Master of Science, The Ohio State University, 2020, Kinesiology

Breast cancer survivors are a unique cancer population in that they are having success in treatment but are experiencing the negative side effects that various treatments cause, whether it be soon or very long after treatment. As a result of advances in treatment, less and less breast cancer survivors are dying from of their disease. Instead, their mortality is caused by the other conditions that they become at risk for from the treatment effects. Weight gain is an example of one of these side effects that is seen in breast cancer survivors that places these individuals at risk for poor cardiovascular and metabolic health. The combination of benefits seen from engagement in physical activity and dietary behavior change could lend itself to an optimal approach to mitigate the detrimental side effects that we see, especially weight gain. The lifestyle weight management literature in breast cancer survivors has shown that physical activity can be performed safely and effectively, and the inclusion of diet aids in further improvements in weight management. With the increased knowledge and community support for breast cancer survivor programming, assessing the feasibility and preliminary efficacy of a community-based lifestyle weight management intervention will assist in addressing the lack of community access that currently exists for breast cancer survivors after their treatment. The purpose of this study is to determine the feasibility and preliminary efficacy of a community-based lifestyle weight management intervention in breast cancer survivors on select body composition, physical function, and quality of life outcomes during the first 3 months of the first wave of the Healthy New Albany Breast Cancer (HNABC) pilot trial. The 24-week, HNABC study is held at a community center and promotes lifestyle behavior changes through a group-mediated cognitive behavioral (GMCB) approach driven by Social Cognitive Theory, in hopes of producing meaningful results for feasibili (open full item for complete abstract)

Committee: Brian Focht (Advisor); Maryam Lustberg (Committee Member) Subjects: Behavioral Sciences; Behaviorial Sciences; Cognitive Therapy; Health Sciences; Kinesiology; Nutrition; Oncology

Doctor of Philosophy, The Ohio State University, 2023, Molecular, Cellular and Developmental Biology

The number of cancer diagnoses worldwide is on the rise as populations continues to grow older. In the US, the amount of money allocated to cancer research by the National Cancer Institute increases yearly. With increasing focus towards cancer research, it is important researchers maintain perspective and to ensure that these resources are utilized efficiently. The research mission of the Stover Lab is to improve the outcomes of patients with cancer. We keep the patients in mind during the entire research process, from project conception to publication. In this dissertation, three distinct research projects undertaken during my PhD are summarized. In Chapter 2, we investigated the survivorship needs of patients with gynecological cancers. By extracting posts made on the American Cancer Society's Cancer Survivorship forums, we discovered some of the needs of cancer patients by looking at their posted conversations and concerns. We developed an analysis methodology to allow post extraction that pertain to custom themes. We showed its utility by extracting and qualitatively analyzing posts that pertain to the psychosocial aspects of survivorship. In Chapter 3, a novel image analysis-based algorithms were developed to investigate the patterns of expression of HER2 in breast cancer patients. Current treatment strategy for breast cancer is reliant on determining whether a patient is HER2 positive using a clinical immunohistochemistry stain for HER2. The criteria used by pathologists for this test is simplistic, in that it only looks at a proportion of intensely stained cells and uses a single cutoff to define a patient as HER2 positive or negative. We believe there is an opportunity to gather more information from these IHC stains and use this information to further delineate breast cancer patients based on their HER2 expression, better predicting patient outcomes. We showed a new method that quantifies the heterogeneity of HER2 expression and significantly predicted recu (open full item for complete abstract)

Committee: Daniel Stover (Advisor); Ramesh Ganju (Committee Member); Raghu Machiraju (Committee Member); Anne Strohecker (Committee Member) Subjects: Molecular Biology

Doctor of Philosophy, The Ohio State University, 2018, Psychology

Background: Breast cancer survivors often experience fatigue. Previous studies suggest that vagally mediated heart rate variability (HRV) is related to fatigue among breast cancer survivors. However, the mechanism behind this relationship is unclear. Research in non-cancer populations indicates that people with lower HRV experience more intrusive thoughts than individuals with higher HRV. Breast cancer survivors commonly experience cancer-related intrusive thoughts and survivors who experience intrusive thoughts at diagnosis have increased fatigue. Thus, cancer-related intrusive thoughts may mediate the relationship between HRV and fatigue. Aims: This study investigated whether cancer-related intrusive thoughts mediate the relationship between HRV and fatigue among breast cancer survivors. This study also investigated social support as a potential moderator in the mediational model, as the relationship between intrusive thoughts and fatigue appears to be attenuated by high social support. Methods: This study utilized multiple samples of survivors. The first sample was comprised of breast cancer survivors who had completed surgery but not begun adjuvant treatment. Survivors' HRV was recorded and they completed measures of fatigue (MFSI), intrusive thoughts (IES/IES-R), and social support (ISEL). The second sample consisted of women who had completed their breast cancer treatment. Similarly, survivors HRV was recorded and they completed measures of fatigue (MFSI), intrusive thoughts (IES), and social support (ISEL). The third sample consisted of longitudinal data from second sample participants, collected 3 months and 6 months after the initial visit. Results: In the first sample, HRV was not associated with fatigue. Similarly, HRV was not associated with cancer-related intrusive thoughts. Cancer-related thoughts were associated with fatigue, although they did not mediate the hypothesized relationship between HRV and fatigue. Further, there was no evidence that socia (open full item for complete abstract)

Committee: Janice Kiecolt-Glaser (Advisor); Charles Emery (Committee Member); Michael Vasey (Committee Member) Subjects: Psychology

Doctor of Philosophy, The Ohio State University, 2017, Psychology

Background: Breast cancer survivors commonly experience cognitive problems following cancer and its treatment. Although prior research focused on chemotherapy-related cognitive impairment, newer studies suggest that some women also experience cognitive problems prior to chemotherapy and radiation treatments. Accordingly, factors besides cancer treatment may also influence breast cancer survivors' cognitive function. Physical fitness benefits cognitive function in healthy adults, and breast cancer survivors experience declines in fitness even prior to adjuvant treatment. Aims: The study investigated the extent to which cardiorespiratory fitness (CRF) impacted cognitive function among post-surgery breast cancer survivors prior to chemotherapy and radiation treatment, and examined the potential psychological pathways for this relationship. The prospective effect of cognitive function on adherence to chemotherapy and radiation treatments was also evaluated. Methods: Following cancer surgery but before chemotherapy or radiation treatments, stage I through IIIA breast cancer survivors (n = 90, ages 26 to 75) completed neuropsychological tasks of verbal memory (Hopkins Verbal Learning Test), verbal fluency (FAS), executive function (Trail-Making Test, n-back task), and sustained attention (Conners Continuous Performance Test) in the context of a larger observational study. They also underwent a graded cycle ergometry test to measure peak oxygen consumption (VO2peak), and reported their depressive symptoms (Center for Epidemiologic Studies Depression Scale), anxiety symptoms (PROMIS Anxiety Scale), and sleep problems (Pittsburgh Sleep Quality Index). Chemotherapy and radiation treatment adherence was measured by concordance with National Comprehensive Cancer Network (NCCN) standards as well as the number of treatment appointments that were missed/cancelled by the patient, using medical record data. Results: CRF did not concurrently benefit performance on ver (open full item for complete abstract)

Committee: Janice Kiecolt-Glaser PhD (Advisor); Charles Emery PhD (Committee Member); Ruchika Prakash PhD (Committee Member) Subjects: Clinical Psychology; Health; Psychology

Master of Science in Pharmaceutical Science (MSP), University of Toledo, 2013, College of Pharmacy

Objective: Review of the literature suggests that there is a gap in understanding the psychosocial factors affecting adherence to Aromatase Inhibitors (AI). The aim of this study is to identify and assess the factors affecting adherence to Aromatase Inhibitor Theory in breast cancer patients using the Protection Motivation. Methods: Cross-sectional retrospective study. 288 patients, taking aromatase inhibitors as adjuvant therapy, were identified using a cancer registry managed by a University-based medical center. A survey instrument measuring patient's medication taking behavior was developed using the Protection Motivation Theory, which was mailed to the patients. The Morisky Scale was used to measure adherence to Aromatase Inhibitor, on a scale of 0-8. ANOVA, Pearson's correlation and Multiple Regression were used to analyze the data using SPSS with significance being measured at the 0.05 alpha level. Results: 145 responses were received bringing the response rate to a 54.10%. Out of the 145 patients, 6 who had discontinued Aromatase Inhibitor therapy on doctors' orders were removed from the final analysis. The patients scored a mean of 6.84 (±0.66) and a median of 7.75 on the Morisky Scale. Using the mean as a cutoff, 38% of the patients were non-adherent to their medications including 6 who had discontinued therapy for reasons other than doctors' orders. The level of protection motivation showed a significant positive correlation with the adherence scale (r=0.310). Multiple regression revealed that Coping Appraisal was a better predictor of adherence (ß=0.437), while Threat Appraisal did not show a significant correlation. Pearson's Correlation revealed that Self Efficacy (r=0.485) and Response Efficacy (r=0.206) showed a positive correlation with adherence while Response Cost (r=-0.235) showed a negative correlation. A second multiple regression showed that Self Efficacy was the only significant predictor of adherence (ß = 0.429). Other factors attribut (open full item for complete abstract)

Committee: Sharrel Pinto Ph.D. (Committee Chair); Timothy Jordan Ph.D. (Committee Member); Monica Holiday-Goodman Ph.D. (Committee Member) Subjects: Aging; Behavioral Psychology; Behavioral Sciences; Behaviorial Sciences; Health; Health Care; Health Education; Health Sciences; Oncology; Pharmaceuticals; Pharmacy Sciences; Public Health; Public Health Education; Womens Studies