Project Name:  Quality of Life Outcomes Among Older Adults with Colorectal Cancer


Colorectal cancer is diagnosed in over 140,000 Americans each year and approximately 65% of those diagnoses are in adults over the age of 65.  In the past 30 years, treatment of colorectal cancer has resulted in increases in survival rates, from 50% in 1975 to 66% in 2007.  Although historically older adults were not offered curative therapy for colorectal cancer trends have demonstrated a decrease in denial of treatment for older adults and an increase in the amount of curative therapies. 

Given the increased survival rates and increased curative treatment options for older adults, my research will explore how colorectal cancer treatment affects psychological and social well-being, or quality of life, among older adults. 

My three major research objectives are:

  1. To identify the most appropriate ways to define and measure quality of life among the aging as it relates to social and psychological outcomes.

  2. To explore quality of life outcomes by conducting a qualitative study of older adults who have been diagnosed with colorectal cancer.

  3. To conduct a survey study of older adults with colorectal cancer informed by the findings from the qualitative study.


In my first year of research, I plan to focus on delving into the existing literature on quality of life to determine the most appropriate ways to measure quality of life among older adults with colorectal cancer in order to achieve my first objective.  While doing this, I plan on completing my comprehensive exams which will focus on the history and epistemology of oncology social work as well as the current research on colorectal cancer and quality of life.  I also will begin to formulate my dissertation proposal which will include finalizing a research design and methodology that will help me to achieve my second and third research objectives. Depending on my first year outcomes, in my second year of research I will begin both the qualitative and quantitative data for my research project and begin data analysis.


Summer 2018 Update from Dr. Alford: Kristen (Admiraal) Alford is an associate professor of social work and public health at Calvin College. She is currently involved in two major research projects. The first project seeks to understand the tools parents need to better discuss their (the caregiver’s) diagnosis of cancer with their children. This research began with a survey of parents who were diagnosed with cancer to understand how they communicated with their children about their diagnosis and the reactions the children displayed in response to their parent’s diagnosis. The second part of the research is talking with parents and professionals to discuss the communication needs of parents with a diagnosis of cancer.

The second project is analyzing the efforts of a water filter distribution project in Liberia. This project is being completed over four years with the intention of ensuring every person in Liberia has access to clean drinking water. Kristen’s role in the project is to analyze and report on the public health effects of this project, specifically how the distribution of filters affects childhood diarrheal rates as well as overall family medical expenditures, adult employment, and childhood schooling. Kristen also continues to teach in public health and social work. In this position, she helps students understand the interactions between biological, psychological, and social well-being as well as how one’s context affects their outcomes. She frequently discusses her work in cancer and chronic disease to highlight these interactions and discuss interventions and policy to address these challenges.


Summer 2019 Update from Dr. Kristen Alford: Dr. Alford is wrapping up elements of the parents with cancer survey and focus groups she did in recent years. She notes that health professionals say they talk extensively with and provide resources to parents about how to communicate with their children about the parent’s cancer diagnosis and treatment. However, parents say they must find the resources and they have so many other things on their plate that this isn’t something that is addressed with health professionals. Dr. Alford notes that these two perspectives show some form of disconnect, and although the sample size was quite small, the findings are important.

Dr. Alford is working with colleagues to conduct research as part of a large multi-year project which is distributing water filters to all households in Liberia without access to clean drinking water within a 15-minute walk of home.

Now a tenured associate professor at Calvin College, Dr. Alford is also director of a student summer research program. She is excited to be an ambassador for the ACS ResearcHERS campaign in Michigan, noting that it is exciting for her to help support other early career cancer researchers.