Michigan Cancer Research Fund                                                                                            American Cancer Society
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Research Project Description and Objectives from Kristen Alford, MSW, MCRF 2012 Fellow

Project Name:  Quality of Life Outcomes Among Older Adults with Colorectal Cancer

Colorectal cancer is diagnosed in over 140,000 Americans each year and approximately 65% of those diagnoses are in adults over the age of 65.  In the past 30 years, treatment of colorectal cancer has resulted in increases in survival rates, from 50% in 1975 to 66% in 2007.  Although historically older adults were not offered curative therapy for colorectal cancer trends have demonstrated a decrease in denial of treatment for older adults and an increase in the amount of curative therapies. 

Given the increased survival rates and increased curative treatment options for older adults, my research will explore how colorectal cancer treatment affects psychological and social well-being, or quality of life, among older adults. 
My three major research objectives are:

  1. To identify the most appropriate ways to define and measure quality of life among the aging as it relates to social and psychological outcomes.
  2. To explore quality of life outcomes by conducting a qualitative study of older adults who have been diagnosed with colorectal cancer.
  3. To conduct a survey study of older adults with colorectal cancer informed by the findings from the qualitative study.

In my first year of research, I plan to focus on delving into the existing literature on quality of life to determine the most appropriate ways to measure quality of life among older adults with colorectal cancer in order to achieve my first objective.  While doing this, I plan on completing my comprehensive exams which will focus on the history and epistemology of oncology social work as well as the current research on colorectal cancer and quality of life.  I also will begin to formulate my dissertation proposal which will include finalizing a research design and methodology that will help me to achieve my second and third research objectives.
Depending on my first year outcomes, in my second year of research I will begin both the qualitative and quantitative data for my research project and begin data analysis.

Summer 2013 Update

In the past year, I have had the opportunity to further explore my research topic and to discuss my topic with oncology social workers. I spent the first part of the year delving into the research and better understanding the existing literature on psychosocial well-being among older adults. Through public health courses on poverty and culture, I began to better understand how individual demographic factors can influence one's adjustment and understanding of a disease, along with diagnosis and treatment. I also attended the American Public Health Association Annual Meeting and the Society for Social Work and Research Annual Conference. These events provided many opportunities to network with other cancer researchers and to discuss potential research methodologies.

I dedicated the second part of the year to writing my comprehensive exams using the resources that I collected earlier. Much to my dismay, there is very little written in the area of psychosocial well-being among older adults with colorectal cancer, or with cancer in general, and thus I had to expand my research to include all types of cancer. This paucity of research is very troubling as older adults are disproportionately affected by cancer; however, this also reinforces the need for research in this area and re-emphasizes the importance of serving this population.

I recently passed my comprehensive exams. In the coming year, I will be developing my dissertation proposal, and beginning my dissertation research. I am very grateful for the support of the MCRF and I look forward to sharing results and recommendations.

Summer 2014 Update

The grant I received from the Michigan Cancer Research Fund allowed me to expand my knowledge in the area of psychosocial well-being among older adults with cancer as well as better understand how this subject fits into the larger public health arena. With MCRF support, I was able to complete a Master in Public Health degree, finalize my comprehensive exams and dissertation proposal, attend several conferences and workshops in this field of research, engage in networking opportunities with colleagues in the field, and consider new ways of data collection among those with cancer.

Further, the funding has allowed me to think in new ways, to utilize cutting-edge research methodologies, and to develop a long-term research agenda. I have taken coursework and attended conferences that I would not otherwise have had the resources to attend. This knowledge has influenced both my research and teaching. The MCRF investment in my research is also an investment in my social work and public health students. The support of the MCRF further highlights the importance of workforce development and investment in future generations. I truly appreciate the MCRF's investment in me as I begin my career in oncology social work research.

In the coming year, I will be conducting a nationwide survey of the impact of cancer in three older age brackets: 65-74, 75-84, and 85+. This study will assess the psychological and social well-being challenges faced by cancer patients in each of these age groups.

Summer 2015 Update

Kristen defended her dissertation earlier this year and will be receiving her doctoral degree
from Michigan State University in August. She acknowledged the MCRF and ACS in her dissertation, saying
"This research would not have been possible without generous financial support from the American
Cancer Society Doctoral Training Grant in Oncology Social Work and the Michigan Cancer Research
Fund. Additionally, thank you to the national office of the American Cancer Society for bringing
together experts in oncology social work who helped provide input on my study and provided me
with their research expertise. Thank you to my friends at the Michigan Cancer Research Fund who
have been so encouraging and supportive of my research."

Summer 2016 Update

Kristen Alford, PhD., used MCRF funding to complete her dissertation research on psychosocial outcomes among older adults with cancer.  Kristen is currently an assistant professor of social work and public health at Calvin College.  In addition to teaching, Kristen is involved in several different research projects and initiatives including secondary data analysis on barriers to medical care among families in three Grand Rapids communities, co-teaching chronic disease and determinants of health to girls ages 9 to 15 in a week-long summer HEALTH camp, and engaging with a college-wide public health initiative.  Kristen is also working with a colleague in biology to better understand what resources are available for parents with cancer to talk about cancer with their children, particularly resources describing what cancer is, treatment types, side effects, and other physiological components of a cancer diagnosis.  This project utilizes both parent surveys and focus groups to determine what resources are available, what resources are not getting to parents, and further needs parents have in this area of cancer care.

Summer 2018 Update from Dr. Alford: Kristen (Admiraal) Alford is an associate professor of social work and public health at Calvin College. She is currently involved in two major research projects. The first project seeks to understand the tools parents need to better discuss their (the caregiver’s) diagnosis of cancer with their children. This research began with a survey of parents who were diagnosed with cancer to understand how they communicated with their children about their diagnosis and the reactions the children displayed in response to their parent’s diagnosis. The second part of the research is talking with parents and professionals to discuss the communication needs of parents with a diagnosis of cancer.

The second project is analyzing the efforts of a water filter distribution project in Liberia. This project is being completed over four years with the intention of ensuring every person in Liberia has access to clean drinking water. Kristen’s role in the project is to analyze and report on the public health effects of this project, specifically how the distribution of filters affects childhood diarrheal rates as well as overall family medical expenditures, adult employment, and childhood schooling. Kristen also continues to teach in public health and social work. In this position, she helps students understand the interactions between biological, psychological, and social well-being as well as how one’s context affects their outcomes. She frequently discusses her work in cancer and chronic disease to highlight these interactions and discuss interventions and policy to address these challenges.