Publication list via PubMed

Description of Research

Dr. Albright conducts transdisciplinary research spanning the fields of preventive oncology, behavioral medicine, health psychology, medicine, and epidemiology. Her research emphasizes the promotion of healthy lifestyles and the prevention of chronic diseases, especially cancer, both at the level of the individual and in community-based participatory research projects. Her community-based research addresses multiple risk factors for chronic disease via multimedia public health campaigns.  Her individual-based interventions have addressed smoking cessation, changes in dietary intake, and increases in physical activity in multiethnic populations.  Much of her work focuses on underserved or high-risk populations, and the development of interventions that are culturally sensitive to these populations’ attitudes, resources, and needs with respect to making changes in their lifestyle, weight control, and the reduction of chronic disease risk.

Dr. Albright also analyzes data from a large epidemiological study to investigate differences in the prevalence of obesity in adults who report having more than one race/ethnicity (i.e., having an ethnic admixture) compared to obesity in adults who report  one race/ethnicity. Obesity reflects a complex interaction of genetic, environmental, cultural, and behavioral influences, including the health consequences of race/ethnicity mixing. These analyses could help identify individuals who have an ethnic admixture that places them at increased risk for obesity.  This line of research will investigate a range of influences on obesity in a multicultural population that will pave the way for future interventions to prevent and control obesity, improve health outcomes, and reduce health disparities in the ethnic populations of Hawaii.

Below are brief descriptions of a few of her recent research studies.

Increasing Physical Activity in New Mothers in Hawaii
Adult women with young children are much less likely to be regularly active compared to women without children.  New mothers are also at increased risk for postpartum weight gain. The factors that promote and/or inhibit physical activity (PA) in new mothers, especially differences across ethnic groups, are not fully understood.

In 2007 Dr. Albright was awarded an NIH, National Cancer Institute grant to test the efficacy of a tailored intervention to increase and maintain physical activity in a multiethnic population of 268 young, healthy postpartum women living in Hawaii. The project is called the “Na Mikimiki Project”(the “active ones” in Hawaiian).  It recruits  women with an infant 2-12 months old from health care setttings, online websites for new mothers, newspaper and magazine advertisements, and through a coalition of community organizations that provide clinical care and promote maternal and child health in women, many of whom are low-income. The design is a randomized clinical trial with two study conditions: a tailored postpartum counseling intervention on physical activity and a standard physical activity condition (i.e., that includes a website and print materials). The tailored physical activity intervention uses a variety of methods (telephone, e-mail, website) to deliver theoretically-derived, culturally sensitive physical activity counseling, behavioral skills training (e.g., goal setting), and local resources/referrals tailored to mothers with infants. The standard PA condition receives American College of Sports Medicine print materials, e-mails and referral to physical activity internet resources.  The primary physical activity outcome is minutes of moderate/vigorous physical activity (MVPA) per week, as measured by questionnaire, with validation by accelerometers worn by all subjects. Key psychosocial, physiological, and cultural factors are also being tested as mediators or moderators of physical activity, for example: self-efficacy, social support, ethnicity, BMI, and cultural values.

This study will serve as a model for the design and implementation of physical activity interventions for at-risk ethnic minority postpartum women.

Prevalence of Obesity in Adults with an ethnic admixture
Dr. Albright conducts research to determine if there are differences in the prevalence of heath risk behaviors in individuals with an ethnic admixture compared to individuals with only one race/ethnicity. She has analyzed the body mass index (BMI) levels of adults enrolled in the Multiethnic Cohort Study (MEC- a large cohort study at CRCH) to determine if the BMI of individuals with an ethnic admixture varied systematically from the ethnic groups with whom they shared a common ethnicity or race.

National data indicates that a majority of U.S. adults are overweight (BMI ≥ 25), and 30% are obese (BMI ≥ 30); however, the prevalence of obesity differs by age, gender, and ethnicity.  But, very little research has been conducted on individuals with an ethnic admixture, especially when that admixture is a combination of two races/ethnicities that have a high versus low risk of obesity (e.g., Hawaiian and Asian).  Hawaii has the highest proportion of people who report more than one race, on the U. S. Census; thus, it is a perfect place to investigate individuals with an ethnic admixture.

Dr. Albright’s results from the MEC sample of over 200,000 adults showed that the highest prevalence of overweight (BMI ≥ 25) was in Hawaiian/Latino men (88%; n= 41) and Black/Latina women (74.5%; n = 79), and highest obesity (BMI ≥ 30) rates were in Hawaiian/Latino men (53.7%; n = 41) and Hawaiian women (39.2%, n = 1, 247). After controlling for diet, exercise, age, and 14 other confounders the prevalence of obesity in most of the admixed groups was similar to or higher than the average of the prevalences for the ethnic groups with whom they shared a common ethnicity.  For instance, the prevalence of obesity in five ethnic admixtures: Asian/White, Hawaiian/White, Hawaiian/Asian, Latina/White, and Hawaiian/Asian/White ethnic admixtures was significantly higher (p<.0001) than the average of the prevalence estimates for their component single race groups.

This analysis was one of the first large scale investigations of obesity in adults who reported 2 or 3 specific, unique ethnic or racial heritages, particularly Asian-Americans and Pacific Islanders. This line of research is important because the number of Americans of mixed race/ethnicity is increasing and will constitute a large proportion of the U.S. population in coming decades. Her results have implications for future health disparities and risk reduction efforts in high-risk ethnic minority populations.

Health behaviors of Cancer Survivors
Dr. Albright also investigates lifestyle risk factors in survivors of cancer (e.g., dietary intake, exercise, tobacco/alcohol use, etc.).  She is pursuing this area of research via two populations of cancer survivors:  adolescents/young adults and adults:

A. Adolescent and Young Adult Survivors of Childhood Cancer (AYASCC).
Due to advances in therapy over the last 30 years, survival rates for children with cancer exceed 75% up to 20 years after diagnosis.  While the majority of pediatric cancer patients will live many years after their treatment ends, they are at increased risk for development of chronic diseases due to the added burden of toxicities associated with their primary malignancies and their treatments.  Consequently, unhealthy lifestyle factors take on great significance for adolescent and young adult survivors of childhood cancer (AYASCC).

Dr. Albright and her colleagues conducted a series of focus groups with AYASCC, parents of AYASCC, and pediatric oncologists in Hawaii.  The goal was to determine survivors’ diet/exercise habits and the receptivity of these groups to make/facilitate favorable changes in these behaviors.  In addition, she also surveyed a multiethnic sample of 64 AYASCC between the ages of 13 and 24 about their health behaviors.

Focus group data revealed a general lack of knowledge by the survivors and their parents about survivors’ increased risk for chronic diseases due to cancer therapy.  Pediatric oncologists identified a lack of experience with using behavior change methods with patients.  Physicians also reported difficulty in determining whether both the parent and survivor had the same level of interest in making lifestyle changes.  Survey results showed that compared to a national teen sample and sample of Hawaii teens, AYASCC from Hawaii under the age of 18 had lower rates of smoking, alcohol use and fruit/vegetable intake, but a higher level of physical activity.  In contrast, AYASCC over 18 smoked, drank alcohol, and had physical activity levels that were similar to or higher than national or Hawaii samples.  Both survivor age groups had a very low intake of fruits and vegetables.

The results of this study revealed a strong need for parents and survivors to have a better understanding of the risks for chronic diseases.  Diet and exercise were identified as two potential behavior areas meriting additional efforts for improvement.  Most importantly, her results suggest that determining the readiness of survivors and parents to make positive behavioral changes may be a key driver for the implementation of successful intervention strategies.

B. Adult Cancer Survivors
Dr. Albright is the Principal Investigator on a Department of Defense funded project to improve the quality of life and promote healthy behaviors in adult cancer survivors using a website-delivered intervention.

There are over 10 million adult cancer survivors in the U.S. Early diagnosis and more effective cancer therapies mean that two out of three individuals diagnosed with cancer today will live five years or more following their diagnosis. However, the impact of cancer therapy continues well beyond the period of active treatment.   Cancer survivors can experience physical and psychosocial problems, such as chronic fatigue, disabilities due to surgery or amputation, long-term cognitive limitations, fear of recurrence, and family difficulties.  However, a cancer diagnosis and completion of cancer therapy can also provide a “teachable moment” when survivors are particularly motivated to make positive lifestyle changes, such as increasing exercise, eating a more healthy diet, and controlling stress. Website  interventions offer considerable potential for improving the health and quality of life in cancer survivors.   Our website will provide survivors with “state of the art” self management training to reduce isolation and improve health behaviors.

Research on organ donation in Asian-Americans
The U.S. Public Health Service has described the lack of organs for transplant as a “public health crisis”.  Over 90,000 Americans are currently waiting for donated organs, but only about 28,000 transplant operations are completed annually.  As a result, many seriously ill patients, including patients with cancer, often wait years for a transplant, and over 6,000 die annually while waiting for an available organ

Surveys of adolescents on Oahu showed that only 20% of AA & PI were a designated organ donor on their driver’s license or had talked to their family about becoming an organ donor on their driver’s license application. The question on the driver’s license application regarding the choice to become an organ donor may be the first and only time most adolescents (and even adults) think about becoming an organ donor after their death.

  In 2007 Dr. Albright was awarded a NIH/National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK) grant to test, via a randomized clinical trial, the efficacy of an interactive multimedia intervention to increase the number of AA & PI adolescents who are a designated donor on their state issued driver’s license. Teen groups are recruited from community organizations (churches and high schools, n = 40 groups, 530 teens).  Each teen group receives information about two topics, organ donation and the prevention of underage drinking of alcohol; however, the order or sequence of these two topics is randomly assigned.

The intervention includes information delivered to participants via a DVD, e-mail, text messaging, and a website.  The primary outcomes are avoidance of alcohol and donor status on the teens' driver's license/ID.  After the randomized trial has established the efficacy of the multimedia intervention on the designated donor choice, the intervention will be disseminated to Organ Procurement Organizations in Hawaii and across the United States.

This project has the potential to reduce risky behavior and to increase the number of ethnic minority teens who decide to be a designated organ donor on their Hawaii driver’s license.  Once a person chooses to become a designated donor on their driver’s license they tend to keep that designation for the rest of their life.  Thus, having more designated donors could potentially benefit the AA & PI living in Hawaii who need a transplant, and for whom an ethnically matched kidney would improve their chances of long-term survival.

Future Research Interests:
Dr. Albright’s future research will continue to focus on behaviors related to cancer prevention and control for both healthy populations and for cancer survivors.  In particular, she will continue to focus on research studies designed to increase physical activity, modify dietary intake of fat, fruits & vegetables, and prevent weight gain in adolescents and young adults. She will continue to conduct cross-sectional research on the factors that contribute to obesity in mixed race adults.

In the future, she would like to conduct a large-scale obesity prevention study in recently married young adults. This transition period has been linked to weight gain in both men and women.  In addition to having a child, the initial years of a marriage can result in shifting roles and preferences with respect to physical activity and diet.   If young adults could be taught to make small, realistic changes in their lifestyle in order to prevent gaining 1-3 pounds a year, their risk of future chronic diseases such as cancer, heart disease, and diabetes could be substantially reduced.

Active Grants

NIH Grants
C.L. Albright, Principal Investigator
R01 CA115614
"Physical Activity in Women with Infants"
September 29, 2007-July 31, 2011

C.L. Albright, Principal Investigator
R01 DK079684
"Multimedia intervention to motivate ethnic teens to be a designated organ donors"
August 1, 2007-July 31, 2012

C.L. Albright, Principal Investigator
R41 HL091592
"A Home Exercise Program (DVD) for Women with Infants and Young Children"
September 1, 2008-August 31, 2009

C.W. Vogel, Principal Investigator
C.L. Albright, Project Leader
W81XWH-06-2-0042
"A web-based intervention to improve quality of life and promote healthy behaviors in cancer survivors"
January 1, 2008-May 1, 2009

NIH funded research projects:
T. Vogt, Principal Investigator (Center for Health Research Hawai‘i)
C.L. Albright, Co-Principal Investigator
R01 HL079505
"Overweight and Obesity control at worksites"
October 1, 2004-September 30, 2009

J. Inouye, Principal Investigator (University of Hawai‘i School of Nursing)
C.L. Albright, Co-Principal Investigator
P20NR010671
"Center for ‘Ohana Self-Management of Chronic Illnesses in Hawaii (COSMIC):   Building Research Teams for the Future"
January 1, 2008-June 30, 2012

Contracts with State of Hawaii Government Agencies:
C.L. Albright, Principal Investigator
Team PLUS Project
Monitoring on-premise sales of alcohol to underage minors
Honolulu Liquor Commission
2004-Present

C.L. Albright, Principal Investigator
Enforcement of Underage Alcohol Sales in Retail Stores
REACT Project
Hawaii Department of Health, Alcohol and Drug Abuse Division
2006-Present

C.L. Albright, Principal Investigator
Monitoring sales of tobacco to underage minors
KATS and SYNAR Projects
Hawaii Department of Health, Alcohol and Drug Abuse Division
2006-Present

C.L. Albright, Principal Investigator
Teen Advocacy against Tobacco Industry
Project REAL
Hawaii Department of Health
Winner 2008 Ola Pono Award
2006-Present