Intervention Research Advancing Care Equity (iRACE)

care equity

Welcome to the Intervention Research Advancing Care Equity (iRACE) program. The goal of our intervention research is to improve patient care among medically underserved populations through evidence-based behavioral interventions in the context of learning healthcare systems. Guided by a dissemination and implementation science framework, we aim to understand and intervene on factors that influence health outcomes among patients coping with substance misuse, depression, HIV infection and other chronic conditions, in addition to our work investigating the effects of medical marijuana on the psychomotor function adults 50 and older with chronic or severe pain. We investigate the influence of individual, social, and structural barriers using an interdisciplinary team approach.

For more information regarding the iRACE program, please contact the iRACE Director Dr. Nicole Ennis.


Ongoing Projects

Novel Extensions of Alcohol Contingency Management in People Living with HIV

National Institute of Alcohol Abuse and Alcoholism, P01 Subaward 
Nicole Ennis, PhD: Principal Investigator

Alcohol misuse in people living with HIV (PLWH) is a public health issue given relationships to cognitive and physical effects, which may subsequently accelerate HIV progression, increase likelihood of transmission, and hasten related comorbidities. The goal of this project is to recruit PLWH that have AUD to participate in a contingency management (CM; tangible reinforcement to change behavior) to reduce their alcohol consumption. Our novel approach will marshal mobile health (mHealth) capabilities, alcohol biosensors and gamification, which seeks to enhance engagement through social connections and friendly competition. Primary aims will test the magnitude of increases in percent days abstinent during the 30-day CM induction and baseline predictors of outcome (e.g., drinking severity, executive function). Investigators will also test alcohol abstinence as a predictor of cognitive, biological, and HIV outcomes. This project is an initial step to implement affordable, technology-based CM for alcohol in PLWH.

Mechanism Explaining the Link Between Weight Discrimination and Poor Cardiovascular Health  

NIH, R56
Mary Gerend, PhD at FSU College of Medicine: Principal Investigator 

Nicole Ennis, PhD: Co-Investigator

Using a rigorous experimental approach, this project works to identify mechanisms through which weight discrimination harms health. Findings will facilitate the long-term goal of this research: developing interventions to decrease the negative health consequences of weight discrimination. As a step toward this goal, this project proposes three experiments in which a diverse sample of adults with obesity will be randomly assigned to experience (vs. not experience) weight discrimination in a controlled experimental setting. Drawing on previous research and our pilot data, the interpersonal contexts chosen for these studies simulate situations in which people with obesity commonly experience weight discrimination in their daily lives (e.g., health care and employment settings). Exposure to weight discrimination (vs. control) is hypothesized to result in elevated responses on early-stage mechanisms that culminate in poor cardiovascular health (e.g., impaired self-regulation, cognitive vigilance to signs of social disapproval, higher negative emotion, more social withdrawal and comfort eating, increased cortisol secretion and inflammation). This research will identify novel and highly modifiable targets for interventions designed to reduce the negative health effects of weight discrimination and, at a broader level, this work will provide critical insight into mechanisms that underlie adverse health effects of other common forms of social stigma such as discrimination due to race, ethnicity, sexual orientation, or social class.

Fostering Institutional Resources for Science Transformation: The FLORIDA-FIRST Health-Science Brigade

NIH, U54
Nicole Ennis, PhD: Faculty Development Core Co-Investigator 

The mission of the FLORIDA FIRST Health Science Brigade (aka The FLORIDA FIRST Brigade) is to transform institutional culture at Florida State University to generate a self-sustaining scientific community dedicated to inclusive excellence. The program recruits new tenure-track assistant professors from diverse backgrounds using a cohort-based model and invests in the development, mentorship, advancement, and retention of new faculty in two broad domains of research excellence: chronic disease prevention and management; and mental health. The FLORIDA FIRST Brigade implements a systems-level approach to support individual faculty research and career development (micro), within their cohort and collaborative networks (meso), that can be replicated through sustainable changes to university culture (macro).

Closed Projects

Medical Marijuana Use and Driving Performance: A Test of Psychomotor Function in Adults 50 and Older

NIH, R21
Nicole Ennis, PhD: Principal Investigator

The long-range goal of this work is to improve our understanding of the consequences of medical marijuana use in later life. A study that examines older adults’ pre-exposure to medical marijuana and systematically tracks medical marijuana initiation, dosage, and psychomotor functioning is needed. Thus, the current study will test medical marijuana use as the exposure variable in adults age 50 and older and simulated driving performance (i.e. errors in response time, attention, and executive functioning tasks that predict on-road performance) as the primary outcome. Medical marijuana use is increasing among adults 50 and older. Both the National Institute on Drug Abuse (NIDA) and the National Institute on Aging (NIA) have identified the need to understand how habitual use of medical marijuana affects psychomotor functioning in real-world tasks such as driving. The current proposal will address this question by examining medical marijuana use in the context of driving performance among adults 50 and older.

Feasibility of Screening, Brief Intervention, Referral to Treatment with Peer Navigation (SBIRT-PN) for Underserved HIV+ Adults 50+ in Primary Care Settings 

National Institute on Drug Abuse, K23
Nicole Ennis, PhD: Principal Investigator

Although screening, brief intervention and referral to treatment (SBIRT) is a proven technique that has been shown in some health care settings to reduce substance there is limited data available for its effectiveness among HIV care settings. HIV+ individuals have high rates of substance abuse but access to intervention is limited. Substance abuse increases the risk for poor treatment adherence and is a recognized contributor to the spread of HIV, which necessitates the development of treatments specifically for HIV+ individuals. We were able to implement SBIRT in HIV care settings to optimize health outcomes.


For a full list of publications, CLICK HERE.