The P30-funded Center for Technology and Behavioral Health (CTBH: c4tbh.org) and its affiliates are based at institutions across the country and in Switzerland. Comprised of an interdisciplinary team of leaders in behavioral science, health services science, and technology, the overarching aim of the CTBH is to integrate expertise across multiple disciplines and provide an infrastructure to enhance the quality, pace of achievement and impact of innovative scientific research and development activities that systematically combine science-based behavior change interventions with state-of-the-science technologies to create, empirically test and disseminate technology-based interventions targeting substance use disorders and related issues.
Dr. Lisa Marsch directs the Center in concert with a Leadership Team that includes our T32 Faculty. The Center comprises 4 Science Cores: Treatment Development and Evaluation, Dissemination and Implementation, Emerging Technologies and Data Analytics, and Pilot. The CTBH runs a weekly seminar and regularly sponsors workshops and tutorials, all on topics highly relevant to the T32 program. CTBH resources are available for all T32 trainees. Of particular note, the CTBH Pilot Core awards 2-3 competitive grants ($5-20,000 / year). The application process is similar in structure to that of an NIH R03 award - outside reviewers are engaged to provide NIH style scoring using NIH summary sheet format. Postdoctoral trainees are eligible for these awards, and predoctoral trainees are encouraged to apply with their mentor as PI.
In addition to the Center grant itself and multiple CTBH pilot grant and core-related projects, CTBH faculty who are also T32 faculty have numerous federal, extramural, and institutionally funded projects. Note that CTBH extramural affiliates have many additional funded projects that provide opportunities for trainees.
Cancer Population Sciences (CPS) Program of the Dartmouth Cancer Center / C. Everett Koop Institute
The Dartmouth Cancer Center (DCC) is an NCI-funded comprehensive cancer center. DCC is home to 250 active research projects, led by its 135 research scientists, and supported over 60 million in grants each year from federal and other sources. Research is divided into 6 programs. The program associated with ourT32 is the Cancer Populations Science (CPS) program. T32 associated CPS investigators study cancer risk behaviors (tobacco, alcohol, cannabis, unhealthy eating). T32 associated CPS investigators study cancer risk behaviors (tobacco, alcohol, cannabis, unhealthy eating).
The mission of the associated Koop Institute is to advance health and well-being through research, education, and policy efforts to protect the public health and prevent disease. The Institute seeks to mitigate threats posed by the unhealthy promotion and use of consumer products, including tobacco, alcohol, cannabis, prescription drugs and highly processed foods.
The CPS includes an array of supportive core resources, including Biostatistical Shared Services, a Geospatial Resource (important for studies of sales and marketing), and a Media Resource (that aids in identifying and content coding of media and marketing for substance or unhealthy food use). Behavioral researchers in the CPS have had multiple NIH-funded projects that are available for trainee participation; in addition, DCC has several pilot mechanisms for developmental research.
The AI and Mental Health: Innovation in Technology Guided Healthcare (AIM HIGH) Lab hopes to modernize treatment for mental health by utilizing passive data (e.g. unobtrusive data collected via smartphones, wearable sensors, electronic health records, digital footprints on the internet) to create personalized and adaptable evidence-based treatments. Directed by Dr. Nicholas Jacobson, the program’s Education Co-Director, AIM HIGH hopes to further this research by: Enhancing precision assessment of anxiety and depression using intensive longitudinal data; Conducting multi-method assessment utilizing passive sensor data from smartphones and wearable devices; and Providing scalable, personalized technology-based treatments utilizing smartphones. Active projects focus on using personalized deep learning models to study rapid changes in Major Depressive Disorder symptoms with passive sensor data from smartphones and wearable devices (R01), developing ecological momentary assessment approaches to understand the relationship between racial microaggressions and alcohol use among African American young adults (R21), and creating digital interventions for pregnant and postpartum women with opioid use disorder (R44). Dr. Jacobson is also an MPI on two CTBH pilot projects - one focused on developing a digital intervention for positive valence system dysfunction in co-occurring depression and cannabis use, and the other seeks to enhance psychotherapy effectiveness for patients with COD by identifying and sharing meaningful moments from audio-recorded therapy sessions.
Led by Dr. Alan Budney, the Cannabis Lab focuses on the development and evaluation of innovative behavioral/digital interventions for SUD (specifically cannabis) and co-occurring disorders and exploring their mechanisms of action, as well as using digital research methods to enhance understanding of cannabis use phenomenology, consequences, and public health impact. Dr. Budney’s current NIDA-funded R01, Leveraging Social Media to Develop a Cannabis Exposure Index, A Standardized Measure of Cannabis Use focuses on developing digital methods to quantify cannabis consumption in the population and relate quantity to risks and consequences. He is also involved in the study, Vaping Nicotine and Cannabis Across Adolescence and Youth Adulthood (MPIs, Tremis and Leventhal from USC), which aims to provide public health officials with data regarding the potential adverse public health impact of vaping and clear targets for intervention to reduce youth vaping and associated health consequences.
Members of the Cannabis Lab include T32 faculty member, Dr. Jacob Borodovsky and T32 postdoctoral trainee, Dr. Cara Struble. Dr. Borodovsky leads a study, Digital Cannabis Regulatory Science Paradigm for Testing the Cognitive and Behavioral Impacts of Online Cannabis Retailer Practices, which is developing a flexible, realistic cannabis retailer website and online shopping experience for use in a proof-of-concept study aimed at isolating how cannabis product features and marketing impact consumers. Dr. Cara Struble’s research includes a focus on Developing a Tailored Intervention for Cannabis Use and Co-Occurring Internalizing Disorders among Sexual and Gender Minority (SGM) Young Adults.
Health Behavior Lab
Dr. Catherine Stanger, the program’s Postdoctoral Director, and her team study the development of digital interventions focused on improve self-management of health behavior. Dr. Stanger is a licensed Clinical Psychologist whose work has primarily focused on teens and young adults. She currently leads a large national remote NIDDK-funded R01 study, Thinking Outside the Clinic: A Digital Health Approach for Young Adults with Type 1 Diabetes. This study focuses on young adults with a chronic health condition (type 1 diabetes) and includes assessment of substance use and other risk behaviors. This clinical trial is testing two unique intervention components as add-ons to a smartphone app: (1) incentives to promote consistent daily adherence to goals, and (2) web health coaching to teach effective problem solving focused on personalized barriers to self-management. Dr. Stanger is also involved two studies with other investigators focused on substance use prevention https://reporter.nih.gov/search/xhFQeIs9Skuq1qzJsJ9zrw/project-details/10441566 - and Amy Lansings to be funded pilot study – add link when on ctbh website), a study testing novel ways to assess cognitive predictors of unhealthy eating and alcohol use in daily life (https://www.c4tbh.org/funded-pilot/assessing-the-associations-between-negative-news-exposure-and-attentional-bias-to-food-and-alcohol-cues-an-eye-tracking-investigation-on-a-smartphone-platform/), and a collaboration with a company developing an app to improve stimulant medication adherence and to prevent medication diversion among youth with ADHD.
Members of this lab include T32 predoctoral trainee Enzo Plaitano and postdoctoral trainee Tonychris Nnaka, Ph.D. Mr. Plaitano’s is enrolled in the TDI Health Policy and Clinical Practice doctoral program (https://tdi.dartmouth.edu/education/degree-programs/phd/health-policy-phdworking) and is working to plan, develop, and pilot test a smartphone app focused on stress reduction and PTSD prevention/early intervention among Emergency Medical Technicians.
Dr. Nnaka is working to develop a culturally informed digital intervention to support the management of cardiovascular disease among Black patients.
Led by the program’s Predoctoral Director, Dr. Paul Barr, and principally based in CTBH and TDI, Open Recordings is a multidisciplinary group of researchers, patients, caregivers, and clinicians working together to understand how to improve the communication of clinic visit information, especially with older adults with multimorbidity and individuals experiencing depression. The group is particularly interested in the application of audio and video recordings of clinic visits to support this communication. Since 2015 Dr. Barr and his team have also received more than $20 million funding (R01, R21, R56) from foundations and federal agencies (NIA, NLM, NCI, NIDA and PCORI) to support their research agenda, including: 1) the user centered development of technologies that enhance doctor-patient communication (VOiCES HealthPAL AudioCARE), screening, communication and access to depression services (iPATH) 2) to conduct both pilot and large-scale multisite randomized controlled clinical trials evaluating effectiveness (REPLAY CHRONICLE AudioTRIAL VideoALS) and 3) examine barriers and facilitator to implementation of the newly developed interventions using existing theoretical frameworks e.g., CFIR. Dr. Barr is also the MPI of an existing CTBH Pilot grant seeking to improve the effectiveness of psychotherapy for patients with co-occurring disorder via the use of therapy recordings. In this project Dr. Barr and CTBH member Dr. Nicholas Jacobson (MPI) guide Dr. Lisa Mistler, a psychiatrist and current primary care T32 postdoc in leading this research.
Dr. Lisa Marsch is Principal Investigator of The Northeast Node of the National Drug Abuse Treatment Clinical Trials Network (CTN-NE). The CTN-NE includes partners across the states of NH, VT and ME – regions heavily impacted by the opioid crisis in the U.S. The CTN-NE has led multiple clinical trials focused on identifying effective prevention and treatment models for substance use and COD – including among children, adolescents, young adults, and adults. Dartmouth investigators and T32 trainees have participated in multiple CTN-NE sponsored projects: e.g., buprenorphine implementation in the emergency department, novel community-based models to address the opioid crisis, implementation of digital screening tools in FQHCs, integration of pharmacists to enhance OUD treatment. The CTN-NE also sponsors an academic bimonthly Science Series on the state of the science on addiction and integrated care models, which provides opportunities for T32 trainees to learn about current advances in the science of COD. T32 trainees can also participate in the CTN Youth Special Interest Group’s webinar series.
Located in the Department of Psychological and Brain Sciences at Dartmouth College and directed by Dr. Luke Chang, The Computational Social Affective Neuroscience Laboratory aims to understand the computational processes underlying social interactions and their neurobiological substrates. Techniques from psychology, cognitive neuroscience, economics, and computer science are combined to develop and test novel models about how psychological processes are represented in the brain and motivate behavioral actions such as making a decision. The lab also seeks to understand how social interactions can both modulate and regulate our emotions, which has implications for broader health outcomes such as treating depression, anxiety, substance use, and managing acute and chronic pain.
The Cognitive and Affective Neuroscience Lab, directed by Professor Tor Wager, studies the neurophysiology of affective processes—pain, emotion, stress, and empathy—and how they are shaped by cognitive and social influences. The lab is interested in how thoughts, beliefs, and expectations affect the brain and body. A range of techniques, including fMRI, psychophysiology, EEG, pharmacology, and computational modeling of brain networks and behavior, are employed to explore diverse aspects of cognitive and affective neuroscience. The lab is dedicated to developing models for the analysis and synthesis of functional neuroimaging data, especially fMRI, and open sharing of tools and scientific data.