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
2001- Member, Society of Behavioral Medicine
2001- Member, American Psychological Association
2009- Member, Society for Research on Nicotine and Tobacco
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 ReviewC. Contribution to Science
- 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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)
Assistant Professor, Department of Population Health
PhD from University of Rhode Island
Memorial Sloan-Kettering Cancer Center, Psycho-Oncology
American journal of preventive medicine. 2018 May 20; 54(5):620-629
Evaluating policies for integrating smoking cessation into lung cancer screening delivery [Meeting Abstract]
Implementation science : IS. 2018 MAR 28; 13:?-?
Health communication. 2018 Jan 15; 1-7
JMIR mHealth & uHealth. 2017 Dec 19; 5(12):e197-e197
Annals of behavioral medicine. 2017 Aug; 51(4):532-546
Nutrition Education among Cancer Survivors: Feasibility Results from the Healthy Eating and Living against Breast Cancer (HEAL-Breast Cancer): A Pilot Randomized Controlled Trial [Meeting Abstract]
FASEB journal. 2017 APR; 31:?-?