Candyce Kroenke, MPH, ScD

Kroenke, Candyce

Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-5969 (phone)
candyce.h.kroenke@kp.org
Kaiser Permanente Researcher Profiles

Candyce Kroenke, MPH, ScD, is a research scientist at the Kaiser Permanente Northern California Division of Research (DOR). Social determinants including social networks, race/ethnicity, and socioeconomic status have been reliably related to differences in cancer survival. Dr. Kroenke's research focuses on understanding these relationships as well as the behavioral, biological, and treatment-related factors underlying associations. Dr. Kroenke's work further considers the influence of lifestyle and behavioral factors on cancer survivorship.

She is currently the principal investigator of three studies funded by the National Cancer Institute. The first study examines the influence of social networks on breast cancer treatment and prognosis. The second study, Exploring Networks in a Cohort of Latina and Asian Emigrants, lifestyle, and Vital status (ENCLAVE), evaluates the role of multilevel social networks in associations between immigrant status, health behaviors, and breast cancer outcomes. In a third, her team is developing an electronic health record-based tool to identify breast cancer patients at risk of low social support (EHR-SUPPORT). She is also principal investigator of the Investigating Network Support In Gaps in Health and Treatment in Breast Cancer (INSIGHT-BC) study, funded by the American Cancer Society, which examines the role of social networks in racial disparities in breast cancer treatment and survival.

Dr. Kroenke received her doctorate in Epidemiology from the Harvard School of Public Health and her master's and undergraduate degrees in Epidemiology and Sociology from the University of Minnesota. Prior to her work at the Division of Research, she was an instructor at the Harvard Medical School and a Robert Wood Johnson Health and Society Scholar at the University of California, San Francisco/Berkeley site.

Current Position(s):

Research Scientist II, Division of Research, Kaiser Permanente Northern California

Section Affiliations:

Primary Research Interests:

Social roles and relationships, lifestyle and obesity, and breast cancer survival
Psychosocial and lifestyle factors and differences in breast cancer survival by race
Body composition and cancer outcomes
Biological mechanisms of aging and chronic disease development across the lifecourse

Studies

An Electronic Health Record-Based Tool to Identify Newly Diagnosed Breast Cancer Patients at Risk of Low Social Support

Goals of the project are to: 1) Identify terms from content in the EHR, based on theory and prior literature, and informed by clinical stakeholders in BC care, that measure structural and/or functional social support, have been associated with BC treatment and outcomes, and could be extracted through code or natural language processing (NLP); 2) Develop an EHR-based social support measure, EHR-SUPPORT, using data from structured, semi-structured, and unstructured (through NLP) sources that help identify patients at risk of low social support, overall and by race/ethnicity, and validate the measure against published social support measures; and 3) Evaluate associations of EHR-SUPPORT and its component variables with BC treatment outcomes (surgery delays, chemotherapy delays, nonadherence to hormonal therapy) and BC-specific and total mortality, overall and by race/ethnicity. In an exploratory aim, we propose to: Explore, with clinician stakeholders, workflow and information technology requirements to implementing EHR-SUPPORT.
Investigator: Kroenke, Candyce
Funder: National Cancer Institute

Social Networks and Disparities in Health Behaviors and Breast Cancer Outcomes in Immigrant Women

The goals of this study are to evaluate associations between: 1) immigrant status and social networks at the neighborhood level and at the individual level, overall and by race/ethnicity, further evaluating associations among Asian/Pacific Islander and Hispanic, relative to non-Hispanic white women; 2) immigrant status and multilevel social network characteristics with behavioral factors known to influence breast cancer survival, overall and by race/ethnicity; and 3) immigrant status, multilevel social network characteristics, and breast cancer outcomes including recurrence, breast cancer-specific mortality, and total mortality, overall and by race/ethnicity, evaluating the degree to which social network characteristics and behavioral risk factors mediate associations.
Investigator: Kroenke, Candyce
Funder: National Cancer Institute

Race Disparities in Social Networks, and Breast Cancer Treatment, Prognosis

The goal of this research is to determine, through the use of mixed qualitative and quantitative methods, how the social environment influences women's breast cancer treatment, decisions about treatment, and subsequent survival, and how these relationships may help to explain racial disparities in breast cancer survival. This research may have implications for possible social interventions in breast cancer survivors.
Investigator: Kroenke, Candyce
Funder: American Cancer Society

Social Networks, Breast Cancer Treatment and Survival

The research goal is to better understand how breast cancer patients’ social networks influence breast cancer treatment and prognosis. Aims are to: 1) evaluate associations of social network size, types and diversity of network members, and levels of social support, and time to and adherence with breast cancer treatment in the Pathways cohort of stage I-IV breast cancer patients; 2) evaluate associations of social networks and breast cancer recurrence and mortality; and 3) develop, pilot, evaluate, and refine a brief “social networks as a vital sign” (SVS) questionnaire in breast cancer patients at the Kaiser Permanente Oakland Medical Center.
Investigator: Kroenke, Candyce
Funder: National Cancer Institute

Highlighted Publications

Post-diagnosis social networks and breast cancer mortality in the After Breast Cancer Pooling Project

Author(s): Kroenke CH; Michael YL; Poole EM; Kwan ML; Nechuta S; Leas E; Caan BJ; Pierce J; Shu XO; Zheng Y; Chen WY

Cancer. 2016 Dec 12.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Studies

An Electronic Health Record-Based Tool to Identify Newly Diagnosed Breast Cancer Patients at Risk of Low Social Support

Social Networks and Disparities in Health Behaviors and Breast Cancer Outcomes in Immigrant Women

Race Disparities in Social Networks, and Breast Cancer Treatment, Prognosis

Social Networks, Breast Cancer Treatment and Survival

Highlighted Publications

Post-diagnosis social networks and breast cancer mortality in the After Breast Cancer Pooling Project

Analysis of Body Mass Index and Mortality in Patients With Colorectal Cancer Using Causal Diagrams

Post-diagnosis social networks, and lifestyle and treatment factors in the After Breast Cancer Pooling Project

Race and breast cancer survival by intrinsic subtype based on PAM50 gene expression

Social networks, social support mechanisms, and quality of life after breast cancer diagnosis

Social networks, social support, and burden in relationships, and mortality after breast cancer diagnosis in the Life After Breast Cancer Epidemiology (LACE) Study

Social networks, social support and burden in relationships, and mortality after breast cancer diagnosis

Social networks, social support, and survival after breast cancer diagnosis

Weight, weight gain, and survival after breast cancer diagnosis.

Publications

Association of Low Muscle Mass and Low Muscle Radiodensity With Morbidity and Mortality for Colon Cancer Surgery

Social Support, Social Network Size, Social Strain, Stressful Life Events, and Coronary Heart Disease in Women With Type 2 Diabetes: A Cohort Study Based on the Women's Health Initiative

Lifestyle and Psychosocial Patterns and Diabetes Incidence Among Women with and Without Obesity: a Prospective Latent Class Analysis

Egocentric social networks, lifestyle behaviors, and body size in the Asian Community Health Initiative (CHI) cohort

The association of delay in curative intent treatment with survival among breast cancer patients: findings from the Women's Health Initiative

Prediagnosis social support, social integration, living status, and colorectal cancer mortality in postmenopausal women from the women's health initiative

It's Absolutely Relative: The Effect of Age on the BMI-Mortality Relationship in Postmenopausal Women

The Association of Abdominal Adiposity with Mortality in Patients with Stage I-III Colorectal Cancer

The Effect of Reverse Causality and Selective Attrition on the Relationship Between Body Mass Index and Mortality in Postmenopausal Women

A descriptive pilot study of structural and functional social network ties among women in the women's health initiative (WHI) study

A Cross-Sectional Analysis of Telomere Length and Sleep in the Women's Health Initiative

Body Composition and Cardiovascular Events in Patients With Colorectal Cancer: A Population-Based Retrospective Cohort Study

Social Relationships and Risk of Type 2 Diabetes Among Postmenopausal Women

Post-cancer diagnosis dietary inflammatory potential is associated with survival among women diagnosed with colorectal cancer in the Women's Health Initiative

The association of medical and demographic characteristics with sarcopenia and low muscle radiodensity in patients with nonmetastatic colorectal cancer

Changes in physical and mental health are associated with cardiovascular disease incidence in postmenopausal women

Association of Body Fat and Risk of Breast Cancer in Postmenopausal Women With Normal Body Mass Index: A Secondary Analysis of a Randomized Clinical Trial and Observational Study

Prediagnostic circulating markers of inflammation and risk of oesophageal adenocarcinoma: a study within the National Cancer Institute Cohort Consortium

A conceptual model of social networks and mechanisms of cancer mortality, and potential strategies to improve survival

Stratified probabilistic bias analysis for BMI-related exposure misclassification in postmenopausal women

Muscle radiodensity and mortality in patients with colorectal cancer

Antidepressant Use and Risk of Colorectal Cancer in The Women's Health Initiative

The deterioration of muscle mass and radiodensity is prognostic of poor survival in stage I-III colorectal cancer: a population-based cohort study (C-SCANS)

The Obesity Paradox in Cancer: How Important Is Muscle?

Associations of pre-existing co-morbidities with skeletal muscle mass and radiodensity in patients with non-metastatic colorectal cancer

Personal and clinical social support and adherence to adjuvant endocrine therapy among hormone receptor-positive breast cancer patients in an integrated health care system

The Importance of Body Composition in Explaining the Overweight Paradox in Cancer-Counterpoint

The Plausibility of the Obesity Paradox in Cancer-Response-Reply to Point

Association of Muscle and Adiposity Measured by Computed Tomography With Survival in Patients With Nonmetastatic Breast Cancer

Social relationships, inflammation markers, and breast cancer incidence in the Women's Health Initiative

Associations between ACE-Inhibitors, Angiotensin Receptor Blockers, and Lean Body Mass in Community Dwelling Older Women

The Women's Health Initiative (WHI) Life and Longevity After Cancer (LILAC) Study: Description and Baseline Characteristics of Participants

Association between post-cancer diagnosis dietary inflammatory potential and mortality among invasive breast cancer survivors in the Women's Health Initiative

Understanding the relation between socioeconomic position and inflammation in post-menopausal women: Education, income and occupational prestige

Muscle mass at the time of diagnosis of nonmetastatic colon cancer and early discontinuation of chemotherapy, delays, and dose reductions on adjuvant FOLFOX: The C-SCANS study

Methodological considerations for disentangling a risk factor's influence on disease incidence versus postdiagnosis survival: The example of obesity and breast and colorectal cancer mortality in the Women's Health Initiative

Association of Systemic Inflammation and Sarcopenia With Survival in Nonmetastatic Colorectal Cancer: Results From the C SCANS Study

Optimism, Pessimism, Cynical Hostility, and Biomarkers of Metabolic Function in the Women's Health Initiative

Explaining the Obesity Paradox: The Association between Body Composition and Colorectal Cancer Survival (C-SCANS Study)

Prognostic significance of marital status in breast cancer survival: A population-based study

Impact of social and built environment factors on body size among breast cancer survivors; the Pathways Study

Metabolic Phenotype and Risk of Colorectal Cancer in Normal-Weight Postmenopausal Women

Association of Weight Change after Colorectal Cancer Diagnosis and Outcomes in the Kaiser Permanente Northern California Population

Post-diagnosis social networks and breast cancer mortality in the After Breast Cancer Pooling Project

Re: High- and low-fat dairy intake, recurrence, and mortality after breast cancer diagnosis. Response.

Development and Use of a Traditional Mexican Diet Score in Relation to Systemic Inflammation and Insulin Resistance among Women of Mexican Descent

Metabolic Dysfunction, Obesity, and Survival Among Patients With Early-Stage Colorectal Cancer

Post-diagnosis Weight Change and Survival Following a Diagnosis of Early Stage Breast Cancer

Exercise and Prognosis on the Basis of Clinicopathologic and Molecular Features in Early Stage Breast Cancer; The LACE and Pathways Studies

Psychosocial Clusters and their Associations with Well-Being and Health: An Empirical Strategy for Identifying Psychosocial Predictors Most Relevant to Racially/Ethnically Diverse Women's Health

Exercise and Risk of Cardiovascular Events in Women With Nonmetastatic Breast Cancer

Analysis of Body Mass Index and Mortality in Patients With Colorectal Cancer Using Causal Diagrams

Relationship of pre-diagnostic body mass index with survival after colorectal cancer: Stage-specific associations

Reproductive Risk Factors and Coronary Heart Disease in the Women's Health Initiative Observational Study

Pre-diagnostic Sleep Duration and Sleep Quality in Relation to Subsequent Cancer Survival

Enhancing Breast Cancer Recurrence Algorithms Through Selective Use of Medical Record Data

Impact of Body Weight and Body Composition on Ovarian Cancer Prognosis

Post-diagnosis social networks, and lifestyle and treatment factors in the After Breast Cancer Pooling Project

Representativeness of breast cancer cases in an integrated health care delivery system

Leukocyte Telomere Length and Risks of Incident Coronary Heart Disease and Mortality in a Racially Diverse Population of Postmenopausal Women

Association of high obesity with PAM50 breast cancer intrinsic subtypes and gene expression