For our last faculty spotlight of 2014, we talk to Leah Zullig, PhD about her research on quality of care for survivors of colorectal cancer, efforts to improve self-management for patients living with chronic diseases, and swimming with sand tiger sharks off the North Carolina coast.
How long have you been at Duke? How long have you been at the Division?
Although I’ve been in the area for about a decade, I’m relatively new to Duke and the Division. I joined the GIM faculty last summer. Before that I earned my PhD at UNC and I worked with the Durham VA HSR&D group (and still do!).
You wear hats within Duke and the Durham VAMC. How do you manage these responsibilities? What does a typical day for you look like?
My time is mostly split between Duke and the VA. Much of my time is spent in front of a computer screen – preparing manuscripts, developing grant proposals, and sharing research findings. I’m fortunate to work with diverse partners from Durham to Tanzania, and that helps me form meaningful ideas. A typical day involves lots of time spent writing with a cup of coffee, interspersed with research meetings.
You’re the principal investigator for a VA HSR&D Career Development Award looking at colorectal cancer survivor’s quality of care within the VA system. Can you tell me more about this research?
Absolutely! Many VA colorectal cancer survivors tend to be complex patients with additional chronic conditions. My CDA focuses on improving colorectal cancer survivors’ care quality through a self-management intervention bridging cancer surveillance and chronic disease management. As part of the CDA, my team and I are tackling three projects. First, we will identify a national cohort of VA colorectal cancer survivors and will characterize their comorbidities and self-management behaviors. Second, we will conduct a telephone-based survey to assess colorectal cancer survivors’ perceptions of self-management. I’m most excited about our third project. We’re designing and pilot-testing an intervention to motivate colorectal survivors’ adherence to survivorship self-management.
In addition to this award, much of your other research focuses on self-management for patients dealing with chronic disease. Can you tell me more about that research? What results have you found so far? What are the major challenges and opportunities in this area?
I am privileged to work with an expert in the field of self-management, Hayden Bosworth. I’ve conducted secondary data analyses from a number of his clinical trials. One of those that I found most interesting examined the influence of a chaotic lifestyle on medication adherence among a post-myocardial infarction population. Patients reported the level of chaos in their life. We found that a chaotic lifestyle may negatively impact medication adherence, an important self-management behavior. A chaotic lifestyle is an interesting and often overlooked factor. Each patient is unique, so developing a one-size-fits-all intervention to improve self-management would be challenging. However, a major opportunity moving forward is creating tailored interventions that encompass multiple self-management behaviors addressing behavioral and lifestyle factors.
What other areas of research are you interested in?
In addition to my interests in U.S. cancer care quality and chronic disease self-management, I’m interested in cancer care quality and control in a global context. Establishing cancer registries is a critical first step in understanding cancer incidence and mortality. Yet in many developing countries, like Tanzania, registries are rare. In January I’ll kick off a newly funded Duke Global Cancer pilot project. We will evaluate the quality of data from a recently established cancer registry at Kilimanjaro Christian Medical Center (Moshi, Tanzania) while simultaneously building infrastructure to support the development of an additional hospital-based cancer registry in at Bugando Medical Center (Mwanza, Tanzania). Our ultimate goal is to link these registries to expand population coverage for a more complete understanding of the cancer burden in Tanzania.
What passions or hobbies do you have outside of the division? I love travel and all things aquatic, and I am passionate about scuba diving. I’ve been diving all over the world, from the Indian Ocean of eastern Africa to the Silfra fissure in Iceland. My favorite diving destination of all is our very own North Carolina coast. The WWI and WWII wrecks, coupled with our gorgeous sand tiger sharks, make it unparalleled for adventure. When not conducting research or being underwater, I attend many band and symphony concerts. My better half is faculty in the UNC Department of Music and I enjoy supporting his great work!
Dr. Zullig scuba-diving in the Turks and Caicos Islands