Member Biography

I am a health services researcher with a long-standing commitment to cancer prevention. My research centers on two complementary themes: 1) optimizing colorectal cancer (CRC) screening and surveillance through patient and provider engagement, and 2) improving our understanding of, and care delivery for, patients with hereditary CRC syndromes. 1) Optimizing CRC Screening and Surveillance Uptake : My early work focused on the appropriate use of colonoscopy, a high value but limited resource. Specifically, I investigated colonoscopy use for low-risk adenoma (LRA) surveillance, where early repeat colonoscopies lead to overuse, exposure to unnecessary harms, and delays in care for high-risk patients. My initial scenario-based and survey-driven studies revealed significant patient resistance – nearly 50% of patients with LRAs and a third of older or frail adults – were opposed to de-intensifying or stopping screening/surveillance, even when educated about risks. These studies provided new insights into behavioral barriers to guideline-concordant care. Building on these findings, I was awarded an IU Clinical and Translational Sciences KL2 Young Investigator Award (2020-2022), under the mentorship of Drs. Thomas Imperiale and Marianne Matthias. Using semi-structured qualitative interviews across the VA, Eskenazi, and IU health systems, I evaluated decision-making among patients, primary care providers, and gastroenterologists, identifying key differences in their perceived roles and communication regarding surveillance recommendations and care coordination. This work laid the foundation for my current 5-year VA Health Systems Research Career Development Award (CDA IK2 HX0036964; 2024-2029). My focus areas include: 1) conducting a nationwide study of Veterans with advanced vs. non-advanced colorectal neoplasia to identify patient, provider, and facility factors driving surveillance adherence, and 2) developing and pilot-testing an intervention to optimize surveillance timing, particularly among vulnerable populations, ensuring high-risk patients receive priority access to care. Additionally, in collaboration with Drs. Imperiale and Charles Kahi, I have explored broader CRC screening perspectives including those of younger adults (age 40-49 years), critically evaluated online CRC risk calculators, and validated the National Cancer Institute’s CRC Risk Assessment Tool using two large U.S. cohorts – the Nurses’ Health Study and the Health Professionals Follow Up Study. In the future, I am interested in the clinical application and integration of advanced neoplasia risk prediction tools to guide clinical decision-making for those who are due for screening and surveillance. While we have a good understanding of who needs to start CRC screening and surveillance, we have a poor understanding of how to determine who would be most likely to benefit from ongoing screening and surveillance, and with which type of test (invasive vs non-invasive), and who is unlikely to benefit from ongoing screening and surveillance (i.e., when can we safely stop). 2) Care Delivery for Patients with Hereditary Colorectal Cancer Syndromes: In addition to average-risk populations, I focus on high-risk cohorts with hereditary cancer predispositions. I co-lead the multidisciplinary IU Inherited CRC Syndromes Clinic alongside geneticist Dr. Gail Vance at the Simon and Schwarz Cancer Centers. To bridge clinical management with research, I am establishing infrastructure to support long-term tracking through local registries and multicenter collaborations. I have developed a local database for individuals with colonic polyposis of uncertain etiology (CPUE) to characterize clinical outcomes retrospectively. I am also joining national registries for Lynch Syndrome colorectal polyposis to support prospective cohort studies. These local and national registries will allow us to provide the infrastructure required to participate in and launch future multicenter observational studies and one day, cancer prevention clinical trials.

M.S. - University of Michigan, Ann Arbor, MI 08/2015

Fellowship - University of Michigan, Ann Arbor, MI 07/2017

Residency - University of Michigan, Ann Arbor, MI 06/2013

M.D. - Rush Medical College, Chicago, IL 05/2010