As the director of research operations in the Department of Community Health Sciences, Kara Magane operates largely behind the scenes—but she plays a vital role in a department that has maintained a visible standing as a national leader in substance use disorder treatment and research.
Describing her position as a “Jack-of-all-trades research role,” Magane oversees the vast research portfolio of Richard Saitz, chair and professor of community health sciences, including several projects that focus on her two main research interests: HIV and substance use.
“I love being the behind-the-scenes person who can bring research to life, without necessarily having my name on a grant,” says Magane, who arrived to SPH in July 2019 from Boston Children’s Hospital, where she managed studies on adolescent substance use. She jumped right into her role at SPH, supervising the operational aspects of research projects, such as grant proposal submissions and a multi-million-dollar budget, and leading a team of research coordinators and research managers.
Magane also oversees the data collection and assists with data analyses of major studies, including the URBAN ARCH Boston Cohort study, which is a component of the Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS.
“I really like to stay close to the science,” she says, which also includes the drafting and revising of manuscripts for submission to peer-reviewed journals. “I spent my first year at SPH becoming familiar with the studies to understand the research questions, hypotheses, and data, and now I’m getting into a position where I can more significantly contribute to the dissemination of our findings, which is really exciting.”
Magane says her team just entered the last year of the five-year URBAN ARCH Boston Cohort study, which aims to understand and address the association between alcohol consumption and falls, and related healthcare utilization, among people living with HIV. More than one-third of this population consumes too much alcohol, which can increase inflammation and exacerbate the HIV-related comorbidities and complications (such as osteoporosis or other physical impairments) that lead to falls.
“What I like about this project is that we’re collecting and analyzing quantitative and qualitative data to develop a tailored fall prevention intervention,” says Magane. “That’s important because people living with HIV are experiencing falls and frailty in the context of possible premature aging. In other words, they are experiencing frailty, falls, and fractures at a younger age than the rest of the population, so the fall prevention intervention that we design for them is different than what we would design for the general geriatric population.
“I really appreciate that this study not only examines the problem—whether alcohol consumption leads to falls—but takes that finding one step further to determine what we can do to prevent these falls,” she says. “In the next year, I’m looking forward to communicating everything that our study team has learned over the course of this five-year grant. That’s why I’m in this type of position—to disseminate valuable information and make an impact in the community.”
Magane says the COVID-19 pandemic and resulting stay-at-home measures forced the team to reevaluate the in-person procedures for all of their studies. For the URBAN ARCH Boston Cohort study, certain data collection such as saliva and breathalyzer tests, sit-to-stand and gait tests, and grip strength with a dynamometer were put on hold, but the team swiftly identified any data that could be collected virtually.
“We began to conduct interviews over the phone or on Zoom to collect standardized assessment measures, such as the timeline follow-back which measures the quantity and frequency of someone’s alcohol consumption over a recent time period,” Magane says. “We’re also asking questions about their mental health, including depression and anxiety symptoms, and quality of life. So we were able to pivot very quickly and that’s a testament to the creativity and flexibility of our researchers.”
Magane also manages the Alcohol Disorder hosPital Treatment (ADOPT) study. The study is comparing the effectiveness of oral versus extended-release injectable naltrexone, a medication that is used to curb cravings among people experiencing alcohol use disorder—specifically in this case, 248 patients at Boston Medical Center at the time of hospital discharge.
“Our intended goal is to reduce or eliminate alcohol consumption among people with alcohol use disorder, but we don’t have the empirical evidence on which form of the medication is more effective,” says Magane, adding that the extended-release option can last up to 30 days, but tablets must be taken daily. “We’re in the final year of this study and have collected most of the data, so I’m excited to begin the data analysis, and take more of a role in writing the results and communicating them to prescribers, clinicians, the public health community, and people with lived experience of alcohol use disorder.”