Noyes Wants to Understand the Complexity of Human Behavior

Back when Professor Katia Noyes, PhD, MPH, was a graduate student doing preclinical basic science research at a university medical center, she came to a realization: the people in nearby economically disadvantaged neighborhoods used the center’s ER for health care because they couldn’t access preventive care, let alone take advantage of innovative treatments her research might lead to.

That opened her eyes to the issue of access and changed the course of her career. Today, her work is in health services research, focused on understanding how to deliver care most accessibly and conveniently. Her role as associate dean for translational and team science highlights another vital part of herwork: multidisciplinary collaborations.

Those are important, she says, because “humans are complex, and their behavior is driven by a variety of intertwined factors.”

Clearly proving her multidisciplinary bent is a sample of recent papers she’s published: “Cross-sector collaboration in transitional care of people experiencing homelessness”; “Association between hospital participation in Medicare Shared Savings Program and hospital use of robotic surgical approach” and “Micro-credentials and translational workforce development: Motivation and benefits.”

Noyes describes a project that, to her, captures her experience as a cross-disciplinary patient-centered researcher. Funded by M&T Bank, the study tried to understand various reasons that some people don’t get screened for cancer. Focus groups and surveys conducted by UB and community partners engaged representatives of groups with the lowest screening rates and discovered surprising explanations why people don’t get screened. Lack of health insurance might seem a natural reason for not being screened, but the study uncovered a range of reasons.

Often, people don’t want to know early that they might have cancer; they may be experiencing a rough patch and don’t need another reason to worry, Or, they don’t know that treatment for earlier stages of cancer is much more effective. Another group believes in cancer screening but doesn’t think it’s important enough—“today”—to allocate time to do it.

“Economists call this revealed preference,” Noyes says. “It’s not what you say but what you do. We realized that, as health professionals, we often don’t appreciate the complexities of lives of everyone in community. People have immediate duties that might take priority. For instance, lots of women put their responsibilities to families and others first.”

This small project turned out to be informative and eye-opening. Noyes learned that criticizing people for not adhering to medical advice isn’t appropriate and only compounds pressure on them.

“We need to be very practical when we give health care advice,” she says. “That’s especially true regarding prevention.” Asking people to prioritize some statistically valid future gain is too complicated: “We need to give very clear, doable solutions."

Noyes’ journey into issues of health care access and quality proved to her that the answers were so diverse and complex that they require collaboration with researchers and non-researchers alike. Determining which factors can actually be modified to help is key. Take Wi-Fi, for example.

“Is Wi-Fi a modifiable health care factor?” Noyes asks. “What if we offer routers to people in studies so they can access learning materials, remote monitoring, etc.? A router is not a health care solution, but it is enabling.”

Health care researchers and professionals need to be able to measure more than mortality, she says: “We need to determine how we measure quality of life, distinguish good quality of life from poor, and then design interventions to maximize quality of life, not just survival.”

Considering the complex social, economic, behavioral and other factors that guide human behavior, she believes, will guide researchers to the right answers.

Her newest project from the National Center for Advancing Translational Sciences/NIH, which she co-directs with another UB faculty, Dr. John Canty, SUNY Distinguished and Albert and Elizabeth Rekate Professor of Medicine at the Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, also evidences that affinity: It funds a program affiliated with UB's Clinical and Translational Science Institute that offers mentored research and career development opportunities to early-career faculty who want to advance clinical and translational science, improve health outcomes and address health disparities