigr Minor Health. 2020 Oct 10. doi: 10.1007/s10903-020-01107-1.
Zimmaro LA, Deng M, Handorf E, Fang CY, Denlinger CS, Reese JB. Understanding benefit finding among patients with colorectal cancer: A longitudinal study. Supportive Care in Cancer, 2020 Sep 11. doi: 10.1007/s00520-020-05758-6.
Fang CY, Ragin CC. Addressing disparities in cancer screening among US immigrants: Progress and opportunities. Cancer Prevention Research, 2020;13(3):253-60. PMC7080302
Fang CY, Egleston BL, Byrne C, Bohr GS, Pathak HB, Godwin AK, Siu PT, Tseng M. Inflammation and breast density among female Chinese immigrants: Exploring variations across neighborhoods. Cancer Causes & Control, 2019; 30:1113–1126. PMC6745706
Fang CY, Lee M, Feng Z, Tan Y, Levine F, Nguyen C, Ma GX. Community-based cervical cancer education: Changes in knowledge and beliefs among Vietnamese American women. Journal of Community Health. 2019 Jun;44(3):525-533. PMC6529234...Expand
Senchak JJ, Fang CY, Bauman JR. Interventions to improve quality of life (QOL) and/or mood in patients with head and neck cancer (HNC): A review of the evidence. Cancers Head Neck. 2019; 4:2. PMC6560898.
Fang CY, Tseng M. Ethnic density and cancer: A review of the evidence. Cancer, 2018; 124(9):1877-1903. PMC5920546.
Fang CY, Ma GX, Handorf EA, Feng Z, Tan Y, Rhee J, Miller SM, Kim C, Koh HS. Addressing multilevel barriers to cervical cancer screening in Korean American women: A randomized trial of a community-based intervention. Cancer. 2017 Mar 15;123(6):1018-1026. PMC5339039.
Ma GX, Fang CY, Seals B, Feng Z, Tan Y, Siu P, Yeh MC, Golub SA, Nguyen MT, Tran T, Wang M. A Community-Based Randomized Trial of Hepatitis B Screening Among High-Risk Vietnamese Americans. Am J Public Health. 2017 Mar;107(3):433-440. PMC5296686.
Packel L, Fang CY, Handorf E, Rodoletz M. A 12-Week Exercise and Stress Management Pilot Program from Theory Through Implementation and Assessment. Rehabilitation Oncology, 35(4):172-80, 2017.
Fang CY, Heckman CJ. Informational and Support Needs of Patients with Head and Neck Cancer: Current Status and Emerging Issues. Cancers of the Head & Neck, 2016;1:15. PMC5488795 Collapse
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