Natoshia R. Cunningham, PhD, is a tenure-track assistant professor in the Department of Family Medicine.
What brought you to MSU and Family Medicine?
When I first saw the position at MSU to conduct health systems research focused on the management of chronic pain and psychological disorders, I wondered if this position might have been written for me! This opportunity with the Department of Family Medicine at MSU, with a focus on community engaged research, not only described how I already defined myself as a researcher, but also encompassed who I aspired to be.
My research has focused on improving mental health outcomes for youth with chronic health conditions involving pain, such as functional abdominal pain disorders and childhood-onset systemic lupus. I began my research career at Cincinnati Children’s Hospital, which was a great start and a highly productive experience. However, I was eager to test the approaches I developed outside of a single academic medical center. I also wanted to be part of building a new research infrastructure.
The opportunity to interface with multiple medical systems and community-focused researchers drew me to MSU. Further, when I interviewed for the position, I was struck by the collaborative spirit of those I met both within the department and from healthcare systems external to MSU.
Finally, the strong mentorship and support from within the Department was evident. It was clear that the Department of Family Medicine would provide me with all of the tools, resources, and support needed to allow me to achieve my goals. When I was presented with an offer to join the department, I was delighted to accept!
What are your research interests and what kind of researchers would you be interested in working with?
I am broadly interested in the psychological assessment and treatment of youth with chronic health conditions that involve pain and comorbid psychological concerns. Working with a multidisciplinary team is vital to the success of my research. To continue my funded research conducting clinical trials in the areas of functional abdominal pain and childhood-onset lupus, I am in the process of building relationships with subspecialists such as pediatric gastroenterologists and rheumatologists.
Going forward, I also envision collaborating with pediatricians and family medicine physicians who provide care to youth throughout the state of Michigan. I hope to help enable primary care providers and their teams to better manage pediatric pain and anxiety using nonpharmacological approaches. I am particularly interested in connecting with physicians to improve access to care in rural areas of the state such as northern Michigan and the upper peninsula.
An important part of my work involves developing and testing tailored and accessible psychological interventions for youth using telehealth and web-based platforms. Working with bioinformatics specialists and others with expertise in telehealth treatment is highly appealing to me. Individuals with expertise in biostatistics and an interest in mental health research and clinical trials are also ideal collaborators. I am also interested in partnerships with basic scientists to use neuroimaging techniques and to explore other biomarkers (e.g., metabolomics) to better understand the mechanisms of pain, anxiety, and response to psychological treatments.
As a clinical psychologist by training, I am always excited to connect with other MSU psychology collaborators with an interest in pediatric and child clinical psychology, neuroimaging, and implementation research. I also enjoy working with graduate students of psychology and related disciplines who are interested in intervention-focused research.
I am also interested in partnering with child psychiatrists and other professionals with an interest in mental health research. I enjoy collaborating with community members on these topics. To improve care for youth with lupus, I am currently conducting research with a group of patient/caregiver co-investigators and find this work to be very energizing. I am hoping to engage in more community-based research in the future.
I also welcome collaborations with investigators outside of Michigan and abroad. I plan to conduct multi-site, cross-cultural investigations of the feasibility and effect of the psychological treatment tools I’ve developed to manage pediatric chronic health conditions (such as functional abdominal pain and lupus) and co-occurring mental health problems.
What are you currently researching?
As part of my NIH/NCCIH K23 grant award, I am currently studying the neural mechanisms of response to tailored a cognitive behavioral treatment (Aim to Decrease Anxiety and Pain Treatment [ADAPT]) I developed to manage pain and anxiety in youth with functional abdominal pain disorders (FAPD) and co-occurring anxiety. I am partnering with providers in radiology, gastroenterology, and pain psychology at Helen DeVos Children’s Hospital/Spectrum Health System to conduct this research.
In partnership with rheumatology collaborators at Helen DeVos Children’s Hospital/Spectrum and Metro Health, I am also leading a multi-site study funded by the Childhood Arthritis and Rheumatology Research Alliance-Arthritis Foundation (CARRA-AF) to test a telehealth application of a tailored cognitive behavioral intervention (Treatment and Education Approach for Childhood-onset Lupus [TEACH]) developed for adolescents and young adults diagnosed with childhood-onset lupus to manage fatigue, mood, and pain.
With these partners from Spectrum, I am also serving as a co-investigator on another CARRA-funded multi-site investigation to understand the relationship between Adverse Childhood Experiences (ACES) in disease-related outcomes in youth with Juvenile Idiopathic Arthritis (JIA). These projects are aligned with my broader interests in improving mental health outcomes for youth with pediatric rheumatic conditions. As such, I currently serve as the co-chair of the Mental Health Workgroup of the CARRA organization and am currently co-leading this group on the development of consensus statements for the assessment and treatment of mental health conditions in the context of pediatric rheumatologic care.
What got you interested in doing this kind of research?
I aim to improve pediatric mental health, particularly for youth with complex needs such as those with chronic health issues that involve pain and co-occurring mental health concerns. I am drawn to this work because there are evidence-based strategies that can be effective to improve the functioning of youth afflicted with these conditions. To get those strategies in the hands of children and families who need them is highly reinforcing.
However, there are many barriers to youth receiving appropriate psychological care. Children and adolescents with complex needs (such as those with medical conditions and co-occurring mental health needs) often require specialized care. My goal is to lead a program of research that aims to developing easily accessible, tailored, and evidence-based approaches for improving health and mental health outcomes for children. I also enjoy using novel methods such as neuroimaging and biomarkers to explore why such interventions are effective.
What do you plan on researching in the future?
I plan to conduct multi-site studies to test the effect of the psychological interventions I have developed, and explore the role of biomarkers in treatment response. I also hope to continue to develop and refine psychological treatments to be accessible and effective working with multidisciplinary teams. I also hope to adapt the tools I have developed for managing pain and anxiety for use in primary care settings and other community-based settings.
