NIH – Fundamental Mechanisms of Affective and Decisional Processes in Cancer Control (R01)

August 3, 2016 by School of Medicine Webmaster

This FOA encourages circumscribed projects to generate fundamental knowledge of affective processes with key consequences for single (e.g., cancer screening) and multiple (e.g., adherence to oral chemotherapy regimen) event decisions and behaviors across the cancer control continuum. The FOA solicits applications that involve collaboration among cancer control researchers and those from scientific disciplines not traditionally connected to cancer control applications (e.g., affective and cognitive neuroscience, decision science, consumer science) to elucidate perplexing and understudied problems in affective and decision sciences with downstream implications for cancer prevention and control.

Projects should leverage classic and contemporary experimental designs and methodological paradigms to expand our understanding of affective and decisional processes that contribute to cancer risk and outcomes. Applications are encouraged to incorporate more than one operationalization of affect (e.g., fMRI, brain lesion, physiological assessment, self-report, induction). The FOA engages scientists with expertise not traditionally brought to bear on cancer control research. As such, there is a need for substantial partnership with collaborators and other key personnel with expertise in cancer control. Projects proposed by collaborative teams of affective and cancer control scientists and submitted as multiple program director/principal investigator (PD/PI) applications are strongly encouraged.

Background and Rationale

Decisions about health and health behaviors confer significant risks and benefits along the cancer control continuum. Informed by decades of basic and translational evidence, behavioral science efforts to reduce the cancer burden have historically targeted risk perception and social normative determinants of such decisions and behaviors. Those investments have yielded actionable findings. However, new knowledge is needed to optimize individual and group decision making relevant to cancer risk and outcomes. Recently converging evidence demonstrates affect is a pervasive– sometimes harmful and sometimes beneficial – determinant of decision making, with multiple mechanisms of influence and means for intervention. Association studies implicate affective states in cancer-related information processing; decisions about cancer risk and prevention behaviors (e.g., smoking, overeating, cancer screening, HPV vaccination); decisions about treatment and treatment adherence; and decisions about palliative and end-of-life care.  However, our understanding of how emotions influence single and multiple event decisions relevant to cancer prevention and control is in its infancy.

Without improvements in basic knowledge about how affect influences individual and collective cancer-related behavioral decision making, efforts to develop, test, and disseminate cancer control and biomedical interventions to reduce cancer risk, incidence, morbidity and mortality are hampered. Importantly, the influence of emotion is highly context-specific, highlighting the critical need for elucidating the role of emotion in cancer-specific decision making to maximize the ability to translate advances in affective science into objective and measurable improvements in cancer control.

Specific Research Objectives

Specific gaps in our knowledge with important downstream implications for cancer control include, but are not limited to:

  • How does affect contribute to decisions to adhere to recommendations for biomedical treatments or interventions, such as HPV vaccination or cancer treatments?
  • How do emotions influence patient-provider interactions and clinical encounters? How does the emotional tenor of such interactions influence shared decision making surrounding cancer screening or treatment?
  • What are the neuropsychological underpinnings of craving for cigarettes or highly palatable foods? Can we identify patterns of stimuli that trigger affective craving responses so future communication efforts do not inadvertently elicit those responses?
  • How do specific positive (e.g., pride) and negative (e.g., anger) emotions facilitate decision making about cancer risk and prevention behaviors with short-term costs but long-term gains, such as exercise or quitting smoking? How does emotion regulation modify associations between these emotions and cancer risk behaviors?
  • How does emotion influence sensitivity to risk, particularly in the context of prognostic uncertainty?
  • How does emotion contribute to decision to seek treatment or palliative care under ambiguous circumstances?
  • How can we best measure affect in cancer decision contexts involving healthy individuals, and those at increased risk for cancer, diagnosed with cancer, in treatment for cancer, in palliative care, and/ or in cancer survivorship?
  • What are the implications of “blended” emotional states (e.g., being happy about the ability to express sadness, experiencing both anger and fear in concert)? Do blended negative emotional reactions to a cancer diagnosis influence decisions about treatment adherence?

Deadlines:  Full proposals are due on April 11, 2017, October 10, 2017; April 11, 2018, October 10, 2018, April 11, 2019, and October 11, 2019.  Letters of intent are due 30 days before the full proposal.


Filed Under: Funding Opportunities