The Hull Research Team conducts impactful research aimed at promoting the implementation of evidence-based practices related to cancer prevention and care and addressing the social determinants of health.
Comprehensive Connected Cancer Care (C4) Program
Grant from Merck Foundation (Principal Investigators: Tim Mullett, Pamela Hull, Ming-Yuan Chih)
Markey Cancer Center (MCC) received this grant as one of eight institutions in the U.S. funded under the Alliance for Equity in Cancer, which is coordinated by the Virginia Commonwealth University Massey Cancer Center. The purpose of this project is to refine, implement, and evaluate the Comprehensive Connected Cancer Care (C4) Program at MCC and three community-based oncology programs in the MCC Research Network in Kentucky. The overall goal of the C4 Program is to advance health equity in cancer care by improving timely access to community-focused, patient-centered, and high-quality care. To achieve this goal, the C4 Program provides digital tools to screen for and address social determinants of health that pose barriers to initiating and completing cancer treatments. These tools enhance the ability of oncology programs to successfully implement two Commission on Cancer (CoC) standards: 5.2 Psychosocial Distress Screening and 8.1 Addressing Barriers to Care. The components of the C4 Program include a mobile application for cancer patients and caregivers, a dashboard for social workers and non-clinical patient navigators, and provider/staff education modules. The program is intended to facilitate assistance and support for social needs and mental health needs of patients with cancer, in particular patients from vulnerable and underserved groups, including rural, Appalachian, low-income, Medicaid-enrolled, and racial/ethnic minority populations.
Enhancing Patient Navigation at University of Kentucky Markey Cancer Center
Grant from American Cancer Society (Principal Investigators: Tim Mullett, Pamela Hull, Ming-Yuan Chih)
Markey Cancer Center (MCC) received this grant as one of 20 institutions in the U.S. and Puerto Rico funded under the American Cancer Society’s Navigation Capacity-Building Initiative. The purpose of this project is to enhance the patient navigation services provided through MCC’s Psych-Oncology Program by: 1) adding a non-clinical patient navigator position to complement existing clinical social workers, 2) utilizing continuous quality improvement, and 3) augmenting the program with innovative digital tools. This project will improve health equity by increasing MCC’s capacity to address social determinants of health that pose barriers to timely access to care. Through this project, MCC will also enhance it tools for tracking and reporting metrics for continuous improvement in oncology patient navigation and addressing the social needs of patients with cancer.
Increasing HPV Vaccination in Community-Based Pediatric Practices
Grant # R01CA207401
HPV causes 6 cancers, most of which can be prevented with the HPV vaccine. Low HPV vaccination rates reflect an implementation gap, in which most healthcare providers have adopted HPV vaccination guidelines but do not implement them with sufficient fidelity and consistency to produce optimal benefits. To address the implementation gap, we have examined the short- and long-term clinical and cost effectiveness of an evidence-based multi-component, multi-level intervention in the real-world setting of 21 diverse community-based, private pediatric practices within a pediatric network.
CHEW (Children Eating Well) App Usability Study
Grant # 2017-68001-34846 / 2017-68001-26352 USDA
Our team has developed the Children Eating Well (CHEW) mobile app for low-income families, which aims to increase purchasing of healthy foods and improve overall diet quality of preschool-aged participants by providing easy, practical ways for parents to increase consumption of healthy foods. The app provides healthy recipes, meal planning, quizzes, goal setting, and goal tracking features and tools to help low-income families improve their children's diet quality through validated nutrition education and tools. The target users for the app are low income families with 2-5 year-old children, many of whom are eligible for public assistance programs such as: WIC, Head Start, SNAP, Medicaid, and others.
The purpose of the usability study was to gather user testing feedback and stakeholder input into the development of the CHEW app, enhancement of app features. The purpose of the intervention study is to assess the efficacy of the CHEW app on improving child dietary intake, obesity risk score, and child feeding strategies. In addition, we will assess barriers, facilitators, and costs of implementation.
2021 Kentucky Cancer Needs Assessment
Dr. Hull’s research team contributed to the 2021 Kentucky Cancer Needs Assessment (KY CNA) conducted by the UK Markey Cancer Center Community Impact Office and a steering committee of community partners. The purpose of the KY CNA is to tell the story of cancer in Kentucky. Combining data and community perspectives, this story describes how social determinants of health, behaviors and biology intersect to produce the current state of cancer burden and disparities in Kentucky, and it highlights opportunities to rewrite the story. The KY CNA combined data from the Kentucky Cancer Registry with multiple existing data sources, plus focus groups with lay community members from diverse demographic groups across Kentucky.
As a final step to the KY CNA, Dr. Hull’s research team led a process called “concept mapping” to gather community stakeholder input on prioritizing Kentucky’s numerous cancer-related needs and potential strategies for addressing them. This process resulted in identifying priority focus areas and strategies to inform development of the next Kentucky Cancer Action Plan, the strategic plans of individual organizations, collaborative research, health policy, and other future initiatives.
Implementation of School-Entry Policies for Human Papillomavirus Vaccination
Grant # R01CA232743, National Cancer Institute (Dr. Vivian Cólon-López, Principal Investigator)
Dr. Hull contributes as co-investigator on this grant led by Dr. Vivian Cólon-López at the University of Puerto Rico Cancer Center. School-entry requirements are an evidence-based strategy for increasing immunization rates. While 49 states require Tdap and 26 require meningococcal vaccine, in March 2017, Puerto Rico became the fifth U.S. state or territory to adopt an HPV vaccine school-entry policy, requiring it for sixth graders starting in August 2018.
The goal of this study is to enhance understanding of geographic variation in HPV vaccine policies and outcomes across U.S. states and territories, while taking advantage of the timely opportunity to study the implementation and impact of the new school-entry HPV vaccine policy in Puerto Rico. Findings from this effort can inform states/territories considering adopting HPV vaccination policies and future implementation of these policies. The specific aims are to: Identify barriers and facilitators to implementation of the new HPV vaccine school-entry policy in Puerto Rico, Evaluate the impact of the new school-entry policy on HPV vaccination in Puerto Rico, and Understand geographic variation in the dissemination, implementation, and outcomes of HPV vaccine school-entry policies across U.S. states and territories.