Paul Krebs

Paul Krebs, PhD, is Assistant Professor in the Department of Population Health and a Clinical Psychologist at the VA New York Harbor. His research focuses on extending the reach of tobacco cessation and health behavior change strategies, especially among cancer patients and persons with a mental health diagnosis. He has received NIH and VA funding to investigate the use of technologies to facilitate behavior change. His published research examines the design and efficacy of mHealth technologies for tobacco and health interventions and meta-analyses addressing the efficacy of behavioral interventions related to cancer prevention and symptom control. Dr. Krebs completed his undergraduate training at the University of Scranton, followed by a PhD in Clinical Psychology at the University of Rhode Island, and a post-doctoral fellowship at Memorial Sloan-Kettering Cancer Center.

Positions and Employment

2001-2006                   Research Assistant. Cancer Prevention Research Center, University of Rhode Island, Kingston, RI

2003-2005                   Clinical Interventionist. Project REFRAME. Center for Alcohol and Addiction Studies, Brown University, Providence, RI

2004-2006                    Adjunct Instructor. Introduction to Psychology. Providence College, Providence, RI

2004                            Adjunct Instructor. Health Promotion. University of Rhode Island, Kingston, RI

2006-2007                   Clinical Psychology Intern. US Veteran’s Administration: New York Harbor, Brooklyn

2007-2010                   Post-Doctoral Research Fellow, Memorial Sloan-Kettering Cancer Center, New York, NY

2010-                           Clinical Psychologist, Research and Psychology Services, VA New York Harbor, Manhattan

2010-                           Assistant Professor, Tenure-Track, Department of Population Health. New York University School of Medicine, New York, NY               

 

Professional Memberships

2001-               Member, Society of Behavioral Medicine

2001-               Member, American Psychological Association

2009-               Member, Society for Research on Nicotine and Tobacco

 

Honors

1997 - 2001     Presidential Full-Tuition Merit Scholarship, University of Scranton

1999                APA Summer Science Institute Scholar, UC Berkeley

2001               Psychology Dept. Achievement Award, University of Scranton

2001                Bachelor of Science presented Summa Cum Laude, University of Scranton

2005                Research Citation Award, Society of Behavioral Medicine

2011                Research Citation Award, Society of Behavioral Medicine

2011                Selected for NYU Medical Center LEADS leadership development program

2015                Selected for NIH OBSSR Summer Institute in Randomized Clinical Trials (July 2015)

2016                IPTA review committee, NIH Center for Scientific Review

C.        Contribution to Science

1. Technology and Behavior Change
   My most recent work and resulting publications have addressed the development of technology-based interventions for health behavior change. Modifiable behaviors, such as smoking, physical activity, and nutrition practices, are the most significant contributors to chronic disease burden. Technology offers innumerable options for addressing such modifiable risk factors at the population level. These publications discuss innovative methods for engaging at-risk populations in health behavior change. Findings support the value of using careful formative evaluation plans to ensure that interventions are acceptable for target populations. In these projects, I led development of the mixed-method evaluation plans, conducted interviews, coded data, and summarized findings for publication. Results have directly informed crucial changes to the interventions to increase their feasibility in the field.

• Krebs P, Shtaynberger J, McCabe M, Iocolano M, Williams K,  Shuk E, Ostroff J. (2017). An e-Health intervention to increase physical activity and healthy eating in older adult cancer survivors: Summative evaluation results. JMIR Cancer, 3(1).
• Krebs P & Duncan D. (2015). A national survey of health app use among U.S. smartphone owners. JMIR mHealth and uHealth, 3(4).
• Krebs P, Burkhalter JE, Snow B, Fiske J, Ostroff, JS. (2013). Development and alpha testing of QuitIT: An interactive video game to enhance skills for coping with smoking urges. J Medical Internet Research, 2(2). PMID: 24025236. http://muzzylane.com/project/quit_it      
• Bower K, Krebs P, Lamoth CJ, Lyons EJ. (2013). Effective feedback procedures in games for health: A roundtable discussion. Games for Health Journal, 2(6). 320-326.

       2. Improving Reach of Tobacco Cessation Services

           Ensuring that smokers receive evidence-based tobacco cessation treatment remains a challenge. While rates of provider advice to quit are now high, few patients follow up with referrals for tobacco cessation treatment. Our research has examined multiple methods for improving connection to evidence-based                       treatment within healthcare systems including enlisting specialty providers, modifications to electronic record screening systems, and proactive outreach using EHR data. Results indicate that proactive methods are highly effective for improving rates of connection to quitting resources. In these projects I helped                    develop the tobacco intervention protocols, trained counselors and provided ongoing supervision.

• Krebs P, Rogers ES, Smelson D, Fu SS, Wang B, Sherman SE. (online ahead of press). Relationship between tobacco cessation and mental health outcomes in a tobacco cessation trial. J Health Psychology.
• Tseng T, Krebs P, Schoenthaler A, Wong S, Sherman SE, Gonzalez M, Urbina A, Cleland CM, Shelley D. (2016). Combining text messaging and telephone counseling to increase varenicline adherence and smoking abstinence among cigarette smokers living with HIV: a randomized controlled study. Aids and Behavior.
• Rogers ES, Smelson, Gillespie CC, Elbel B, Poole S, Hagedorn HJ, Kalman D, Krebs P, Fang Y, Wang B, Sherman SE. (2016). Telephone smoking cessation counseling for smokers in mental health clinics: A patient-randomized controlled trial. Am J Prev Med, 50(4), 518-27. PMID: 26711163.

           Sherman SE, Link AR, Rogers ES, Krebs P, Ladapo JA, Shelley D, Fang Y, Wang B, Grossman E. (2016). Smoking cessation interventions for urban hospital patients: A randomized comparative effectiveness trial. Am J Prev Med, 51(4):566-77.

       3.Quality of Life in Cancer Patients

• Many patients continue to experience impairments in physical and mental well-being following cancer treatment. Specific knowledge of these conditions is needed to improve follow-up care. These publications examine multiple aspects of health among a sample of post-treatment lung cancer survivors. Findings indicate that most survivors are burdened by ongoing health symptoms, primarily pain and fatigue. In these projects, I collaborated in identifying important outcomes in this population, conducted data analyses in SAS (b-d), and summarized findings.
• Lowery A, Krebs P, Coups EJ, Feinstein MB, Burkhalter JE, Park BJ, Ostroff JS. (2014). Impact of symptom burden in post-surgical non-small cell lung cancer survivors. Supportive Care Cancer, 22(1), 173-80. PMID: 24018910.
• Krebs P, Coups EJ, Park BJ, Feinstein MB, Burkhalter JE, Steingart RM, Logue A, Ostroff JS. (2012). Health behaviors among early stage non-small cell lung cancer survivors. J Cancer Survivorship, 6(1), 37-44. PMID: 21725627.
• Hung R, Feinstein MB, Krebs P, Coups EJ, Park BJ, Steingart RM, Burkhalter J, Logue AE, Ostroff JS. (2011). Fatigue and functional impairment in early-stage non-small cell lung cancer survivors. J Pain and Symptom Management, 41(2), 426-435. PMID: 21216563.

           Ostroff JS, Krebs P, Coups EJ, Burkhalter J, Feinstein MB, Steingart RM, Logue AE, Park BJ.  (2011). Health-related quality of life in early-stage, non-small cell lung cancer survivors. Lung Cancer, 71, 103-108. PMID: 20462654.

      4.Meta-analysis

          The number of behavioral interventions continues to grow at a rapid pace. Replication of studies is essential in the scientific process, but differing methods and samples poses a difficulty for informing generalizable knowledge. Reviews and meta-analysis serve a critical role in advancing science by summarizing                    available literature and by facilitating between-study analyses. This body of work examines the value of behavioral interventions for cancer prevention and symptom management. Findings support the efficacy of tailored communications to promote health behavior change and indicate the value of psychosocial                    treatments for reducing pain and improving interpersonal well-being following cancer treatment. Importantly, findings also highlight the value of using treatment protocols and fidelity checks in conducting clinical trials. In these studies, I collaborated with my co-authors in defining questions that needed to be                            addressed, conducted literature searches, coded data, and conducted all statistical analyses. 

• Sheinfeld Gorin S, Haggstrom D, Han PK, Fairfield KM, Krebs P, Clauser SB. (in press). Cancer care coordination: A systematic review and meta-analysis of over thirty years of empirical studies. Annals of Behavioral Medicine.
• Sheinfeld Gorin S, Krebs P, Badr H, Janke A, Jim H, Spring B, Mohr D, Jacobsen P. (2012). A meta-analysis of psychosocial interventions to reduce pain in cancer patients. J Clinical Oncology, 30(5). PMID: 22253460.
• Badr H & Krebs P. (2013). Systematic review and meta-analysis of psychosocial interventions for couples coping with cancer. Psych-Oncology, 22(8), 1688-704. PMID: 23045191
• Krebs P, Prochaska JO, Rossi JS. (2010). Defining what works in tailoring: A meta-analysis of computer-tailored interventions for health behavior change. Preventive Medicine, 51(3-4), 214-22.  PMID: 20558196.

 

Research Support

Ongoing Support

NYU Cancer Institute   - Krebs and Tsay (PIs)  8/2017-8/2018

Assessing Impact of Smoking Cessation on Tobacco-Induced DNA Adducts in Post-Diagnosis Lung Cancer Patients

This project will pilot the feasibiltiy of and provide initial data on the effect of smoking cessation on biomarkers of lung cancer progression.

Role: MPI

IIR 15-297-2 (VA HSR&D) - Sherman/Krebs (MPI)  -  7/2017-6/2020

Text Messaging to Engage and Retain Veterans in Smoking Cessation Counseling                                            

This study is testing the effect of two types of text messaging in combination with telephone cessation counseling to increase enrollment in and adherence to cessation treatment.

Role: MPI

CDA-2 Career Development Award (VA) - Krebs (PI) - 4/2013-6/2018

Development and Evaluation of a Targeted Risk Communication Intervention for Tobacco-Dependent Veterans Receiving Cancer Care

This project is developing and pilot testing a risk communications tool to assist healthcare providers in discussing tobacco cessation with cancer patients at the VA.

Role: PI

I01 HX002172-01A1 (VA HSR&D) - Zeliadt  - 4/2017-4/2020

Promoting Smoking Cessation in Lung Cancer Screening through Proactive Treatment

This study will examine strategies for ensuring patients undergoing lung cancer screening receive tobacco cessation services.

Role: Co-Investigator

U48DP005008-02S3 (CDC) - Krebs/Rogers (MPI) - 9/15-9/18

Proactive Care Coordination for Cancer Survivors Who Smoke     

This project is examining the feasibility of using cancer registries to identify smokers and comparing four types of outreach strategies to engage them in treatment.

Role: MPI

Completed Support

Eurasia Foundation  - Sherman (PI) - 10/2015-6/2017

Developing a bi-national buddy intervention for smoking cessation and cultural education

In this project we are develop a smartphone app for young adults, which aims to promote engagement in tobacco cessation by linking young adult smokers with cross-cultural partners also interested in quitting.

Role: Co-Investigator

I01 HX000817 (VA HSR&D) - Sherman (PI) - 4/2013-11/2016

Proactive Outreach for Smokers in VA Mental Health

This project is examining use of proactive outreach to enroll tobacco-dependent Veterans receiving mental health services in tobacco cessation and provide enhanced coordination with their mental health providers.

Role: Co-Investigator

PPO 14-130-2 (VA HSR&D) - Zeliadt (PI) -  11/2014-8/2016 

Integrating Smoking Cessation with Lung Cancer Screening

This VA pilot project is developing and collecting pilot data on patient acceptability of a protocol for integrating tobacco cessation discussions in the context of CT screenings for lung cancer.

Role: Co-Investigator

NYU Cancer Institute - Parekh (PI) - 9/2014-12/2015

Healthy Eating and Living against Breast Cancer (HEAL)                                                                                                                                       

This project developed and is pilot testing a group-based nutrition literacy program for breast cancer survivors.

Role: Co-PI

1R42DA029353 (NIDA) - Ostroff/Snow (MPI)   - 8/2010-8/2015

Quit IT: Development of a Web-based, 3D Coping Skills Game to Increase Self-Efficacy for Maintaining Smoking Abstinence

This project is developing and pilot testing a structured mobile gaming environment to promote tobacco cessation and prevent relapse in older adult hospitalized cancer patients.

Role: Co-I (PIs: Ostroff and Snow). I identified our collaborating industry partner, organized the grant submission, worked closely with designers to outline the game, conducted alpha testing and summarized results for publication. I continue to provide guidance in implementing the game during the clinical trial phase.

1R34DA031636-01A (NIDA) - Shelley (PI) - 11/2012-10/2014

Improving adherence to smoking cessation medication among PLWHA

This project is an RCT pilot investigating three strategies, including text messaging support and counseling, for improving tobacco cessation and adherence to cessation medications among this at-risk population.

Role: Co-Investigator

SDP 07-034 (VA HSR&D)  - Sherman (PI)  - 10/2008 – 09/2014

Telephone Care Coordination for Smokers in Mental Health Clinics

Major Goals: 1) Evaluate the process of adapting, implementing, and sustaining a smoking cessation telephone care coordination program in Mental Health Clinics; 2) Determine the effectiveness of telephone counseling in promoting long-term abstinence from smoking among mental health patients; and 3) Compare the effectiveness of telephone counseling delivered by VA staff with that delivered by state Quitlines.

Role: Co-I (PI Sherman)