Voice magazine, spring 2023

Bringing Global Public Health to BC

from the dean

Dear friends and colleagues,

I am excited to share with you the spring 2023 issue of Voice, which examines the critical role that nursing plays in promoting health worldwide.

The nursing profession has long been recognized for its critical contribution to the well-being of individuals and communities around the world. Whether we’re providing bedside care, managing complex health systems, educating the next generation of health care leaders, or developing cutting-edge research, nurses are more important than ever before.

And yet, the heart of nursing remains unchanged: the belief that every person deserves to be treated with dignity and respect. We are, and always have been, at the forefront of health care. This makes us uniquely skilled at building relationships, creating a sense of trust and safety, and empowering individuals and communities to take charge of their health and well-being.

This issue of Voice celebrates our community. It features a story about our new interdisciplinary undergraduate major in Global Public Health and the Common Good, administered by the Connell School of Nursing in partnership with the Schiller Institute for Integrated Science and Society. It explores the work of Associate Professor Tam Nguyen, whose research is aimed at tailoring treatment programs to better serve the unique culture and circumstances of diverse communities. It welcomes our new Associate Dean for Inclusive Excellence, Diversity, and Belonging, Leah Gordon. And it highlights the impact made by our faculty and students as they resumed their international immersion and educational trips for the first time since the start of the pandemic.

I hope that this issue inspires you and fills you with hope as you learn about the ways CSON is supporting communities of all sizes in all corners of the globe. Our strength comes from our community. I am grateful that you are part of it.

Sincerely,

dean

Katherine E. Gregory

editors

John Shakespear

Kathleen Sullivan

managing editor

Tracy Bienen

art director

Diana Parziale

graphic designer

Monica DeSalvo contributors

Tracy Bienen

Nathaniel Moore

John Shakespear

Kathleen Sullivan photographers

Caitlin Cunningham

Lee Pellegrini

Voice is published by the William F. Connell School of Nursing and the Boston College Office of University Communications.

Address letters and comments to: csonalum@bc.edu

Associate Director, Marketing and Communications

William F. Connell School of Nursing

Maloney Hall 140 Commonwealth Ave. Chestnut Hill, MA 02467

katherine e. gregory Dean

Baccalaureate and direct entry master’s degree programs have full approval by the Massachusetts Board of Registration in Nursing. CCNE Accredited 2018–2028

Spring 2023

news

2 Associate deans named Macy Faculty Scholar and accepted into Culture of Health Leaders Institute for Racial Healing, doctoral students published in JAMA Oncology and joined the Academy for Emerging Leaders in Patient Safety Program, and alumna awarded UCSF Medal.

Features

4 Bringing Global Public Health to BC

The Connell School introduces a new interdisciplinary major, in partnership with the Schiller Institute.

8 Treating a silent epidemic Associate Professor Tam H. Nguyen works to improve diabetes prevention among Vietnamese Americans.

12 The importance of truly belonging Diversity and inclusion advocate Leah Gordon joins Connell as associate dean.

14 Revival CSON restarts international trips after pandemic hiatus.

achievements

18 Faculty publish research on mental health risks among Arab and Arab American college students, update an ethics textbook for APRNS, and connect chronic conditions and mental health in African Caribbeans. Faculty present on genomic health care, algorithms to improve care for older adults, and graduate psychiatric mental health nursing education.

Photography

Cover, iStock; inside front cover, pages 3, 7 (left), and 9, Caitlin Cunningham; pages 1 (right), 7 (center, right), 14–17, courtesy of students and faculty; pages 1 (left) and 4, Adobe Stock; pages 2 (top), 6, 12, Lee Pellegrini; page 2 (bottom), Steven Constantine; back cover, Peter Julian

Research

Scholars led by Katie Fitzgerald Jones, Ph.D. ’22, published a study in JAMA Oncology offering the first consensus-based guidance to help specialists treat cancer patients who misuse opioids or have a history of opioid use disorder.

The Gerontological Advanced Practice Nurses Association (GAPNA) presented Ph.D. student Katherine Ladetto ’96, M.S. ’02, with the 2022 GAPNA Foundation Research Project Grant Award for her project “Long-Term Care Nurses’ Intent to Stay: A Qualitative Hermeneutic Phenomenology Study.”

The New England Regional Black Nurses

Two faculty teams were awarded CSON Innovation Grants, which fund small research projects essential to supporting large external research grant applications:

▪ Assistant Professor of the Practice Patricia Underwood and her team, which includes Assistant Professors Cherlie Magny-Normilus and Victor Petreca and researchers from Lahey ClinicBeth Israel Lahey Health and Veterans Administration Boston, for their project “CGM Use and Diabetes SelfManagement Behaviors: A Pilot Study to Inform Nurse-Led Interventions.”

▪ Assistant Professor Brittney van de Water and her team, which includes Assistant Professor of the Practice Ashley Longacre and two members of the nonprofit Seed Global Health, for their project “Implementation of a Midwifery Preceptor Program in Sierra Leone: Organizational Readiness and Easy Effectiveness Using the RE-AIM Framework.”

At the 2022 American Speech-LanguageHearing Association Convention, Jinhee Park and her team were awarded a Meritorious Poster Submission for their project “Social Determinants of Health and Feeding in the First Six Months in HighRisk Infants.”

Van de Water also presented her scholarship at two conferences: the poster “Implementation of Comprehensive TB Prevention Cascade Analysis in Three Clinic Catchment Areas in Rural Eastern Cape, South Africa” at the 7th South African TB Conference in Durban, and “Student, Graduate, and Preceptor Outcomes from a Midwifery Clinical Training Needs Assessment in Sierra Leone” at the State of the Science Congress on Nursing Research in Washington, D.C.

Van de Water recently was selected for an HIV Implementation Science Fellowship in the Inter-CFAR (Center for AIDS Research) Fellowship Program in Implementation Science at Johns Hopkins University. This NIH-funded training opportunity in implementation science is for early-stage investigators engaged in HIV-related research.

Students

D.N.P. student Esther Apraku Bondzie, M.S. ’22, was awarded a 2022 New England Minority Nurse Leadership Conference Scholarship.

Ph.D. candidate Amy Delaney received the Ann Stadtler Excellence in Practice Award from the Mass. chapter of the National Association of Pediatric Nurse Practitioners.

Ph.D. student Rose LaPlante was accepted into the Academy for Emerging Leaders in Patient Safety Program.

D.N.P. students Gina Pallanta; Julie Sanders, M.S. ’22; and Katherine Valovcin presented “Reducing Weight Bias in Nursing: A Review of Effective Educational Interventions” at NETNEP 2022, an international nurse education conference in Barcelona.

issue on endocrine conditions.

Brittney van de Water

Cherlie Magny-Normilus

Alumni

Briana Sasso Ferreira ’20 received a Rookie of the Year Award from the Massachusetts Nurses Association.

Faculty

Surviving the Survivor, Professor Ann Burgess interviewed the daughter of a serial killer about the investigation into the murders of four students in Idaho.

Interim Associate Dean for Graduate Programs

Andrew Dwyer (left) was named a Macy Faculty Scholar, joining a select cohort of educators in medicine and nursing in career development and implementation of a scholarly project.

On NPR’s All Things Considered and WGBH News, Associate Professor Joyce Edmonds commented on the Nurse-Family Partnership model, in which a nurse is designated for low-income, first-time parents from pregnancy until the child turns two.

The National Collaborative for Health Equity accepted Leah Gordon, associate dean for inclusive excellence, diversity, and belonging, into the second cohort of its Culture of Health Leaders Institute for Racial Healing, which is supported by the Robert Wood Johnson Foundation.

was promoted to full professor with tenure.

, Assistant Professor Monica O’Reilly-Jacob, and Assistant Professor of the Practice Patricia Underwood responded to a Boston Globe article with a letter to the editor outlining the contributions of nurse practitioners and their “potential to mitigate the physician shortage.”

Two newly elected members of the Massachusetts Coalition of Nurse Practitioners Board of Directors are part-time faculty member Colleen McGauley (Region I) and Assistant Professor of the Practice Sherri St. Pierre (Region IV).

Associate Professor of the Practice Aimee Milliken and Assistant Professor Melissa Uveges conducted a one-day conference—Using the Liberal Arts to Explore and Heal from Moral Distress—for BC students.

On the Marketplace Morning Report, Assistant Professor Monica O’Reilly-Jacob weighed in on personnel needs in the health care sector.

Assistant Professor of the Practice Melissa Pérez Capotosto (right) was awarded a Diversity Supplement Grant from the National Institutes of Health/National Institute of Child Health and Human Development.

Associate Professor Patricia Tabloski, together with School of Social Work faculty and a person whose family was affected by Alzheimer’s disease, screened the documen tary Alzheimer’s: A Life Interrupted at Boston College in February.

Jennie Chin Hansen ’70, H’08, was awarded a UCSF Medal—the highest honor given by the University of California, San Francisco— for her work leading systemic change in senior health care. She was also named one of 12 “Sages of Aging” in the American Society on Aging’s Legacy Interviews series of leading experts in the field of gerontology.

Emese Parker, M.S. ’08, authored To Carry Wonder: A Memoir and Guide to Adventures in Pregnancy and Beyond (Larkwell Press, 2023). Learn more at tocarrywonder.com.

Events

The end of CSON’s 75th anniversary year was marked by a celebration with a keynote presentation by Dean Katherine E. Gregory and a panel discussion with Brianna Cheatham ’22; Marsha Maurer, M.S. ’90; Karen Jennings Mathis, M.S. ’11, Ph.D. ’16; and Rolando Perea ’85.

Jennie Chin Hansen ’70, H’08, presented the spring Pinnacle lecture “Reflections and Projections: My Career at the Vanguard of Public Health Policy.” View video at bc.edu/pinnacle.

Two scholars presented Grand Rounds talks in the spring semester:

▪ Paule Joseph, the Lasker Clinical Research Scholar at the National Institute on Alcohol Abuse and Alcoholism, gave “The Neglected Senses: A Program of Research Investigating Taste and Smell in Disease States.”

▪ Assistant Professor Monica O’Reilly-Jacob presented “Nurse Practitioners and Value-Based Care: The Perfect Marriage.”

Marsha Maurer, M.S. ’90, a former senior vice president of patient care services and chief nursing officer at Beth Israel Deaconess Medical Center, received CSON’s Dean Rita P. Kelleher Award.

Bringing Global Public Health to BC

THE CONNELL SCHOOL INTRODUCES A NEW, INTERDISCIPLINARY MAJOR

by John s hakespear

In the 19th and early 20th centuries, nurses across the United States extended health care and social services to the nation’s neediest communities through programs like Manhattan’s Henry Street Settlement, which provided medical care, shelter, food, and education to the immigrant families of the Lower East Side. In 1893, Henry Street founder Lillian Wald coined a new term needed to describe this interdisciplinary work: “public health nursing.”

Today, the field of public health encompasses many professions—clinicians, scientists, administrators, educators, policy makers, community leaders—but the interdisciplinary ethos of Wald and her contemporaries lives on. This fall, Boston College will build on their legacy with the launch of a new undergraduate major in Global Public Health and the Common Good, administered by the Connell School of Nursing in partnership with the Schiller Institute for Integrated Science and Society.

The B.A./B.S. program will welcome an inaugural cohort of 15 students from diverse disciplinary backgrounds. Some intend to pursue careers in nursing, while others are headed toward medicine, dentistry, public health, and even law and international relations.

“Our faculty come from nearly every school at BC, but the choice to house the degree within the Connell School was a natural one because of nursing’s deep and long-standing connections with public health,” said Professor of Biology Philip J. Landrigan, M.D., the program’s founding director.

CSON Associate Professor Joyce Edmonds, who helped design BC’s first public health sequence, views the major as an opportunity for Connell School faculty to contribute their public health expertise to building something greater.

“As nurses and researchers, we can share our knowledge with the broader population at BC while also learning from colleagues who approach public health issues from other perspectives.”

A moral dimension

Boston College is not alone in expanding public health education—once primarily offered at the graduate level—to undergraduates: according to the Association of Schools and Programs of Public Health, the number of undergraduate public health graduates grew 1,100 percent between 2001 and 2020. In Landrigan’s view, though, BC’s liberal arts curriculum and Jesuit, Catholic framework make the new program unique.

“Any public health program understands that there are differences in health between rich and poor and majority and minority,” Landrigan said. “But ours is grounded in the Catholic idea of the preferential option for the poor—the notion that these differences are not just

issues to be observed, but rather that they have a moral dimension—and we impress upon our students that they have a calling to do something about remedying these disparities.”

The major’s eight required core courses include classes on health inequities and ethics as well as specialized courses in areas ranging from public health law and policy to epidemiology and biostatistics. Students will also complete two electives and an interdisciplinary Senior Capstone Experience. Across the curriculum, there is an emphasis on understanding the social determinants of health in a global context.

“You can’t address public health without thinking globally,” Edmonds said. “But our global focus also reflects the particular expertise of our faculty and our vision for what graduates need to know to be successful in the field.”

Interdisciplinary origins

The road to the new major began at a new-faculty orientation in the fall of 2012, when Edmonds met Summer Sherburne Hawkins, who was joining the Boston College School of Social Work (SSW) as BC’s first epidemiologist. Despite coming from different fields, the two scholars connected over their interest in maternal-child health and public health. Their chance meeting led to research collaborations, shared publications, and conversations about public health education at BC.

“At the time, there were lots of people here doing public health work, but there wasn’t yet a community or program around that work,” Edmonds said.

With the partnership of the late SSW Dean Alberto Godenzi and the blessing of Susan Gennaro and Maureen Kenny—then the deans of CSON and the Lynch School, respectively—Hawkins and Edmonds convened a faculty committee to design a three-course public health sequence for undergraduates. From the beginning, they wanted the courses to reflect the interdisciplinary nature of the field.

“Public health professionals are bridges—we synthesize the work of specialists who are addressing the specific needs of individuals, communities, and populations,” Hawkins said. “To find appropriate solutions, we need to have different perspectives around the table.”

For this reason, the committee designed the introductory course, Public Health in a Global Society, to be co-taught by two professors from different disciplines. When Hawkins and Edmonds teach the class together, for instance, they can offer both clinical expertise and an epidemiological lens. As Hawkins put it, “I can talk about big data and populations, and Joyce can talk about what it’s like to work with communities on the ground.”

When the sequence launched in 2014, student interest was overwhelming, and BC took notice. In 2018, the University hired Landrigan—a renowned pediatrician, epidemiologist, and expert on how environmental factors impact health—to be the founding director of its Global Public Health Initiative. Within a year, the initiative had launched a six-course minor, which enrolls 50–60 students each year.

Meanwhile, individual students began to approach Landrigan about going beyond the minor. With his guidance, eight students have now completed an independent major in Global Public Health, which helped pave the way toward the official major. ▪

PHILIP J. LANDRIGAN

JENNA MU ’22

FAVORITE COURSE: Children’s Health and the Environment

CURRENT ROLE: Truman-Albright Fellow, Public Health Analyst, U.S. Department of Health and Human Services, Federal Office of Rural Health Policy

NAOMI ALTER ’23

FAVORITE COURSE: Introduction to Epidemiology

EXPERIENCE: Boston College Delegate to COP27: The United Nations Climate Change Conference

SEBASTIAN COTA ’24

FAVORITE COURSE: Public Health Law and Policy

INTERNSHIPS: Boston Children’s Hospital, Mass General Hospital COVID Corps

Jack Murray and I were the first two students to complete an independent major in Global Public Health. The major was a perfect fusion of my interests in dentistry and political science. My goal is to be a dentist for underserved populations while also working on the policy side to help families like mine navigate linguistic and cultural barriers to care. The faculty at BC have inspired me by showing me that it is possible to maintain a career with a foot in both practice and policy.

Attending COP27 as an undergraduate was a great joy and privilege. I’m interested in epidemiology and environmental contributions to disease, and I learned from experts on these topics from around the world. One of my biggest takeaways from the conference was that you can’t just have climate scientists saying we need to lower warming; you need legal experts, world leaders, health professionals, and people from all disciplines. In my career, I hope to contribute to this effort from my own lens.

When I got the news about the launch of the official major, I was excited. Growing up in southeast Los Angeles, I was exposed to the health issues and barriers that my community faces, and I was interested in studying public health before I even got to BC. I believe the courses I’m taking will help me become a more well-rounded primary care physician, because there’s more to practicing medicine than science and physiology, and your zip code matters as much as your genetic code.

Hear from three Global Public Health majors about their experience and their plans for the future.

Treating a silent epidemic

Associate Professor Tam H.

Nguyen’s plan to improve diabetes prevention among Vietnamese Americans

by n athaniel m oore

In just a couple generations, type 2 diabetes has gone from being a relatively rare disease to America’s seventh leading cause of death. Today, more than one in 10 Americans live with the condition, while at least 100 million more are prediabetic. In response to this crisis, public health officials have often tried to help prediabetics with a one-size-fits-all approach, but the intervention that effectively helps one community may not meet the needs of another. As a result, many of America’s most vulnerable people are effectively denied access to lifesaving care.

Tam H. Nguyen, an associate professor at the Connell School, believes that one way to expand access is to tailor treatment programs to the unique culture and circumstances of each community. Her latest research project, which is funded by a three-year, $450,000 Betty Irene Moore Fellowship for Nurse Leaders and Innovators from the nursing school at UC Davis and the Gordon and Betty Moore Foundation, aims to determine the most effective ways of doing so.

In partnership with Quincy Asian Resources, Inc. (QARI), a nonprofit focused on promoting the welfare of immigrant communities in New

York and Boston, Nguyen will be designing and evaluating prediabetic interventions tailored to Vietnamese American communities of varying income levels and proficiency in English. This research could not be more urgent, since diabetes rates are rising faster among Asian Americans than among any other racial group. “One in two Asian Americans will become diabetic or prediabetic in their lifetime,” Nguyen said. “Supporting the health and well-being of the community is important to me not just because I am Vietnamese American but because this community is extremely under-researched and underserved.”

The Challenge

The diabetes epidemic results from the interaction of many complex causes, but Nguyen singled out a few particular culprits.

“Asian Americans, like all Americans, live in an environment that promotes obesity,” she explained. “We’ve systematically taken physical activity out of our daily lives, and our work is often sedentary. For Asian Americans, however, what makes the situation more challenging is that the diabetes epidemic is largely silent.”

Asian Americans tend to be less obese than the general population, Nguyen explained, so they are less likely to be considered high risk or screened, which means diabetes often goes undetected. The problem is exacerbated

by widespread ignorance about consequential physical differences between Asian American populations and others.

“The problem is that for Asian Americans, most of their fat is concentrated in the belly, which is the most metabolically active,” she said. “That creates a situation where there’s a greater likelihood of chronic illnesses such as diabetes and cardiovascular disease at a lower BMI than you would see in other racial groups.”

The fast-rising rates among Asian Americans also result from earlier well-intentioned but ill-conceived outreach efforts from health officials. These efforts proved inadequate, Nguyen argues, because they tended to take a simplistic view of the communities they were trying to help.

“What the health services research world has done over the last 30 years is take an existing medical intervention, translate it, adapt some details, and say all Vietnamese Americans can now do this program,” she said. “The problem

Tam H. Nguyen

with that approach is that even within the Vietnamese American community, there’s far too much diversity for a one-size-fits-all program to work.”

That’s because the prevailing paradigm for treating prediabetics—the Diabetes Prevention Program (DPP)—is simple yet difficult to put into practice. The DPP is an evidence-based self-management and lifestyle intervention that focuses on helping patients lose 5–7% of their body weight through dietary changes and increased physical activity. When followed, the program has been shown to reduce the incidence of type 2 diabetes by more than 50 percent—but following the program requires a certain level of privilege and stability.

“The DPP works really well for someone who has the resources to engage in the program and buy the groceries to change their diet,” said Nguyen. “But not everyone has the resources to buy fresh fruits and vegetables, or the control of their lives required to show up for coaching once a week for six months.” These people, she explained, are not going to be well served by an intervention that puts the onus on the individual to make and sustain different choices.

The Research Project

One of the primary goals of Nguyen’s research project will be to determine the psychosocial phenotypes that inform how effective a given prediabetes treatment is for a given person. Psychosocial phenotyping is the method by which researchers identify patterns of measurable behaviors, psychological characteristics, and social factors that help explain the variation in people’s ability to self-manage chronic conditions.

“For example, if somebody doesn’t have the capacity or resources to fully engage in certain parts of the DPP, that circumstance could be associated with certain outcomes,” Nguyen said. “Identifying phenotypes like that could help us determine if a particular person should start medication, the program, or both.”

To reach diverse populations of Vietnamese Americans, Nguyen will partner with QARI, which has deep ties with local communities. “We will help Dr. Nguyen manage the community outreach and identify the Vietnamese American groups in several states who can take part in the research project,” said Philip Chong, QARI’s president and CEO. “We’ll help her find the focus groups and get her the right data to eventually create a pilot that is culturally sensitive, creative, and life-changing.”

QARI will also help Nguyen by offering study participants essential social services—workforce development, mental health care, supplemental nutrition—that may make prediabetics more likely to respond well to treatment. For his part, Chong

believes the project could help fill a crucial gap in the services QARI already offers.

“When Dr. Nguyen approached me about this grant, I was excited to see a more culturally sensitive approach to such an important issue,” he said. “We know that offering people rewards for changing their lifestyle that week is unlikely to motivate long-term change. What we need are stronger methods and more success stories.”

Because there is uncertainty about which interventions will prove effective, Nguyen will be conducting an adaptive study. That means she will be able to make changes to the trial design based on emerging evidence without jeopardizing the validity of the final results.

“We thought, Why not take a look at a particular decision point to see if it’s working for people or not?” she explained. “If it’s not, how might we take additional resources, support, or social services to get better outcomes?”

While Nguyen hopes that this project will provide the support some Vietnamese Americans with prediabetes need to change their lifestyles, she emphasized that systemic

changes will also be necessary to address the diabetes crisis.

“Since healthy living takes a village, we have to address the social determinants of health,” she said. “During the pandemic, many Vietnamese Americans lost access to fresh food while for many reasons, mental health problems skyrocketed. These are not separate concerns: mental health and stress have a negative effect on diabetes and cardiovascular disease.”

Although this project is based around treating the unique needs of different Vietnamese American communities, Nguyen believes that the research could help improve care for all prediabetics.

“If we do our homework and get this right, the principles informing our culturally specific care can be applied to other populations as well,” she said. “This project is one way to think about how to restructure the system to make it easier for people to make healthy changes. Instead of just asking individuals to change their behaviors, however, we always need to start by listening to each community.” ▪

Closing the Gap Closing the Gap

Among Nguyen’s team of collaborators is her advisee May Tadano ’23, a nursing student from New Jersey. “I’m interested in public health nursing,” Tadano said, “so when Dr. Nguyen got the grant, I helped her do an overview of the existing literature.”

Her most important finding? The profound gaps in the research. “Almost none of the studies of Asian Americans included subanalyses based on age, gender, income, education level, and acculturation status,” she said. “That’s what Dr. Nguyen’s project is designed to fix.”

Tadano says she feels lucky to be taking part in the project. “Working with Tam has been a really great experience. I’m grateful that the nursing school integrates research into the curriculum.”

The importance of truly belonging

by k athleen s ullivan

The struggle for equity was something Leah Gordon recognized as a young child, well before anything was called diversity, equity, and inclusion, or DEI. It was core to her father’s work as commandant of the Soldiers’ Home in Chelsea, Massachusetts.

“Making sure veterans got their fair and equitable share of good health care and access was so important to him,” said Gordon, an Afro-Latina whose mother immigrated from Panama.

“Seeing his commitment to veterans resonated with my family and our world as people of color.”

DEI advocate Leah Gordon, D.N.P., RN, CNP, FNP-C, joins Connell

Gordon joined the Connell School of Nursing in January as associate dean for inclusive excellence, diversity, and belonging after serving as director of diversity for Mass General Hospital’s Nursing and Patient Care Services Department. As associate dean, Gordon provides leadership and vision for CSON’s diversity and inclusion efforts. She is a central resource and advocate for CSON students, faculty, and staff, and leads the Diversity in Nursing and Action Committee (previously known as the Diversity Advisory Board). She is also developing training programs, events, and activities geared toward the entire CSON community.

Gordon sees a sense of belonging as a crucial first step in diversity efforts. “We need to create an environment that makes people feel like they belong—where their identities are acknowledged and they can be their authentic selves. It’s essential groundwork for building and maintaining a diverse faculty and student body,” said Gordon.

One of her priorities is to deepen CSON’s connections with community partners, who bring a “highly developed understanding of the communities and patients we serve and help us bridge the gaps caused by social determinants of health.” She also launched a monthly healing circle where “the CSON community comes together to hold an open conversation about outside events that are affecting them in an atmosphere of respect and concern.” Participants offer and receive support and listen without question or judgment.

Gordon said that CSON Dean Katherine Gregory’s support has been invaluable. “In DEI work, if you don’t have leadership support, it’s very difficult for these initiatives to thrive,” she said. “I came to BC because I saw the level of support around the idea of creating community and a commitment to DEI work.”

Gordon is also an associate professor of the practice who is currently co-teaching Advanced Health Assessment to CSON graduate students who are preparing to be advanced practice clinicians. For nearly 20 years, the focus of her clinical practice has been caring for oncology patients, and she continues to work

one day a week as a radiation and oncology nurse practitioner at MGH.

Because nurses lead with empathy, Gordon sees them as natural leaders in making health care more equitable and just. She wants Connell to be a place where the seeds of equity are planted.

“We can offer the training, knowledge, and preparation to create stewards who will call out bias, racism, or any ‘ism’ or ‘phobia’ in health care settings, help address it, and provide a resolution to it.” ▪

Being seen and valued

Gordon knows how transformational a sense of belonging can be. Early in her career, she worked at Dana-Farber Cancer Institute in multiple support roles, engaging with patients and supporting nurses and physicians. During that time, she met nurse practitioner and CSON alumna Kim Noonan, M.S. ’88, who felt Gordon belonged in the nursing profession.

“What are you doing with your life?” Gordon recalls Noonan saying to her. “I see qualities in you to be a nurse.”

While nursing appealed to Gordon, the journey to earn a college degree and become a nurse practitioner seemed daunting. At the time, she was a single mother to a toddler and would need to work full time while going to school. After years of hard work, she graduated from Regis College with an M.S. in nursing around the same time her daughter graduated high school. In 2017, Gordon earned a D.N.P.

Gordon and Noonan have remained good friends since those early days at Dana-Farber.

“There have been lots of changes and struggles on this journey. The nursing profession saved my life. And it’s a profession that I absolutely love.

“All it takes sometimes is one person to just say, ‘I believe in you. Go do it.’”

RESTARTING INTERNATIONAL TRIPS AFTER PANDEMIC HIATUS

In January, CSON faculty and students resumed their international immersion and educational trips for the first time since the start of the pandemic, traveling to the Dominican Republic, Belize, and Chile to connect with health promoters, meet and treat community members, and teach health.

“I thought you had forgotten us,” said Maria, a community member in Experimental, Dominican Republic, when she reunited with CSON faculty member Rosemary Byrne. The two women have known each other for years, having met during one of CSON’s regular visits, but it was the first time they had seen each other since 2020.

“It’s important to the community that we returned,” said Byrne. “It’s a note of support for them.”

These types of immersive experiences benefit both host communities and the BC students. The communities receive health care and training while BC students have opportunities to enhance their Spanish language skills, witness other traditions and cultures firsthand, and increase their awareness of global health issues and inequities.

Specifically, the CSON groups assisted Jesuit colleagues who are developing a nursing school in Belize; studied the differences between public and private health care settings in Chile; and cared for children, adults, and elders in Dominican Republic communities. Here’s what some of the CSON students had to say about their experiences:

Accounts of student experiences have been condensed and edited. Photographs courtesy of students and faculty.

BELIZE

“The nursing health service trips were a major reason I came to BC. This trip allowed me to visualize how I can connect my passions for public health and nursing and got me interested in returning for my own career.”

✭ BELIZE TRIP PARTICIPANT ✭

“[In Chile] we saw firsthand how social policies can drive health. The government funds the public system, while more economically sound individuals pay into the private system.… Social determinants of health drive the differences between care in Chile. As in the United States, access to adequate care may decrease with a decrease in income.”

✭ CHILE TRIP PARTICIPANT ✭

DOMINICAN REPUBLIC

“My biggest takeaway from the trip is that nursing care is so much more than taking vitals and administering medications. Taking the time to get to know each individual patient, their values, their family, and what they value is a privilege and blessing.”

DOMINICAN REPUBLIC TRIP PARTICIPANT ✭

Summaries of notable articles and talks

by c orinne s teinbrenner

publications

Arab and Arab American College Students at Risk for Depression and Anxiety

A team of researchers, including Associate Professor Nadia Abuelezam, recently analyzed data from the 2015–2018 Healthy Minds Survey to assess mental health risks among Arab and Arab American students at U.S. colleges. The survey, which is administered annually to a random sample of undergraduate and graduate students, measures mental health status and related factors and includes an extensive demographics section. The researchers’ analysis showed that, after adjusting for a variety of factors, students who identified as Middle Eastern/Arab/Arab American had 40 percent higher odds of reporting symptoms of depression and 41 percent higher odds of reporting symptoms of anxiety than did non-Arab white students. Further analysis showed that Arab students who reported religion was important in their lives had lower odds of depression and anxiety than did non-religious Arab students. Conversely, Arab students who reported having experienced some form of discrimination in the previous year had higher odds of depression and anxiety than did those who reported no incidents of discrimination. A paper detailing these findings, “Depression and Anxiety Symptoms among Arab/Middle Eastern American College Students: Modifying Religiosity and Discrimination,” was published in November in the journal PLOS ONE

An Ethics Textbook for Advanced Practice

Registered Nurses

Associate Professor Emerita Pamela Grace and Assistant Professor Melissa Uveges, both specialists in nursing ethics, have published an updated fourth edition of Grace’s textbook, Nursing Ethics and Professional Responsibility in Advanced Practice (Jones & Bartlett Learning, 2023), with contributions from numerous Connell School graduates and faculty members. According to the publisher, the book remains the only comprehensive textbook available on the ethical issues faced by advanced practice registered nurses providing frontline care. Its early chapters provide a foundation in ethics and its application to nursing. Later chapters address ethical issues in specific specialty areas, such as neonatal care, gender-re -

lated care, mental health, and palliative care. The new edition—the latest update of the text since 2017—includes expanded information on social justice and new discussions of managing social media, electronic health records, and ethical issues specific to certified registered nurse anesthetists and clinical nurse specialists in surgical settings. Instructors who adopt the textbook have access to downloadable supplements, including lecture slides, discussion questions, and additional case studies. One reviewer suggested the book could be a valuable resource not just for educators but also for nurse leaders and mentors.

Understanding the Connections between Chronic Conditions and Mental Health in African Caribbeans

Caribbeans are disproportionately affected by chronic noncommunicable diseases (NCDs), such as diabetes and hypertension. Given that mental illness can make managing chronic diseases more difficult, a team of Connell School researchers recently conducted a review of published studies, looking to better understand the association between mental health and NCDs in the African Caribbean population. The researchers—Assistant Professor Cherlie Magny-Normilus, Barry Family/Goldman Sachs Endowed Chair in Nursing Christopher Lee , and Associate Professor Corrine Y. Jurgens —published their findings in the October 2022 issue of Biomedicines in a paper titled “Implications for Self-Management among African Caribbean Adults with Noncommunicable Diseases and Mental Health Disorders: A Systematic Review.” The researchers identified 14 quality studies completed between 2006 and 2021 that fit their research criteria. These studies showed a strong association between depression and chronic NCDs among African Caribbeans, especially among women. The studies identified many barriers to NCD self-management among African Caribbeans, including depressive symptoms, social isolation, lack of social support, lack or resources, and substance abuse. (While overall African Caribbeans had reduced substance use, those with severe mental illness had elevated substance use disorder.)

Family and general social support were found to improve selfmanagement for both NCDs and mental illness.

presentations

A Framework to Guide Genomic Health Care

Associate Professor and Interim Associate Dean for Graduate Programs Andrew Dwyer and an international team of colleagues presented a research poster, “ACCESS: A Practice-Guiding Framework for Overcoming Disparities in Genomic Healthcare,” at the 2022 International Society of Nurses in Genetics World Congress in November. The poster outlined the researchers’ proposal for a framework that bedside nurses can use to guide their interactions with patients with gene-related conditions, with the ultimate goal of allowing more people to access the benefits of genomic medicine. The framework is built around the acronym ACCESS. The A in ACCESS urges nurses to Advocate for patients and families to receive genetic testing and counseling. The Cs ask nurses to support active Coping so patients can then decide whether and how to Communicate their genetic information to family members. If patients do communicate genetic risks to family, the framework asks nurses to advocate for cascadE Screening of at-risk relatives. Finally, the framework reminds nurses of the importance of long-term Surveillance of patients. Dwyer and colleagues discussed their ACCESS framework again in April during a webinar organized by the Global Genomics Nursing Alliance.

Building Algorithms to Improve Care for Older Adults

Professor Elizabeth Howard is part of an international team of researchers working on the I-CARE4OLD project—a European Union-funded initiative to develop a digital platform that will help health care providers create well-informed care plans for older adults with chronic complex conditions. As part of this work, Howard and colleagues analyzed longitudinal data gathered between 2015 and 2018 in U.S. and Canadian nursing homes to identify predictors of cognitive decline in nursing home residents. They then used that analysis to create an algorithm to predict cognitive decline in patients in long-term care settings. (Further work by I-CARE4OLD collaborators will identify interventions that improve cognitive-decline trajectories, and that data will be added to the platform.) Howard presented her work on the algorithm at

the annual meeting of interRAI’s Network for Integrated Care and Aging in Quebec City in October. She is a fellow of interRAI, an international network of researchers and practitioners committed to improving care for persons who are disabled or medically complex. The I-CARE4OLD project makes use of data that is routinely collected using instruments developed by interRAI.

Creating a Toolkit for Graduate-Level Nursing Programs

In 2021, the American Association of Colleges of Nursing (AACN) approved new standards for nursing education based on expected competencies for graduates of nursing programs. As a member of the American Psychiatric Nurses Association (APNA) Graduate Education Council, Associate Professor of the Practice Karen Pounds serves on a task force working to create a toolkit that will help graduate-level nursing programs align their mental health curricula with these competencies. Her task force’s portion of the toolkit will address competencies related to providing person-centered care. At APNA’s annual conference in October, Pounds and a colleague presented a poster summarizing the work they’ve completed on the toolkit thus far: “Patient-Centered Care: Development and Application of the New AACN Domain #2 in Graduate Psychiatric Mental Health Nursing Education.” The poster outlines the theories nursing classes should teach to address the expected competencies, clinical experiences students should have to learn the competencies, and ways to evaluate students’ mastery of the competencies. Pounds says she and colleagues on the council will be adding more specific details to the toolkit, with the goal of presenting their completed work at APNA’s fall 2023 conference.