Research Summary

My research examines the socio-cultural and institutional dimensions of inequities in cancer care. As an anthropologist, I specialize in ethnographic approaches, but use a range of mixed qualitative and quantitative methods and community-based participatory research to investigate issues affecting vulnerable and medically underserved populations across the cancer continuum and in the context of the translation of new genomic technologies to clinical settings. My research program primarily focuses on 1) the translation of hereditary cancer services to underrepresented populations and under resourced settings and 2) the participation of vulnerable populations in cancer clinical research. In both these areas, I am particularly interested in identifying and addressing the challenges of effectively communicating with low-income, low-health literacy, and limited-English-proficient (LEP) populations in both clinical and community settings.

I am currently site PI/Co-Investigator on the CHARM (Cancer Health Assessments Reaching Many) study (MPI Goddard/Wilfond), one of the seven clinical project of the CSER consortium (funded by NHGRI, NCI and NIMHD). The Clinical Sequencing Evidence-Generating Research (CSER) consortium, now in its second funding cycle, is investigating the effectiveness of integrating genomic (exome or genome) sequencing into the clinical care of diverse and medically underserved individuals in a variety of healthcare settings and disease states. The goal of CHARM is to examine the utility of exome sequencing for cancer screening and how it affects care in diverse populations. My role includes leading the intervention development for a RCT comparing the ARIA genetic counseling model (Accessible, Relational, Inclusive, Actionable) and usual care genetic counseling for the return of exome sequence results with historically underserved patients. Also, for the CHARM study, I am leading the development and evaluation of an intervention to teach professional health care interpreters about exome sequencing, and to examine interpreters’ impact on the communication dynamic as well as LEP patient understanding and follow-up care.

I am also PI of the ELSI (ethical, legal social issues) study of the WISDOM trial, a pragmatic, preference sensitive RCT of risk-based breast cancer screening. This study is ethnographic and involves both empirical and normative bioethics methods to examine the ethical and social issues that arise in the context of precision population medicine (co-PI Barbara Koenig).

Most recently, I received funding with Dr. Kim Rhoads (MPI) for a study Mapping Mutographs and Epigenetic Changes in the Bayview Hunters Point Historical Cohort. This study combines CBPR, ethnographic and mapping methods to understand the relationship between a deeply toxic environment and the health of multigenerational African American families in the Bayview Hunters Point neighborhood.

Research Funding

  • January 12, 2017 - December 31, 2021 - Precision Genomics in the WISDOM Pragmatic Clinical Trial: An Embedded ELSI Study of Risk-based Breast Cancer Screening, Co-Principal Investigator. Sponsor: NIH/NCI, Sponsor Award ID: R01CA211999
  • June 14, 2013 - May 31, 2021 - Exome sequencing in Diverse Populations in Colorado & Oregon, Co-Investigator. Sponsor: NIH, Sponsor Award ID: U01HG007292
  • April 12, 2016 - March 31, 2021 - Comparison of 3 Modes of Genetic Counseling in High-Risk Public Hospital Patients, Co-Investigator. Sponsor: NIH/NCI, Sponsor Award ID: R01CA197784
  • January 20, 2021 - January 20, 2021 - Engaging Underserved Women in Health Research, . Sponsor: California Breast Cancer Research Program, Sponsor Award ID: 20BB-2100

Education

Wesleyan University, Middletown, Connecticut, B.A., 1988, Anthropology
University of California, Santa Cruz, M.A., 1993, Cultural Anthropology
University of California, Santa Cruz, Ph.D., 1999, Cultural Anthropology
Yale University, Center for International & Area Studies, Post-Doctoral Fellowship, 2001, Migration, Globalization, & Citizenship

Honors & Awards

  • 1992
    Graduate Fellowship Honorable Mention, National Science Foundation
  • 1994
    Wenner-Gren Foundation for Anthropological Research Dissertation Research Fellowship
  • 1998
    Spencer Foundation Dissertation Writing Fellowship
  • 1999
    Advanced Studies Fellowship, Anthropology and Education Institute, Spencer Foundation
  • 2010
    Best Published Paper Award Nomination, Asian/PI Caucus, American Public Health Association
  • 2012
    Best Abstract, first-time presenter at Genomics Forum, American Public Health Association
  • 2013
    Mentored Community-Academic Team, Community-Based Participatory Research for Health Equity Institute, NIMHHD (Grant # 1R13MD007620-01), San Francisco State University, San Francisco, CA
  • 2015
    UCSF CORO Leadership Training Institute
  • 2016
    National Society for Genetic Counselors Best Abstract Award: “Adapting Evidenced Based Strategies for Effective Communication in Cancer Genetic Counseling"
  • 2018
    National Society for Genetic Counselors Best Trainee Paper Award for mentee Daniella Karmara, Journal of Genetic Counseling "Cancer counseling of low-income limited English proficient Latina women using medical interpreters: Implications for shared decision making"

Selected Publications

  1. Mittendorf KF, Knerr S, Kauffman TL, Lindberg NM, Anderson KP, Feigelson HS, Gilmore MJ, Hunter JE, Joseph G, Kraft SA, Zepp JM, Syngal S, Wilfond BS, Goddard KAB. Systemic Barriers to Risk-Reducing Interventions for Hereditary Cancer Syndromes: Implications for Health Care Inequities. JCO Precis Oncol. 2021; 5.  View on PubMed
  2. James JE, Riddle L, Koenig BA, Joseph G. The limits of personalization in precision medicine: Polygenic risk scores and racial categorization in a precision breast cancer screening trial. PLoS One. 2021; 16(10):e0258571.  View on PubMed
  3. Lee R, Frick M, Joseph G, Guerra C, Stewart S, Kaplan C, Dixit N, Tsoh JY, Flores S, Pasick RJ. Research to reduce inequities in cancer risk services: Insights for remote genetic counseling in a pandemic and beyond. J Genet Couns. 2021 Oct 23.  View on PubMed
  4. Almeida R, Lopez-Macha A, Dugatkin T, Joseph G, Duron Y, Hurtado de Mendoza A, D Graves K, Fejerman L. Community research collaboration to develop a promotores-based hereditary breast cancer education program for Spanish-speaking Latinas. Health Educ Res. 2021 07 12; 36(3):319-336.  View on PubMed
  5. Mittendorf KF, Kauffman TL, Amendola LM, Anderson KP, Biesecker BB, Dorschner MO, Duenas DM, Eubanks DJ, Feigelson HS, Gilmore MJ, Hunter JE, Joseph G, Kraft SA, Lee SSJ, Leo MC, Liles EG, Lindberg NM, Muessig KR, Okuyama S, Porter KM, Riddle LS, Rolf BA, Rope AF, Zepp JM, Jarvik GP, Wilfond BS, Goddard KAB, CHARM study team. Cancer Health Assessments Reaching Many (CHARM): A clinical trial assessing a multimodal cancer genetics services delivery program and its impact on diverse populations. Contemp Clin Trials. 2021 07; 106:106432.  View on PubMed
  6. Laura Amendola, Sabrina A. Suckiel, Julianne O’Daniel, Katherine Donohue, Katie Gallagher, Marian Gilmore, Laura Hendon, Galen Joseph, Billie Lianoglou, Jennifer M. Mathews, Mary Norton, Jaqueline Ogdis, Alexis Poss, Shannon Rego, Sarah Scollon, Tiffany Yip. eP317 Genomic sequencing results disclosure in diverse and underserved populations: themes, challenges and strategies from the CSER Consortium. Molecular Genetics and Metabolism. 2021 Apr 1; 132:s201-s203.  View on PubMed
  7. Suckiel SA, O'Daniel JM, Donohue KE, Gallagher KM, Gilmore MJ, Hendon LG, Joseph G, Lianoglou BR, Mathews JM, Norton ME, Odgis JA, Poss AF, Rego S, Scollon S, Yip T, Amendola LM. Genomic Sequencing Results Disclosure in Diverse and Medically Underserved Populations: Themes, Challenges, and Strategies from the CSER Consortium. J Pers Med. 2021 Mar 13; 11(3).  View on PubMed
  8. Riddle L, Amendola LM, Gilmore MJ, Guerra C, Biesecker B, Kauffman TL, Anderson K, Rope AF, Leo MC, Caruncho M, Jarvik GP, Wilfond B, Goddard KAB, Joseph G. Development and early implementation of an Accessible, Relational, Inclusive and Actionable approach to genetic counseling: The ARIA model. Patient Educ Couns. 2021 05; 104(5):969-978.  View on PubMed
  9. Biesecker BB, Lillie SE, Amendola LM, Donohue KE, East KM, Foreman AKM, Gilmore MJ, Greve V, Liangolou B, O'Daniel JM, Odgis JA, Rego S, Rolf B, Scollon S, Suckiel SA, Zepp J, Joseph G. A review and definition of 'usual care' in genetic counseling trials to standardize use in research. J Genet Couns. 2021 02; 30(1):42-50.  View on PubMed
  10. Goddard KAB, Angelo FAN, Ackerman SL, Berg JS, Biesecker BB, Danila MI, East KM, Hindorff LA, Horowitz CR, Hunter JE, Joseph G, Knight SJ, McGuire A, Muessig KR, Ou J, Outram S, Rahn EJ, Ramos MA, Rini C, Robinson JO, Smith HS, Waltz M, Lee SS. Lessons learned about harmonizing survey measures for the CSER consortium. J Clin Transl Sci. 2020 Apr 24; 4(6):537-546.  View on PubMed
  11. Kraft SA, McMullen C, Lindberg NM, Bui D, Shipman K, Anderson K, Joseph G, Duenas DM, Porter KM, Kauffman TL, Koomas A, Ransom CL, Jackson P, Goddard KAB, Wilfond BS, Lee SS. Integrating stakeholder feedback in translational genomics research: an ethnographic analysis of a study protocol's evolution. Genet Med. 2020 06; 22(6):1094-1101.  View on PubMed
  12. Van Blarigan EL, Chan H, Van Loon K, Kenfield SA, Chan JM, Mitchell E, Zhang L, Paciorek A, Joseph G, Laffan A, Atreya CE, Fukuoka Y, Miaskowski C, Meyerhardt JA, Venook AP. Self-monitoring and reminder text messages to increase physical activity in colorectal cancer survivors (Smart Pace): a pilot randomized controlled trial. BMC Cancer. 2019 Mar 11; 19(1):218.  View on PubMed
  13. Nickell A, Stewart SL, Burke NJ, Guerra C, Cohen E, Lawlor C, Colen S, Cheng J, Joseph G. Engaging limited English proficient and ethnically diverse low-income women in health research: A randomized trial of a patient navigator intervention. Patient Educ Couns. 2019 07; 102(7):1313-1323.  View on PubMed
  14. Joseph G, Lee R, Pasick RJ, Guerra C, Schillinger D, Rubin S. Effective communication in the era of precision medicine: A pilot intervention with low health literacy patients to improve genetic counseling communication. Eur J Med Genet. 2019 May; 62(5):357-367.  View on PubMed
  15. Lara-Otero K, Weil J, Guerra C, Cheng JKY, Youngblom J, Joseph G. Genetic Counselor and Healthcare Interpreter Perspectives on the Role of Interpreters in Cancer Genetic Counseling. Health Commun. 2019 11; 34(13):1608-1618.  View on PubMed
  16. Amendola LM, Berg JS, Horowitz CR, Angelo F, Bensen JT, Biesecker BB, Biesecker LG, Cooper GM, East K, Filipski K, Fullerton SM, Gelb BD, Goddard KAB, Hailu B, Hart R, Hassmiller-Lich K, Joseph G, Kenny EE, Koenig BA, Knight S, Kwok PY, Lewis KL, McGuire AL, Norton ME, Ou J, Parsons DW, Powell BC, Risch N, Robinson M, Rini C, Scollon S, Slavotinek AM, Veenstra DL, Wasserstein MP, Wilfond BS, Hindorff LA, CSER consortium, Plon SE, Jarvik GP. The Clinical Sequencing Evidence-Generating Research Consortium: Integrating Genomic Sequencing in Diverse and Medically Underserved Populations. Am J Hum Genet. 2018 09 06; 103(3):319-327.  View on PubMed
  17. Atreya CE, Kubo A, Borno HT, Rosenthal B, Campanella M, Rettger JP, Joseph G, Allen IE, Venook AP, Altschuler A, Dhruva A. Being Present: A single-arm feasibility study of audio-based mindfulness meditation for colorectal cancer patients and caregivers. PLoS One. 2018; 13(7):e0199423.  View on PubMed
  18. Hilary Chan, Katherine Van Loon, Stacey A. Kenfield, June M. Chan, Emily Mitchell, Li Zhang, Alan T Paciorek, Galen Joseph, Angela Laffan, Yoshimi Fukuoka, Christine Miaskowski, Jeffrey A. Meyerhardt, Alan P. Venook, Erin Van Blarigan. Effect of physical activity trackers and daily text messages on quality-of-life in colorectal survivors (Smart Pace): A pilot randomized controlled trial. Journal of Clinical Oncology. 2018 Mar 1; 36(7_suppl):168-168.  View on PubMed
  19. Hilary Chan, Katherine Van Loon, Stacey A. Kenfield, June M. Chan, Emily Mitchell, Li Zhang, Alan Paciorek, Galen Joseph, Angela Laffan, Yoshimi Fukuoka, Christine Miaskowski, Jeffrey A. Meyerhardt, Alan P. Venook, Erin Van Blarigan. Effect of physical activity trackers and daily text messages on quality-of-life in colorectal survivors (Smart Pace): A pilot randomized controlled trial. Journal of Clinical Oncology. 2018 Feb 1; 36(4_suppl):559-559.  View on PubMed
  20. Erin Van Blarigan, Katherine Van Loon, Stacey A. Kenfield, June M. Chan, Emily Mitchell, Hilary Chan, Li Zhang, Alan Paciorek, Galen Joseph, Angela Laffan, Yoshimi Fukuoka, Christine Miaskowski, Jeffrey A. Meyerhardt, Alan P. Venook. Self-monitoring and reminder text messages to increase physical activity after colorectal cancer (CRC): A pilot randomized controlled trial. Journal of Clinical Oncology. 2018 Feb 1; 36(4_suppl):615-615.  View on PubMed

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