Don’t be fooled by the intricately woven stories we academics tell linking everything we’ve ever done and produced together…the road through academia, for many, dare I say most, of us, is not linear. My research training and interests over time are a prime example. The truth is, sometimes, we have to be sponges and sit in a topic or field for some time to get a sense of whether or not this is where we want to be. While changing directions is often looked at as a bad thing, it can actually offer quite a few benefits, including having a diverse set of skills (usually some germane and some that are quite transferable) and having the opportunity to build cross-disciplinary collaborations. Is it just me, or do we never talk about the perks of transitioning fields of study? The good news, though, is that with each pivot we make, we usually get one step closer to zeroing in on the direction we wish to go, whether that’s in academia or industry. Since entering academia in 2016, despite the swivels and turns and loop de loops, I feel like I am finally in the research field I am meant to be in (6 years later, mind you).
My name is Kristin Morrill and I am a Postdoctoral Research Associate in the Community & Systems Health Science Division of the University of Arizona’s College of Nursing. As a health disparities and health services researcher, the long-term goal of my research is to improve oncology care for the underserved. This passion is largely driven by my experiences as a Cuban American woman and my understanding of some of the barriers faced by women, like my grandmother, while navigating the healthcare system. Currently, my research focuses on two specific time intervals along the cancer care continuum: 1) the time in days between the first clinical presentation of cancer to diagnosis (referred to as diagnostic delay) and 2) the time in days between a diagnosis and initiation of treatment (referred to as treatment delay). My research has largely been focused on breast cancer given breast cancer remains the deadliest cancer for Hispanic women in the U.S. comprising 14% of all cancer deaths. Consistently, it has been demonstrated that Hispanic women diagnosed with breast cancer experience longer diagnostic and treatment delay compared to other subpopulations, and the detrimental effects of these delays range from increased psychological distress (anxiety and depression) to enlargement of the tumor and poorer overall prognosis. Put succinctly, ensuring timely diagnosis and treatment are critical to improving cancer outcomes among Hispanic women diagnosed with breast cancer. To develop interventions and policies to reduce these delays; however, more data regarding reasons for these delays and who is at greater risk of experiencing them is needed. To this end, my ongoing research includes the following: 1) evaluating factors (including race and ethnicity) associated with treatment delay among patients with five common cancers (including breast cancer); 2) describing overall trends for breast cancer diagnostic and treatment delay in a nationally representative sample of US Medicare beneficiaries and examining trends by racial and ethnic subpopulation and geographic location; and 3) exploring the experiences of Hispanic cancer patients through the diagnosis and treatment process and the factors influencing decisions on where and when to be diagnosed and treated. Together, findings from this research will provide a holistic understanding of how delays have changed over time and reasons for delays, thereby elucidating targets for developing effective interventions and policies to decrease delays among Hispanic adults. The third research objective will be funded through a Postdoctoral Research Development Grant, which will provide funds for participant compensation and a wonderful undergraduate research assistant.
As I mentioned earlier, the path to being a health services researcher was not linear. In 2016, I began my PhD journey in the University of Arizona’s Department of Nutritional Sciences as a USDA National Needs Fellow. As a graduate research associate, my research focused on reducing health disparities faced by Mexican-origin communities and Hispanic communities in Southern Arizona. For 4.5 years, I conducted research to inform the development of a future culturally-tailored lifestyle intervention for Hispanic women with nonalcoholic fatty liver disease, a risk factor for liver cancer. What I learned from my interactions with participants throughout this time resonated with memories of challenges my Spanish-speaking grandmother faced as an immigrant in this country. Lack of access to care is a pivotal barrier to living healthful and vibrant lives. After I defended, I realized that what I was passionate about was researching ways to reduce barriers related to access and doing so in ways that would be sustainable and reach a greater number of individuals. This realization helped guide my next journey as an NCI T32 Cancer Prevention and Control Health Disparities Postdoctoral Fellow at the University of Arizona Cancer Center. Throughout this fellowship, my interests in addressing access to care barriers crystalized and I received focused training in cancer health disparities research, cancer epidemiology, and health services research. Additionally, I had the opportunity to greatly expand my research collaborations in the field of implementation science through actively participating in the Consortium for Cancer Implementation Science action group to develop a priority public good to improve operationalization of multi-level intervention core functions and forms and The Cancer Prevention and Control Research Network (CPCRN) as a CPCRN Scholar. As a Scholar, I am working with a team at the University of New Mexico to explore the implementation context in community oncology practices as it relates to implementing screening/assessment and referral processes to improve the uptake of physical activity interventions. I began my second postdoc position in May of this year and will continue expanding my training in oncology health services research.
I would not be able to conduct the research I do without fully embracing a cross-disciplinary, team science approach. If you would be interested in collaborating, or maybe just grabbing a coffee, please do not hesitate to reach out to me via email – firstname.lastname@example.org. You can also link up with me on Twitter @KMorrill_PhD.
Dr. Kristin Morrill was awarded a Postdoctoral Research Development Grant (PRDG) from the University of Arizona for a project titled “Factors Influencing the Decisions of When and Where to be treated in Hispanic Cancer Survivors”.
Each month we'll feature a Postdoctoral Scholar and their research, sharing their experiences from the UA, life in Arizona and their research interests.