Pilot Projects Core

Core leader

David R. Williams, PhD, MPH
Harvard School of Public Health

The Pilot Projects Core (PPC) supports innovative research projects and promotes transdisciplinary research through collaboration with the Training Program to engage scientists from other disease- and discipline-based programs in its research.

Current pilot projects

Seasonal Tobacco Smoke Exposure in Boston Public Housing

Principal Investigator
Douglas E. Levy, PhD
Harvard Medical School, Mongan Institute for Health Policy at Massachusetts General Hospital

Because smoking rates are higher among low-income groups, non-smokers in multiunit public housing are more likely to have neighbors who smoke and therefore are likely to have higher rates of ETS exposure and increased risk of its adverse health consequences. Beginning in September 2012, the Boston Housing Authority (BHA) will begin prohibiting smoking in all BHA housing units. Intended to reduce levels of ETS throughout BHA buildings, the policy may lead to increases in ETS levels outside buildings—for example, around entryways.

This pilot study is identifying baseline ETS levels in the BHA prior to the implementation of the smoke-free policy. Its aims are to:

  • Measure ETS levels in common spaces of BHA buildings and assess the association of season/weather and building characteristics with variability in ETS levels
  • Test the characteristics of tobacco smoke diffusion around building entryways and identify best practices for setting smoking policy in those areas

Correlates and consequences of perceived unmet need for care and perceived discrimination in cancer care among lung cancer patients

Principal Investigator
Dolly John, PhD
Harvard School of Public Health

Documented race/ethnicity and nativity-related disparities in perceived overall quality of care for lung cancer patients are only partially accounted for by language and experiences of interpersonal care. This project examines perceived unmet need for care and perceived discrimination in cancer care–their social causes and their roles in explaining disparities in perceived quality of care. Findings will advance knowledge about the joint roles of race/ethnicity and nativity in explaining perceived quality of cancer care and potential pathways, identify priority sub-populations of patients needing increased access to equitable, patient-centered treatment and psychosocial care, and inform future efforts to improve outcomes. Its specific aims are to:

  • Describe the prevalence of perceived unmet need for cancer care and perceived discrimination in cancer care by race/ethnicity, nativity and socioeconomic status (education, income, wealth)
  • Determine the associations between race/ethnicity and nativity and perceived unmet need for cancer care and perceived discrimination in cancer care
  • Determine if unmet need for care/services and perceived discrimination in cancer care are associated with perceived overall quality of care and whether they explain racial/ethnic and nativity-related disparities in perceived quality of cancer care

Past pilot projects

Project Provide: Provider-delivered Health Promotion Interventions in Primary Care

Principal Investigator
Gary Bennett, PhD
Duke University

The primary care physician (PCP) is key to smoking cessation, particularly among the socially disadvantaged. The US Preventive Services Task Force recommends that PCPs screen “all adults for tobacco use and provide tobacco cessation interventions for those who use tobacco products,” and suggests that providers utilize NCI’s “5 A’s” framework. While “5 A’s” is effective, physicians report that they lack time to routinely implement it, and, further, that this disproportionately affects racial/ethnic minority and low-SES patients. Project Provide is using data collected from providers in a network of community health centers and CHC-level data from HRSA’s Uniform Data System (UDS) to inform the translation and dissemination of evidence-based cancer prevention lifestyle counseling interventions in community health centers. Its specific aims are to:

  • Assess types of cancer prevention lifestyle counseling resources used by primary care providers (PCPs) in a North Carolina CHC health system
  • Assess PCP adherence to clinical practice recommendations for cancer prevention lifestyle counseling
  • Examine facilitators and barriers to clinical practice recommendations adherence
  • Examine whether cancer prevention lifestyle counseling resources and adherence to clinical practice recommendations vary by organizational and provider characteristics