Andrew (Drew) Busch, PhD, recently joined the Minneapolis Medical Research Foundation (MMRF) Addiction Research team. A licensed psychologist, Dr. Busch specializes in treating mood disorders and facilitating health behavior change (e.g., smoking cessation) in medical patients. His current projects include a large-scale clinical trial targeting smoking cessation in cardiac patients using Behavior Activation (BA) counseling. He recently received a National Institutes of Health Research Project Grant (R01) totaling almost $3 million to support his research. Dr. Busch discusses his research studies, what inspired him to pursue treatment research, and what he enjoys doing when he’s not working on ways to prevent and treat disease.
Q: Tell us about your grants and your lab.
The overarching aim of my lab is to investigate the intersection of mental health, health behaviors (especially smoking), and physical health outcomes.
The primary project in our lab is a trial funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) that is combining smoking cessation and mood management counseling following a cardiac event, such as a heart attack. Depression is common following cardiac events and predicts early morbidity and mortality. The effect of depression on morbidity/mortality post-cardiac event is, at least partially, though depressed mood interfering with smoking cessation. This project will recruit participants during hospitalization for a cardiac event who are daily smokers and provide treatment over 12 weeks. The primary aim of this project is to test the efficacy of a combined treatment for smoking cessation, mood, and long-term cardiac outcomes. Dr. Woubeshet Ayenew is a collaborator on this project.
We are also starting up a new NHLBI-funded project this summer that will develop a new counseling intervention targeting both depression and multiple behavioral risk factor reduction following a cardiac event. This treatment will enroll participants 3-6 months after a cardiac event who have major depression and struggle with at least two behavioral risk factors (i.e., smoking, low physical activity, poor diet, medication non-adherence). We will first develop a new treatment manual through qualitative interviews with HCMC patients who are depressed and recently experienced a cardiac event. We will then conduct a pilot randomized trial of the resulting manual and evaluate effects on depression and cardiac risk. The long-term goal of this project is to test the effect of our new counseling treatment on secondary prevention following a cardiac event. Drs. Woubeshet Ayenew and Kate Diaz Vickery are collaborators on this project.
Finally, we are conducting a trial of strength training (i.e., weight lifting) as a treatment for depression and cardiovascular risk reduction among African American men. The trial is funded by the National Institute of Nursing Research (NINR) of the NIH. African American men have higher rates of untreated depression and higher rates of some cardiovascular diseases, such as hypertension and stroke). Supervised strength training has potential to reduce both of these disparities. My Co-PI on this project is Dr. Joseph Ciccolo at Teachers College, Columbia University, and all participants in this pilot will participate at Columbia. If this pilot is successful, we plan to conduct a multi-site trial that would enroll HCMC patients.
Q: What inspired you to become a medical researcher?
I started graduate school planning to become a full-time clinician counseling patients with serious mental illness. I was inspired to pursue treatment research after learning that much of the counseling conducted in the community was not evidence based. Much of my early work focused on how to disseminate existing evidence-based depression treatments into community settings. All of my current work develops and tests behavioral treatments that do not require specialty training in psychology or psychiatry, making these treatments more amenable to broad dissemination if found to be effective.
Q: What do you find the most exciting or interesting about the research you are doing?
I am most excited about addressing glaring disparities in care and outcomes. For example, those with mental illness are 70% more likely to smoke than those without mental illness. Those with serious mental illness have a significantly shorter lifespan, primarily due to smoking and other behavioral risk factors. I hope that my work will play a small part in resolving these disparities.
Q: What do you find the most challenging?
To insure internal validity and safety most clinical trials have several inclusion and exclusion criteria, thus many patients who are interested do not qualify. In my clinical trials, we often provide treatment that patients do not have access to or cannot afford to pursue outside of a research study. My least favorite part of clinical research is turning away patients who are motivated to engage in a needed treatment without being able to provide them with a timely referral to similar care.
Q: What is your hometown?
I grew up in Highland Park in St. Paul.
Q: What interests do you have apart from science and medicine? What do you do in your free time?
When I have the time, I love to spend time with my daughter, camp, and downhill ski.