Robert L Cook

Research topics

Matched from this investigator's NIH project titles and abstracts.

• Developmental Cognitive Neuroscience
• Cognitive Aging
• Learning and Memory

Active NIH awards

• Technology-based assessments and intervention to reduce alcohol consumption and improve HIV viral suppression in the Florida Cohort

  5R01AA030481-04

  NIAAA · FY 2025 · $609K

  The majority of persons with HIV (PWH) in the US consume alcohol, despite that alcohol use is associated with lower levels of HIV care engagement and HIV viral suppression. Over the past decade, our research team has established the Florida Cohort to support research and training with a mission to maximize HIV viral suppression and improve health outcomes in PWH. Key features of the Florida Cohort include a focus on alcohol-related issues, academic and community-based partnerships across the state, enrollment of individuals with varied backgrounds and risk factors, and linkage to statewide HIV surveillance data. Meanwhile, several agencies in Florida are implementing new interventions to help achieve HIV viral suppression, including the PositiveLinks (PL) app. The overarching goals of the current grant proposal are to advance understanding of the mechanisms influencing adherence to contemporary HIV therapeutic regimens, and to incorporate alcohol-related interventions into emerging strategies to achieve and maintain HIV viral suppression. We propose to enroll and survey 1200 new Florida Cohort participants, with targeted enrollment for persons with heavy alcohol use. The survey data will allow us to identify multilevel factors contributing to ART adherence and viral suppression among alcohol-using PWH. From the overall cohort, 80 alcohol-using PWH will complete “enhanced monitoring (EM)” for one month. The EM group will wear a wrist alcohol biosensor, report alcohol and other risk factors (e.g., real-time anxiety, depression) and ART adherence through an ecological momentary assessment (EMA) app, and provide two dried blood spots (DBS) viral load tests. The EM data will help disentangle the temporal relationships between alcohol, other risk factors, and ART adherence in real-time. Survey and EM data together with input from the EM participants will be used to inform the development of several aspects of the biosensor-based intervention. Our interdisciplinary team will also meet regularly with a new Community/Provider Advisory Board (CAB), who will provide input related to the ongoing Florida Cohort (e.g., enrollment, survey design) and help develop a plan to integrate the alcohol biosensor-based intervention into the PL app. The specific aims include: 1) Systematically investigate multilevel factors based on the social-ecological model and WHO model that influence ART adherence and subsequently HIV viral suppression in alcohol-using vs. non-using PWH. 2) In 80 alcohol-using PWH, use alcohol biosensors and EMA data to identify alcohol consumption patterns and risk factors most strongly associated with ART non-adherence and poor HIV viral suppression. 3) Develop an intervention that incorporates an alcohol biosensor into an existing mHealth ART adherence intervention, with input from alcohol-using PWH and a Community/Provider Advisory Board. The rich information we collect in this project will establish a solid foundation for our next step: a hybrid implementation/effectiveness trial of an integrated alcohol intervention across a large network of clinic-/community-based HIV settings in Florida.

• Southern HIV and Alcohol Research Consortium Biomedical Data Repository

  5U24AA029959-05

  NIAAA · FY 2025 · $483K

  Abstract: The number of persons living with HIV (PLWH) continues to increase in the United States. Alcohol consumption is a significant barrier to both achieving the goal of ending the HIV epidemic and preventing comorbidities among PLWH, as it contributes to both HIV transmission and HIV-related complications. Recent advances in data capture systems such as mHealth devices, medical imaging, and high-throughput biotechnologies make large/complex research and clinical datasets available, including survey data, multi-omics data, electronic medical records, and/or other sources of reliable information related to engagement in care. This offers tremendous potential of applying “big” data to extract knowledge and insights regarding fundamental physiology, understand the mechanisms by which the pathogenic effects of biotic and abiotic factors are realized, and identify potential intervention targets. We propose to integrate the disparate data sources maintained by our partners and then utilize the big data to address research questions in treating HIV and alcohol-related morbidity and mortality. Specifically, we will pursue the following three aims: 1) Integrate the disparate data sources through standardization, harmonization, and merging; 2) Develop a web-based data sharing platform including virtual data sharing communities, data privacy protection, streamlined data approval and access, and tracking of ongoing research activities; 3) Provide statistical support to junior investigators to use the data repository for exploratory data analysis and proposal development. The proposed study will tap into disparate data sources, unleash the potential of data and information, accelerate knowledge discovery, advance data-powered health, and transform discovery to improve health outcomes for PLWH.

• Translational Science Training to Reduce the Impact of Alcohol on HIV Infection

  5T32AA025877-08

  NIAAA · FY 2025 · $426K

  This is an application to continue to support both predoctoral trainees and postdoctoral fellows in the T32 training program, “Translational Science Training to Reduce the Impact of Alcohol on HIV Infection”. This training need remains significant across the state of Florida which continues to rank among the top 3 states in new HIV infections per year and total HIV/AIDS cases. Alcohol consumption, and related issues such as drug use and mental health, contributes to enduring HIV transmission and to poor HIV outcomes. We need an interdisciplinary research task force skilled in alcohol research to help reduce HIV transmission and HIV- related comorbidities. The specific aims of our T32 are to: (1) Deliver an outstanding training curriculum focused on alcohol and HIV that incorporates three key focus areas (health behavior intervention science, epidemiology and data science, and cognitive science related to aging); (2) Provide effective mentorship for establishing or advancing programs of research in alcohol and HIV science; (3) Facilitate leaderships skills and experience collaborating with multidisciplinary research teams; (4) Promote excellence in the communication and dissemination of alcohol and HIV science; and (5) Ensure professionalism and ethical conduct of research. The training program will support five pre-doctoral and two post-doctoral trainees at any time and be based in 6 academic programs. The program is led by three MPIs who represent departments of Epidemiology, Health Education and Behavior, and Nursing. We will provide in-depth training around the intersection of alcohol and HIV, together with three additional focus areas: a) health behavior intervention science; b) epidemiology and data science integrated with the UF AI initiative; and c) cognitive science related to aging. Training activities include required courses, T32 Program activities, and training activities associated with the Southern HIV Alcohol Research Consortium (SHARC), itself supported by over $10 million in ongoing NIH funding through 2022. Trainees also will receive training in the responsible conduct of research. The research environment is strong at the University of Florida, which collectively has pledged an additional $500,000 in overall support to our specific training program. Given the success of our trainees to date, and breadth and depth of our faculty mentors’ expertise around alcohol and HIV, we reaffirm our readiness and commitment to training the next cohort of researchers to reduce the risk of negative health outcomes from alcohol and HIV infection throughout Florida and beyond.

• Cognitive and Inflammation Targeted Gut-Brain Interventions in People Living with HIV who are High-Risk Alcohol Users

  5P01AA029543-05

  NIAAA · FY 2025 · $292K

  The overarching goal of Research Component 2 (RC2) is to determine whether two non-invasive biological interventions, transcutaneous vagal nerve stimulation (tVNS) and a probiotic supplementation intervention (PBI), will improve cognitive and brain functioning, systemic and neuroinflammation, and gut microbiome health in people living with HIV (PWLH) who are high risk users of alcohol. The study will also delineate mechanisms of the gut-brain axis, which is particularly relevant, given that the factors underlying adverse cognitive and brain effects of alcohol use among PLWH remains unresolved. There is also considerable public health significance if beneficial effects of tVNS and/or PBI can be demonstrated, as cognitive disturbances that adversely impact health outcomes, functional abilities and quality of life are common (~ 50% prevalence), despite marked reductions in mortality in the era of antiretroviral therapies (ART). Among PLWH with reconstituted immune function and undetectable viral loads, comorbid conditions remain common and can have adverse functional consequences. High risk alcohol use, prevalent among PLWH, not only contributes to cognitive and brain dysfunction, but also further exacerbates comorbidities (e.g. liver disease, hepatitis coinfection, obesity, and cardiovascular and gastrointestinal dysfunction), and reduces treatment adherence while increasing the propensity for high risk sexual behaviors, worse health outcomes, and transmission of the virus. The study’s clinical significance is strong given the need for effective interventions to improve cognition and health outcomes in PLWH. To test these hypotheses, we will conduct a hybrid randomized clinical trial that will enroll 80 PLWH who are high risk drinkers from our existing research infrastructure supported by the Southern HIV Alcohol Research Consortium (SHARC). In a 2x2 factorial design, participants will be randomly assigned to one of 4 conditions (tVNS+placebo, sham- stimulaiton+placebo, tVNS+probiotic, sham-stimulation+probiotic). We will obtain data on alcohol consumption, cognitive assessments, blood biomarkers, stool microbiome, and neuroimaging at three timepoints (baseline, 30-days, 90 days).