The Waters Lab seeks to understand how people think about health issues and how those thoughts influence their health-related decisions and behavior.
The lab explores the rich variety of cognitive, emotional and social factors that make it difficult for people to make adaptive health decisions. Understanding these inter-relationships enables the development of health communication and behavior interventions that aim to improve health and reduce health disparities.
The lab is led by Erika Waters, PhD, MPH, a professor of surgery in the Division of Public Health Sciences at WashU Medicine.
Dr. Waters leads a program of health communication, risk communication, and behavior change research that translates foundational epidemiological, clinical, and genomic science into forms that help laypeople make adaptive health decisions. The interventions that result from this work are designed to maximize the potential for future dissemination and implementation and reduce health disparities.
One branch of her research explores the rich variety of cognitive, emotional, and socio-contextual factors that shape whether, when, and how people make decisions about engaging in healthy behaviors. A second branch applies lessons-learned from earlier-phase research to develop traditional, eHealth, and mHealth communication and behavioral interventions that aim to increase engagement in health protective behaviors and reduce engagement in health damaging behaviors.
Dr. Waters has a strong interest in research that seeks to understand and meet the needs of populations that have been marginalized or underrepresented in research, including people of color and people with limited education, health literacy, and numeracy.
Principal investigator
Contact
Waters Lab
600 S. Taylor Ave.
St. Louis, MO 63110
314-747-5707
[email protected]
Opportunities
Graduate and undergraduate research assistants
Research assistant positions may be available for undergraduate or graduate students with interests in qualitative research methods and/or a background in medical anthropology, psychology, behavioral science, health communication, or health education. Activities may include recruiting participants, taking notes during interviews or focus groups, analyzing qualitative data, communicating results to an interdisciplinary research team, and communicating results to community partners and the broader public. Contact Dr. Waters for more information at [email protected].
Current research
Healthy Hearts 2 Study
Technical name: Evaluation of Cardiovascular Health Outcomes among Survivors 2
Funded by the National Institutes of Health/National Cancer Institute (R01CA297448)
Multiple Principal Investigators: Erika A. Waters, PhD, MPH; Matthew Ehrhardt, MD, MS
Co-Investigators and Consultants: April Carcone, PhD; Melissa Hudson, MD; Sedigheh Mirzaei, PhD; Gregory Armstrong, MD
The Healthy Hearts 2 Study lays the groundwork for improving the lives of adult survivors of childhood cancer. Many children with cancer receive treatments that increase their risk of heart failure as adults. Screening echocardiograms can detect early signs of heart failure. However, few survivors receive such screening and therefore are not diagnosed with heart failure for many years.
This study is an extension of the Healthy Hearts Study. In that study, we translated a telephone-based intervention that increased cardiomyopathy screening into an eHealth tool that was more widely accessible. In this study, we test the efficacy of the new eHealth tool to improve uptake of cardiomyopathy screening among adults who received cardiotoxic therapy as children. If successful, we will use the results to inform future dissemination and implementation efforts.
This project is currently in progress. If you would like additional information about the study, contact Dr. Waters at [email protected].
Cancer Awareness, Risk, and Education (CARE Aware) Study
Technical name: Understanding and Addressing Rejection of Personalized Cancer Risk Information
Funded by the National Institutes of Health/National Cancer Institute (R01CA279953)
Multiple Principal Investigators: Erika A. Waters, PhD, MPH; Laura D. Scherer, PhD
Co-Investigators and Consultants: Ashley Housten, OTD, MSCI; Carmen Lewis, MD, MPH; Jennifer M. Taber, PhD; Channing Tate, PhD, MPH
The Cancer Awareness, Risk, and Education (CARE Aware) study is based on the idea that risk-based cancer screening seeks to maximize the benefits and minimize the harms of screening. To achieve these goals, cancer risk prediction models need to be translated into risk assessment tools that are meaningful and useful for the public and in clinical practice. However, a critical barrier to implementing risk-based screening is that many people are skeptical about how well their risk estimate actually reflects their true personal risk. Therefore, our goal is to understand the reasons for skepticism about personalized risk information, and to identify methods for communicating personalized risk information that people can both understand and accept.
This project is currently in progress. If you would like additional information about the study, please contact Dr. Waters at [email protected].
Epigenetics Perspectives in Communities (EPIC) Study
Technical name: Investigating ELSI issues that may facilitate or impede clinical translation of epigenomic research
Funded by the National Institutes of Health/National Institute for Environmental Health Sciences (R01ES033743)
Co-Investigators: Chelsey R. Carter, PhD, MPH; Jada G. Hamilton, PhD, MPH; Erin Linnenbringer, PhD, MS; Jessica Mozersky, PhD; George Souroullas, PhD
Few people realize that environmental pollution and some behaviors like physical activity and tobacco smoking can affect their health by “turning on” or “turning off” certain genes through a process called epigenetic modification. This project is using a series of studies to develop and test strategies for communicating about epigenetics that are understandable to people from different socio-demographic groups, that do not promote harmful beliefs (such as genetic determinism, essentialism, discrimination, racism, or stigma), and that increase acceptance of using epigenetics in clinical settings. We will compile the results of our research into a toolkit for use by basic scientists, laypeople, health care providers, and journalists.
Previous research projects
Technical name: Translating ECHOS into an eHealth platform
Funded by the St Jude – Washington University/Siteman Cancer Center Implementation Science Collaborative
Multiple Principal Investigator: Matt J. Ehrhardt, MD, MS.
Co-Investigator: Melissa M. Hudson, MD. Consultant: April Carcone, PhD
Many adult survivors of pediatric cancer experience heart failure as a consequence of their cancer treatment during childhood. This study is translating an efficacious—yet time- and resource-intensive—intervention to promote cardiomyopathy screening into a low-cost, high-reach, and interactive eHealth platform that (a) provides information to users that is tailored to their unique circumstances and concerns, and (b) supports users’ autonomy as they deliberate about the value of screening. The results of this study will provide the evidence base needed to support broad-scale implementation efforts.
Technical name: Child Asthma Exacerbation: Role of Caregiver Risk Beliefs
Funded by the National Institutes of Health/National Heart, Lung, and Blood Institute (R01HL137680)
Multiple Principal Investigator: James A. Shepperd, PhD.
Co-Investigators: David A. Fedele, PhD, ABPP; Jean M. Hunleth, PhD; Sreekala Prabhakaran, MD; Gregory D. Webster, PhD
Childhood asthma affects over 6.2 million U.S. children, particularly children who are African American and whose parents have limited incomes and formal education. This project is using a series of studies to characterize: (a) the basic psychological nature of caregivers’ beliefs about their child’s risk of having an asthma exacerbation, (b) the cognitive and affective processes by which such beliefs encourage or discourage caregiver-initiated risk-reducing behavior, and (c) how risk beliefs interact with broader socio-contextual factors to shape child health and caregiver behavior. We will use the results of this research to develop and implement improved interventions for caregivers of children with asthma. All study materials, including recruitment advertisements, stimuli, data collection materials, datasets, and analytic code are available free of charge at: https://osf.io/vbjuh/.
Funded by the National Institutes of Health/National Cancer Institute (R01CA197351)
Co-Investigators: Graham A. Colditz, MD, DrPH; Ying Liu, MD, PhD.
Consultants: Deborah J. Bowen, PhD; Linda D. Cameron, PhD; Hank Dart, MS; Bernard Rosner, PhD.
Understanding that a single behavior can affect the likelihood of developing a variety of diseases is a vital component of understanding the consequences of performing (or not performing) the behavior. This project used a series of studies to translate epidemiological data about five major health consequences of insufficient physical activity (i.e., colon cancer, breast cancer, heart disease, diabetes, stroke) into a visual display that conveyed personalized risk information in a way that was comprehensible and motivating to diverse lay audiences. Supplemental funding allowed the research team to supplement the risk assessment tool with a self-regulation intervention. This research resulted in a fully functional, mHealth-based risk communication and behavior change tool that could be integrated into individual, community, or clinical interventions. All study materials, including recruitment advertisements, stimuli, data collection materials, datasets, and analytic code are available free of charge at: https://osf.io/jnwhq/.
Funded by the American Cancer Society (MRSG 1121401-CPPB)
Mentors: Graham A. Colditz, MD, DrPH; Sarah Gehlert, PhD
Effective translation of genomics research into practice depends on public understanding that most health problems are multifactorial—that is, caused by a combination of genetic, behavioral, and environmental factors. This project used a series of studies to explore how laypeople came to understand multifactorial health risks associated with tobacco use, and to test communication strategies for conveying this concept more effectively. The results of this project led to greater scientific knowledge about the factors that lead to public acceptance of potentially controversial health information.
Our team
Julia Maki, PhD
Supervisor, Public Health Research Coordinator
Nicole Ackermann, MPH
Staff Scientist
Caitlin Yuen
Undergraduate Research Assistant
Aantaki Raisa, PhD
Postdoctoral Research Scholar
Irania Santaliz Moreno, MS
Graduate Research Assistant