Grace Hillyer

Grace Hillyer

Grace Hillyer

Assistant Professor
Epidemiology at the Columbia University Medical Center
Director, Online MS in Epidemiology

Office/Address:

722 W. 168th Street, room 1611
New York NY USA 10032
Phone:
212-342-1658
Website address: Email: CV:

Biography

Trained as an epidemiologist and health educator, my research interests are centered on the social, cultural, and cognitive determinants of health behaviors to inform the design and implementation of tailored educational interventions to improve health and cancer-related outcomes, particularly among minority and underserved populations. My current research involves investigations related to the underrepresentation of diverse patients with cancer to clinical trials. In one study, I am evaluating of the role of implicit bias plays in the discussion and offer of clinical trial participation to patients of color with cancer. Another involves providing patients with cancer and their providers with an electronically generated list of trials to which the patient has been matched to increase the probability of clinical trial discussions and accrual of diverse patients with cancer. Lastly, we are examining the multilevel barriers to clinical trial enrollment that are specific to the needs of adolescents and young adults (AYAs). I also serve as the Director of Community Clinical Trial Outreach for the HICCC National Cancer Institute Minority Underserved Community Oncology Research Program (MU-NCORP), the Assistant Director of the HICCC Community Outreach and Engagement (COE) and am the Director of the Online MS in Epidemiology program. My prior work includes 1) the promotion of clinical trial enrollment among minority and under-represented groups using culturally and linguistically tailored curricula; 2) the development and implementation of community-based education to increase knowledge of cancer, cancer genetics, clinical trials, and precision medicine among Hispanics in Northern Manhattan utilizing qualitative and quantitative formative assessments; and 3) the development of a tobacco cessation program among smokers in Johannesburg, South Africa. Other activities in the past include the management of a New York State Department of Health-funded cancer control program for uninsured residents of NYC and a $10 million, 10-year Department of Defense study investigating racial disparities in the initiation of and adherence to hormonal therapy among women newly diagnosed with invasive estrogen/progesterone receptor positive breast cancer

Education

EdD, 2011, Teachers College
MPH, 2000, Mailman School of Public Health
BA, 1986, Kean University

Columbia Affiliations

Other Affiliations

Honors & Awards

The President's Grant for Student Research in Diversity, 2009
Calderone Prize for Junior Faculty. Mailman School of Public Health, Columbia University.

Select Urban Health Activities

Barriers to Cancer Clinical Trial Enrollment Among Underrepresented Populations: : In my role as Director of Community Clinical Trials Outreach at the Herbert Irving Comprehensive Cancer Center Minority Underserved NCORP over the past several years, I have led a multidisciplinary team to conduct investigations of the barriers to the enrollment of diverse patient populations to cancer clinical trials. Our recent investigation of the clinical trial attitudes of providers and patients at our large tertiary care medical center in New York City demonstrated that provider attitudes/bias about patients' receptivity and reasons for declining participation in clinical trials, particularly for patients from diverse racial and ethnic groups, do not accurately reflect patient attitudes and this disconnect implies implicit bias on the part of the provider that may result in fewer discussions about and offers to participate in clinical trials and may contribute to the underrepresentation of these groups in clinical trials. That work formed the foundation for our newly funded Genentech study to investigate the presence of provider implicit bias and its role in patient-provider communication and shared decision-making surrounding cancer care including the enrollment into a clinical trial. Our preliminary findings also informed the work we are currently undertaking, funded by Stand Up to Cancer, to disrupt norms around clinical trials on multiple fronts, including in the clinical setting. Other projects include an evaluation of the clinical trial attitudes of primarily male African American Veterans at a large Veterans Administration hospital in the Bronx. In this study, we found that strong bonds exist between patients and providers and that Veterans hold positive attitudes toward research at the VA facility but have a lack of understanding of clinical trials and lingering mistrust of research related to historical injustice. Other work revealed that YouTube videos about cancer clinical trials posted on the internet, the most common source of health-related information among Americans, provides highly selected information about trials with content that varied widely by the source of the information.
Community-based Cancer Control: My roots in community-based cancer control are best exemplified by past work as Director of the Northern Manhattan Cancer Screening Program funded by New York State Department of Health and my current role as the Assistant Director of the Office of Community Outreach and Engagement at the Herbert Irving Comprehensive Cancer Center. Relying on training in the biological sciences, epidemiology, health behavior, and health education, I excel at the investigation of community understanding of cancer and risk, attitudes toward cancer screening and other forms of cancer control and designing educational curricula and interventions to meet the literacy, language, and cognitive needs of the community to reduce cancer risk and ultimately, cancer mortality. My work has included beta site testing of fecal immunochemical test (FIT) in the late 1990s with funding from the New York State Department of Health and the development of an educational intervention to instruct low literacy, non-English speaking individuals about FIT which was subsequently adopted statewide. Other research, also based in this community, examined the multilevel determinants of CRC screening utilization among Latinas and tested an intervention to increase CRC screening uptake by "piggybacking" CRC screening with breast cancer screening. Findings indicated that pairing CRC education with breast cancer screening was not only a feasible but resulted in more than 90% CRC screening compliance in this "hard to reach" population. More recently I have become involved in tobacco control and direct the HICCC Tobacco Cessation Program for patients with cancer who smoke. This work resulted in a collaboration with investigators in South Africa to examine tobacco use behavior and interest in tobacco treatment.
Cancer Control Messages Communicated on the Internet and in Social Media: : Over the past two decades, how health information is communicated to the average American has evolved. First, in print (e.g., in magazines) and on television to nearly exclusively on the internet and, most recently in social media. Information on literally any topic related to cancer and cancer prevention can be found on Google, YouTube, Instagram, TikTok, and other platforms. While evidence supports that social media can disseminate accurate and useful information, there also exists the potential for unintentional misinformation and intentional disinformation. The role of public health practitioners and health educators is to generate clear and accurate messaging that is calibrated to the evolving context of science, to vet content with experts, and to gear communication to a very heterogenous public in terms of age, beliefs, culture, sociodemographics, literacy, and information-seeking behaviors.

Select Global Activities

Assessment of lung cancer risk and screening needs among primary care patients in South Africa: Among men in South Africa, the prevalence of tobacco smoking is as high as 33%. Although smoking is responsible for most lung cancer in South Africa, occupational and environmental exposures contribute greatly to risk. We conducted a tobacco and lung cancer screening needs assessment and administered surveys to adults who smoked >100 cigarettes in their lifetime in Johannesburg (urban) and Kimberley (rural). We compared tobacco use, risk exposure, attitudes toward and knowledge of, and receptivity to cessation and screening, by site. Of 324 smokers, nearly 85% of current smokers had a <30 pack-year history of smoking; 58.7% had tried to stop smoking A¢a€°A¥1 time, and 78.9% wanted to quit. Kimberley smokers more often reported being advised by a healthcare provider to stop smoking (56.5% vs. 37.3%, p=0.001) than smokers in Johannesburg but smokers in Johannesburg were more willing to stop smoking if advised by their doctor (72.9% vs. 41.7%, p<0.001). Findings indicate that tobacco smokers in two geographic areas of South Africa are motivated to stop smoking but receive no healthcare support to do so. Developing high risk criteria for lung cancer screening and creating tobacco cessation infrastructure may reduce tobacco use and decrease lung cancer mortality in South Africa.

Select Publications

Hillyer GC, Park Y-H, Rosenberg T-C, Mundi P, Patel I, Bates S. Positive attitudes toward clinical trials among military Veterans leaves unanswered questions about poor trial accrual. Seminars in Oncology. 2021; 48(2):130-140. https//0.1053/j.seminoncol.2021.01.001.
Hillyer GC, Nazareth M, Lima S, Schmitt KM, Reyes A, Fleck E, Schwartz GK, Terry MB. E-cigarette use among young adults: The opportunity to intervene on risky lifestyle behaviors and reduce cancer risk. Journal of Community Health. 2021. 47(1):94-100. https:// 10.1007/s10900-021-01027-7
Hillyer GC, Beauchemin DL Hershman, M, Kelsen M, Brogan FL, Drimer DL, Sandoval R, Schmitt KM, Reyes, Terry MB, Lassman AB, Schwartz GK. Discordant attitudes and beliefs about cancer clinical trial participation between physicians, research staff, and cancer patients. Clinical Trials. 3 February 2020. 17(2): 184-194. https://doi.org/10.1177/1740774520901514; PMCID: PMC7211123.
Hillyer GC, Basch CH, Beauchemin M, Kelsen M, Brogan F, Schwartz GK. Readability of websites devoted to clinical trials. Cancer Control. 2020; 27 (1): 1073274819901125. PMCID: PMC6984426
Hillyer GC, Schmitt KM, Reyes A, Cruz A, Lizardo M, Schwartz GK, Terry MB. Community education to enhance the more equitable use of Precision Medicine: Findings for a National Outreach Network Community Health Educator Initiative in Northern Manhattan. Journal of Genetic Counseling. 2020; 29(2):247-258. https://doi.org/10.1002/jgc4.1244
Hillyer GC, Mapanga W, Jacobson JS, Graham A, Mmoledi K, Makhutle R, Osei-Fofie D, Mulowayi M, Masuabi B, Bulman WA, Neugut AI, Joffe M. Attitudes toward tobacco cessation and lung cancer in two South African communities. Global Public Health; 2020 May 14 [Epub ahead of print.] https://doi.org/10.1080/17441692.2020.1761425
Hillyer GC, MacLean SA, Basch CH, Schmitt KM, Segall L, Beauchemin M, Kelsen M, Brogan FL, Schwartz GK. YouTube videos as a source of information about clinical trials. JMIR. 2018; 4(1):e10600.
Hillyer GC, Schmitt KM, Lizardo M, Reyes A, Bazan M, Alvarez M, Sandoval R, Abdul K, Orjuela MA. Electronic communication channel use and health information source preferences among Latinos in Northern Manhattan. Journal of Community Health. 2017; 42(2):349-357. doi: 10.1007/s10900-016-0261-z. PMCID: PMC5481779.
Hillyer GC, Neugut AI, Schmitt KM, Basch CE. Feasibility and efficacy of pairing fecal immunochemical testing with mammography for increasing colorectal cancer screening among uninsured Latinas in northern Manhattan. Preventive Medicine. 2011; 53(3): 194-8. doi: 10.1016/j.ypmed. 2011.06.11.

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