Nora Nock, PhD, PE

Associate Professor
Department of Population and Quantitative Health Sciences
School of Medicine
Associate Professor
Department of Medicine
School of Medicine
Member
Population and Cancer Prevention Program
Case Comprehensive Cancer Center
School of Medicine

Dr. Nora L. Nock has a broad background in epidemiology, biostatistics and engineering, as well as specific training in lifestyle interventions, genetic and molecular epidemiology, functional neuroimaging, neuromodulation and multivariate modeling.

Dr. Nock’s research focuses on using innovative technologies and methodologies to improve the quality of life and survival in adults and adolescents with cancer, obesity, substance use disorders and other chronic diseases and conditions.  Her research also seeks to understand the genetic, behavioral, environmental and neural underpinnings of these diseases. Dr. Nock is currently leading an NIH funded intervention which is utilizing a mixed-methods optimization research approach to evaluate the effects of enhancing exercise with "assisted" exercise and psychotherapy with biofeedback to improve outcomes in adults with an opioid use disorder and chronic pain. Her team has also received a supplement to better understand the multiple dimensions of stigma in adults with a substance use disorder. Dr. Nock is also leading the NIH-funded trial "REWARD" which is evaluating a novel lifestyle intervention involving "assisted" exercise and a behavioral nutritional counseling program to improve weight loss and weight loss maintenance in obese endometrial cancer survivors.  The REWARD trial builds upon a neuroimaging study she led in obese endometrial cancer survivors, which found that a 6-month behavioral lifestyle intervention decreased neural response to high-calorie food images in brain regions implicated in food reward and motivation.

She recently published a review of the neurobiology and putative therapeutic effects of exercise in substance use disorders, which was one of the journal’s (Birth Defects Research) top 20 most downloaded papers from January 2017 through December 2018. In addition, she is an analyst on the Ohio Opioids Analytics Project, which is identifying high-risk groups and modifiable factors associated with opioid overdose and opioid related deaths using several large datasets.  

Dr. Nock’s earlier career research focused in the genetic, environmental and behavioral determinants of cancer, obesity and obesity-related traits. She led several studies that provided early findings showing that associations between smoking and prostate cancer varied by race. She also led work in her early career that found associations between BMI and cancer cell growth promotion, as well as associations between bone mineral density (BMD) and colorectal adenomas, suggesting that BMD could serve as a screening related biomarker for colorectal cancer in women.  

Her work has included developing new methods (Latent Gene Construct Method) in data analysis that enable the integration of diverse data types including genomic, biomarker and behavioral data, and that is now being extended to imaging data.

Teaching Information

Courses Taught

Obesity and Cancer: Transdisciplinary Views from Molecules to Health Policy
Design and Measurement in Population Health Sciences

Teaching Schedule

2013-present: Design and Measurement (EPBI 465). This course focuses on common design and measurement approaches used in population health sciences research, building on introductions to these approaches provided in pre-requisite courses. This overview consists of understanding the preliminary considerations that go into selecting a qualitative, quantitative, or mixed methods research design, including understanding different philosophical worldviews, strategies of inquiry and methods and procedures for each. Students will develop in-depth knowledge of these approaches through readings, lectures, group discussions and project, class presentations, and hands-on applications.

2008-present: Obesity and Cancer: Transdisciplinary Views from Molecules to Health Policy (EPBI/MPHP 464). This course provides an overview of energy balance components (diet, physical activity, resting metabolic rate, dietary induced thermogenesis) and obesity, a consequence of long term positive energy balance, and relations with certain cancers. After presenting an overview of epidemiological evidence for the obesity epidemic, the cellular and molecular biology of energy metabolism is discussed. Emerging research on biologically plausible connections and epidemiological associations between obesity and various types of cancer (e.g., colon, breast) are presented; and, interventions targeted at decreasing obesity and improving quality of life in cancer patients are also discussed.

2008-present: Genetic and Molecular Epidemiology Seminar (EPBI 502). Students are exposed to a broad range of advanced topics related to the field of genetic and molecular epidemiology. The seminar includes student presentations of dissertation/thesis work and recent journal articles as well as presentations by invited speakers.

2005-2007: Epidemiology of Environmental Health (MPHP 429). Developed and instructed new course in Spring 2005 that presents key local and global issues in environmental health and epidemiology. This course provides students with an understanding of how genetic factors modify disease risk from environmental agents and how emerging exposure assessment (biomarkers, GPS-GIS) and statistical (PBTK/TD) methods will help improve protection of human health.

Research Information

Research Interests

An overarching goal of Dr. Nock’s research is to utilize innovative technologies and techniques to provide personalized medicine for improved survival and prevention of chronic diseases by capitalizing on the integration of diverse data such as imaging, genomic, environmental, behavioral and clinical data using mixed-method research and multi-level modeling frameworks.

Research Projects

Dr. Nock is currently leading an NIH NCI R01 funded trial (entitled "REWARD") evaluating a novel lifestyle intervention involving "assisted" exercise in obese endometrial cancer survivors, which is collecting and analytically integrating multi-dimensional, longitudinal "big data" sources including imaging data (from functional MRI food and cognitive tasks), genomic data, circulating biomarker data, clinical data, and dietary and physical activity (accelerometer, heart rate) data.

Professional Memberships

American Association for Cancer Research
American College of Sports Medicine
American Public Health Association
American Society of Professional Engineers
American Society of Civil Engineers
American Society of Human Genetics
American Society of Nutrition
Chi Epsilon: Civil Engineering Honor Society
Cleveland Engineering Society: Environmental Division
International Genetic Epidemiology Society
International Society for Environmental Epidemiology
The Obesity Society

External Appointments

Visiting Scientist, Department of Pathobiology
Cleveland Clinic
2010

Publications

Textbooks/Textbook Chapters

  1. Cancer and Energy Balance: Epidemiology and Overview, Edited by Nathan Berger, Chapter
    5: Obesity and Cancer: Molecular Mechanisms Overview by Nora L. Nock and Nathan
    Berger, Springer USA, NY, NY. 2010. (ISBN 978-144-195-514-2). Available at:
    http://www.springerlink.com/content/v825651u472q4860/
  2. Dyslipidemia: From Prevention to Treatment, Edited by Roya Kelishadi, Ch.6, Dyslipidemia:
    Genetics and Role in the Metabolic Syndrome and Syndrome Z by Nora L. Nock and
    Aiswarya Chandran Pillai*, InTech Publishing, Rijeka, Croatia. 2012. (ISBN 978-953-307-
    904-2) Available at: http://www.intechopen.com/articles/show/title/dyslipidemia-genetics-and-role-in-the-metabolic-syndrome *MS Student under my direction
  3. Statistical Human Genetics, Edited by Robert Elston, Jaya Satagopan and Shuying Sun,
    Chapter 27: Structural Equation Modeling by Catherine Stein, Nathan J. Morris and Nora L.
    Nock, Springer USA, NY, NY. 2012. (ISBN 978-1-61779-554-1). Available at:
    http://www.springerlink.com/content/p4j377347nn18622/#section=1031191&page=1
  4. Energy Balance and Gastrointestinal Cancer, Edited by Sanford Markowitz and Nathan
    Berger, Chapter 1: Obesity and Gastrointestinal Cancers: Epidemiology by Nora L. Nock,
    Springer USA, NY, NY. 2012. (ISBN 978-1-4614-2366-9 e-ISBN 978-1-4614-2367-6).
    Available at: http://www.springerlink.com/content/l5n1rg43706vhj05/?MUD=MP
  5. Exercise, Energy Balance and Cancer, Edited by Cornelia Ulrich, Karen Steindorf, Nathan
    Berger, Chapter 3: Exercise Associated Regulation of Tumor Promoters, Hormones and
    Cytokines in Cancer Control by Nora L. Nock and Nathan Berger, Springer USA, NY, NY.
    2013. ISBN 978-1-4614-4492-3. Available at:
    http://www.springer.com/biomed/cancer/book/978-1-4614-4492-3
  6. Metabolic Syndrome: A Comprehensive Textbook, Edited by Rexford Ahima, Chapter 5:
    Genetics of Lipid Disorders by Nora L. Nock, Springer USA, NY, NY. 2016. ISBN 978-3-
    319-11250-3. Available at: http://www.springer.com/la/book/9783319112503
  7. Nutrition and Diet in Therapy of Bone Diseases, Edited by Ronald Watson and Daruka Mahadevan, Chapter 6: Vitamin D, Calcium, Bone Mineral Density and Colorectal Adenomas  and Colorectal Cancer by Nora L. Nock, Wageningen Academic Publishers, Wageningen, The
    Netherlands. 2016. ISBN: 978-90-8686-278-8. Available at:
    https://www.wageningenacademic.com/doi/book/10.3920/978-90-8686-823-0
  8. Energy Balance and Cancer: Focus on Gynecologic Malignancies, Edited by Ann Klopp, Karen Lu, Nathan Berger, Chapter 12: Exercise and Lifestyle Interventions in Gynecologic Cancer Survivors by Nora L. Nock, Springer USA, NY, NY. 2018. ISBN 978-3-319-63482-1. Available at: http://www.springer.com/us/book/9783319634821
     

View all of Dr. Nock's publications

  1. Nock, NL, Dimitropoulos, A, Zanotti, KM, Waggoner, S, Nagel, C, Golubic, M, Michener, CM, Kirwan, JP, Alberts, J. Sleep, quality of life, and depression in endometrial cancer survivors with obesity seeking weight loss. Support Care Cancer 2020; 28 (5): 2311-2319. PubMed PMID:31478164 PubMed Central PMC7050326.
  2. Oh, A, Gaysynsky, A, Knott, CL, Nock, NL, Erwin, DO, Vinson, CA. Customer discovery as a tool for moving behavioral interventions into the marketplace: insights from the NCI SPRINT program. Transl Behav Med 2019; 9 (6): 1139-1150. PubMed PMID:31313817 .
  3. Flocke, SA, Nock, NL, Fulton, S, Margevicius, S, Manne, S, Meropol, NJ, Daly, BJ. A National Study of Oncology Nurses Discussing Cancer Clinical Trials With Patients. West J Nurs Res 2019; 41 (12): 1747-1760. PubMed PMID:30782111 PubMed Central PMC6699918.
  4. Owusu, C, Antognoli, E, Nock, N, Hergenroeder, P, Austin, K, Bennet, E, Berger, NA, Cerne, S, Foraker, K, Heine, K, Heyman, E, Moore, H, Petkac, J, Schluchter, M, Schmitz, KH, Whitson, A, Flocke, S. Perspective of older African-American and Non-Hispanic white breast cancer survivors from diverse socioeconomic backgrounds toward physical activity: A qualitative study. J Geriatr Oncol 2018; 9 (3): 235-242. PubMed PMID:29306608 PubMed Central PMC5936661.
  5. Nock, NL, Minnes, S, Alberts, JL. Neurobiology of substance use in adolescents and potential therapeutic effects of exercise for prevention and treatment of substance use disorders. Birth Defects Res 2017; 109 (20): 1711-1729. PubMed PMID:29251846 PubMed Central PMC5751741.
  6. Stein, CM, Morris, NJ, Hall, NB, Nock, NL. Structural Equation Modeling. Methods Mol. Biol. 2017; 1666 : 557-580. PubMed PMID:28980265 .
  7. May, CN, Nock, NL, Bentley, D, Demaree, HA. Acute aerobic exercise increases implicit approach motivation for dessert images. J Health Psychol 2018; 23 (6): 807-817. PubMed PMID:27402729 .
  8. Nock, NL, Ievers-Landis, CE, Dajani, R, Knight, D, Rigda, A, Narasimhan, S, Uli, N. Physical Activity Self-Efficacy and Fitness: Family Environment Relationship Correlates and Self-Esteem as a Mediator among Adolescents Who Are Overweight or Obese. Child Obes 2016; 12 (5): 360-7. PubMed PMID:27243476 .
  9. Markowitz, SD, Nock, NL, Schmit, SL, Stadler, ZK, Joseph, V, Zhang, L, Willis, JE, Scacheri, P, Veigl, M, Adams, MD, Raskin, L, Sullivan, JF, Stratton, K, Shia, J, Ellis, N, Rennert, HS, Manschreck, C, Li, L, Offit, K, Elston, RC, Rennert, G, Gruber, SB. A Germline Variant on Chromosome 4q31.1 Associates with Susceptibility to Developing Colon Cancer Metastasis. PLoS ONE 2016; 11 (1): e0146435. PubMed PMID:26751797 PubMed Central PMC4709047.
  10. Nock, NL, Owusu, C, Flocke, S, Krejci, SA, Kullman, EL, Austin, K, Bennett, B, Cerne, S, Harmon, C, Moore, H, Vargo, M, Hergenroeder, P, Malone, H, Rocco, M, Tracy, R, Lazarus, HM, Kirwan, JP, Heyman, E, Berger, NA. A Community-Based Exercise and Support Group Program Improves Quality of Life in African-American Breast Cancer Survivors: A Quantitative and Qualitative Analysis. Int J Sports Exerc Med ; 1 (3): . PubMed PMID:26640827 PubMed Central PMC4667740.

Publishing impact 

Metrics from Web of Science/publons and Scopus/SciVal: 

  • H-index: 17
  • Total publications: 50
  • Total citations:  795
  • Publications in top-tier journals: 32%   
  • Collaborative publishing national/international: 77%/19%

Editorial roles:

  • PeerJ, editorial board
  • Genes, Molecular Diversity Preservation Int’l (MDPI), editorial board & cancer genetics section editor
  • Frontiers in Genetics, Journal of Toxicogenomics, associate editor
  • Journal of Translational Medicine & Epidemiology, associate editor
  • Frontiers in Nutrition, Journal of Sport and Exercise Nutrition, associate editor

Education

PhD
Epidemiology & Biostatistics
MS
Civil and Environmental Engineering
BS
Civil Engineering

Additional Information

Contributions to science:

  • Utilizing novel exercise technologies, neuroimaging, and community partnerships to reduce obesity and related chronic diseases
  • ‘Latent gene construct’ method for integrating genetic, environmental, and behavioral data
  • Genetic, environmental and behavioral determinants of prostate cancer
  • Genetic, environmental and behavioral determinants of obesity and obesity-related traits

Active grants:

  • NIH/NCI R01: Revving-up exercise for sustained weight loss by altering neurological reward and drive (REWARD): a randomized trial in obese endometrial cancer survivors
  • NIH/NIMHD R01: Reducing functional health disparities in older and socially-disadvantaged breast cancer survivors
  • St. Baldrick’s Supportive Research Grant: Cybercycling to improve quality of life in adolescent and young adult cancer survivors
  • Ohio Medicaid Technical Assistance & Policy Program G18: Develop and apply analytic strategies for identifying high-risk groups and modifiable factors with opioid overdose and deaths using several large databases
  • Bravo Wellness, LLC: Analysis of workplace wellness program data.
  • NIH/NCI: Oncology Nurse IMPACT: Improving communication with patients about clinical trials
  • NIH/ NINR T32 NR01: Multiple Chronic Conditions: Interdisciplinary nurse scientist training

Student and mentee totals, over Case Western Reserve University career/full academic career:

  • Master’s:  190
  • PhD: 3/5
  • A sampling of Case Western Reserve PhD graduates and post-docs’ current careers:  
    • IBM Watson Health
    • Research Associate, CWRU
    • VP, Biostatistics and Informatics, Thrive Earlier Detection Corp.