About

Carla L. Fisher, Ph.D., M.S.W., is a behavioral scientist with a clinical social work background and a faculty member in the College of Medicine’s Department of Health Outcomes and Biomedical Informatics at the University of Florida. Her research career has focused on developing interventions and implementing psychosocial support for caregivers and their loved ones coping with cancer. She has teamed with Deidre B. Pereira, Ph.D., a psycho-oncologist, to address the needs of cancer caregivers, who often face significant burden and stress with little support or training. Fisher was selected for the first cohort of a National Cancer Institute program aimed at expanding caregiver support in cancer centers across the nation. She is participating in a 10-month training program with INCITE (INcreasing Caregiver support Implementation through Training and Education). Additionally, she was awarded a 2026 Faculty Enhancement Opportunity to develop a caregiver support program for the UF Health Cancer Institute, which aims to provide mental health assessments, psychosocial services, education, and research connections, including clinical trial enrollment. Her work emphasizes creating a culture of support for caregivers to improve their well-being and reduce the burden on the health system.

Research topics

• Medicine
• Psychology
• Family medicine
• Developmental psychology
• Clinical psychology

Selected publications

• Blood cancer caregivers’ communication with clinicians about online cancer information

  Palliative & Supportive Care · 2026-01-01

  articleOpen access

  OBJECTIVES: Adult children caring for a parent with cancer often assume the role of a "surrogate seeker," looking online for information regarding their parent's diagnosis, which they may then discuss with their parent's clinician. The current study aims to apply the previously developed "Stoplight typology" to explore caregivers' experiences discussing online health information with their parents' clinicians and factors associated with each response type within the typology. METHODS: We conducted an online survey of adult children caring for a parent with a blood cancer about their experiences communicating with their parent and their parent's clinicians. We used regression analyses to examine the association between physician responses as categorized according to the stoplight typology with 3 caregiver communication measures assessing eHealth literacy, caregiver communication, and physician-caregiver and patient communication. Second, we examined the experiences participants had with clinician communication about online health information. RESULTS: A total of 121 caregivers completed the survey. Over half reported clinicians giving green light responses, with fewer reporting yellow or red light responses. Lower eHealth literacy significantly predicted greater likelihood of red light responses, whereas higher self-reported communication skills predicted more green light and fewer red light responses; neither communication measure predicted yellow responses. Thirty-two percent did not discuss their most recent online search with clinicians, most commonly because they saw no need. Seventy-four percent had discussed online information with a clinician, and 56% of these encounters were coded as green light responses. Among caregivers who had been told not to search online, 77% continued to do so despite the clinician's discouragement. CONCLUSIONS: The study findings provide support for the stoplight typology in a caregiver population. Although most clinician responses were engagement responses, results demonstrate that the rejection response is ineffective. Future research could examine caregivers who reported lower eHealth literacy to target for future intervention.

  PublisherOA PDFDOI

• A Proof‐of‐Concept Analysis of the <i>Healthy Communication Practice</i> Intervention to Enhance Adult–Child Caregivers' Psychosocial Well‐Being: A Brief Report

  Psycho-Oncology · 2026-05-01

  article1st authorCorresponding

  BACKGROUND: Caregivers manage complex demands with little support, contributing to significant psychological distress. Though caregiver-focused supportive care is scarce, this type of psychosocial support enhances well-being and caregiving ability. Given the caregiver support gap, we developed an online, self-directed intervention (Healthy Communication Practice) to reduce caregivers' distress by enhancing their online, clinical, and family communication skills. It was first developed for adult children of parents with blood cancer. We previously established the acceptability and feasibility of the intervention in partnership with Blood Cancer United (formerly The Leukemia & Lymphoma Society). AIM: This proof-of-concept analysis examined the impact of Healthy Communication Practice on adult-child caregivers' distress and secondary psychosocial outcomes. METHODS: Participants were adult-child caregivers of parents with blood cancer diagnosed at least 3 months prior and in treatment or completed treatment within a year. Outcomes were assessed pre-, immediate-post, and 3-month post-intervention using paired t-tests to analyze pre- and post-intervention differences. RESULTS: Participants (N = 55) were aged 18-59, mostly female (76%) and white (78%). Caregivers experienced reduced distress between pre-intervention and 3-month post completion as well as increased positive meaning associated with their caregiving role between pre-intervention to 3-month post completion. Communication skills in each care domain (online, clinical, and family communication) increased between pre- and 3-month post completion. CONCLUSIONS: Results provide proof-of-concept evidence that the Healthy Communication Practice can enhance caregivers' psychological well-being and caregiving communication skills. Results further demonstrate a sustainable, innovative communication-focused approach to providing caregiver-targeted supportive care that can also be widely disseminated, thus warranting further evaluation.

  PublisherDOI

• Turning points in prognostic uncertainty across the disease trajectory for emerging and young adult caregivers of a parent with advanced cancer

  SSM - Qualitative Research in Health · 2026-02-20

  articleOpen accessSenior author

  Emerging and young adult caregivers (EYACs, aged 18-35) of a parent with cancer are an understudied, under-resourced, and growing caregiving population. Little is known about their experiences coping with and managing distressing uncertainty about their parent’s prognosis, which is even more distressing when their parent is living with advanced cancer. It is critical to better understand what impacts EYACs’ prognosis uncertainty as their parent’s disease continues to progress to better support their psychosocial needs and promote adaptive coping and adjustment. We conducted interviews with recently bereaved EYACs ( N = 33) of a parent with advanced cancer who died within 12 months after diagnosis using the Retrospective Interview Technique (RIT). Participants identify any events that caused a change in their prognostic uncertainty (i.e., turning points) between their parent’s diagnosis and death by plotting them on a graph. Participants’ graphs were used to guide their interview, which also captured the context and meaning of each turning point (TP). RIT graphs and interview transcripts were thematically analyzed, and a typology of 5 TP types emerged: medical events, observable condition changes, online research, clinical communication, and family communication. EYACs also characterized how the TP timing mattered: TPs that occurred early in the cancer trajectory that influenced EYACs’ beliefs about their parent’s prognosis in turn informed their positive or negative interpretation of future TPs. Findings highlight the significant role communication plays in EYACs’ prognostic uncertainty and provide key insights for future psychosocial interventions to better support this underrepresented, unsupported population of caregivers.

  PublisherDOI

• Supporting Family Caregivers’ Clinical Communication Skills: Adapting a Cancer Caregiver Communication Model for Dementia Caregiving

  International Journal of Environmental Research and Public Health · 2026-02-10

  articleOpen accessSenior author

  Background: Psychosocial support that enhances caregivers’ clinical communication skills can alleviate distress while enhancing their ability to communicate with nurses and clinical teams to achieve care goals. We sought to adapt a cancer caregiver clinical communication model (C3PM-Cancer) for dementia spousal caregivers that identifies key communication strategies they can enact before, during, after, and between appointments to promote better care. Methods: Interviews were conducted with caregivers of spouses diagnosed with dementia within the last 10 years. Data were thematically analyzed to confirm and extend the communication strategies and care goals in C3PM-Cancer to develop C3PM-Dementia. Results: Caregivers for spouses with dementia in our sample reported the same strategies and goals in each communication phase of C3PM-Cancer, which provides support for the utility of these caregiving communication skills across these two disease contexts. They described the importance of new communication strategies, which informed an emotionally focused communication approach used to protect their spouse’s personhood and dignity. The findings inform the adapted C3PM-Dementia. Conclusions: C3PM-Dementia can be an educational tool offered by clinicians to caregivers to provide guidance on key communication strategies to enact before, during, after, and between appointments to achieve critical care goals. The model can enhance communication between caregivers and clinicians, which can promote better outcomes in both cancer and dementia care.

  PublisherOA PDFDOI

• Feasibility and Acceptability of a Social Media-Based Physical Activity Intervention for College Women

  Psychology of sport and exercise · 2026-05-01

  article
  PublisherDOI

• Survivorship Care After Childhood Cancer: A Systematic Review of Reported Barriers and Facilitators

  Cancer Control · 2025-08-01 · 2 citations

  articleOpen access

  IntroductionChildhood cancer survivors (CCS) experience many long-term health problems that can be alleviated by receiving guideline-concordant survivorship care. However, many CCS encounter barriers to accessing care and do not receive recommended survivorship care. We reviewed the empirical evidence of barriers to and facilitators of survivorship care for CCS.MethodsAs part of a larger project on CCS, this systematic review followed a detailed protocol (CRD42021227965) and searched PubMed, CINAHL, and PsycINFO for studies on survivorship care for CCS without date restriction, and abstracted reported barriers and facilitators. Searches identified 8585 citations and 2 independent reviewers screened 2934 publications at full text. We evaluated the risk of bias for individual studies and quality of evidence (QoE) across barriers and facilitators.ResultsA total of 49 studies reported barriers and facilitators (survivors N = 33, clinicians N = 19, family members N = 8, and health system leaders N = 7) addressing knowledge (beliefs, autonomy, culture), prioritization (active avoidance, trust, communication), and infrastructure (health system resources, transitions). We found high QoE of barriers including lack of knowledge and inaccurate beliefs (survivorship care not needed or redundant), active avoidance and lack of trust (high level of emotional trauma and anxiety, lack of confidence in care team, no local providers with experience in survivorship care), and gaps in infrastructure (financial toxicity/hardship, lack of insurance coverage, difficulty scheduling appointments, and lack of stable housing). Conversely, knowledge (providing a survivorship care plan or treatment summary, supporting patient autonomy) and prioritization (close relationships with clinicians, enhanced care coordination, communication) can also facilitate survivorship care engagement, documented with high QoE.ConclusionsWe found strong empirical evidence of barriers to and facilitators of survivorship care, including potentially modifiable factors surrounding knowledge, prioritization, and infrastructure survivorship care. Prospective, multilevel approaches are needed to improve the receipt of guideline-concordant survivorship care among CCS.

  PublisherDOI

• The Role of Personal Social Networks in Parental Decision-Making for HPV Vaccination: Examining Support and Norms Among Florida Parents

  Vaccines · 2025-06-21 · 1 citations

  articleOpen access

  Background: Human papillomavirus (HPV) vaccination is crucial for preventing HPV-related cancers, yet vaccination rates remain suboptimal, particularly in Florida. Social influence, including family and peer support, may shape parental decisions to vaccinate their children. In this study, we examined the role of social networks (online and offline) in parental intention to vaccinate their 11- to 12-year-old children against HPV. Methods: We conducted a cross-sectional survey among 746 parents in Florida as part of the Text &amp; Talk trial (2022–2023). Among other questions, parents reported on their intention to vaccinate, perceived social norms, and support received from up to three reported confidants. We performed logistic regression and multivariable analyses to assess the relationship between network support, social norms, and vaccination intent. Results: Seventy percent of parents intended to vaccinate their children. Greater support from the first reported confidant was significantly associated with higher vaccination intention (OR = 1.30, p &lt; 0.0001). Perceived norms among friends (p = 0.01) and higher overall network support (p &lt; 0.0001) were also predictive of intent. The higher the percentage of reported family members, the higher the support received for the vaccine (p = 0.04). Conclusions: Social support, particularly from close confidants and peers, plays a critical role in shaping parental HPV vaccination decisions while accounting for perceived social norms. Public health interventions can leverage peer networks alongside family support to enhance HPV vaccine uptake.

  PublisherOA PDFDOI

• Race, ethnicity, and insurance inequities in Hodgkin lymphoma (HL) treatment and survivorship care in the US: A study in progress

  Klinische Pädiatrie · 2025-12-01

  article
  PublisherDOI

• How cancer impacts adolescents’ and young adults’ (AYAs) scholastic experiences: Insight on supportive survivorship care needs from AYAs, parents, and clinicians.

  Journal of Clinical Oncology · 2025-05-28

  article1st authorCorresponding

  11053 Background: Cancer disrupts AYAs’ educational and vocational trajectories given treatment demands and acute or late effects of treatment on cognitive functioning. This occurs during a developmental phase when scholastic experiences are central to AYAs’ socioemotional and cognitive growth. Despite education being a critical determinant of health-related quality of life, typically families do not receive support for scholastic issues. According to clinical guidelines, key stakeholders in cancer care must have a shared understanding of these concerns to effectively address them. We aimed to identify how cancer impacts scholastic experiences when diagnosed at age 15-29 through the perspectives of diagnosed AYAs, parents caring for AYAs, and AYA oncology clinicians. Methods: Drawn from studies funded by The Leukemia &amp; Lymphoma Society and an NCI-Designated Cancer Center, a secondary thematic analysis was conducted on three interview datasets: AYAs (n=10); parents (n=15); clinicians (e.g., oncologists, APPs, LCSWs) (n=7). Analyses were separated by stakeholder group and triangulated to identify shared perspectives. Results: AYAs, parents, and clinicians all describe cancer contributing to four challenging scholastic-related impacts: 1) having to advocate for academic accommodations (e.g., virtual option, reduced workload, disability assistance); 2) disrupting school/vocational trajectories (e.g., relocating/changing schools for treatment, stopping school/career pursuits, limitations in performance); 3) losing extracurriculars (e.g., sports, school activities); and 4) losing peer social connection (e.g., feeling isolated/disconnected). They collectively described the impacts as distressful, as a parent expressed: “He was managing all this mental and emotional pain [with cancer], and then [the school] caused so much other stress and pain in our life.” One positive impact was identified by AYAs and parents: changing mindsets about school/career (e.g., using school/work as motivator or way to take control, being inspired to change passion/paths). Conclusions: Findings illustrate distressful scholastic issues parents and AYAs need support with during cancer care. AYAs and parents described having to advocate on their own with no support. While clinicians recognized the same concerns as patients/caregivers, AYAs and parents described needing to initiate discussions with clinicians, further demonstrating a need to streamline scholastic performance into the standard of care. AYAs and parents recognized cancer could also impact AYAs’ mindset about school/work in a positive manner, thus, addressing scholastic concerns may help empower and engage AYAs. Findings can inform resources and support the importance of developing a patient-centered metric that addresses scholastic performance in AYA survivors.

  PublisherDOI

• Characterizing Hodgkin lymphoma survivors' shared decision making across the care continuum

  Blood · 2025-11-03

  articleOpen access

  Abstract Introduction: With multiple stage-based treatment options like systemic treatment alone, combined modality therapy, and immunotherapy available for Hodgkin Lymphoma (HL), shared decision making (SDM), a patient-centered communication (PCC) approach, is key to high quality care. Studies of SDM in HL are limited. Nearly half of HL survivors do not experience SDM, which is associated with poor health outcomes and high utilization. We need to understand HL survivors' SDM experiences to improve PCC and HL treatment and survivorship care quality. We filled this gap by characterizing survivors' experiences with SDM in HL care across the continuum (initial treatment; relapse or change in treatment; survivorship care). Methods: HL survivors were recruited for in-depth, semi-structured interviews to explore SDM experiences. Recruitment was conducted in collaboration with national non-profit partners Blood Cancers United, Elephants &amp; Tea, and Cactus Cancer Society via social media and direct email. Eligibility was confirmed by participants uploading documentation to REDCap of their HL diagnosis occurring at age ≥18 years . A qualitative rapid analysis was conducted using SDM sensitizing constructs to characterize survivors' SDM experiences when making decisions in each care phase. Thematic analysis and qualitative content analysis were conducted. Results: A total of 29 survivors participated: 7 experienced relapse; median age at diagnosis was 32 (interquartile range, IQR, 28-44) and current age was 36 (IQR, 28-52); 66% identified as White, 21% as Black, and 17% as Hispanic; 66% were privately insured, 23% were publicly insured, and 10% were uninsured at diagnosis. Collectively, survivors experienced one of three types of decision making: 1) SDM with options, 2) SDM without options, or 3) paternalistic decision making (no SDM features). For both initial treatment and survivorship decisions, survivors typically experienced SDM without options (i.e., given one treatment option but experienced other SDM features, like managing uncertainty). Most survivors (88%) felt included in decisions across all phases of care, except for those experiencing paternalistic decision making. Survivors described experiencing five key features of SDM. First, information exchange included the presence/absence of treatment options, receipt of tailored information, discussions on treatment risks/benefits, and receipt of treatment or survivorship education. Second, survivors described how they manage uncertainty by asking questions about what to expect, risks of mortality and relapse, and side effects, to which their clinicians responded with education, emotional support, and referrals to specialists, especially for survivorship care. Third, survivors indicated engagement with clinicians when clinicians prioritized survivors' voices in decisions by allowing them to ask questions and providing thorough explanations. Fourth, survivors reported that clinicians were responsive to emotions by listening and responding to concerns, being accessible, and validating and empathizing with their feelings. Fifth, survivors describedfostering a trustworthy relationship when clinicians were accessible, knowledgeable, and responsive to concerns and, specific to survivorship care decisions, when they already had an established rapport. Lastly, it is noteworthy that clinicians' decision-making role was described differently depending on the phase of care. For treatment and relapse decisions, survivors prioritized the clinicians' decision-making role as manager/director, teacher/educator, and driver/main decider whereas for survivorship decisions, clinicians' role was more supportive and referred to as advisor, supporter/listener, or not having a decision-making role. Conclusions: Although HL survivors typically did not receive options for initial treatment (which is part of information exchange in PCC and SDM), they do describe other SDM features and report feeling included in decisions. Results characterize survivors' experiences with SDM across the continuum and indicate survivors' perceptions of their clinician's decision-making role may differ with treatment and survivorship care decisions. Studies can use this conceptualization of SDM in HL to explore differences by survivor demographics and socioeconomic states among survivors who have a risk of worse survival outcomes, such as those who are racially, ethnically diverse, or uninsured.

  PublisherOA PDFDOI

Recent grants

• Using Targeted Social Media to Communicate Culturally Sensitive and Interactive Environmental Risk Information about Breast Cancer to Mothers

  NIH · $345k · 2017–2019

Frequent coauthors

• Christy J. W. Ledford

  119 shared

• Paul Crawford

  University of Kansas

  107 shared

• Carma L. Bylund

  University of Florida Health

  106 shared

• Amanda Kastrinos

  91 shared

• Mollie Rose Canzona

  Wake Forest University

  76 shared

• Jeremy T. Jackson

  Prisma Health

  69 shared

• Lauren A. Cafferty

  George Washington University

  69 shared

• Bianca Wolf

  University of Puget Sound

  68 shared

Awards & honors

• 2026 Faculty Enhancement Opportunity